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991.
Introduction Myasthenic crisis is a great threat to patients with myasthenia gravis. Usage of non-invasive ventilation (NIV) to prevent
intubation and timing of extubating of patients in myasthenic crisis are important issues though not well documented.
Methods To explore the factors predicting NIV success and extubation outcome in myasthenic crisis, we reviewed the records of 41 episodes
of myasthenia crisis.
Results NIV was applied to 14 episodes of myasthenic crisis and eight (57.1%) of them were successfully prevented from intubation.
An Acute Physiology and Chronic Health Evaluation (APACHE) II score of <6 and a serum bicarbonate level of <30 mmol/l were
independent predictors of NIV success. For patients undergoing invasive mechanical ventilation, extubation failure was observed
in 13 (39.4%) of 33 episodes, and the most common cause was sputum impaction due to a poor cough strength (61.5%). A maximal
expiratory pressure (Pemax) of ≥40 cmH2O was a good predictor of extubation success. Extubation failure led to poorer outcomes.
Conclusions NIV may be applied to those patients with a low APACHE II score and a lesser degree of metabolic compensation for respiratory
acidosis. For patients undergoing invasive mechanical ventilation, extubation failure is associated with significant in-hospital
morbidity in myasthenic crisis. Adequate levels of Pemax and cough strength correlate significantly with extubation success. 相似文献
992.
Paola Penza Raffaella Lombardi Francesca Camozzi Claudia Ciano Giuseppe Lauria 《Neurological sciences》2009,30(2):149-151
We describe a 60-year-old woman complaining of severe burning feet for 3 months. A neurological examination showed absent
Achilles tendon reflexes; nerve conduction study demonstrated mild sensory neuropathy, and skin biopsy revealed a length-dependent
loss of intraepidermal nerve fibres. Haematological exams demonstrated a subclinical hypothyroidism and hormone replacement
therapy was started. Conversely, symptomatic treatments for neuropathic pain were withdrawn after few days because of side
effects. During the following months, thyroid function recovered, and the patient experienced a progressive decrease of neuropathic
pain intensity. At 6- and 12-month follow-ups, nerve conduction study and clinical examination were normal, whereas skin biopsy
demonstrated a complete reinnervation of the epidermis. Subclinical hypothyroidism is a possible cause of sensory neuropathy
and hormone replacement therapy can prompt nerve regeneration. 相似文献
993.
目的观察机械通气患者应用间歇声门下吸引联合幽门后喂养预防呼吸机相关性肺炎的效果。方法按随机数字表将56例预计机械通气超过48h的患者分为观察组26例和对照组30例,对照组用常规吸痰联合胃内喂养,观察组用间歇声门下吸引联合幽门后喂养。观察两组3周内呼吸机相关性肺炎及胃潴留、反流、误吸的发生率。结果观察组呼吸机相关性肺炎发生率(3.85%)低于对照组(36.67%);对照组胃潴留、反流和误吸发生例数高于观察组。结论间歇声门下吸引联合幽门后喂养可降低呼吸机相关性肺炎的发生率。 相似文献
994.
Isojärvi H Kallio M Korpelainen R Kaikkonen K Jämsä T Keinänen-Kiukaanniemi S 《Acta neurologica Scandinavica》2009,119(2):107-112
Objective – The aim of this study was to analyze peripheral nervous system (PNS) function in overweight and obese individuals. Materials and Methods – Forty‐four adult non‐diabetic overweight individuals were recruited. Peroneal motor nerve conduction and radial, sural, and medial plantar sensory nerve conduction were studied. Insulin and glucose levels were determined twice (over a 2‐ to 3‐year period) with an oral glucose tolerance test (OGTT). Multiple stepwise linear regression models adjusted for age, height, weight, and skin temperature were used to analyze the data. Results – Analysis revealed that baseline insulin levels measured 120 min after an OGTT explained 18% of the variation in peroneal F‐wave minimum latency, 8% of peroneal F‐wave maximum latency variation, 15% of sural sensory latency variation, 13% of sural sensory nerve conduction velocity (NCV) variation, and 10% of the variation in medial plantar sensory NCV. Discussion and Conclusion – Our study shows that serum insulin levels measured 120 min after an OGGT are positively associated with PNS function. High insulin levels without notably high glucose levels appear to be beneficial for the function of the PNS. 相似文献
995.
目的:观察2%碳酸氢钠对机械通气患者气道湿化的效果。方法:将46例患者随机分成观察组和对照组,对照组用传统方法配制的湿化液湿化,观察组用2%的碳酸氢钠溶液进行气道湿化,用药后对两组痰液黏稠度转化时间进行观察。结果:在痰液黏稠度转化时间方面,观察组明显优于对照组(P〈0.05)。结论:采用2%碳酸氢钠溶液可有效稀释痰液,且不良反应小,具有推广价值。 相似文献
996.
目的观察归龙丸方早期干预0级糖尿病足(DF)的临床疗效及对周围神经传导速度、血管功能的影响。方法将80例0级DF患者按随机数字表随机分为治疗组和对照组各40例。在基础治疗(口服降糖药或胰岛素注射降糖等)的基础上,治疗组加用归龙丸方治疗,对照组加用西洛他唑口服治疗,观察两组患者治疗前后临床症状评分、踝/肱动脉比(ABI)、双下肢腓总神经传导速度、血清基质金属蛋白酶-9(MMP-9)、血清同型半胱氨酸(Hcy)的变化。结果两组患者临床症状评分治疗后与治疗前比较,差异均有统计学意义(P<0.05);治疗组优于对照组,差异有统计学意义(P<0.05)。治疗组治疗后ABI评分与治疗前比较,差异有统计学意义(P<0.05);对照组患者治疗前后ABI评分间差异无统计学意义(P>0.05);治疗组治疗后ABI评分与对照组比较,差异有统计学意义(P<0.05)。治疗后两组患者腓总神经感觉神经传导速度(SCV)、运动神经传导速度(MCV)与治疗前相比,差异均有统计学意义(P<0.05);治疗组与对照组比较,差异亦有统计学意义(P<0.05)。两组患者治疗后血清MMP-9、Hcy水平与治疗前比较,差异有显著统计学意义(P<0.01... 相似文献
997.
目的分析贝尔麻痹(Bell′s麻痹)患者早期面神经运动传导检测指标,探讨其在贝尔麻痹早期诊断中的作用。方法对22例贝尔麻痹患者在起病1周内进行双侧面神经运动传导对比检测,比较患、健侧面神经运动传导动作电位潜伏期、波幅,分析其与早期诊断的关系。结果 22例患者双侧面神经各支均引出运动传导动作电位,患侧面神经各支动作电位波幅较健侧明显下降,差异有统计学意义(P<0.05);患侧面神经各支动作电位潜伏期与健侧相比,差异无统计学意义(P>0.05)。结论面神经颞支和颊支的运动传导波幅检测可作为面神经损伤的早期诊断指标之一。颧支受累较颞支和颊支相对少,它是否能作为损伤程度及预后判定的指标尚需进一步观察。 相似文献
998.
Li S Zhao J Liu J Xiang F Lu D Liu B Xu J Zhang H Zhang Q Li X Yu R Chen M Wang X Wang Y Chen B 《Journal of ethnopharmacology》2011,133(2):543-550
Aim of the study
The purpose of this study was to evaluate the efficacy and safety of a topical Chinese herbal medicine (CHM) compound Tangzu Yuyang Ointment (TYO) for treatment of chronic diabetic foot ulcers.Materials and methods
This multi-center, prospective, randomized, controlled and add-on clinical trial was conducted at seven centers in the China mainland. Fifty-seven patients with chronic diabetic foot ulcers of Wagner's ulcer grade 1-3 were enrolled in this study. Patients who were randomly assigned to the control group (n = 28) received standard wound therapy (SWT), whereas those randomized to the treatment group (n = 28) received SWT plus topical TYO. Only 48 patients who finished 24 weeks of observations were entered for data analysis.Results
The TYO and SWT groups were comparable for baseline characteristics. Ulcer improvement was 79.2% in the TYO group and 41.7% in the SWT group (P = 0.017) at 12 weeks, and 91.7% vs. 62.5% (P = 0.036) at 24 weeks. The number of ulcers that were completely healed at 4, 12 and 24 weeks was similar in both groups, as were the numbers of adverse events. Healing time was 96 ± 56 days (n = 19) in the TYO group and 75 ± 53 days (n = 14) in the SWT group (P = 0.271).Conclusion
TYO plus SWT is more effective than SWT in the management of chronic diabetic foot ulcers and has few side-effects. 相似文献999.
目的 通过分析力学负荷对山羊脊柱生长的影响,探讨机械性因素调节脊柱生长的可能机制.方法 采用单侧椎弓根钉内固定的方法对8只雌性山羊脊柱施加不对称力学负荷,观察期为8周.分别在动物处死前第13天和第3天肌肉注射四环素.观察期满后获取脊柱标本,PMMA包埋,不脱钙切片.荧光显微镜观察加压与非加压两侧椎体生长情况.结果 加压侧骨骺板高度小于非加压侧,加压侧骨小梁矿化沉积率平均为2.36μm/d,非加压侧骨小梁矿化沉积率平均为3.18μm/d,两侧之间差异具有统计学意义(P<0.05).结论 力学负荷并不能完全阻滞椎体骨小梁的生长,加压侧骨小梁的生长率比非加压侧略有减弱. 相似文献
1000.
Yasser Kheralla Werner Götz Afshar Kawarizadeh B. Rath-Deschner Andreas Jäger 《Archives of oral biology》2010,55(3):215-222