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31.
急性肺栓塞时心肌血流灌注的变化 总被引:6,自引:1,他引:5
目的观察急性肺栓塞(APE)后冠状动脉血流量及心脏肌钙蛋白T(cTnT)与肌红蛋白(Mb)含量变化,探讨心肌血流灌注在急性肺栓塞继发心肌损伤机制中的作用。方法通过介入方法经导管注入自体血栓选择性栓塞肺动脉,建立不同栓塞面积的急性肺栓塞动物模型。监测栓前、栓后5、30min,1、2h冠状动脉血流量变化及栓后4h血清cTnT与Mb含量。结果急性肺栓塞后血清cTnT与Mb含量升高。急性肺栓塞导致冠状动脉血流量显著下降,肺血管栓塞后15~30min降至最低值,30min后趋于平稳。右冠血流量下降程度与肺栓塞面积有显著相关性。结论冠状动脉血流量减少及血清心肌结构蛋白含量升高为急性肺栓塞继发心肌缺血改变提供了直接证据。急性心肌缺血严重影响急性肺栓塞的预后。 相似文献
32.
Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. 总被引:4,自引:0,他引:4
Jeffrey R Wienke Wui K Chong Julia R Fielding Kelly H Zou Carol A Mittelstaedt 《Journal of ultrasound in medicine》2003,22(10):1027-1031
OBJECTIVE: To prospectively determine the sonographic findings of nodular hyperplasia of the thyroid, to compare these with reported findings associated with malignancy, and to assess interobserver reliability. METHODS: Seventy thyroid nodules were scanned, and then biopsies of the nodules were performed under sonographic guidance with fine-needle cytologic analysis; in all cases images were reviewed by 2 experienced radiologists without knowledge of clinical outcome. Findings reported associated with malignancy were specifically assessed. Interobserver agreement between the expert and secondary readers for each finding was calculated by the kappa or weighted kappa statistic and the Fisher exact test of independence. RESULTS: There were 68 benign and 2 malignant nodules in a population of 63 female and 7 male patients. The mean benign nodule size was 2.9 cm; 60% were solid; 54% were hypoechoic; 59% were microlobulated or macrolobulated; 47% had central vascularity; 24% contained calcifications; and 82% were elliptical in shape. There was very good interobserver reliability for the presence of calcium (kappa = 0.91) and good agreement for the presence and location of vascularity (kappa = 0.75) and the amount of cystic components (kappa = 0.62; all P < .01). CONCLUSIONS: Sixty-nine percent of benign nodules had at least 1 finding reported previously as associated with malignancy. The interobserver reliability of the sonographic findings was good to very good for 3 of the 5 findings assessed. 相似文献
33.
目的 总结外科手术治疗小婴儿期室间隔缺损(VSD)的临床经验.方法 对2000-2005年83例<6月龄VSD患儿,年龄12 d至6(4.3±1.2)个月,体重3~6.5(5.1±0.8)kg.膜周部VSD 74例,干下型VSD 8例,膜周部并肌部VSD1例.术前中、重度肺动脉高压69例(83.1%).所有患儿均在浅低温体外循环下手术.结果 全组手术死亡4例,手术病死率为4.8%.术后主要并发症为肺动脉高压危象、肺部感染和心律失常.结论 随着麻醉、体外循环、手术技术和围术期监护处理措施的进步,在小婴儿期施行VSD的外科手术已成为安全的治疗方式.术后对肺高压的处理是手术成功的关键. 相似文献
34.
目的 应用超声多普勒技术测量正常婴儿肺动脉主干及左右肺动脉血流速度,并初步探讨其可能的机理.方法 使用GE Vivid7超声诊断仪检查60例正常新生儿,分别检测1周、1个月、6个月及1年时主动脉内径AOD;肺动脉主干内径MPA及血流速度Pv,左、右肺动脉内径LPA、RPA及血流速度LPv、RPv,并计算LPA RPA/AO.结果 1周时左、右肺动脉速度高于肺动脉主干速度,且以右肺动脉明显,1周后左、右肺动脉血流速度逐渐减慢,1年后均基本低于肺动脉主干内血流速度,肺动脉主干血流速度及LPA RPA/AO比例在1周、1个月、6个月及1年组差异无统计学意义.结论 正常新生儿左、右肺动脉血流速度较高,随生长、发育肺动脉血流速度逐渐降低直至正常. 相似文献
35.
慢性低氧大鼠肺动脉内皮素mRNA的表达及定位 总被引:1,自引:0,他引:1
目的:探讨慢性低氧大鼠肺动脉内皮素-1基因表达及分布。方法:采用生物素标记cRNA探针,对Wistar大鼠肺动脉进行原位杂交。结果:低氧1周组及低氧2周组大鼠大部分肺动脉内皮细胞ET-1mRNA表达呈阳性信号,而对照组大鼠仅极少数阳性信号(P<0.01);低氧1周组大鼠部分显示强阳性信号。低氧1周组及低氧2周组大鼠部分肺动脉平滑肌细胞呈现ET-1mRNA表达阳性信号,而对照组大鼠则无阳性信号表达(P<0.01及0.05)。结论:慢性低氧对大鼠肺动脉ET-1分泌的影响是在基因转录水平进行,且主要细胞定位在肺动脉内皮细胞,此外还包括肺动脉平滑肌细胞。 相似文献
36.
Comparison of local and general anesthesia in tension-free (Lichtenstein) hernioplasty: a prospective randomized trial 总被引:3,自引:0,他引:3
To compare pulmonary effects, postoperative pain and fatigue, morbidity, patient satisfaction, and cost of different anesthetic
techniques for inguinal hernia repair, 50 patients were randomized to local and general anesthesia groups (LA and GA). All
patients received the same premedications and the same postoperative analgesic regimen. The standardized postoperative analgesic,
intramuscular pyroxicam 20 mg, was given to all patients in the recovery room and an additional 20 mg on the same day was
given as requested by each patient. Pulmonary function studies and arterial blood gas analysis were performed 1 h prior to
the operation and at the postoperative 8th and 24th hours. All patients underwent Lichtenstein's tension-free hernioplasty.
Postoperative pain and fatigue were registered 8 h and 24 h after the operation. A questionnaire was filled out by the patients,
and they were asked to give grades for the general comfort of the anesthesia and the surgical procedure (1=worst, 10=best).
Postoperative pulmonary function tests were significantly poorer in the GA group both on 8th- and 24th-hour measurements (P<0.05). Patients who underwent LA had significantly lower PCO2 and higher PO2 at the postoperative 8th hour (P<0.05). Mean postoperative pain and fatigue scores revealed a significant difference in favor of local anesthesia at only
the 8th hour (P<0.05). There were two complications, one in each group (a hematoma in LA and a urinary retention in GA). Patient satisfaction
grades were not different in the two groups. We conclude that LA in inguinal hernia repair does not adversely affect pulmonary
functions, patients feel less pain, and patient satisfaction is comparable to that with GA.
Electronic Publication 相似文献
37.
支气管肺蠊缨滴虫感染是一种新的寄生虫疾病,1993年至2008年国内共确诊48例,临床诊断和治疗有一定进展,但蠊缨滴虫感染病例的临床表现缺少特征性,蠊缨滴虫自然宿主、传播途径、流行区域及致病机制等多个方面也尚不明确,其生物学分类地位也有争议,国内还没有建立抗原抗体检测或分子生物学鉴定方法. 相似文献
38.
J. P. G. Kaajan 《Pharmacy World & Science》1989,11(4):112-117
The general management of patients with chronic obstructive pulmonary disease and asthma is discussed. Pathophysiological mechanisms of bronchial obstruction and inflammation are briefly described. The importance of preventive measures is emphasized. Medicine prescribed in chronic obstructive pulmonary disease and asthma, their relative place in treatment schedules and route of administration are reviewed. Finally, the importance of maximal bronchodilatation in exacerbations is stressed and the few indications for antibiotic treatment are discussed. 相似文献
39.
Th1/Th2炎症极化与肺气肿和肺纤维化 总被引:3,自引:1,他引:2
肺气肿具有Ⅰ型T辅助细胞(Th1)炎症极化的特征,表现为损伤过度和修复不足,肺实质的破坏增加,肺间质变薄。与之相反,肺纤维则具有Ⅱ型T辅助细胞(Th2)炎症极化,表现为损伤后修复过度,肺间质增厚,胶原沉积。通过调控Th1和Th2的炎症趋势来控制肺组织的损伤和修复的结局可能会为肺气肿和肺纤维化的防治提供新思路。 相似文献
40.
固定剂量复合剂在省结核病防治规划中应用的研究 总被引:2,自引:0,他引:2
目的 研究固定剂量复合剂在省结核病防治规划中应用的可行性.方法 将初治涂阳肺结核病人按登记序号单双分入研究组和对照组.用对照研究方法对两组的完成治疗率、治疗效果、治疗依从性和不良反应等情况进行分析.结果 研究组和对照组在性别、年龄、体重、完成治疗率、督导管理方式和治疗依从性等方面差异无显著性(P值均>0.05).研究组的2、3个月未痰菌阴转率和治愈率分别为87.0%、93.5%和93.5%,对照组的2、3个月未痰菌阴转率和治愈率分别为89.4%、93.5%和87.0%,两组间的疗效差异无显著性(P值均>0.05).除因链霉素引起的耳鸣(精确概率法P=0.024)外,两组其他不良反应症状出现的比例都无显著性差异(P值均>0.05).结论 在结核病防治规划中推广应用固定剂量复合剂是可行的. 相似文献