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71.
肺表面活性物质治疗新生儿胎粪吸入综合征的临床研究 总被引:4,自引:0,他引:4
目的探讨肺表面活性物质(PS)治疗新生儿胎粪吸入综合征(MAS)的有效性及临床价值。方法采用气管内滴入PS治疗8例MAS患儿,其中6例接受PS2剂,2例接受PS3剂。结果给予首剂PS后10分钟患儿青紫迅速消失,皮肤转红润,经皮测定血氧饱和度(TcSaO2)升高。30分钟后患儿低氧血症迅速改善,动脉血氧分压、动脉血氧分压与吸入氧浓度比值、动脉肺泡血氧分压比值、呼吸机有效指数较治疗前显著增高,分别由原来的528±098kPa、866±352kPa、012±006kPa及014±006ml·kPa-1·kg-1增加到891±143kPa、1681±418kPa、021±005kPa及026±007ml·kPa-1·kg-1;而吸入氧浓度及平均气道压逐渐降低,由原来的068±019kPa及220±042kPa降低到053±008kPa及193±048kPa。重复应用PS后亦有相似效果。结论PS能有效地改善MAS患儿肺顺应性及氧合功能。重复应用PS可巩固和加强疗效。 相似文献
72.
目的 :研究肺表面活性物质 (PS)治疗新生儿呼吸窘迫综合征 (NRDS)前后血管内皮分泌功能变化及可能的治疗机理。方法 :用PS制剂固尔苏治疗 18例NRDS患儿 ,于治疗前 3 0min ,治疗后 1、 6、 12、 2 4h ,用硝酸还原酶法测定NO (一氧化氮 )、放射免疫法测定ET (内皮素 )、 6 K PGF1α (6 酮前列环素 )。结果 :固尔苏治疗后患儿NO、 6 K PGF1α明显升高 ,ET明显下降 ,与治疗前比较有显著性差异 (P <0 0 1)。治疗后 1、 6、 12、 2 4hNO、6 k PGF1α、ET各组间两两比较无明显差异 (P >0 0 5 )。结论 :PS治疗NRDS的机理可能是通过改善血管内皮功能发挥作用 ,为用外源性NO吸入和静注前列环素辅助治疗NRDS提供可能的实验依据。 相似文献
73.
Shinhiro Takeda Kazuhiro Nakanishi Teruo Takano Gen Ishikawa Ryo Ogawa 《Journal of anesthesia》1997,11(2):83-87
Effective gas exchange can be maintained in animals without endotracheal intubation using external high-frequency oscillation
(EHFO). The aim of this study was to evaluate the effect of EHFO in patients with respiratory failure due to severe cardiogenic
pulmonary edema. Seven patients were ventilated with EHFO for 2h at 60 oscillations·min−1, with a cuiras pressure of 36 cmH2O (−26 to +10) and an inspiratory to expiratory ratio of 1:1, with EHFO. Blood gas values and hemodynamic parameters were
measured. Significant increases were noted in cardiac index (2.3±0.5 to 2.5±0.5 l·m−2;P<0.05), stroke volume index (24±7 to 28±8 ml·m−2;P<0.05), and arterial O2 pressure (Pao2) (70±4 to 95±23 mmHg;P<0.01) without a change in pulmonary artery wedge pressure at 1 h after EHFO. The respiratory rate decreased from 28±3 to
22 ±3 breaths·min−1 at 5 min after the termination of EHFO (P <0.01). Arterial CO2 pressure (Paco2) did not, however, decrease. Increased stroke volume without a change in pulmonary artery wedge pressure (preload) suggests
either improved inotropic function of the left ventricle or reduced left ventricular afterload with EHFO. The use of EHFO
may be effective not only for gas exchange but also for left ventricular function in patients with severe cardiogenic pulmonary
edema. 相似文献
74.
目的:提高X线对肺静脉异常连接的诊断准确性,为手术治疗提供可靠的依据。材料与方法:回顾性分析了11例肺静脉异常连接的X线胸片和病理生理改变,男3例,女8例,年龄8—34岁。从血液动力学变化分析了“8”字征,镰刀综合征等X线典型征象。结果:11例中完全性肺静脉异常连接4例,部分性7例。按部位分心上型6例;心内型4例;心下型1例。肺静脉异常连接或多或少合并房间隔缺损,法鲁氏三联症,以及右肺和肺动脉发育不全。结论:肺静脉异常连接的X线征象十分复杂而多变,因此,术前的仔细观察和精心判别对于手术治疗是非常重要的。 相似文献
75.
76.
64层螺旋CT三联检查在急性胸痛诊断中的应用 总被引:13,自引:0,他引:13
目的探讨64层螺旋CT(MSCT)三联检查显示急性胸痛患者肺动脉、胸主动脉和冠状动脉病变的能力及其临床应用价值。方法70例患者进行64层MSCT回顾性心电门控肺动脉、胸主动脉和冠状动脉联合检查。采用多平面重组(MPR)、最大密度投影(MIP)、曲面重组(CPR)及容积再现(VR)多种重组技术显示肺动脉、胸主动脉和冠状动脉,评价成像质量能否满足临床诊断需要。结果平均扫描时间(8.5±1.0)s,总对比剂用量100ml。肺动脉和主动脉增强后CT值均≥200HU者占95.7%(67/70);冠状动脉显影图像质量优的节段占85.8%(720/839),图像质量良的节段占8.6%(72/839),图像质量差的节段占5.6%(47/839)。共检出冠状动脉狭窄≥50%者20例,肺动脉栓塞2例,主动脉夹层2例。结论64层MSCT三联检查能够在8s左右1次扫描完成肺动脉、胸主动脉和冠状动脉检查,图像质量可以满足临床诊断需要,在急性胸痛病因诊断中具有很高的临床应用价值。 相似文献
77.
Objective To investigate the feasibility of the low tube voltage setting and personalized contrast agent application in 64-row multi-slice spiral CT pulmonary angiography.Methods Ninety patients with high risk of pulmonary artery embolism were sequentially enrolled in the study and divided into 3 groups employing completely randomized design: (1) Regular group included 30 patients using 120 kV and fixed dose of 70 ml contrast agent, (2)Another 30 patients were in 120 kV group, using 120 kV and the contrast amount was determined according to the patient weight (1.0 ml/kg), (3) The remaining 30 patients were included in 100 kV group, using 100 kV and the contrast amount was also determined according to the patient weight(1.0 ml/kg).Administration of contrast agent was completed within 20 seconds for all the patients, followed by 20 ml of saline.The objective and subjective indexes for assessing CT image quality, CT dose index volume (CTDIvol) and effective received dose (ERD) were compared between 120 kV group and 100 kV group; then the contrast media volume, injection rate, objective CT image indexes and subjective indexes for image quality was compared between the 100 kV group and regular group.The variance analysis and post hoc test were employed for the statistical analysis.Results Compared with 120 kV group(3.4± 0.7), the image quality of 100 kV group(5.2±1.8)had higher noise(52.9%), but subjective index for the image quality demonstrated no differences(q=0.272 ,P=0.063)in mediastinum window while CTDIvol and ERD decreased for 34.9%[(9.5±0.0) vs (14.6±0.0) mGy]and 36.8%[(3.8±0.6) vs (2.4± 0.4) mSv].The mean CT values on pulmonary artery of 100 kV group[(269.2±54.7) HU]were 13.4% (31.8/237.4) higher than the 120 kV group[(237.4±62.9) HU], but there was no statistical differences eornpared to normal group(q=0.172,P=0.260).Conclusion Using low kV setting (100 kV) to reduce radiation dose is proved to be effective and feasible in 64-MSCT pulmonary angiography.Personalized contrast agent injection has clinical application value for specific patient group. 相似文献
78.
Yuan Xue Tracy L. Williams Ting Li Joshua Umbehr Liang Fang Weiqun Wang Richard C. Baybutt 《Toxicology in vitro》2005,19(8):1061-1069
This study was to evaluate the effects of cigarette smoke constituents upon type II pneumocyte surfactant production in vitro, and how vitamins A and E may alter the response. Freshly isolated type II pneumocytes from Sprague–Dawley rats were incubated 20 h in medium with fetal bovine serum that was or was not treated with cigarette smoke. The number of adherent cells was inversely related to the dose of smoke or benzo(a)pyrene. Despite the decreased number of treated cells, the total amount of surfactant per culture well was unchanged, whereas surfactant production per cell was significantly increased (P < 0.05). Vitamin A concentration was significantly (P < 0.05) lower in the smoke-treated serum compared with untreated serum. When vitamin A or E was added to the cigarette smoke-treated serum, cell adherence and surfactant production returned to control values. In conclusion, cigarette smoke constituents or benzo(a)pyrene alone decreased the number of adherent type II pneumocytes, but did not alter surfactant amounts because of an increased production of surfactant per cell. Type II pneumocytes seem to adjust surfactant production dependent upon the number of type II pneumocytes to produce it and vitamin A or E enhance cell attachment in the presence of the smoke toxins. 相似文献
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80.