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31.
A group of 21 patients with various degrees of chronic obstructive pulmonary disease underwent radionuclide ventriculography with hemodynamic monitoring to assess the extent to which pulmonary artery pressures and pulmonary vascular resistance can be lowered by the vasodilator molsidomine. Molsidomine (N-carboxy-3-morpholino-sydnonimin-ethylester) is similar to nitroglycerin in its mode of action. After hemodynamic and radionuclide data acquisition, at rest and during submaximal exercise in the steady state, 2 mg molsidomine was injected intravenously. Rest and exercise measurements were repeated 45 min after molsidomine injection. In patients with mild to moderate disease (group 1), pulmonary artery resting pressures decreased by 12% (p less than 0.05) at rest by 22% (p less than 0.01) during exercise after the administration of the drug. Total pulmonary resistance during exercise decreased significantly (p less than 0.01) as a result of marked decrease of pulmonary artery pressure (PAP) compared with a minimal decrease in cardiac index (CI). In patients with severe disease (group 2), only the resting values of PAP decreased while the relationship between pressure and flow was unchanged. During the exercise period, the preload parameters of the right and left ventricles decreased by an average of 30%. With regard to gas exchange, only the arterial PO2 at rest decreased slightly but significantly (p less than 0.05) after molsidomine, while the coefficient of oxygen delivery was not affected by the drug. However, in four patients arterial PO2 was markedly reduced by the drug. Right ventricular ejection fraction increased significantly (p less than 0.01) both at rest and during exercise in group 1 and during exercise in group 2 after administration of molsidomine.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
32.
Dr. Shosaku Nakahara M.D. Hideaki Itoh M.D. Ryuichi Mibu M.D. Shinichi Ikeda M.D. Yoshihiro Oohata M.D. Kamesaburo Kitano M.D. Yoshihiko Nakamura M.D. 《Diseases of the colon and rectum》1988,31(10):762-766
Anorectal function was evaluated in eight patients who had low anterior resection of the rectum with a low anastomotic line,
using an EEA™ stapler, with determination of function based on periodic manometric studies and clinical symptoms. Immediately following
surgery all patients suffered from frequent bowel actions and soiling. These symptoms improved with time and most patients
could enjoy almost normal daily life by the sixth postoperative month. One month after surgery, anal canal resting pressure
and maximum squeeze pressure were significantly reduced and rectoanal inhibitory reflex was absent; neither showed a distinct
tendency to improve thereafter. Rectal sensation and reservoir capacity, which also were seriously impaired, recovered satisfactorily
by the time of the six-month examination. This suggests that an improvement of clinical symptoms following this operation
is dependent upon the recovery of reservoir capacity and sensation of the neorectum, and that this operative procedure is
a functionally acceptable option for low rectal cancer. 相似文献
33.
34.
K. G. Lycke J. H. Göthlin J. K. Jensen B. M. Philipson N. G. Kock 《Abdominal imaging》1994,19(2):116-123
The aim of the present study is to describe the radiologic methods used to study continent ileostomy reservoirs and to depict the normal radiologic features and variations identified by these procedures. During an 8-year period, 408 double-contrast studies were performed in 261 patients. The present study comprises 170 examinations in 99 patients with normal findings. A high-density barium contrast medium and air were used. Modest variation in the size and shape of the reservoirs was observed. The mucosal pattern of the reservoirs resembled that of the ileum but the folds were slightly wider. The continence-providing valves were 3–5 cm long and had a diameter of 2.5–4.0 cm. The diameter of the afferent ileal segments was usually slightly larger than that of more proximal ileal segments, with an upper limit of approximately 4 cm. The efferent ileal segments generally had a straight course without widening or outpouches. Retrograde barium double-contrast examination is a satisfactory method for the evaluation of continent ileostomy reservoirs. Here we define the range of normal variations of such reservoirs as seen on retrograde double-contrast radiologic examinations. 相似文献
35.
Dr James Charles Robin Turner MA PhD ScD 《Journal of clinical monitoring and computing》1991,7(3):237-240
Anesthetic gases from several patients can be monitored simultaneously with a centrally located mass spectrometer. Such monitoring requires catheters from patient to spectrometer that are several meters long. Scamman (J Clin Monit 1988;4:227–229) found that when the respiratory frequency is high, as with infants, the CO2 signal from the patient is unacceptably distorted during passage down the catheter. This is due to Taylor dispersion of the input signal. An outline of the theory of Taylor dispersion is given. The equations describe the interaction between the velocity distribution (which, in laminar flow, is parabolic) and the radial diffusion of CO2. This interaction keeps a tracer signal together in a pulse, as it moves down the tube with themean velocity, spreading somewhat as it proceeds. How much does an initially sharp signal become blurred? The spread of such a signal when it reaches the detector, measured in time, can be expressed in various ways. Measurement is complicated, however, by the fact that the gas pressure may fall by as much as a factor of 10 along the line. The resultant expansion and acceleration of the gas cannot be ignored. A full treatment of this complication is given elsewhere, but the following simple equation is described: {ie237-1} Typically, the spread time is up to a quarter of a second for catheters of 50 m, such as used by Scamman. This is comparable with the period of CO2 rise and fall for infants and explains the serious distortion in wave form that Scamman found. Some distortion can be eliminated by reducing R to 0.1 or less, but the extent of this improvement is small. Ideally, for fast-breathing patients, the catheter length should be reduced to 20 m or less, if possible. 相似文献
36.
37.
目的探讨改良去带盲结肠可控膀胱术的护理。方法总结15例因膀胱癌行可控性膀胱成形术的护理,包括术前的心理护理、肠道准备及支持疗法,术后密切监测生命体征、病情变化及各种引流管的固定情况,预防肺部并发症的发生。结果15例膀胱癌患者均成功行可控性膀胱成形术,术后通过精心的护理,无并发症发生,均痊愈出院。结论精心的护理有利于提高手术的成功率,提高患者的生活质量。 相似文献
38.
以高频喷射通气结合胸壁挤压(HFJV+CWC)为通气模式,观察其对组胺致肺损伤犬呼吸循环功能的影响,并与单纯高频喷射通气(HFJV)进行比较。结果表明:与HFJV相比,HFJV+CWC时的功能残气量(FRC)、PaCO_2和PCO_2均显著降低(P<0.01),肺泡通气量(V_A)和二氧化碳排出量(CO_2)均显著增高(P<0.01),每分呼出气量(V_E)、PaO_2、PCO_2、吸气峰压(PIP)、平均气道压(Paw)、呼气末压(EEP)、HR、平均动脉压(MAP)、肺动脉压(PAP)和肺毛细血管楔压(PCWP)均无显著变化(P>0.05)。提示:HFJV+CWC除保留单纯HFJV时气道开放、气道低压、良好的血液氧合、不影响循环功能等特点外,还具有增加呼气动力,改善肺泡通气,显著促进CO_2排除等优点。 相似文献
39.
In a patient who had undergone construction of a continent ileal pouch we successfully repaired an incontinent ileal tube by infolding it in an imbricated portion of the ileal pouch wall. For 2 years postoperatively the patient has been urine continent and has catheterized the pouch easily. We believe this infolding technique is useful for reconstructing the continent mechanism in patients with incompetent ileal valves. 相似文献
40.
本文以兔呼吸频率、通气量和血气作为指标,观察到iv吗啡0.5~4.0mg/kg产生剂量依赖性呼吸抑制。icv匹鲁卡品2.5mg/kg能完全逆转这一抑制效应。icv 4—氨基吡啶(4—AP),1.5μg/kg兴奋呼吸,并使吗啡量效曲线右移。用利血平耗竭儿茶酚胺后,吗啡仍能抑制呼吸,4—AP可消除之。表明吗啡抑制呼吸与中枢胆碱能系统有关,且可能系它抑制Ach释放所致。 相似文献