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51.
清开灵注射液治疗脑血管性痴呆32例 总被引:9,自引:0,他引:9
目的观察清开灵注射液治疗脑血管性痴呆的疗效.方法将中医学辨证属于实证的64例脑血管性痴呆患者随机分为治疗组(清开灵注射液组)和对照组(脑复康组),治疗5周后,将两组治疗前后在智力障碍程度、肢体功能、血液流变学指标、中医证型疗效方面的变化进行比较.结果经治疗后治疗组和对照组相比较,智力障碍程度变化(有效率、MMSE、ADL积分)、肌力、步行能力改变有显著性差异,p<0.05.而治疗前后组内及组间血流变指标虽有一定下降,但无统计学意义(p>0.05).结论清开灵注射液对脑血管性痴呆患者,在改善智力障碍、肌力、步行能力方面有较好的疗效. 相似文献
52.
Asystole Following Left Ventricular Pacing 总被引:1,自引:0,他引:1
During biventricular ICD implantation, pacing the epicardial inferior posterior-lateral surface of the left ventricle via the coronary sinus produced asystole. The proposed mechanism is a Bezold-Jarisch reflex manifested by a drop in heart rate and blood pressure through direct C fiber stimulation. (PACE 2004; 27[Pt. I]:815–817) 相似文献
53.
Steven Elia Peter Liu Carol Chrusciel Alan Hilgenberg Charrisios Skourtis Demetrios Lappas 《Journal canadien d'anesthésie》1989,36(1):2-8
Global coronary blood flow and metabolism were measured in seven patients on the first postoperative day following coronary
revascularization to test the hypothesis that tracheal extubation produces adverse haemodynamic responses akin to those observed
during tracheal intubation. Regional coronary flow and metabolic measurements were made in five of the seven patients. Extubation
from a continuous positive airway pressure (CPAP) of 5 cm H2O was associated with a statistically significant rise in cardiac index from 3.44 ± 0.23 L · min-1 · m-2 to 3.73 ± 0.15L·min-1 ·m-2 related to an increase in stroke index, without significant changes in heart rate, mean arterial and pulmonary capillary
wedge pressure. Consequently the changes in myocardial oxygen consumption (8.52 ± 0.55 to 8.85 ± 0.93 ml · min-1) and coronary blood flow (172 ± 18 to 179 ± 17 ml·min-1) were less prominent than those reported during intubation, where substantial rises in myocardial oxygen consumption and
coronary flow occurred. Two patients experienced cardiac lactate production but there were no changes in systemic or coronary
haemodynamics, nor were there clinical or electrocardiographic signs of ischaemia. We conclude that extubation does not appear
to be associated with adverse systemic or coronary haemodynamic responses in patients following coronary bypass grafting.
However, the revascularized myocardium may remain vulnerable to anaerobic metabolism in the immediate postoperative period.
Pour savoir si comme ľintubation, ľextubation de la trachée provoque des perturbations hémodynamiques, on a mesuré le métabolisme
et la circulation coronarienne globale chez sept patients, au lendemain ďun pontage aorto-coronarien. On a aussi calculé les
valeurs régionales de ces mêmes variables pour cinq ďentre eux. Ľindex cardiaque de 3.44 ± 0.23 L · min-1 · m-2 sous pression positive en respiration spontanée (CPAP) de 5 cm. H2O s’est élevé à 3.73 ± 0.15 L · min-1 · m-2 post-extubation avec une augmentation significative du volume ďéjection. La fréquence cardiaque et les pressions artérielles
moyennes et capillaires pulmonaires n’ont pas changé. Ainsi ľaugmentation de la consommation ďoxygène du myocarde de 8.52
± 0.55 à 8.85 ± 0.93 ml · min-1 et celle du flot coronarien de 172 ± 18 à 179 ± 17 ml · min-1 ont été moindres que celles, importantes, déjà observées lors de ľintubation. On a noté chez deux patients une production
de lactate par le myocarde, sans changement de ľhémodynamic systémique et coronarienne non plus que de signe clinique ou électrocardiographique
ďischémie. Donc, après un pontage coronarien, ľextubation ne semble pas causer ďeffet néfaste sur les circulations systémique
et coronarienne, toutefois, le myocarde revascularisé peut demeurer sensible au métabolisme anaérobique. 相似文献
54.
Takayuki Murakami Atsushi Komiya Kunihisa Mikata Shigeki Kaneko Ichiro Ikeda 《International journal of urology》2007,14(3):240-241
Abstract: A 66-year-old man was referred to our hospital with chest discomfort and shortness of breath. Seven months previously he had undergone a laparoscopic left nephroureterectomy for a left renal pelvic tumor and was given two cycles of adjuvant chemotherapy (methotrexate, epirubicin and cisplatin). Echocardiogram showed an 8-mm sized mass extending from the right atrium into the right ventricle. On computed tomography, multiple lung tumors, as well as the right atrial and ventricular mass, were seen. The patient died of acute heart failure caused by right ventricular outflow obstruction. On autopsy, a right atrial and ventricular metastasis of the initial transitional cell carcinoma was found. The patient's cause of death was acute heart failure as a result of cardiac metastasis of his initial renal pelvic carcinoma. 相似文献
55.
Tadamasa Miyauchi Hiroshi Takiya Toshihiko Sawamura Eiji Murakami 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(4):206-209
Pericardial abscess is rare in healthy individuals, especially the amebic type. We report a case of pericardial abscess and
cardiac tamponade due to intrapericardial rupture of an amebic liver abscess. A 31-year old Japanese male complained of fever
to a local hospital. A liver mass was discovered in his left hepatic lobe by an abdominal echogram. He was referred to the
internal department of our hospital and was treated with quinolone antibiotics. Two weeks after medication, he suddenly complained
of epigastralgia and severe orthopnea and was admitted. Abdominal computed tomographic scan showed an enlarged liver mass,
and massive pericardial effusion suggested cardiac tamponade. He underwent an emergency subxiphoid partial pericardiectomy
under local anesthesia. 1,000 ml of light brownish fluid was removed and his condition improved. Although no ameba was cultivated
from the pus, the amebic serological test was positive. Metronidazole was administered and the patients was discharged 31
days after surgery. 相似文献
56.
蒋丽君 《中国中医药信息杂志》2005,12(9):17-18
目的观察按压骨穴对围绝经期妇女心脏植物神经功能的影响。方法设按压骨穴组30例、空白对照组30例。用美国BraemarDL700型动态心电检测仪,检测试验前后的心率变异性(HRV):TF代表总频,LF代表交感神经活性,HF代表迷走神经活性,LF/HF代表交感神经与迷走神经均衡性。结果按压骨穴后4项指标均有显著下降(P<0.01,P<0.05)。空白对照组变化不显著(P>0.05)。骨穴组4项指标的变化率与对照组比较均有显著性差异(P<0.01)。结论按压骨穴有抑制心脏交感神经活性的良性调整作用,此效应具有相对的特异性。 相似文献
57.
A Sultan C Piot D Mariano-Goulart J P Daures F Comte E Renard A Avignon 《Diabetic medicine》2006,23(4):410-418
AIMS: To assess the association between abnormal stress myocardial perfusion imaging (MPI) and cardiac events (CE) in asymptomatic patients with diabetes and with > or = 1 additional risk factor. Predictors of abnormal stress MPI were also evaluated. METHODS: Four hundred and forty-seven consecutive patients who underwent stress MPI were prospectively followed for 2.1 [0.5-4.1] years for the subsequent occurrence of hard CE (myocardial infarction and sudden or coronary death) and soft CE (unstable angina and ischaemic heart failure requiring hospitalization). Re-vascularization procedures performed as a result of the screening protocol were not included in the analysis. RESULTS: Follow-up was successful in 419 of 447 patients (94%), of whom 71 had abnormal MPI at baseline. Medical therapy was intensified in all subjects and especially in those with abnormal MPI. Twenty-three patients with abnormal MPI underwent a re-vascularization procedure. CEs occurred in 14 patients, including six of 71 patients (8.5%) with abnormal MPI and eight of 348 patients (2.3%) with normal MPI (P < 0.005). Only two patients developed a hard CE and 12 a soft CE. In multivariate analysis, abnormal MPI was the strongest predictor for CEs [odds ratio (OR) (95% CI) = 5.6 (1.7-18.5)]. Low-density lipoprotein cholesterol > or = 3.35 mmol/l [OR (95% CI) = 7.3; 1.5-34.7] and age > median [OR (95% CI) = 6.0 (1.2-28.6)] were additional independent predictors for CE. The independent predictors for abnormal MPI were male gender, plasma triglycerides > or = 1.70 mmol/l, creatinine clearance < 60 ml/min and HbA1c > 8%, with male gender the strongest [OR (95% CI) = 4.0 (1.8-8.8)]. CONCLUSIONS: Asymptomatic patients with diabetes in this study had a very low hard cardiac event rate over an intermediate period. This could be explained by the effects of intervention or by the low event rate in the background population. Randomized studies of cardiac heart disease screening are required in asymptomatic subjects with diabetes to determine the effectiveness of this intervention. 相似文献
58.
59.
Autotransfusion after open heart surgery: the oxygen delivery capacity of shed mediastinal blood is maintained 总被引:1,自引:0,他引:1
H. Schmidt U. Kongsgaard J. Kofstad O. Geiran H. E. Refsum 《Acta anaesthesiologica Scandinavica》1995,39(6):754-758
Autotransfusion of mediastinal shed blood after open heart surgery has become a common and accepted procedure in reducing the need for homologous transfusion during the last 15 years. The objectives of the present study were to investigate the oxygen delivery capacity of autotransfused shed mediastinal blood, compared to patient-blood, during cardiopulmonary bypass and in the postoperative period.
Ten consecutive patients undergoing elective cardiac surgery were studied. Mediastinal shed blood was collected in the cardiotomy reservoir and retransfused during the first 18 postoperative hours. The oxygen delivery capacity of the blood to the tissues was calculated by use of the oxygen status algorithm (OSA 2.0) programme and measurement of the 2,3-diphosphoglycerate (2,3-DPG) concentration.
Autotransfusion volume ranged from 450–1530 ml per patient (median 824 ml). Shed blood had a mean haemoglobin level of 8.8 g/dl and 7.4 g/dl at 1 h and 6 h of autotransfusion, respectively. There were no significant changes of 2,3-DPG concentration in the patient-blood during cardiopulmonary bypass or after autotransfusion compared to preoperative values. P50 for oxygen (3.6 and 3.6 kPa) and 2,3-DPG concentrations (5.3 and 5.1 mikromol/ml erythrocyte) in shed mediastinal blood (1h and 6h postoperatively) were not significantly different compared to patient-blood.
The results demonstrate that the oxygen delivery capacity of shed mediastinal blood is maintained and that the oxygen affinity of patient-blood is not influenced by autotransfusion. 相似文献
Ten consecutive patients undergoing elective cardiac surgery were studied. Mediastinal shed blood was collected in the cardiotomy reservoir and retransfused during the first 18 postoperative hours. The oxygen delivery capacity of the blood to the tissues was calculated by use of the oxygen status algorithm (OSA 2.0) programme and measurement of the 2,3-diphosphoglycerate (2,3-DPG) concentration.
Autotransfusion volume ranged from 450–1530 ml per patient (median 824 ml). Shed blood had a mean haemoglobin level of 8.8 g/dl and 7.4 g/dl at 1 h and 6 h of autotransfusion, respectively. There were no significant changes of 2,3-DPG concentration in the patient-blood during cardiopulmonary bypass or after autotransfusion compared to preoperative values. P50 for oxygen (3.6 and 3.6 kPa) and 2,3-DPG concentrations (5.3 and 5.1 mikromol/ml erythrocyte) in shed mediastinal blood (1h and 6h postoperatively) were not significantly different compared to patient-blood.
The results demonstrate that the oxygen delivery capacity of shed mediastinal blood is maintained and that the oxygen affinity of patient-blood is not influenced by autotransfusion. 相似文献
60.
Stephan E. Maier Harvey E. Cline Ferenc A. Jolesz 《Magnetic resonance in medicine》1995,34(5):706-712
Three dimensional (3D) phase contrast angiograms contain velocity data, which is discarded after the reconstruction of the projections. In extension to earlier work on velocity quantification with ungated 2D phase data, this paper shows that a useful estimate of the average velocity and flow rate can be extracted from ungated 3D phase contrast angiograms. Simulations and experiments in a phantom and in vivo were performed. For pulsatile flow and strong spin saturation, an over-estimation of the flow rate at the net in-flow end of the imaging volume and underestimation at the net out-flow end was observed. Imaging at lower RF tip angles yielded flow rates close to the correct value within the entire imaging volume. In contrast to ungated 2D experiments, the flow rates determined by repeated 3D experiments showed no variation. 相似文献