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41.
目的:研究单肺通气时PETCO2和Qs/Qt之间的关系。方法:选择28例择期开胸手术的患者分别于TLV 20min、OLV 5min、15min、30min、60min测动脉血和混合静脉血气并同时记录PETCO2,计算Qs/Qt,进行统计学处理。结果:OLV时不同时段PETCO2、PaCO2、Qs/Qt比TLV时增大(P<0.05),TLV时PETCO2与Qs/Qt不相关(r=-0.0230,P=0.9077)。OLV时PETCO2与Qs/Qt相关(r=0.4739,P=0.00001),其直线回归方程为y=3.4862+0.0147x(y=PETCO2,x=Qs/Qt)。结论:OLV时PETCO2与Qs/Qt呈直线相关,PETCO2随Qs/Qt增加而增大。 相似文献
42.
43.
Jonathan P. Purday 《Journal canadien d'anesthésie》1994,41(9):818-844
Monitoring of paediatric anaesthesia has become increasingly more complex in recent years and this is particulary true of
cardiac anaesthesia. The purpose of this review is to give a comprehensive update of published material related to both routine
and specialized cardiac monitoring. Routine monitoring can be particularly affected by the alterations of cardiac rhythm,
blood flow, cardiac output and oxygenation which result from the congenital heart abnormalities themselves, the type of surgery
undertaken and the effects of cardiopulmonary bypass. The use of specialized monitoring is becoming more widespread, particularly
in the areas of cerebral function, mixed venous oxygenation, cardiac output measurement and coagulation. In the last five
years, with the development of smaller probes, a great deal has been published on transoesophageal echocardiography. The use
of the current monitors of cerebral function still remains controversial despite the need for a monitor of adequate brain
perfusion, reflecting the need for a great deal of further research in this area. This review will concentrate on particular
areas which have seen the most profound changes and on monitoring that may form the standards of tomorrow. Finally, amongst
all the technology, it should not be forgotten that the most important clinical monitor is the bedside clinical monitoring
of the physicians themselves.
Depuis quelques années, le monitorage de l’anesthésie pédiatrique devient déplus en plus complexe et tout particulièrement
en anesthésie cardiaque. L’objectif de ce travail consiste à passer en revue la littérature actuelle qui traite du monitorage
usuel et spécialisé. Le monitorage usuel peut être influencé par les modifications de la fréquence cardiaque, du courant sanguin,
du débit cardiaque et de l’oxygénation provoqués par les anomalies cardiaques congénitales, du type de chirurgie et des retentissements
de la circulation extracorporelle. L’utilisation du monitorage spécialisé est de plus en plus répandu et concerne particulièrement
la circulation cérébrale, l’oxygénation du sang veineux mêlé, la mesure du débit cardiaque et la coagulation. Au cours des
cinq dernières années, le développement de sondes plus petites a généré de nombreuses publications sur l’échocardiographie
transoesophagienne. L’utilisation des moniteurs actuels de la fonction cérébrale demeure sujet à controverse bien qu ’un moniteur
de perfusion cérébrale adéquat demeure toujours aussi essentiel, confirmant ainsi le besoin de recherches supplémentaires
sur ce sujet. Ce survol se portera spécialement sur les champs d’activités qui ont connu les changements les plus profonds
et sur le monitorage qui établira les standards du futur. Finalement, au milieu de cette technologie, il ne faut jamais oublier
que le moniteur clinique le plus important se trouve au chevet du malade en la personne du médecin. 相似文献
44.
Background Patient discomfort 0–24 h after double-contrast barium enema (DCBE) was investigated in two ways.Methods In part 1, 139 patients, not previously informed, were contacted by telephone to assess symptom rates without bias. In part 2, designed as a prospective randomized double-blind trial, the effect of carbon dioxide (CO2) as an insufflating gas was compared with conventional atmospheric air (AA).Results Part 1: 10% experienced severe abdominal pain, and 18% severe abdominal distention. Part 2: Low discomfort rates were found for both severe pain (7% for AA vs. 2% for CO2) and severe distention (13% for AA vs. 8% for CO2); the differences were not significant. In both parts of the study, female patients with a history of abdominal discomfort of colon irritabile type were significantly overrepresented in the severely symptomatic groups. Equal numbers of patients experiencing severe abdominal distention for the first time were found in both the AA and CO2 groups, ruling out AA as the sole cause of these symptoms.Conclusion Abdominal post-DCBE discomfort seems to be less frequent than previously reported and is not effectively eliminated by CO2. We still find the use of AA in DCBEs justified. 相似文献
45.
Bodmeier Roland Wang Hui Dixon David J. Mawson Simon Johnston Keith P. 《Pharmaceutical research》1995,12(8):1211-1217
Purpose. The objective was to prepare polymeric microparticles by atomizing organic polymer solutions into a spray chamber containing compressed CO2 (PCA-process) and to study the influence of various process parameters on their morphological characteristics.
Methods. The swelling of various pharmaceutically acceptable polymers [ethyl cellulose, poly(methyl methacrylate), poly(-caprolactone), poly(dl-lactide), poly(l-lactide) and poly(dl-lactide-glycolide) copolymers] in CO2 was investigated in order to find polymers which did not agglomerate during the spraying process. Poly(l-lactide) (L-PLA) microparticles were prepared by spraying the organic polymer solution into CO2 in a specially designed spraying apparatus. The effect of various process (pressure and temperature of the CO2 phase, flow rate) and formulation (polymer concentration) variables on the morphology and particle size of L-PLA-microparticles was investigated.
Results. Polymers with low glass transition temperatures agglomerated even at low temperatures. The formation of microparticles was favored at moderate temperatures, low polymer concentrations, high pressures and high flow rates of CO2. High polymer concentrations and low flow rates resulted in the formation of polymeric fibers. Colloidal L-PLA particles could also be prepared with this technique in a surfactant-free environment. Initial studies on the microencapsulation of drugs resulted in low encapsulation efficiencies.
Conclusions. The PCA method is a promising technique for the preparation of drug-containing microparticles. Potential advantages of this method include the flexibility of preparing microparticles of different size and morphology, the elimination of surfactants, the minimization of residual organic solvents, low to moderate processing temperatures and the potential for scale-up. 相似文献
46.
Six mainstream and twelve sidestream infrared carbon dioxide (CO2) analysers were tested for accuracy of the CO2 display value, alarm activation and the effects of nitrous oxide (N2O), oxygen (O2) and water vapour according to the ISO Draft International Standard (DIS) #9918. Mainstream analysers (M-type): Novametrix Capnogard 1265; Hewlett Packard HP M1166A (CO2module HP M1016A); Datascope Passport; Marquette Tramscope 12; Nellcor Ultra Cap N-6000; Heilige Vicom-sm SMU 611/612 ETC. Sidestream analysers: Brüel &; Kjaer Type 1304; Datex Capnomac II; Marquette MGA-AS; Datascope Multinex; Ohmeda 4700 OxiCap (all type S1: respiratory cycles not demanded); Biochem BCI 9000; Bruker BCI 9100; Dräger Capnodig and PM 8020; Criticare Poet II; Heilige Vicom-sm SMU 611/612 A-GAS (all type S2: respiratory cycles demanded). The investigations were performed with premixed test gases (2.5, 5, 10 vol%, error ?1% rel.). Humidification (37° C) of gases were generated by a Dräger Aquapor. Respiratory cycles were simulated by manually activated valves. All monitors complied with the tolerated accuracy bias in CO2 reading (≤ 12% or 4 mmHg of actual test gas value) for wet and dry test gases at all concentrations, except that the Marquette MGA-AS exceeded this accuracy limit with wet gases at 5 and 10 vol% CO2. Water condensed in the metal airway adapter of the HP M1166A at 37° C gas temperature but not at 3(P C. The Servomex 2500 (nonclinical reference monitor), Passport (M-type), Multinex (S1-type) and Poet II (S2-type) showed the least bias for dry and wet gases. Nitrous oxide and O2 had practically no effect on the Capnodig and the errors in the others were max. 3.4 mmHg, still within the tolerated bias in the DIS (same as above). The difference between the display reading at alarm activation and the set point was in all monitors (except in the Capnodig: bias 1.75 mmHg at 5 vol% CO2) below the tolerated limit of the DIS (difference ≤ 0.2 vol%). The authors conclude that the tested monitors are safe for clinical use (except those failing the DIS limits). The accuracy of the CO2-reading (average of mean absolute bias) is better in the M-type than in the S1- or S2- type analysers although no statistical (nor clinical) significant differences could be detected. Most manufacturers work with stricter limits than those proposed by the DIS. 相似文献
47.
稳定性二氧化氯消毒性能及毒性的试验研究 总被引:4,自引:0,他引:4
稳定性二氧化氯采用液体二元包装方式,贮存稳定。经活化后,二氧化氯浓度50mg/L的消毒液作用10min能完全杀灭细菌繁殖体,400mg/L作用5min能完全杀灭细菌芽胞.300mg/L作用5min能有效地破坏HBsAg抗原性。10%有机物对其杀菌作用无影响。该消毒液对人体无毒、无刺激性,但对金属有不同程度的腐蚀性。 相似文献
48.
目的 :用化学发光法检测O2 、CO2 、CO和正庚烷 (CxHy)四种气体对离体家兔肺泡巨噬细胞 (AM )的直接效应。 方法 :将AM悬液暴露于上述气体 ,不同时间检测用PMA激发的细胞发光及其存活率。结果 :培养在 99.5 %N2 (0 .5 %O2 )中的AM受激发光仅能维持 10h ;高浓度O2 、CO2 、CO和CxHy具有刺激或增强AM发光之效应 ;含 16 %O2 、1.9%CO2 、46mg/m3 CO和 176mg/m3 CxHy的模拟潜艇混合气体未见对AM激发光功能和存活率产生不利影响。结论 :空气氧含量对细胞十分重要 ,提高氧浓度有利于细胞存活 ,但氧浓度 >16 %和 <2 0 %的低氧还原性气体环境更有利细胞长时间生存。 相似文献
49.
50.
The introduction of fiberoptic endoscopes has fostered the development of minimally invasive aesthetic facial plastic surgery.
The application of this new technology is most widely used in rejuvenation of the mildly to moderately ptotic brow. The concept
of endoscopic foreheadplasty is based upon the following maneuvers. First, a sub- or supraperiosteal dissection of the parietal,
occipital, and frontal scalp to the level of the superior and lateral orbital rims and zygomatic arch must be accomplished.
Second, incision and release of the superior and lateral orbital periosteum are performed. Third, selective myotomies of the
brow depressor muscles are completed. These maneuvers allow the brow to be permanently elevated into a desired position following
fixation and healing. A significant limitation of this procedure appears to be the ability to predict the long-term forehead
and brow elevation. We believe that permanent fixation is one of the best methods to ensure that the desired elevation is
maintained. We contrast two series of patients, one with temporary fixation technique and the other with permanent fixation.
We review the results and discuss the rationale and advantages of permanent fixation. 相似文献