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排序方式: 共有513条查询结果,搜索用时 31 毫秒
31.
目的 探讨高压氧对脑外伤治疗的价值。方法 对76例脑外伤病人进行了高压氧治疗并对其疗效进行了分析。结果 高压氧治疗脑外伤的有效率为96.05%,其疗效与病程、疗程和临床症状有关。结论 高压氧治疗脑外伤具有较好的疗效。 相似文献
32.
Priv.-Doz. Dr. Horst J. Feldmann Michael Molls Peter Vaupel 《Strahlentherapie und Onkologie》1999,175(1):1-9
Purpose There is a large body of evidence suggesting that blood flow and oxygenation of human tumors are important research topics
which may explain, in particular, resistance to radiation and to many antineoplastic drugs, which can limit the curability
of solid tumors by radiotherapy and chemotherapy.
Materials and Methods This manuscirpt reviews the clinical investigations which have been performed regarding blood flow and oxygenation status
of human tumors in radiation oncology.
Results The possible uses and limitations of the prognostic significance and the changes under therapy measuring blood flow and oxygenation
in human tumors were discussed. In addition, several aproaches were summarized, which can improve the microvascular O2 availability and perfusion-limited O2 delivery.
Conclusion The clinical data concerning the prognostic significance of blood flow, vascular function and oxygenation of human tumors
are relevant for patient selection in clinical oncology. Strategies to improve traditional cancer therapy by modulation of
the oxygenation status remain quite promising but more critical research and sophisticated clinical studies are necessary
before its true potential is known.
相似文献
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34.
血液滤过对严重创伤后并发急性呼吸窘迫综合征患者氧合功能和血流动力学的影响 总被引:1,自引:1,他引:1
目的 研究血液滤过对严重创伤后并发ARDS患者氧合功能和血流动力学的影响。方法 选择严重创伤后ARDS患者12例,在呼吸机辅助或控制呼吸下行血液滤过治疗,于血液滤过后1-5d内用Swan-Ganz漂浮导管监测血流动力学和肺氧功能的变化。结果 与血液滤过前比较,滤过后第1天CVP、MPAP、SVRI、PVRI显著降低,整个血液滤过时间PaO2/FiO2升高非常显著,MAP、PCWP、HR、CI、DO2、VO2、ExtrO2、Qs/Qt无显著变化。结论 血液滤过对严重创伤后ARDS患者的血流动力学和氧合功能无明显影响,但可使氧合指数升高。 相似文献
35.
Effects of NO inhalation on pulmonary leukocyte sequestration and blood volume in porcine endotoxaemia 总被引:5,自引:0,他引:5
Dahm PL Blomquist S De Robertis E Jonson B Myhre E Svantesson C Thörne J 《Intensive care medicine》2000,26(3):336-343
Objective: Sequestration and migration of activated neutrophils plays a major role in the pulmonary injury typical of septic shock and the adult respiratory distress syndrome. Inhaled NO may counteract alveolar-capillary damage attributed to activated neutrophils. The present study describes a method to directly demonstrate the effects of NO inhalation on endotoxin-induced sequestration of 99 mTc-labelled leukocytes [As(t)] in the lungs of pigs.¶Design: Prospective controlled study.¶Setting: Laboratory for experimental surgery at a university medical centre.¶Subjects: Anaesthetised and ventilated pigs.¶Interventions: To induce inflammatory shock 26 animals received a continuous endotoxin infusion. Thirteen animals inhaled NO from the start of the experiments, while 13 served as controls. In 13 animals from both groups, leukocytes were labelled in vitro and reinjected, while in the 13 others erythrocytes were labelled in vivo to provide corrections for changes in blood volume.¶Measurements and results: The pulmonary distribution of 99 mTc-labelled leukocytes or erythrocytes was studied dynamically for 180 min. After correction for changes in pulmonary and heart blood volume (PBV, HBV), leukocyte sequestration curves were generated. Endotoxin induced pulmonary vasoconstriction, reduced PBV, impaired oxygenation, and caused a maximum increase in As(t) of 30 % in the lungs. NO inhalation attenuated pulmonary vasoconstriction and the reduction in PBV. The maximum increase in As(t) was reduced to 15 % of baseline.¶Conclusions: Inhaled NO exerts its main vascular effects in the pulmonary microvasculature, the primary site of physiological neutrophil margination and pathological adhesion of activated leukocytes. Early use of NO inhalation may offer protection against the development of more lasting pulmonary failure in septic shock by reducing leukocyte sequestration in the lungs. 相似文献
36.
目的:探讨一氧化氮(NO)吸入对羊感染性急性呼吸窘迫综合征(ARDS)血流动力学和肺氧合功能的影响。方法:静脉注入小剂量内毒素诱导羊感染性ARDS模型。随机分为两组:(1)NO组(n=6)为ARDS建立后,在容量控制通气基础上持续吸入40ppmNO 3h;(2)对照组(n=6)为ARDS一单纯容量控制通气,观察3h以确定模型的稳定性并与NO组比较,通过肺动脉导管和动脉血气分析,测定各组每小时肺气体交换和血流动力学参数,3h结束实验时,检测血中高铁血红蛋白(MetHb)浓度。结果:静脉注入小剂量内毒素能够诱导稳定的羊感染性ARDS模型,该模型的平均肺动脉压(MPAP)较基础值明显升高(P<0.01),体循环血液动力学则能维持稳定。NO组各时点MPAP均较治疗前和同时点的对照组低(P<0.01),动脉氧分压(PaO2)则明显增加(P<0.01),肺泡动脉血氧分压差(PA-aO2)和肺内分流(Qs/Qt)明显低于治疗前和同时点的对照组(P<0.01)。两组平均动脉压(MAP)和心排量(CO)各时点及治疗前后比较均无明显变化(P>0.05),MetHb未见明显升高,结论:吸入NO选择性降低肺动脉压,改善肺氧合,无明显毒副作用。 相似文献
37.
38.
J. Räsänen J. B. Downs D. J. Malec B. DeHaven W. L. Garner 《Intensive care medicine》1988,14(2):118-122
We designed a ventilation-perfusion index (VQI) to estimate venous admixture (Qsp/Qt) in a real-time fashion by simultaneous pulse and pulmonary artery oximetry in 17 patients with acute respiratory failure. Changes in Qsp/Qt were produced by altering the level of continuous positive airway pressure. VQI correlated well with Qsp/Qt (r=0.78). This contrasts with the poor correlation found between Qsp/Qt and the commonly used oxygen tension based indices such as PaO2/FIO2 (r=-0.51), PaO2/PAO2 (r=-0.47), and PAO2-PaO2 (r=0.23). The use of dual oximetry to derive a VQI appears to be a reliable and accurate method for real-time assessment of pulmonary gas exchange in patients with acute respiratory failure. 相似文献
39.
40.
Improvement in oxygenation by prone position and nitric oxide in patients with acute respiratory distress syndrome 总被引:5,自引:0,他引:5
Martinez M Diaz E Joseph D Villagrá A Mas A Fernandez R Blanch L 《Intensive care medicine》1999,25(1):29-36
Objective: Inhaled nitric oxide (NO) and prone position improve arterial oxygenation in patients with the acute respiratory distress
syndrome. This study was undertaken to assess the combined effects of NO and prone position in these patients. Design: Prospective clinical study. Setting: General intensive care service in a community teaching hospital. Patients: 14 mechanically ventilated adult patients with the acute respiratory distress syndrome (mean lung injury score 3.23 ± 0.27).
Measurements and results: We measured hemodynamic and oxygenation parameters in the supine position and 2 h later in the prone position, before and
during inhalation of 10 ppm NO. A positive response in oxygenation was defined as a ≥ 20 % increment in the arterial oxygen
tension/fractional inspired oxygen ratio (PaO2/FIO2). In the prone position PaO2/FIO2 increased significantly (from 110 ± 55 to 161 ± 89 mmHg, p < 0.01) and venous admixture decreased (from 38 ± 12 to 30 ± 7 %, p < 0.01) compared to the supine position. Ten of the 14 patients were responders in the prone position. In the supine position,
inhalation of NO improved oxygenation to a lesser extent, increasing PaO2/FIO2 to 134 ± 64 mmHg (p < 0.01) and decreasing venous admixture to 35 ± 12 %, (p < 0.01). Five of the 14 patients responded to NO inhalation supine and 8 of 14 responded prone (p = 0.22). The combination of NO therapy and prone positioning was additive in increasing PaO2/FIO2 (197 ± 92 mmHg) and decreasing venous admixture (27 ± 8 %) (p < 0.01). This combination also showed a positive oxygenation response on compared to the supine value without NO in 13 of
the 14 patients (93 %). NO-induced changes in PaO2/FIO2 were correlated to changes in pulmonary vascular resistance only in the prone position. Conclusions: In patients with the acute respiratory distress syndrome, the combination of NO and prone position is a valuable adjunct
to mechanical ventilation.
Received: 15 June 1998 Final revision received: 13 October 1998 Accepted: 30 October 1998 相似文献