竹叶提取物的抗缺氧作用

目的观察竹叶提取物的抗缺氧作用,为竹叶提取物的临床新用途提供实验依据.方法采用小鼠常压耐缺氧实验、亚硝酸钠中毒小鼠存活时间、氰化钾中毒小鼠存活时间、利多卡因中毒小鼠存活时间、夹闭气管小鼠心电消失时间的影响、断头小鼠张口动作持续时间模型观察竹叶提取物的抗缺氧作用.结果竹叶提取物(22.5 mg/kg,45.0 mg/kg,90.0 mg/kg)可明显延长常压缺氧条件下的小鼠存活时间,延长亚硝酸钠、氰化钾、利多卡因中毒后的小鼠存活时间,延长夹闭气管小鼠心电消失时间,明显延长断头小鼠的喘气时间.结论竹叶提取物能提高整体动物的抗缺氧能力.     

长托宁联合预防性气管插管治疗重度有机磷农药中毒的疗效观察

目的 观察长托宁联合预防性气管插管治疗重度有机磷农药中毒的疗效.方法 回顾分析安徽医科大学附属巢湖医院2006年1月至2016年8月收治62例重度有机磷农药中毒患者的临床资料,根据治疗方法分为两组,使用长托宁联合预防性气管插管治疗的32例患者为A组,使用长托宁治疗的30例患者为B组,比较两组患者病死率、药物使用总量、误吸和谵妄发生率和ICU平均住院时间.结果 A组患者无一例死亡、B组患者病死率分别为13.3%,误吸发生率分别为9.4%和33.3%,谵妄发生率分别为21.9%和46.7%,差异有统计学意义(P<0.05).A组患者ICU平均住院时间为(5.3±2.4)d,B组为(6.2±2.5)d,差异有统计学意义(P<0.05);A组患者长托宁用药总量平均为(16.9±3.2) mg、B组为(18.4±3.9)mg,差异无统计学意义(P>0.05).结论 长托宁联合预防性气管插管治疗重度有机磷农药中毒可提减少病死率、减少误吸和谵妄发生率及ICU平均住院时间.     

Pediatric anesthetic for tracheobronchial foreign body extraction: A survey of practice in France

Background

Tracheobronchial foreign body aspiration is a classic pediatric emergency, and its associated morbidity particularly depends on the anesthetic management, which differs according to the center and the practitioner.

Aims

The aim of this study was to evaluate the different anesthetic practices for tracheobronchial foreign body extraction.

Methods

A survey was sent via email to the member physicians of the Association des Anesthésistes Réanimateurs Pédiatriques d'Expression Française (ADARPEF). The survey included 28 questions about the organizational and anesthetic management of an evolving clinical case.

Results

A total of 151 physicians responded to the survey. Only 13.2% of the respondents reported that their institution had a management protocol, and 21.7% required a computerized tomography scan before the procedure was performed for children who were asymptomatic or mildly symptomatic during the night. There were 56.3% of the respondents who reported that extraction with a rigid bronchoscope is the only procedure usually performed in their institution. Regarding rigid bronchoscopy, 47.0% used combined intravenous-inhalation anesthesia. The objective was to maintain the child on spontaneous ventilation for 63.6% of the respondents, but anesthesia management differed according to the physician's experience.

Conclusions

Our study confirms the diversity of practices concerning anesthetic for tracheobronchial foreign body extraction and found reveal differences in practice according to physician experience.     

芬太尼与舒芬太尼对气管插管时血浆ET 和TXA2的影响

目的:探讨芬太尼与舒芬太尼在气管插管过程中对血浆内皮素( ET) 、血栓素A2( TXA2 ) 的影响及其
意义。方法:将符合实验条件的60 名择期全麻手术病人随机分为两组: 芬太尼组( F 组) 和舒芬太尼组( S 组) ，
各30 例。全麻诱导: F 组静注咪唑安定0． 05 mg /kg，芬太尼3． 0μg /kg，异丙酚1． 5 mg /kg，阿曲库铵0． 15 mg /kg;
S 组将芬太尼替换为舒芬太尼0． 4μg /kg，其余同F 组。分别记录麻醉诱导前2 min( T1 ) 、气管插管前即刻( T2 ) 、
插管后1 min( T3 ) 、3 min( T4 ) 、6 min( T5 ) 和10 min( T6 ) 病人的收缩压( SBP) 、舒张压( DBP) 和心率( HＲ) ，同时
抽取静脉血，测定血浆ET 和TXA2 含量。结果: F 组气管插管后各时点ET 和TXA2 含量明显高于基础值( P
＜0． 05) ; S 组气管插管后ET 含量与基础值比较无显著变化( P＞0． 05) ，TXA2 含量较基础值升高，但上升幅度明
显小于F 组，两组在气管插管后的四个时点ET、TXA2 含量组间比较具有显著性差异( P＜0． 05) 。结论: 气管插
管可引起机体血浆ET 和TXA2 含量的增加，与芬太尼相比，舒芬太尼能够更加有效地抑制ET、TXA2 的合成与释
放，对手术病人具有更好的保护作用。     

纤维支气管镜微波介入治疗中心气道狭窄17例临床分析

目的探讨纤维支气管镜(纤支镜)微波介入治疗中心气道狭窄的临床应用价值。方法对17例确诊为中心气道狭窄患者,应用纤支镜微波介入治疗,观察治疗前后气道直径和气促的变化情况。结果17例中心气道狭窄患者经纤支镜微波介入治疗后,气道直径、气促均得到明显改善,气道直径由治疗前(2.8±2.1)mm扩大为治疗后(8.4±2.1)mm(P<0.01),气促评分由治疗前(3.4±0.6)级改善为治疗后(1.2±0.8)级(P<0.01)。结论纤支镜微波介入治疗是中心气道狭窄患者的有效治疗手段,其安全可靠,并发症少。