急性缺血性卒中的亚低温治疗研究进展

脑缺血神经细胞损伤的保护措施一直是临床和基础研究的重点。但迄今为止,仍然缺少令人满意的措施。缺血性脑血管病的发病机制复杂,亚低温作为一种脑保护疗法,可干预脑缺血的多个病理生理学环节,对脑缺血及再灌注损伤起到保护作用。目前国际医学界将低温划分为轻度低温(33~35℃)     

膀胱肿瘤开放手术与经尿道电切术治疗比较

我院自2001年2月～2005年4月分别对18例膀胱肿瘤病人行膀胱部分切除术和经尿道等离子电切术，现分析报告如下。     

亚低温治疗颅脑损伤延长翻身间隔时间与压疮关系的研究

[目的]探讨颅脑损伤病人应用亚低温治疗仪时具体间隔多长时间翻身不发生压疮.[方法]随机选择45例颅脑损伤应用亚低温治疗的病人,采取3 h后开始翻身,侧卧位时每次均为1 h,以后平卧位时间每次逐渐递增1/2 h.[结果]在应用亚低温治疗期间除3例病人在不同时段内发生轻微紫色冻伤外,所有病例均未发生压疮,平均翻身间隔时间为11.31 h,应用单样本统计学处理,有统计学意义(t=8.867,P<0.005).[结论]颅脑损伤病人在使用亚低温治疗过程中翻身间隔时间可以延长至8 h不发生压疮.     

新生儿硬肿症30例临床分析

目的探讨新生儿硬肿症发病的高危因素，降低高危新生儿病死率。方法选取本科30例新生儿硬肿症患儿，对其发病原因、治疗方法及预后进行分析。结论新生儿硬肿症与早产、低出生体重、窒息、环境温度低及合并感染关系密切。     

兔肢体爆炸伤合并海水浸泡后在不同复温速率及维持浅低体温下机体炎症反应的特征

Objective To investigate effects of different rewarming rates and maintenance of light hypothermia on inflammatory response in rabbits after limb blast injury, coupled with seawater immersion. Methods First, the model of limb blast injury coupled with seawater immersion was reproduced [the animals were immersed to low body temperature of (31.0±0.5℃)]. Then, 24 adult rabbits were randomly divided into group Ⅰ [the rapid rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (8.94±0.93)℃/h], group Ⅱ [the slow rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (3.88±0.22)℃/h], group Ⅲ [another slow rewarming group, n=6, rewarmed to (38±0.5)℃ at a rate of (2.18±0.12)℃/h], and the H group [the hypothermia group, n =6, rewarmed to (34 - 35)℃ at a rate of (4.49±0.66)℃/h and kept at that temperature till termination of the experiment]. Regulation of ambient temperature and warm transfusion were used to restore body temperature to target levels and maintained there for 6 hours. Blood samples were taken at 5 different times, I.e. Pre-injury time(T0), post-immersion time (T1), the time when rewarming started (T2), 3 h after rewarming (T3), and 6 h after rewarming (T4). Tissue samples from heart, liver, intestinum, lung and kidney were also collected. Levels of TNF-α (tumor necrosis factor-α), IL-1β (interleukin-1β) and IL-6 (interleukin-6) in plasma and MPO (myeloperoxidase) in homogenate were detected. Results Following rewarming, TNF-α, IL-1β, IL-6 concentrations in the plasma of the animals in group Ⅰ and group H were significantly higher when compared with those of the animals in group Ⅱ and group Ⅲ (P<0.05, P<0.01), and MPO activity in homogenate was significantly higher when compared with that of the animals in group Ⅱ and group Ⅲ(P<0.01, P<0.05), and no statistical difference could be seen between group Ⅱ and Ⅲ (P>0.05). Conclusions Rapid rewarming and maintenance of light hypothermia could obviously elevate TNF-α, IL-1β, IL-6 concentrations in plasma and MPO activity in homogenate, following limb blast injury coupled with hypothermia induced by seawater immersion, while slow rewarming (with a rewarming rate of 2-4℃/h) could significantly inhibit TNF-α, IL-1β, IL-6 levels and PMN activity.     

我国低温生物学和低温医学的现状

低温医学和低温生物学是近几十年随着生物学、医学和低温制冷技术的发展而逐渐形成的一门边缘学科,是研究在自然和人工低温条件下生命体、组织、细胞不同层次的活动规律及其应用的学科.具体而言,低温医学是研究低温对人体的影响、冷冻损伤的防治以及利用低温技术实现或达到医疗目的的一门学科[1].为了解我国低温生物学和低温医学的现状和存在的问题,作者查阅和复习了有关文献.现综述如下.     

亚低温治疗患者鼻饲营养并发症的观察及护理

报道48例亚低温治疗患者采用一次性投给、间歇滴注和连续输注营养膳的方式鼻饲营养，其并发症有：腹泻、腹胀、肠蠕动亢进，便秘，食物反流，吸入性肺炎，代谢紊乱，高血糖，水、电解质失衡，鼻胃管堵塞等。护理中体会到亚低温治疗患者鼻饲营养的时机最好在急性期1～2d后，应用鼻饲泵连续输注，适时使用胃肠动力药西沙比利．掌握营养膳的配制和正确的鼻饲方法，严密观察，发现异常及时处理，可大大降低并发症的发生。     

特重型颅脑损伤的亚低温治疗

特重型颅脑损伤（GCS3～5分）是目前颅脑损伤治疗中的重点和难点，病死率极高，尤其是GCS3分的颅脑损伤患者病死率几乎高达100％。为探讨亚低温治疗对特重型颅脑损伤的疗效，我院2001年2月-2006年2月对63例符合入选条件的特重型颅脑损伤患者分为亚低温组和对照组进行对照研究，现报告如下。     

低温操作台在血液制备中的应用

目的探讨低温操作台在确保血液质量方面的作用。方法分别测试在低温操作台（4℃）和室温下（22℃）翻备血液的温度以及两种情况制备的血液在有效储存期的生化指标。结果在低温操作台制备，包装的血液，30min和60min测得的温度均符合血液2～6℃保存要求，而室温下制备．包装的血液在30min和60min测得的温度均超过血液保存要求温度;低温操作台制备，包装的血液K＋的升高速度和Na＋降低速度均此在室温剖备、包装的血液要慢，两者有显著差异。结论医用低温操作台能够使血液制备，包装等环节处于温度要求范围内，使冷链过程得到保障，保证血液质量。     

局部低温对血流动力学影响的研究

有关全身低温对人体循环系统影响的研究报道很多，但关于局部低温对血流动力学影响的报道较少，本文对此进行了研究。