腹横肌神经阻滞联合喉罩全麻在老年腹股沟无张力疝修补术中的应用

目的 观察腹横肌神经阻滞联合喉罩全麻在老年腹股沟无张力疝修补术中的应用效果.方法 选择2018年1月至2018年12月本院收治的200例老年腹股沟疝行无张力疝修补术患者,按照随机数字表法分为研究组和对照组各100例,研究组采取腹横肌神经阻滞联合喉罩全麻,对照组仅进行喉罩全麻,比较两组围术期不同时间点[麻醉诱导前(T0)...     

Measurement of laryngeal elevation by automated segmentation using Mask R-CNN

The methods of measuring laryngeal elevation during swallowing are time-consuming. We aimed to propose a quick-to-use neural network (NN) model for measuring laryngeal elevation quantitatively using anatomical structures auto-segmented by Mask region-based convolutional NN (R-CNN) in videofluoroscopic swallowing study. Twelve videofluoroscopic swallowing study video clips were collected. One researcher drew the anatomical structure, including the thyroid cartilage and vocal fold complex (TVC) on respective video frames. The dataset was split into 11 videos (4686 frames) for model development and one video (532 frames) for derived model testing. The validity of the trained model was evaluated using the intersection over the union. The mean intersections over union of the C1 spinous process and TVC were 0.73 ± 0.07 [0–0.88] and 0.43 ± 0.19 [0–0.79], respectively. The recall rates for the auto-segmentation of the TVC and C1 spinous process by the Mask R-CNN were 86.8% and 99.8%, respectively. Actual displacement of the larynx was calculated using the midpoint of the auto-segmented TVC and C1 spinous process and diagonal lengths of the C3 and C4 vertebral bodies on magnetic resonance imaging, which measured 35.1 mm. Mask R-CNN segmented the TVC with high accuracy. The proposed method measures laryngeal elevation using the midpoint of the TVC and C1 spinous process, auto-segmented by Mask R-CNN. Mask R-CNN auto-segmented the TVC with considerably high accuracy. Therefore, we can expect that the proposed method will quantitatively and quickly determine laryngeal elevation in clinical settings.     

早期检出适合于面罩无创正压通气治疗慢性阻塞性肺病急性发作患者的临床研究

目的 寻找早期预测面罩无创正压通气治疗慢性阻塞性肺病急性发作期患者有效的指标。方法 动态观察面罩无创正压通气（ＮＩＰＰＶ）治疗前后的血气指标变化,分析有效组与无效组患者临床特征及辅助检查结果异同,寻找早期判断ＮＩＰＰＶ治疗慢性阻塞性肺病（ＣＯＰＤ）急性发作斯患者是否成功的指标。结果 ５８名ＣＯＰＤ急性发作患者进入该研究。ＮＩＰＰＶ最终治疗成功率达４１．４％,综合患者血浆白蛋白浓度、ＳＡＰＳⅡ积分、     

慢性阻塞性肺病病人使用面罩通气效果观察

目的 :了解采用改进后的双流向面罩行机械通气时二氧化碳的排出情况。方法 :选取符合条件的慢性阻塞性肺病 (COPD)并Ⅱ型呼吸衰竭病人 3 0例 ,随机分为试验组和对照组 ,试验组采用改进后的双流向面罩通气 ,对照组采用传统面罩通气 ,观察两组血气分析情况。结果 :试验组PaCO2 明显降低 (P <0 .0 1) ,两组使用前后PaCO2 经差值的t检验 ,有统计学意义 (P <0 .0 1)。结论 :使用双流向面罩通气 ,能明显降低COPD并Ⅱ型呼吸衰竭病人二氧化碳潴留。     

普通喉罩在俯卧位脂肪抽吸手术中的应用

目的 探讨普通喉罩在俯卧位脂肪抽吸术中应用的可行性与安全性.方法 选择ASAI～Ⅱ级腰背部脂肪抽吸手术女性住院患者30例,入室后患者俯卧,头偏向左侧,静脉注射芬太尼0.2 μg/kg、丙泊酚2.0 ～2.5 mg/kg诱导,插入喉罩,行IPPV模式控制呼吸,维持气道压20 kPa以内,术中以微量泵持续泵入丙泊酚、瑞芬太尼维持麻醉,手术结束前10 min停药,待患者醒后拔出喉罩;消毒铺巾后利用肿胀术行腰背部肿胀麻醉,之后开始手术直至结束.结果 全部患者俯卧位下喉罩置入顺利,麻醉效果满意,血流动力学平稳,术后10 ～ 25 min清醒,感觉舒适,安全返回病房,无明显不良反应.结论 普通喉罩在俯卧位脂肪抽吸手术中应用简单、安全、易行.     

中药面膜综合疗法治疗113例寻常痤疮疗效观察

目的评价中药面膜综合疗法治疗寻常痤疮的疗效。方法将入选的233例痤疮患者随机分为2组,分别予中药面膜综合疗法治疗(2次/周)和5%过氧化苯甲酰凝胶(每晚1次)治疗,两组疗程均为4周,疗程结束后按照不同标准分别判定疗效。结果治疗4周后,治疗组按皮损类型、数量、颜色、肿胀程度分类评价的治疗有效率分别是61.06%、61.06%、73.45%和74.77%,对照组是46.67%、46.67%、58.33%、59.13%,两组间不同程度皮损疗效相比差异有统计学意义(P<0.05);中药面膜综合疗法能降低各项皮损严重程度分级。结论中药面膜综合疗法治疗Ⅰ～Ⅲ度寻常痤疮疗效明显。     

Mask Acne in Skin of Color: A Significant Dermatological Condition Amidst the COVID-19 Pandemic

The COVID-19 pandemic has given rise to the need to use personal protective equipment such as masks, among healthcare professionals and the general public. Numerous facial dermatoses linked to the use of masks have been described, from which the term maskne or mask acne has emerged. Although prolonged mask usage has been necessary, and a vast majority of people develop various skin conditions, there is a lack of research on the effects of masks on skin. In this article, we review alterations in biochemical properties of skin associated with mask use in individuals with skin of color and the factors predisposing them to developing acne. Because masks are crucial in preventing the spread of COVID-19, we also elucidate some fundamental strategies such as gentle skin care measures, decreasing the duration of mask wear, and following appropriate protocols for mask re-use, which may prevent mask acne and its long-term effects.     

喉罩通气麻醉在乳腺癌根治手术中对血流动力学和通气的影响

目的观察乳腺癌根治手术中运用喉罩通气对血流动力学和通气功能的影响。方法择期行乳腺癌根治术患者50例,年龄25～65岁,ASAⅠ-Ⅱ级,随机分为气管导管组（T组）和喉罩组（L组）,每组25例。记录患者人室安静5min时（TO）,插管前即刻（T1）、插管后即刻（T2）、插管后3min（T3）、拔管时（T4）和拔管后3min（T5）的平均动脉压（MAP）和心率（HR）;记录间歇通气10min时（T6）、30min时（T7）和60min时（T8）的气道峰压（Ppeak）、分钟通气量（MV）、潮气量（VT）、呼气末二氧化碳分压（PETCO2）和脉搏血氧饱和度（SPO2）。结果阿组插管时、间歇通气10min、30min时MV、VT、SPO2的差异无统计学意义（P〉0.05）,L组间歇通气60min时的Ppeak和PETCO2高于T组（P〈0.05）,L组插管后即刻、插管后3min、拔管时和拔管后3min的MAP和HR较T组降低（P〈0.05）。结论喉罩通气麻醉操作简便,对心血管系统刺激性小,通气可靠。