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21.
非体外循环冠状动脉搭桥手术的麻醉方法及血液动力学和氧代谢的变化 总被引:18,自引:0,他引:18
目的 观察非体外循环冠状动脉搭桥手术的麻醉方法、术中病人血液动力学和氧代谢的变化以及术后病人的早期.非体外循环冠状动脉搭桥手术闰人20例,麻醉用咪唑安定0.1-0.2mg/kg、芬太尼15-30μg/kg及0.5%-2%的吸入麻醉药等,在切皮前、开心包后、心脏操作中、操作完成后10min及术毕观察血液动力学指标及脑氧饱和度,同时采集桡动脉和肺动脉血,测定血气及动脉血乳酸(ABL),计算氧供DO2)、氧耗(VO2)和氧摄取率(ERO2)。术后早期观察术后拔除气管插管、ICU停留及术后住院时间、并发症及死亡等情况。结果 心脏操作中MAP、SV、SI下降,HR、CVP升高,MAP下降以搭回旋支时最明显(P<0.01),HR升高以搭右冠时最明显(P<0.01);心脏操作中DO2降低(P<0.05),VO2无变化,ERO2升高(P<0.01);操作后DO2、ERO2恢复至操作前水平;操作后ABL升高(P<0.01)。结论 本组麻醉方法使病人完全度过非体外循环搭桥术,在心脏操作期易出现血压、每搏量、心指数下降,伴心率、静脉压升高,但时间短暂无严重后果,氧代谢紊乱及缺氧程度较轻。 相似文献
22.
G. Kostopanagiotou A. Pandazi I. Andreadou A. Doufas I. Chondroudaki T. Kotsis D. Rizos C. Costopanagiotou V. Smyrniotis 《European journal of vascular and endovascular surgery》2005,30(6):648-653
OBJECTIVE: We investigated the dose-related effect of dopexamine and dopamine on free radical production and lipid peroxidation estimated by MDA measurements in an ischaemia-reperfusion model of supraceliac aortic repair. DESIGN: Prospective, randomized, blinded experimental study. MATERIALS: Twenty-five healthy pigs. METHODS: All experiments were performed under general endotracheal anaesthesia. Supraceliac aortic cross clamping was performed in all pigs. The pigs were randomly assigned into five groups (n=5 in each group) and received a continuous intravenous infusion of normal saline (CTL), dopamine 2 microg kg(-1)min(-1) (dopa 2), dopamine 8 microg kg(-1)min(-1) (dopa 8), dopexamine 2 microg kg(-1)min(-1) (dopex 2), dopexamine 8 microg kg(-1)min(-1) (dopex 8). Cardiac output, mean arterial pressure, arterial blood gas analysis and blood sampling for plasma MDA measurements (to reveal lipid peroxidation) were recorded after induction of anaesthesia (baseline), 60 and 120 min after cross-clamping of aorta (ischaemia phase), and 60 and 120 min after restoration of flow (reperfusion phase). RESULTS: Dopexamine and dopamine at 8 microgkg(-1)min(-1) reduced MDA at 60 and 120 min after reperfusion. CONCLUSION: Dopexamine seems superior to dopamine in reducing oxygen free radicals and subsequent lipid peroxidation during reperfusion after supraceliac aortic cross clamping in pigs. 相似文献
23.
The effect of the novel 1,4-dihydronaphthyridine Ca2+ channel inhibitor Goe 5438 (CI-951) on voluntary ethanol consumption was examined in selectively bred alcohol-preferring (P) rats in a free choice two bottle preference test versus water. Intraperitoneally injected Goe 5438 dose-dependently (5, 10 or 20 µmol/kg, twice daily) inhibited ethanol and increased water intake over the 24 h period (injection day). The drug decreased ethanol preference, originally above 90%, by 6%, 19% and 45% at respective doses, on the injection day. That inhibitory effect of the highest dose of Goe 5438 on ethanol preference remained significant also on days 2 and 3 after injections (–51% and –18%, respectively). Goe 5438, in the highest dose, also tended to decrease granulated chow consumption during the injection day only. To further test whether the inhibition of ethanol preference is secondary to decrease in reinforcing properties of ethanol and not due to interference with satiety mechanisms, we compared the effect of two higher doses (10 and 20 µmol/kg, intraperitoneally, twice daily) of Goe 5438 on spontaneous preference for a non-caloric 0.04% saccharin solution in Sprague-Dawley rats. We observed a dose-dependent suppression of preference (by 44% and 58%, respectively) during the injection day, but not the subsequent 24 h period. However, Goe 5438 also significantly alleviated food pellet intake on the injection day. In conclusion, Goe 5438 produces potent and long-lasting inhibition of voluntary ethanol consumption, which may be secondary to attenuation of reinforcing properties of ethanol. Additionally, this particular Ca2+ channel inhibitor appears to have mild anorectic properties which may be conducive to acute suppression of alcohol intake. 相似文献
24.
目的 探讨持续吸入不同浓度氧气对新生大鼠肺血管内皮生长因子(VEGF)及其受体1(VEGFRl)和受体2(VEGFR2)mRNA表达的影响.方法 新生足月SD大鼠32只,随机分为对照组和实验组.实验组生后12 h开始持续吸入氧气,按不同的吸入氧浓度,将实验组又分为30%O2组、50%O2组和75%O2组.对照组吸入空气.每组8只.于实验开始后21 d处死实验大鼠,取出右肺下叶,RT-PCR技术检测VEGF、VEGFR1和VEGFR2 mRNA表达,根据2-△△CT的计算方法,实验组基因表达差异用实验组相对于对照组基因表达量的倍数表示.结果 与对照组相比,30%O2对新生大鼠肺VEGF及其受体mRNA表达无影响.75%O2组VEGF mRNA表达是对照组的0.48倍;50%O2组、75%O2组VEGFR1 mRNA分别为对照组的0.18倍和0.06倍;VEGFR2 mRNA分别为对照组的0.22倍和0.10倍,差异均有统计学意义(P<0.05).结论 长时间吸入低浓度氧对新生大鼠肺VEGF及其受体mRNA影响不明届,而持续吸入中等浓度及较高浓度氧可降低VEGF及其受体mRNA的表达. 相似文献
25.
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27.
In order to evaluate the pump output control based on the oxygen delivery to peripheral tissues, arterial and mixed venous hemoglobin content ([Hb]) and oxygen saturation (SO2) were continuously monitored in three biventricular bypass animals (3-, 6-, and 40-day experiments) with fibrillating ventricles. The specially developed oxygen sensors were mounted in the outflow ports of the artificial hearts to measure [Hb] and SO2. One animal was exercised on the treadmill at 2.0 mile/h for 15 min with pump flows fixed to deliver oxygen of (a) above 13 cc/min/kg, (b) 10, and (c) 9. In (a), the mixed venous saturation (SvO2) dropped to approximately 25% with no increase in the blood lactate level. In (b) and (c), the SvO2 decreased to approximately 10-15% with increase in blood lactate levels from 4 to 10-30 mg/dl. Also, the recovery of the SvO2 in these groups following the termination of the exercise was slower in comparison to (a). The lower limit of the SvO2 level that would create oxygen debt situation in the peripheral tissues was approximately 25-30% for the exercise of 2.0 mile/h. The SvO2 reflects changes in respiratory status, pump output, hemoglobin level, and metabolism, and is thus a useful indicator to diagnose quickly the circulatory status as well as possibly to control the artificial heart output. 相似文献
28.
煤烟型大气污染对儿童肺功能的影响 总被引:4,自引:1,他引:3
为观察煤烟型大气污染对儿童健康的影响 ,选择了太原市 3个污染程度不同地区的 45 0名儿童进行肺功能测试和问卷调查。研究结果显示 ,儿童呼吸功能表现为重度污染区 <中度污染区 <相对清洁区 ;肺通气功能阻塞性异常率表现为重度污染区 >中度污染区 >相对清洁区 ;Logistic回归分析发现肺通气功能阻塞性异常率与小学生家庭的取暖方式、厨房和卧室是否分开以及污染物的水平有关 ;多元线性回归分析显示重度污染区儿童的FVC、FEF5 0与相对清洁区相比分别减少了 65 80ml、119 2 7ml,中度污染区儿童的FVC、FEF5 0与相对清洁区相比分别减少了 5 7 2 8ml和 114 2 9ml;Ln(SO2 )每升高一个单位 ,FVC和FEF5 0分别减少69 10ml和 119 79ml,Ln(PM1 0 )每升高一个单位 ,FVC、FEF5 0等分别减少了 193 5 0ml和 171 69ml。结果提示 ,太原市煤烟型大气污染对儿童呼吸系统产生了危害。 相似文献
29.
A. Dal Monte F. Sardella B. Alippi M. Faina A. Manetta 《European journal of applied physiology》1994,69(2):159-162
We describe a new respiratory valve system with minimal dead space, which allows measurement of ventilation and oxygen uptake during swimming. The device offers considerable advantages in efficiency and accuracy over current equipment, and can be used in conjunction either with a miniaturized telemetry system for oxygen uptake measurement or with a conventional system. The valve has a low airflow resistance, a small dead space (15 ml), and an electrically operating, closed-circuit pump to remove excess water from the expiratory tube. The external form and the buoyancy of the valve have been hydrostatically and hydrodynamically designed to reduce drag and to ensure a correct mass in the water. To obtain this result a very sophisticated material, carbon fibre, has been utilized. Our studies showed that this respiratory system is ideal for obtaining valid and reliable values of oxygen uptake during swimming, even at high speed and in endurance swimming tests. 相似文献
30.
高渗盐水与甘露醇对颅脑手术患者脑氧代谢的影响 总被引:2,自引:0,他引:2
目的 比较3%高渗盐水(HTS)与20%甘露醇对颅脑手术患者脑氧代谢的影响。方法 择期大脑半球胶质瘤切除术患者40例,ASAⅠ级或Ⅱ级,随机分为2组(n=20):3%HTS组(HTS组)和20%甘露醇组(M组)。采用静吸复合麻醉,呼气末异氟醚浓度为1 MAC、血液动力学稳定15.min后,分别于15 min内静脉输注3%HTS 5.35 ml/kg或20%,甘露醇1 g/kg。L3,4珠网膜下腔置管测脑脊液压力(CSFP),行右颈静脉球穿刺置管、采血,测定颈静脉球氧饱和度。分别于输注前(T0)、输注完即刻(T1)、输注完15min(T2)、30min(T3)、60min(T4)、120min(T5)监测CSFP;于T0、T3-T5时监测平均动脉压,采集颈静脉球部和桡动脉血,进行血气分析,计算动脉-静脉氧含量差(Da-jvO2)、脑氧摄取率(CERO2)。结果 与T0比较,2组CSFP在T2-T5时降低,Da-jvO2和CERO2在T4,5时降低(P〈0.05);与M组比较,HTS组CSFP在T2时降低(P〈0.05)。结论 3%HTS与20%甘露醇均可有效地降低颅内压,改善颅脑手术患者的脑氧代谢。 相似文献