电针对脑梗塞大鼠缺血半影区星形胶质细胞形态的影响

目的： 观察电针对脑梗塞大鼠缺血半影区星形胶质细胞形态学的影响，为探讨针刺治病疗效和机制提供实验依据。方法： 线栓法建立大鼠脑梗塞动物模型，用免疫组织化学方法显示胶质纤维酸性蛋白（GFAP）免疫阳性细胞，对比观察电针对模型大鼠脑皮质缺血半影区星形胶质细胞的形态影响。结果： 免疫组织化学方法显示电针对脑梗塞缺血半影区星形胶质细胞的数量、细胞面积比与对照组相比差异无显著意义。结论： 频率5-10 Hz和强度2 mA的电针穴位刺激没有影响缺血半影区内星形胶质细胞的形态,但是对GFAP的表达有上调的影响。     

Spread of epidural analgesia following a constant pressure injection

(1) The spread of epidural analgesia following injection of 15ml of 2% mepivacaine was 17.3 ± 0.6, 14.3 ± 0.4, and 13.3 ± 0.7 spinal segments in cervical, thoracic, and lumbar epidural analgesia, respectively. The patients age showed significant correlation with the spread of epidural analgesia in cervical (r = 0.5776, p < 0.001), thoracic (r = 0.3758, p < 0.01), and lumbar area (r = 0.8195, p < 0.001). The spread of cervical epidural analgesia was more caudad than cephalad (p < 0.05), but in lumbar epidural analgesia it was more cephalad than caudad (p < 0.05). There was no difference between the cephalad and caudad spread in thoracic epidural analgesia.(2) The epidural pressure immediately after injection of 15ml of 2% mepivacaine into the lumbar epidural space at a constant pressure (80mmHg) correlated to the patients age (r = –0.5714, p < 0.001) and the spread of analgesia (r = –0.3904, p < 0.05). The lower epidural pressure associated with higher age, the wider spread of analgesia. There was no significant correlation between the residual pressure at 60 seconds and the age or the spread of analgesia.(Hirabayashi Y et al.: Spread of epidural analgesia following a constant pressure injection: an investigation of relationships between locus of injection, epidural pressure and spread of analgesia. J Anesth 1: 44–50, 1987)     

Epidural pressure and its relation to spread of epidural analgesia

The relationships between the epidural pressures following the injection of local anesthetic solution and the spread of epidural analgesia were investigated. In 46 patients, 15ml of 2% mepivacaine was injected into the lumbar epidural space at a constant rate (1ml/sec) using an electropowered syringe pump. Injection pressures and residual pressures were recorded and the spread of analgesia to pinprick was assessed. The changes of the epidural pressures during and following the injection of a volume of local anesthetic solution in old subjects were significantly smaller than those in young subjects (P < 0.05). The spread of analgesia closely correlated with the epidural pressures during and following the injection of local anesthetic solution. The most close correlation was found between the epidural pressure immediately after the completion of injection and the spread of analgesia (r = –0.5659, P < 0.001). In conclusion, the lower the terminal injection pressure and the residual pressures associated with higher age, the wider the spread of epidural analgesia.(Hirabayashi Y, Matsuda I, Inoue S et al.: Epidural pressure and its relation to spread of epidural analgesia. J Anesth 1: 168–172, 1987)     

电针加强海马微量注射蝇蕈碱与氯苯氨丁酸的镇痛作用

目的观察电针对大鼠海马微量注射GABA受体激动剂蝇蕈碱（Mus）和氯苯氨丁酸(Bac)镇痛作用的影响。方法实验分生理盐水对照组、药物组和电针+药物组,在2分钟内将1μlMus或Bac（1×10-3mol.L-1）注射入海马,取双侧足三里进行电针,用甩尾法测定大鼠的痛阈。结果从给药后5min至60min,Mus或Bac均能明显提高大鼠的痛阈（P＜0.01）,20min时作用最显著,痛阈分别提高0.386±0.062mA和0.549±0.116mA。电针能加强Mus和Bac的镇痛作用（P＜0.05或P＜0.01）,痛阈最大提高值分别为0.603±0.117mA和0.704±0.099mA。结论海马微量注射Mus或Bac能产生镇痛作用,并且电针能加强其镇痛作用。     

异氟醚吸入分娩镇痛对新生儿神经行为的影响(英文)

目的 :探讨异氟醚用于阴道分娩镇痛对新生儿神经行为的影响。方法 :75例产妇随机分为异氟醚组、笑气组和对照组 ,采用新生儿神经适应能力评分 (NACS)对新生儿出生后 15min ,2h及 2 4h进行监测。结果 :3组新生儿的神经行为状态差异无显著性 (P >0 0 5 )。 15min ,2h及 2 4h的评分相比 ,3组新生儿均为 2h的评分最低。 2 4h评分时 ,3组分别有 92 %、89%和 90 %的新生儿评为高分。结论 :吸入异氟醚分娩镇痛对新生儿 15min、2h及 2 4h的神经行为状态无不良影响。     

耳针分娩镇痛效果及对母儿的影响

目的 :探讨耳针镇痛的临床效果。方法 :对 6 8例正常足月初产妇临产后取耳穴、子宫穴、神门穴、交感穴、内分泌穴针刺镇痛 ,同时以 6 0例足月妊娠的正常产妇为对照组 ,不采取任何方法进行镇痛。记录 2组镇痛效果及产程、分娩方式、产后出血及新生儿评分的数值。结果 :耳针能协调子宫收缩、减轻疼痛、缩短产程 ,对分娩方式、产后出血量及新生儿阿氏评分均无影响。结论 :耳针用于分娩镇痛安全、简便、有效、便于推广     

硬膜外注射曲马多和咪唑安定用于术后镇痛效果观察

目的 :观察硬膜外注射曲马多和咪唑安定用于腹部手术术后镇痛效果、不良反应和对血流动力学及呼吸的影响。方法 :随机选择 40例连续硬膜外麻醉下行中、下腹部手术患者 ,ASAⅠ～Ⅱ级。分为 2组 ,Ⅰ组 (曲马多和咪唑安定组 ) 2 0例 ;Ⅱ组 (曲马多组 ) 2 0例。于关腹时 ,Ⅰ组将曲马多 10 0ml和咪唑安定 2 .5mg ,用生理盐水稀释至 10ml;Ⅱ组将曲马多 10 0mg用生理盐水稀释至 10ml,均一次缓慢注入硬膜外腔。监测注药后 10min ,2 0min和30min的平均动脉压 (pMA)、心率 (fH)、血氧饱和度 (xO2 )、呼吸频率 (fR)和心电图 (ECG)变化。PrinceHennry疼痛评分标准评价镇痛效果 ,同时记录镇痛时间及不良反应。结果 :Ⅰ组镇痛评分为 (1.2 5± 1.10 ) ,疼痛完全缓解率为85 % ,Ⅱ组评分为 (1.75± 1.12 ) ,疼痛完全缓解率为 75 %。镇痛完全时间Ⅰ组为 (15 .4± 4.4)h ,Ⅱ组为 (10 .9± 0 .9)h ,Ⅰ组明显长于Ⅱ组 (P <0 .0 1)。监测各项指标与注药前比较差异无显著性 (P >0 .0 5 )。 2组患者均未发现肺部并发症及心律失常。结论 :术后硬膜外注入曲马多和咪唑安定可提供确切的镇痛效果 ,且患者呼吸及循环功能稳定 ,是一种安全可靠的术后镇痛方法