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作者以间置空肠段修复胸腔内食管缺损5例。其中食管缺损达颈部者1例,以游离空肠段移植的方法予以修复;中下段食管缺损达主动脉弓上缘者3例,2例以游离空肠段移植修复,1例以空肠段带蒂上徙获得成功,下段食管缺损1例,以空肠段带蒂上徙修复。本文对胸腔内游离空肠段移植受区血管的选择进行了探讨,并对手术适应症、优越性和术后处理进行了讨论。 相似文献
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目的探讨胰岛素强化治疗对糖尿病微血管病变患者血小板参数的影响。方法采用自身前后对照,对42例糖尿病微血管病变患者进行2周胰岛素强化治疗,分析比较治疗前后空腹血糖(FPG)及血小板平均体积(MPV)的变化。结果胰岛素强化治疗2周后,FPG、MPV均较治疗前明显下降(P〈0.01),MPV与血糖呈正相关(r=0.78)。2个月后患者的MPV水平稳定在较低水平。结论胰岛素强化治疗能有效降低糖尿病微血管病变患者MPV水平。对于高MPV的糖尿病患者早期进行胰岛素强化治疗对预防糖尿病微血管并发症的发生有临床价值。 相似文献
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目的 观察两种不同的麻醉方法用于乳腺癌根治术对呼吸循环功能的影响以及并发症的发生率.方法 选择诊断明确的乳腺癌患者120例,ASAⅠ~Ⅱ级,随机分为两组.A组66例采用气管插管静脉复合麻醉,B组54例采用高位硬膜外麻醉联合臂丛神经阻滞.结果 A组患者麻醉后平均动脉压(MAP)、心率(HR)相对平稳;B组患者麻醉后MAP下降,HR减慢,与A组比较差异有统计学意义(P<0.05).B组患者麻醉后呼吸抑制发生率较高,脉搏氧饱和度(SpO2)在麻醉后、切皮时及切皮后10 min均低于基础值,A组麻醉后无呼吸抑制,特别在切除腋窝淋巴结时由于静脉注射氯胺酮而引起一过性SpO2下降.B组患者的术中知晓率及麻黄素和阿托品的应用率均高于A组(P均<0.05).结论 气管插管静脉复合麻醉用于乳腺癌根治术具有安全、麻醉效果确切、术中血流动力学平稳等优点,避免了由高位硬膜外麻醉引起的呼吸抑制、硬膜外血肿等一系列并发症.
Abstract:
Objective To observe the effect of breath and circulation and the incidence rate of complication during the breast cancer radical correction with this two methods of anaesthesia. Methods To select 120 patients,all definite diagnosed breast cancer,ASAⅠ-Ⅱdegree,and divided into two groups(group A and group B)at random. Group A received tracheal intubation balanced anesthesia;Group B received high epidural anesthesia with plexus brachialis nerves block. Results The patients of group A with a correspondence MAP and HR after anaesthesia;while MAP decrease(P<0.05) and HR step down (P<0.05) on the patients in group B,compare with group A has obvious statistical significance.The incidence rate of respiratory depression in group B was high, all the SpO2 after anaesthesia, the time of cutting skin and after cut skin 10 min under the base value. None respiratory depression in group A, especially SpO2 temporal descend because of intravenous injection the ketamine when ablate axillary nodes. The rate of awareness in group B, admove ephedrine and atropinic are all higher than that in group A(P<0.05).Conclusions Received tracheal intubation balanced anesthesia in the breast cancer radical correction has several good quality,such as safety, the effect of anesthesia is precisely,an equability haemodynamics;hemodynamics during the operation, to avoid respiratory depression and epidural hematoma;extradural hematoma and other complication originated by the epidural anesthesia. 相似文献
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目的 观察两种不同的麻醉方法用于甲状腺次全切除术中,对呼吸循环功能的影响以及并发症的发生率.方法 选择甲状腺次全切除患者120例,ASAⅠ~Ⅱ级,随机分为两组.A组采用气管插管静脉复合麻醉;B组采用颈丛神经阻滞麻醉.术中连续监测平均动脉血压(MAP)、心率(HR)和脉搏氧饱和度(SpO2),分别于麻醉前,游离甲状腺时及术终测血糖浓度,并评价麻醉效果. 结果 B组在游离甲状腺时,MAP、HR均明显升高,A组患者麻醉后MAP、HR相对平稳,两组比较差异有统计学意义.两组患者术中血糖水平与术前相比均增高(P<0.05),但A组升高幅度低于B组(P<0.05),A、B两组间比较差异无统计学意义(P>0.05),A组麻醉效果(优良率100%)好于B组(优良率75%).结论 气管插管静脉复合麻醉用于甲状腺次全切除术具有安全、麻醉效果确切、术中血流动力学平稳等优点.
Abstract:
Objective To observe the effects of two different methods of anesthesia used in the subtotal thyroidectomy on the respiratory and circulatory function, as well as the incidence of complications. Methods Subtotal thyroidectomy patients 120 cases, ASA Ⅰ-Ⅱ, were randomly divided into two groups. Group A of tracheal intubation using intravenous anesthesia; B group use cervical plexus block anesthesia. Intraoperative continuous monitoring of MAP, HR, and SpO2 respectively, before anesthesia, free thyroid surgery during and final test blood glucose levels and to evaluate the anesthetic effect. Results Group B when the free thyroid, MAP, HR was significantly higher, group A of patients after anesthesia MAP, HR is relatively stable, the difference was statistically significant. In group B patients compared with the preoperative blood glucose levels were significantly higher (P<0.05), but the increasing range of group A were lower than group B (P<0.05), the difference between the two groups was not statistically significant (P>0.05), narcotic effect of group A(excellent and good rate of 100%) was better than that in group B (excellent and good rate of 75%). Conclusions Tracheal intubation intravenous anesthesia for thyroid subtotal resection is safe, the effect of anesthesia is effective, intraoperative hemodynamic is stable, etc. 相似文献
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①目的 探讨现代玻璃体手术对开放性眼外伤玻璃体积血的治疗效果。②方法 对108例开放性眼外伤玻璃体积血的病人,于伤后2~4周施行玻璃体切割置换术(单纯玻璃体切割术24例,联合晶体切割84例,联合视网膜手术76例)。③结果 术后经随访2周~18个月,48例达功能治愈,36例达解剖治愈,总治愈率达77.7%。24例继发青光眼者眼压控制在1.37~2.24kPa。④结论 适时地施行玻璃体切割置换术,可很大程度地改善开放性眼外伤玻璃体积血病人的预后,对有效防治外伤性玻璃体视网膜病变以及牵引性视网膜脱离等具有重要作用。 相似文献
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刘兆荣 《菏泽医学专科学校学报》1998,10(1):40-40
急性脑溢血是内科常见的急重症,此类患者病情危重、变化快、死亡率高,适时合理的护理,是减少死亡的重要环节。1密切观察病情变化11意识的改变脑溢血病人由于脑实质内的血管破裂出血,使脑功能发生障碍,在临床上表现为不同程度的意识障碍,通过简单的问话、试角膜反射、针刺皮肤压眶反射等来判断有无意识障碍。如:清醒、嗜睡、诱妄、浅昏迷及深昏迷等。意识状态是估计出血量的多少,病变部位及预防后的重要指标;敢动态观察甚为重要,如患者意识逐渐转清,提示病情好转,加突然转向昏迷,提示病情加重,有再度出血或发生脑疲的可能,若… 相似文献
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目的 观察星状神经节阻滞(SGB)治疗急性面神经麻痹的临床治疗效果.方法 128例急性面神经麻痹患者随机分为两组,对照组给予常规治疗,治疗组给予常规治疗加星状神经节阻滞疗法.以面瘫综合评分法评价两组的疗效,比较两组治疗后面神经麻痹恢复的有效率、治愈率及疗程的长短.结果 治疗组治愈率为65%、有效率为98%,对照组治愈率为35%、有效率为82%,两组治愈率及有效率差异有统计学意义(P<0.05).治疗组平均显效时间和治愈时间明显短于对照组(P<0.05).结论 星状神经节阻滞合并常规治疗能明显提高急性面神经麻痹的有效率和治愈率,并显著缩短疗程. 相似文献
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2008年山东省滨州市麻疹流行病学特征分析与对策探讨 总被引:3,自引:0,他引:3
目的分析山东省滨州市2008年麻疹流行病学特征。 方法采用描述流行病学方法,分析2008年滨州市麻疹疫情特点,采用酶联免疫吸附试验检测麻疹IgM抗体。结果2008年该市共报告麻疹确诊病例811例,实验室确诊病例464例,占总病例的57.21%;临床/流行病学确诊病例347例,占总病例的42.79%,年发病率为21.73/10万,发病模式呈散发与暴发并存;病例分布广泛,并有明显的季节性。1-5月发病例数占总病例数的96.05%,1-4月为发病高峰;病例分布有明显的地域差异,发病相对集中地区的病例占总病例数的66.34%;15岁儿童发病占总病例数的56.10%,其中学龄前儿童病例占总病例数的38.22%,小学生病例占总病例数的17.39%;病例中无免疫史和免疫史不详占87.92%。结论山东省滨州市2008年麻疹发病水平骤升,发病时间有明显季节性,1-4月为发病高峰。 相似文献