腹腔镜手术患儿压力控制通气和容量控制通气效果的比较

Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in children undergoing laparoscopic surgery. Methods Thirty ASA Ⅰ or Ⅱ children of both sexes,aged 12-36 months, weighing 9-15 kg, scheduled for laparoscopic surgery, were randomly divided into 2 groups (n = 15 each): pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group V) . Anesthesia was induced with propofol 2-4 mg/kg, vecuronium 0.1 mg/kg and fentanyl 2 μg/kg. The children were tracheal intubated and mechanically ventilated. The maximum inspiratory pressure was adjusted to make the tidal volume (VT ) achieve 12 ml/kg in group P and the VT was set at 12 ml/kg in group V. PETCO2 was maintained at 35-45 mm Hg. MAP, HR, PETCO2 , minute ventilation and peak airway pressure were recorded immediately after intubation (T0 ) , immediately before skin incision (T1 ) , 30 min of pneumoperitoneum (T2 ) and 15 min after the end of pneumoperitoneum (T3 ) . Arterial blood samples were taken at the same time points mentioned above for blood gas analysis. Dynamic lung compliance and physiological dead space to tidal volume ratio were calculated.Results Compared with group V, PaCO2 and PETCO2 were significantly decreased and dynamic lung compliance was significantly increased at T1,2 , and minute ventilation and peak airway pressure were significantly decreased at T0-3 in group P ( P < 0.01) . There was no significant difference in MAP, HR and physiological dead space to tidal volume ratio between the two groups ( P > 0.05) . Conclusion Compared with volume-controlled ventilation, pressure-controlled ventilation can better improve the ventilatory efficacy, is more beneficial to gas exchange and reduces the influence of pneumoperitoneum on respiratory function in children undergoing laparoscopic surgery.     

几种虫草发酵菌丝酯酶同功酶及游离全蛋白的比较

几种虫草发酵菌丝酯酶同功酶及游离全蛋白的比较陈敏,戴如琴,邵爱娟,兰江丽,林淑芳,吴志刚(中国中医研究院中药研究所北京100700)许多学者通过对一些菌的酶系统进行电泳分析证实,每1个菌的种、变种都有其特定的酶谱系,并且酶带稳定、重复性强、差异显著、易于区别,可用来澄清分类上的某些问题,因此认为应用酶谱分析技术研究酶的酶谱是一项有用的分类依据。在进行菌种鉴定工作中,可以在应用此法的同时,结合其生理、生化特性及形?...     

冬虫夏草菌丝体中腺苷的提取

<正> 天然虫草和人工培养菌丝在化学成分上基本一致,除含有甾醇类、糖醇类、有机酸及氨基酸化合物以外,还含有丰富的核苷类化合物。Cunningham等早期用Dowex-1-Cl树脂从蛹虫草[Cordyceps militaris (L.) Link.]中提得虫草素。我们采用虫草菌蝙蝠     

蝙蝠蛾拟青霉模式菌相关问题的探讨

蝙蝠蛾拟青霉Paecilomyces hepiali是中国中医科学院中药研究所于1982年从云南省迪庆州白马雪山采集的冬虫夏草上分离得到一种真菌新种,2008年进行名称合格化发表,明确指定该种原描述使用的82-2菌株的干培养物作为模式标本,并指明保存在中国中医科学院植物标本馆(CHICMM)即(CMMI),至今还保存在该馆内。2015年2月姚一建等在《Taxon》杂志上发表"Neotypification of Paecilomyces hepiali(Hypocreales)"一文要求另立蝙蝠蛾拟青霉新模式菌,该文提出另立蝙蝠蛾拟青霉新模式菌不能成立。     

冬虫夏草菌丝的分离培养及发酵工艺的研究(简报)

<正> 冬虫夏草Cordyceps sinensis(Berk.)Sacc.为名贵中药材。为解决药源问题,进行了冬虫夏草的菌丝分离培养及发酵工艺的研究,初步摸索出一套发酵工艺,发酵所得的菌丝经化学室进行菌丝与生药冬虫夏草化学成分对比结果,二者有相同性(待发表),药理实验证明,在一定条件下,菌丝与生药     

腹腔镜手术患儿压力控制通气和容量控制通气效果的比较

Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in children undergoing laparoscopic surgery. Methods Thirty ASA Ⅰ or Ⅱ children of both sexes,aged 12-36 months, weighing 9-15 kg, scheduled for laparoscopic surgery, were randomly divided into 2 groups (n = 15 each): pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group V) . Anesthesia was induced with propofol 2-4 mg/kg, vecuronium 0.1 mg/kg and fentanyl 2 μg/kg. The children were tracheal intubated and mechanically ventilated. The maximum inspiratory pressure was adjusted to make the tidal volume (VT ) achieve 12 ml/kg in group P and the VT was set at 12 ml/kg in group V. PETCO2 was maintained at 35-45 mm Hg. MAP, HR, PETCO2 , minute ventilation and peak airway pressure were recorded immediately after intubation (T0 ) , immediately before skin incision (T1 ) , 30 min of pneumoperitoneum (T2 ) and 15 min after the end of pneumoperitoneum (T3 ) . Arterial blood samples were taken at the same time points mentioned above for blood gas analysis. Dynamic lung compliance and physiological dead space to tidal volume ratio were calculated.Results Compared with group V, PaCO2 and PETCO2 were significantly decreased and dynamic lung compliance was significantly increased at T1,2 , and minute ventilation and peak airway pressure were significantly decreased at T0-3 in group P ( P < 0.01) . There was no significant difference in MAP, HR and physiological dead space to tidal volume ratio between the two groups ( P > 0.05) . Conclusion Compared with volume-controlled ventilation, pressure-controlled ventilation can better improve the ventilatory efficacy, is more beneficial to gas exchange and reduces the influence of pneumoperitoneum on respiratory function in children undergoing laparoscopic surgery.     

腹腔镜手术患儿压力控制通气和容量控制通气效果的比较

目的 比较腹腔镜手术患儿压力控制通气和容量控制通气的效果.方法 择期行腹腔镜手术患儿30例,性别不限,年龄12～36月,ASA分级Ⅰ或Ⅱ级,体重9～15 kg,采用随机数字表法,将其随机分为2组(n=15):压力控制通气组(P组)和容量控制通气组(V组).麻醉诱导后气管插管行机械通气,P组调节麻醉机最大吸气压力使潮气量达到12 ml/kg,V组设置潮气量12 ml/kg,维持PETCO235～45mmHg.于气管插管后即刻(T0)、切皮前即刻(T1)、气腹30 min(T2)和气腹结束后15 min (T3)时,记录MAP、HR、PETCO2、分钟通气量和气道峰压,并采集动脉血样,进行血气分析,计算肺动态顺应性和生理死腔量/潮气量.结果 与V组比较,P组T1,2时PaCO2和PETCO2降低,肺动态顺应性升高,T0～3时分钟通气量和气道峰压降低(P<0.01),MAP、HR和生理死腔量/潮气量差异无统计学意义(P>0.05).结论 与容量控制通气相比,压力控制通气可更好地改善腹腔镜手术患儿肺通气效果,有利于气体交换,减少气腹对呼吸功能的影响.

Abstract：

Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in children undergoing laparoscopic surgery. Methods Thirty ASA Ⅰ or Ⅱ children of both sexes,aged 12-36 months, weighing 9-15 kg, scheduled for laparoscopic surgery, were randomly divided into 2 groups (n = 15 each): pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group V) . Anesthesia was induced with propofol 2-4 mg/kg, vecuronium 0.1 mg/kg and fentanyl 2 μg/kg. The children were tracheal intubated and mechanically ventilated. The maximum inspiratory pressure was adjusted to make the tidal volume (VT ) achieve 12 ml/kg in group P and the VT was set at 12 ml/kg in group V. PETCO2 was maintained at 35-45 mm Hg. MAP, HR, PETCO2 , minute ventilation and peak airway pressure were recorded immediately after intubation (T0 ) , immediately before skin incision (T1 ) , 30 min of pneumoperitoneum (T2 ) and 15 min after the end of pneumoperitoneum (T3 ) . Arterial blood samples were taken at the same time points mentioned above for blood gas analysis. Dynamic lung compliance and physiological dead space to tidal volume ratio were calculated.Results Compared with group V, PaCO2 and PETCO2 were significantly decreased and dynamic lung compliance was significantly increased at T1,2 , and minute ventilation and peak airway pressure were significantly decreased at T0-3 in group P ( P < 0.01) . There was no significant difference in MAP, HR and physiological dead space to tidal volume ratio between the two groups ( P > 0.05) . Conclusion Compared with volume-controlled ventilation, pressure-controlled ventilation can better improve the ventilatory efficacy, is more beneficial to gas exchange and reduces the influence of pneumoperitoneum on respiratory function in children undergoing laparoscopic surgery.     

右美托咪定在小儿体外循环手术中的应用和脑保护作用研究进展

右美托咪定(DEX)是一种高选择性、短效α2-肾上腺素受体激动剂.DEX在小儿体外循环下心脏直视手术中的应用越来越广泛,表现出许多有益的治疗效果,同时DEX具有的潜在器官保护作用为当下研究的热点.本文就DEX在小儿体外循环下心脏直视手术中的应用及其脑保护作用的相关研究进展进行综述.