不同液体术前急性高容量血液稀释对深静脉血栓病人血液流变学的影响

Objective To investigate the effects of acute hypervolemic hemodilution (AHH) with different fluids on blood rheology in patients with deep vein (femoral and iliac) thrombosis. Methods Thirty ASA I or II patients aged 40-64 yr who had developed deep vein thrombosis in 48 h and were scheduled for embolectomy were randomly divided into 3 groups ( n = 10 each) ; group I normal saline (NS) ; group II 6 % HES 200/0.5 ( HES) ; group IE gelofusine (GEL). AHH was performed with normal saline, 6% HES or gelofusine infusion at 20 ml·kg-1 ·h-1 for 40 min. MAP, HR and SpO2 were monitored. Blood loss, volume of blood transfusion and fluid infused and urine output during operation were recorded. Anesthesia was induced with fentanyl 3-5 fig/kg, etomidate 0.15-0.30 mg/kg, propofol 1-2 mg/kg and succinylcholine 1-2 mg/kg and maintained with 2% isoflurane and propofol infusion at 5-8 mg·kg-1·h-1 and intermittent iv boluses of vecuronium. The patients were mechanically ventilated (VT 8 ml/kg, RR 12 bpm). PaO2 and PaCO2 were maintained within normal range. Venous blood samples were obtained before and after AHH for measurement of hematocrit (Hct), whole blood viscocity (WBV) at low or high shear rates, plasma viscosity, RBC aggregation and RBC deformation. RBC aggregation index and RBC deformation index were calculated. Results MAP and HR were stable in all patients. The amount of blood transfusion and fluid infused was significantly less in group HES and GEL than in group NS. The WBV at low or high shear rates in group HES and GEL, Hct in all 3 groups and RBC aggregation index in group HES were significantly decreased after AHH, but the RBC deformation index was significantly increased in group HES. Conclusion Colloid is better than crystalloid and HES is better than gelofusine in improving intraoperative hypercoagulability and sluggish blood flow.     

急性胰腺炎的诊治进展

急性胰腺炎（acute pancreatifis，AP）是指多种病因引起的胰酶激活，继以胰腺局部炎症反应为主要特征，伴或不伴有其他器官功能改变的疾病。临床上，大多数患者的病程呈自限性；20％～30％患者临床经过凶险。总体死亡率为5％～10％。AP临床上表现为急性、持续性腹痛（偶无腹痛），血清淀粉酶活性增高大于或等于正常值上限3倍，影像学提示胰腺有（无）形态改变，排除其他疾病者。可有（无）其他器官功能障碍。少数病例血清淀粉酶活性正常或轻度增高。     

口服吸附剂治疗慢性肾功能衰竭研究进展

口服吸附剂是治疗慢性肾功能衰竭的有效手段之一，对于延迟肾衰发展进程，减少尿毒症的发生和血液透析的次数，尤其对于慢性肾功能衰竭早期预防和治疗是非常重要的。口服吸附剂疗法由于安全有效，价格低廉，便于服用，近年来备受关注，已逐渐成为治疗慢性肾衰竭的重要手段。目前，“吸附疗法”己被列为尿毒症的现代治疗方法之一。     

羟乙基淀粉容量治疗对高龄病人手术的血流动力学影响

目的观察羟乙基淀粉130/0.4氯化纳注射液(6%HES,万汶),应用于老年患者容量治疗时对血流动力学的影响。方法选择30例ASAⅠ～Ⅱ级择期手术的老年患者,给予万汶进行容量治疗,观察术中血流动力学变化。结果所有患者术中血流动力学保持稳定。结论万汶应用于老年患者进行容量治疗时血流动力学保持稳定。     

谷朊粉废水提取物在肉制品中的应用

介绍了一种从谷朊粉废水中提取戊聚糖的工艺,由此工艺得到的产品(戊聚糖质量分数约70%,蛋白质质量分数约20%)能较好地保持戊聚糖的特性.研究了其它添加剂(卡拉胶)对戊聚糖的乳化性,戊聚糖对肉制品持油、持水性以及其质构的影响.谷朊粉废弃水提取物与卡拉胶的复配产品在添加量(质量分数)为6%时能使肉制品有较好的持油性和相应的质构.     

老年重症急性胰腺炎并急性肾功能衰竭诊治分析

重症急性胰腺炎（severe acute pancrertitis，SAP）病情凶险，发病迅速，并发症多，SAP伴发。肾功能障碍又称胰性肾病，发生率14％～43％，病死率71％～84％。近5年我院收治老年SAP中有9例合并急性肾功能衰竭（ARF），现结合有关文献，讨论如下。     

缬氨酸对肝昏迷兔血浆支链α-酮酸的影响

报告了用气相色谱法测定血浆支链酮酸(Branched-ChainKetoAcids;BCKA’s)浓度,以及静脉输注高浓度L-缬氨酸(L-valine,val)治疗半乳糖胺引起兔肝昏迷(HepaticComa;　HC)的结果。HC兔血浆BCKA’S明显低于正常组水平,相对应的支链氨基酸(Branched-Ghain　Amino　acids;BCAA’S)及其它氨基酸多数增高,芳香族氨基酸(AromaticAminoAcids;AAA'S)大幅度升高,用5%val静脉输注48h,血浆BCKA’S提高约3倍,BCAA’S改变不大,AAA’S下降37%;血浆BCKA’S/BCAA’S、BCAA’S/AAA’S比值也明显增高。提示,高浓度val能纠正HC血浆BCKA’S及主要氨基酸紊乱。     

慢性肾衰的预防与治疗

所谓慢性肾衰，其全称是慢性肾功能衰竭(CRF)，是一种临床综合症。在各种肾脏疾病的晚期，肾功能减退，水、电解质平衡失调，毒素不能顺利经尿液排出，引起全身中毒症状。目前来说，大部分治疗慢性肾衰的措施，只能延缓慢性肾衰的进程，晚期只能靠透析和肾移植。因此，慢性肾衰目前还是一种难以治疗的疾病。既然如此，预防慢性肾衰的发生尤为重要。