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"魏新川" 5 results
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脈搏灌注指數變異是新一代脈氧飽和度監測儀上集成的參數。它在預測患者的擴容反應性上敏感性好,特異性高,并且能夠無創、自動、連續地在床旁對患者進行監測,臨床應用前景巨大。現就脈搏灌注指數變異的研究背景、基本原理和測量方法、臨床應用研究進展、局限性等方面作一綜述。
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食管引流型喉罩又稱為雙管喉罩,為第三代喉罩。目前臨床上廣泛應用的食管引流型喉罩包括3種:Proseal喉罩,在Proseal喉罩基礎上加以改進的Supreme喉罩以及無套囊的I-gel喉罩。食管引流型喉罩的主要特點為增加了一根對胃腸道起到密封和引流作用的引流管,并對通氣罩進行了改進。因此食管引流型喉罩具備防止返流誤吸的作用,并改善了通氣功能。目前,食管引流型喉罩除了廣泛應用于全身麻醉下成人、兒童的短小體表和四肢手術,還進一步應用到腹腔鏡手術、腹部外科開放性手術、肥胖患者的手術、困難氣管等領域。其應用的有效性和安全性大大提高, 將逐漸取代普通喉罩。本文就食管引流型喉罩的應用進展作一綜述,便于臨床醫生更方便、更快捷的掌握食管引流型喉罩使用技術,并在臨床上進一步推廣。
Release date:2016-09-07 02:34
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ObjectiveTo evaluate the ultrasonic pre locating internal jugular venous cannulation in infants, comparison with the external landmark technique.MethodsSixty two infants scheduled for cardiac surgery were randomized prospectively into two groups. In the anatomic landmarks group( n =30), the patient’s internal jugular vein(IJV) were cannulated by using the traditional method of palpation of carotid pulsation and identification of other anatomic landmarks. In the ultrasonic pre locating group ( n =32), an two dimensional ultrasound scanner image made for locating the puncture site of vessels was used with an operative probe of HP SONOS 4500 system. The number of attempts, success rate, and incidence of complications were compared for two groups.ResultsThe success rate was 100% vs 80% in the ultrasonic pre locating group vs anatomic landmarks group, with a 3.1% vs 26 7% incidence of carotid artery punctures and the number of attempts 1.57±1.04 vs 2.55±1.76. All differences were statistically significant ( P lt;0.05,0.05,0.01). Conclusion Ultrasonographic pre-localization of the IJV is superior to the anatomic landmarks technique in terms of overall success , and decreases incidence of carotid artery puncture.
Release date:2016-08-30 06:24
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即時檢驗(POCT)技術具有簡便、快速、準確、方便等特點,近年來廣泛應用于臨床各個領域,在圍手術期的應用包括動脈血氣檢測,凝血功能檢測,心肌標志物檢測,輸血相關指標檢測,甲狀旁腺激素監測等。以POCT技術為基礎的圍手術期移動實驗室會在不久的將來得到廣泛的應用,為降低圍手術期死亡率發揮重要作用。現就POCT技術在圍手術期的應用進展作一綜述,便于臨床醫生更多地了解POCT 技術,并推廣應用于臨床。
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摘 要 目的 觀察參附注射液對體外循環(CPB)中腫瘤壞死因子-α(TNF-α)和白細胞介素-6(IL-6)的影響。方法 將20例人工心臟瓣膜置換術患者隨機分成參附組和對照組(每組10例)。參附組分別于麻醉誘導前、CPB前及主動脈開放10分鐘內分別靜脈滴注參附注射液20ml、40ml和40ml,于CPB前、主動脈阻斷前、主動脈阻斷30分鐘,主動脈開放15分鐘和60分鐘時采用放射免疫法測定兩組血心中TNF-α和IL-6的含量。結果 主動脈阻斷前、主動脈阻斷30分鐘、主動脈開放后15分鐘和60分鐘,對照組TNF-α值均明顯高于參附組(P<0.05),各時點IL-6組間比較差別無顯著性意義(P>0.05)。結論 參附注射液可降低主動脈開放后血漿TNF-α的含量,具有對抗CPB所致的炎性反應的作用,而對CPB中IL-6作用不明顯。
Release date:2016-08-30 06:32
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