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1.
Weng Xiao-chuan Zhou Liang Fu Yin-yan Zhu Sheng-mei He Hui-liang Wu Jian 《浙江大学学报(A卷英文版)》2005,6(9):869-872
Objective: To compare the dose requirements of continuous infusion of rocuronium and atracurium throughout orthotopic liver
transplantation (OLT) in humans. Methods: Twenty male patients undergoing liver transplantation were randomly assigned to
two comparable groups of 10 patients each to receive a continuous infusion of rocuronium or atracurium under intravenous balanced
anesthesia. The response of adductor pollicis to train-of-four (TOF) stimulation of unlar nerve was monitored. The infusion
rates of rocuronium and atracurium were adjusted to maintain T1/Tc ratio of 2%–10%. The total dose of each drug given during
each of the three phases of OLT was recorded. Results: Rocuronium requirement, which were (0.468±0.167) mg/(kg·h) during the
paleohepatic phase, decreased significantly during the anhepatic phase to (0.303±0.134) mg/(kg·h) and returned to the initial
values at the neohepatic period ((0.429±0.130) mg/(kg·h)); whereas atracuruim requirements remained unchanged during orthotopic
liver transplantation. Conclusions: This study showed that the exclusion of the liver from the circulation results in the
significantly reduced requirement of rocuronium while the requirement of atracurium was not changed, which suggests that the
liver is of major importance in the clearance of rocuronium. A continuous infusion of atracurium with constant rate can provide
stable neuromuscular blockade during the three stages of OLT. 相似文献
2.
目的：总结体外循环心脏直视术后患者的监护经验。方法：对56例体外循环心脏直视术后的患者在ICU的监护进行回顾性分析,从监护室的准备、呼吸系统的护理、循环系统的护理、引流管的护理、心理护理、压疮预警干预几个方面进行总结。结果：56例患者中除一例因术后并发重度低心排死亡外,其余均康复出院。结论：ICU对患者的监护极为重要,这是体外循环心内直视术后患者的安全保障,直接关系到手术的成败。 相似文献
3.
合用醒脑静和脑多肽注射液治疗急性一氧化碳中毒的疗效比较 总被引：2，自引：0，他引：2
目的：观察合用醒脑静注射液和脑多肽注射液治疗急性一氧化碳（CO）中毒的疗效．方法：62例急性CO中毒患者分为醒脑静、脑多肽组（32例）与脑多肽组（3例）,并对二组疗效进行比较结果：醒脑静、脑多肽组的显效率（87.5％）明显高于脑多肽组（60％）,显效时间（18±2.0）小时（h）则明显短于脑多肽组（33±8h）,二组比较均具有显著性差异（P＜0．05,P＜0．01）．但二组总有效率无显著性差异（P＞0．05）．结论：醒脑静注射液与脑多肽注射液配合应用,二者具有协同作用,临床疗效较好,值得推广应用． 相似文献
4.
为预测ICU患者重症监护时长并研究血糖变异对时长的影响,分别构建K最近邻、决策树、支持向量机以及随机森林4种模型,使用重症患者的血糖变异情况和基本病例信息构成实验数据集进行训练,预测患者能否在72h内转出ICU病房。训练后的4种模型在判断患者重症监护时长的准确率分别为63.94%、78.77%、81.07%和84.14%。实验结果表明,血糖变异情况对患者重症监护时长有重要影响,且随机森林模型相比其它机器学习算法能较好地预测ICU患者的重症监护时长,能帮助医生合理安排治疗计划,在提高医疗资源利用效率上具有参考意义。 相似文献
5.
目的：探讨腹腔镜胆囊切除术与开放胆囊切除术治疗胆囊结石的临床疗效。方法：选择2010年1月至2013年7月收治的胆囊结石患者共90例作为研究对象,按照治疗方式将其分为腹腔镜胆囊切除术（LC）组和开腹胆囊切除术（OC）组,比较两组患者疗效。结果：LC组手术时间、术中出血量、抗生素使用时间、胃肠功能恢复时间以及住院时间等围手术期指标均明显优于OC组（P〈0．05）;LC组并发症发生率为0．1％,OC组并发症的发生率3％,LC组并发症的发生率明显低于OC组（P〈0．05）。结论：腹腔镜胆囊切除术治疗胆囊结石术中出血少,术后恢复快,住院时间短,是一种安全可靠的治疗方式。 相似文献
6.
Wolfgang Huber Uli Mayr Andreas Umgelter Michael Franzen Wolfgang Reindl Roland M. Schmid Florian Eckel 《Journal of Zhejiang University. Science. B》2018,19(7):515-524
Background and objective
Stroke volume variation (SVV) has high sensitivity and specificity in predicting fluid responsiveness. However, sinus rhythm (SR) and controlled mechanical ventilation (CV) are mandatory for their application. Several studies suggest a limited applicability of SVV in intensive care unit (ICU) patients. We hypothesized that the applicability of SVV might be different over time and within certain subgroups of ICU patients. Therefore, we analysed the prevalence of SR and CV in ICU patients during the first 24 h of PiCCO-monitoring (primary endpoint) and during the total ICU stay. We also investigated the applicability of SVV in the subgroups of patients with sepsis, cirrhosis, and acute pancreatitis.Methods
The prevalence of SR and CV was documented immediately before 1241 thermodilution measurements in 88 patients.Results: In all measurements, SVV was applicable in about 24%. However, the applicability of SVV was time-dependent: the prevalence of both SR and CV was higher during the first 24 h compared to measurements thereafter (36.1% vs. 21.9%; P<0.001). Within different subgroups, the applicability during the first 24 h of monitoring ranged between 0% in acute pancreatitis, 25.5% in liver failure, and 48.9% in patients without pancreatitis, liver failure, pneumonia or sepsis.Conclusions
The applicability of SVV in a predominantly medical ICU is only about 25%–35%. The prevalence of both mandatory criteria decreases over time during the ICU stay. Furthermore, the applicability is particularly low in patients with acute pancreatitis and liver failure.7.
INTRODUCTION Conventional coronary artery bypass graftin(CCABG) with cardiopulmonary bypass (CPB) habeen accepted as an effective and safe treatment fomulti-vessel coronary heat disease. CPB may stilcontribute to the operation field because of threlatively easier technical requirement; but it alscauses a serious systematic inflammatory reactiowhich will lead to dysfunction of important organand higher cost for the patients. Off-pump coronarartery bypass grafting (OPCABG) has r… 相似文献
8.
To evaluate the clinic outcome of off-pump coronary bypass grafting (OPCABG) of patients with coronary heart disease and chronic obstructive pulmonary disease, we collected and analyzed 1998-2002 data on 28 patients with these two diseases who had received off-pump coronary bypass operation in our hospital, and compared with data on those who also had the same two diseases but received on-pump coronary artery bypass at same time. There were no operation-related death;one died of respiratory failure 14 days after operation while staying in hospital; there were more respiratory complications in the conventional coronary artery bypass grafting group (CCABG) than in the OPCABG group; and the PaO2/FiO2 in the CCABG group was higher than that in the OPCABG group during operation because of CPB, but lower than that in the OPCABG group 6-12 hours after operation. OPCABG seemed more suitable than CCABG for coronary artery disease patients with chronic obstructive pulmonary disease due to less damage to their oxygen-exchange capability and the fewer respiratory complications. 相似文献
9.
Eighty-two patients with supraventricular tachycardia undergoing radiofrequency catheter ablation (RFCA) were studied to observe
the inhibition effect of aspirin and ticlopidine on platelet aggregability (PAG) and thromboxane B2 (TXB2) of the blood samples. Patients were divided into aspirin group A, ticlopidine group B, aspirin + ticlopidine group C and
control group D. PAG and TXB2 were increased clearly after RFCA in all groups (P<0.001). Treatment with aspirin or ticopidine before operation could reduce the platelet aggregability caused by RFCA and
the joint effect of two drugs (change rate of group A: 52.51±12.51%; group B: 54.78±11.27%; group C: 30.51±10.59%; group D:
91.75±21.43%;P<0.05) was studied. The much decreased platelet aggregability after antiplatelet therapy was evidence of the potential benefit
of the treatment in preventing thromboembolism after ablation. Pretreatment with aspirin and ticlopidine together is a good
way to decrease palatelet aggregability after RFCA. 相似文献
10.
Colak T Akca T Turkmenoglu O Canbaz H Ustunsoy B Kanik A Aydin S 《Journal of Zhejiang University. Science. B》2008,9(4):319-323
Objective: This prospective randomized clinical trial was conducted to evaluate the necessity of drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. Methods: A total of 116 patients who underwent total thyroidectomy or lobectomy for benign thyroidal disorders were randomly allocated to be drained or not. Operative and postoperative outcomes including operating time, postoperative pain assessed by visual analogue scale (VAS), total amount of intramuscular analgesic administration, hospital stay, complications, necessity for re-operation and satisfaction of patients were all assessed. Results: The mean operating time was similar between two groups (the drained and non-drained groups). The mean VAS score was found to be significantly low in the non-drained group patients in postoperative day (POD) 0 and POD 1. The mean amount of intramuscular analgesic requirement was significantly less in the non-drained group. One case of hematoma, two cases of seroma and three cases of transient hypoparathyroidism occurred in the non-drained group, whereas one case of hematoma, two cases of seroma, two cases of wound infections and two cases of transient hypoparathyroidism occurred in the drained group. No patient needed re-operation for any complication. The mean hospital stay was significantly shorter and the satisfaction of patients was superior in the non-drained group. Conclusion: These findings suggest that postoperative complications cannot be prevented by using drains after total thyroidectomy or lobectomy for benign thyroid disorders. Furthermore, the use of drains may increase postoperative pain and the analgesic requirement, and prolong the hospital stay. In the light of these findings, the routine use of drains might not be necessary after thyroid surgery for benign disorders. 相似文献
11.
[目的]了解甘草酸苷对慢性乙肝患者血糖的影响.[方法]把95例确诊为慢性乙型肝炎的患者随机分为A、B、C三组,分别给予复方甘草酸苷80 m l、复方甘草酸单铵120 m l、甘草酸二铵40 m l静脉点滴,用药前、用药2周及4周观察三组患者的空腹血糖、肝功能、HBVM、HBV-DNA定量.[结果]治疗前三组患者空腹血糖的均数分别为5.28±1.75、5.32±1.66及5.65±1.82 mmol/L,在用药2周时,三组患者空腹血糖的均数即已有所下降,至用药4周其空腹血糖的均数分别为4.5 1±1.6 5、4.6 8±1.3 7及4.9 8±1.87 mmol/L,与治疗前相比三组患者空腹血糖的均数都有不同程度下降,但治疗前后的差异无显著性(P>0.05),各组之间下降的差异亦无显著性(P>0.05).[结论]甘草酸苷对慢性乙肝患者的血糖没有升高作用,反而在一定剂量下有降低的作用. 相似文献
12.
丁久香 《襄樊职业技术学院学报》2012,11(2):41-42
目的探讨在超声引导下（超导）可视操作行人工流产术的临床优越性。方法以90例行超导可视无痛人工流产术的早孕患者作为观察组,与90例同期行常规人工流产术患者（对照组）进行比较,观察两组手术时间、术中出血、疼痛、术后并发症如吸宫不全、阴道出血时间长、月经出血量减少、宫腔或宫颈管粘连等情况。结果观察组与对照组相比,镇痛有效率高、出血感染机率低、子宫损伤小等明显的临床优越性。结论超导可视无痛人工流产术安全可靠,手术时间短,出血量少,减少了常见并发症,降低了对子宫内膜功能层的过度损伤,镇痛效果满意。 相似文献
13.
Objective: To investigate the directed transplantation of allograftic bone marrow-derived mesenchymal stem cells (MSCs) in myocardial infarcted (MI) model rabbits. Materials and Methods: Rabbits were divided into 3 groups, heart infarcted model with MSCs transplanted treatment (MSCs group, n=12), heart infarcted model with PBS injection (control group, n=20), sham operation with PBS injection (sham group, n=l 7). MSCs labelled by BrdUrd were injected into the MI area of the MSCs group. The same volume of PBS was injected into the MI area of the control group and sham group. The mortality, LVIDd, LVIDs and LVEF Of the two groups were compared 4 weeks later. Tropomyosin inhibitory component (Tn I) and BrdUrd immunohistochemistry identified the engrafted cells 4 weeks after transplantation. Result: The mortality of the MSCs group was 16.7% (2/12), and remarkably lower than the control group's mortality [35% (7/20) (P＜0.05)].Among the animals that survived for 4 weeks, the LVIDd and LVIDs of the MSCs group after operation were 1.17±0.21 cm and 0.74±0.13 cm, and remarkably lower than those of the model group, which were 1.64±0.14 cm and 1.19±0.12 cm (P＜0.05); the LVEF of the MSCs group after operation was 63±6%, and remarkably higher than that of the model group,which was 53±6% (P＜0.05). Among the 10 cases of animals that survived for 4 weeks in the MSCs group, in 8 cases (80%),the transplanted cells survived in the non MI, MI region and its periphery, and even farther away; part of them differentiated into cardiomyocytes; in 7 cases (70%), the transplanted cells participated in the formation of blood vessel tissue in the MI region. Conclusion: Transplanted allograftic MSCs can survive and differentiate into cardiomyocytes, form the blood vessels in the MI region. MSCs transplantation could improve the heart function after MI. 相似文献
14.
Chen Youbai Niu Zehao Jiang Weiqian Tao Ran Lei Yonghong Guo Lingli Zhang Kexue Xia Wensen Song Baoqiang Huang Luyu Zhang Qixu Han Yan 《Journal of Zhejiang University. Science. B》2021,22(10):866-875
Gradual distraction with an external fixator is a widely used treatment for severe postburn ankle contracture (SPAC). However, application of external fixators is complex, and conventional two-dimensional (2D) imaging-based surgical planning is not particularly helpful due to a lack of spatial geometry. The purpose of this study was to evaluate the surgical planning process for this procedure with patient-specific three-dimension-printed models (3DPMs). In this study, patients coming from two centers were divided into two cohorts (3DPM group vs. control group) depending on whether a 3DPM was used for preoperative surgical planning. Operation duration, improvement in metatarsal-tibial angle (MTA), range of motion (ROM), the American Orthopedic Foot and Ankle Society (AOFAS) scores, complications, and patient-reported satisfaction were compared between two groups. The 3DPM group had significantly shorter operation duration than the control group ((2.0±0.3) h vs. (3.2± 0.3) h, P<0.01). MTA, ROM, and AOFAS scores between the two groups showed no significant differences pre-operation, after the removal of the external fixator, or at follow-up. Plantigrade feet were achieved and gait was substantially improved in all patients at the final follow-up. Pin-tract infections occurred in two patients (one in each group) during distraction and were treated with wound care and oral antibiotics. Patients in the 3DPM group reported higher satisfaction than those in the control group, owing to better patient-surgeon communication. Surgical planning using patient-specific 3DPMs significantly reduced operation duration and increased patient satisfaction, while providing similar improvements in ankle movement and function compared to traditional surgical planning for the correction of SPAC with external fixators.
相似文献15.
Gao Min Zhou Wen Shi Jian-ming Hong De-fei Mu Yi-ping Wang Jian-guo Wang Yao-dong 《浙江大学学报(A卷英文版)》2000,1(4):456-458
Objective: To evaluate the benefit of intraoperative ERCP and endoscopic sphincterotomy (EST) combined with laparoscopic cholecystectomy
(LC) in the treatment of cholelithiasis with choledocholithiasis. Methods: Fifty-two patients with cholelithiasis and choledocholithiasis
(as determined by intraoperative cholangiography) were randomly divided into 2 groups during LC. In group A (27 patients),
common bile duct stones were extracted by intraoperative EST during LC. In group B(25 patients), common bile duct (CBD) stones
were extracted by conversion to open CBD exploration and cholecyctectomy. Results: The success rate was 26/27 (96.3%) in group
A and 25/25 (100%) in group B (0.25<P<0.5); The mean postoperative hospitalization was 3.32±0.56 days in group A and 17.5±4.61 days in group B (P<0.001). In group A, two cases were complicated transient hyperamylasemia after the combined procedure. In group B, one case
of bile leakage and one case of duodenal ulcer occurred after conversion to open cholecystectomy with CBD exploration. There
were no retained stones in group A but 2 cases in group B. Conclusion: Intraoperative ERCP and endoscopic sphincterotomy combined
with LC for treatment of cholelithiasis and chiledochlithiasis is safe, effective and results in shorter hospitalization and
fewer complications than traditional open cholecystectomy with CBD exploration. 相似文献
16.
Ai-bin Zhang Ye Wang Chen Hu Yan Shen Shu-sen Zheng 《Journal of Zhejiang University. Science. B》2017,18(6):532-538
Objective
The aim of this study was to compare complications and oncologic outcomes of patients undergoing laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (LDP) at a single center.Methods
Distal pancreatectomies performed for pancreatic ductal adenocarcinoma during a 4-year period were included in this study. A retrospective analysis of a database of this cohort was conducted.Results
Twenty-two patients underwent LDP for pancreatic ductal adenocarcinoma, in comparison to seventy-six patients with comparable tumor characteristics treated by LDP. No patients with locally advanced lesions were included in this study. Comparing LDP group to LDP group, there were no significant differences in operation time (P=0.06) or blood loss (P=0.24). Complications (pancreatic fistula, P=0.62; intra-abdominal abscess, P=0.44; postpancreatectomy hemorrhage, P=0.34) were similar. There were no significant differences in the number of lymph nodes harvested (11.2±4.6 in LDP group vs. 14.4±5.5 in LDP group, P=0.44) nor the rate of patients with positive lymph nodes (36% in LDP group vs. 41% in LDP group, P=0.71). Incidence of positive margins was similar (9% in LDP group vs. 13% in LDP group, P=0.61). The mean overall survival time was (29.6±3.7) months for the LDP group and (27.6±2.1) months for LDP group. There was no difference in overall survival between the two groups (P=0.34).Conclusions
LDP is a safe and effective treatment for selected patients with pancreatic ductal adenocarcinoma. A slow-compression of pancreas tissue with the GIA stapler is effective in preventing postoperative pancreatic fistula. The oncologic outcome is comparable with the conventional open approach. Laparoscopic radical antegrade modular pancreatosplenectomy contributed to oncological clearance.17.
本文采用精浆肉毒碱测定(DTNB)方法,对40名患有解脲脲原体感染的男性不育患者的精浆肉毒碱测定,结果:精浆肉毒碱含量94.14±57.62nmol/ml:肉毒碱总量286.6±306.87nmol,本实验室吴明章等测得156例正常生育力男子精浆中的肉毒碱,每毫升精浆肉毒碱239.56±105.59nmol/ml;精浆中肉毒碱总量757.34±471.72nmol。两组间相比,经统计学处理(t检验)P<0.01差异非常显著,提示,解脲脲原体感染引起精浆肉毒碱含量下降,是其导致男性不育的原因之一。 相似文献
18.
本文观察46具尸体的胃后动脉、静脉,其结果:①胃后动脉出现率为71.7±6.6％,②胃后动脉起始处外径成人平均为1.81±0.52mm,儿童平均为0.98±0.25mm;终末部外径成人平均为1.45±0.48mm,儿童平均为0.75±0.23mm;胃后动脉长度成人平均为32.89±7.37mm,儿童平均为14.8±5.6mm,③胃后静脉出现率为56.5±7.3％,④胃后动脉距腹腔干平均为29.27±15.19mm,胃后动脉距贲门平均为14.59±7.23mm,胃后静脉汇入脾静脉或脾静脉上极支处距门静脉平均为22.49±12.6mm,胃后动脉多有胃后静脉伴行,静脉以1支为多见。 相似文献
19.
选择胸骨最佳穿刺部位,供临床使用时参考．方法：在胸骨上确定24个穿刺点（胸骨柄、胸骨角各3个穿刺点,胸骨体为18个穿刺点）,用骨穿针、测力计及游标卡尺等在60具尸体上进行该项研究结果：胸骨柄的测试压为8．30±0．24kg（3．02～14.10）,胸骨柄的穿刺深度为21.36±0.19mm（4．73～30．40）胸骨角的测试压为8．83±0.32kg（3.57～13．40),胸骨角的穿刺深度为21.38±0.08mm（11.53～30.57）;胸骨体的平均测试压为7.57±0.66kg（2.00～15.13）,胸骨体的平均穿刺深度为19.54±0.57mm（3.00～31．32）结论：从购骨各穿刺点的压力大小及胸骨后方的毗邻关系等进行全面考虑,位于第3、4胸肋关节之间水平胸骨正中处为最佳穿刺部位,其次为胸骨角正中上、下各1.0～1．5cm处． 相似文献
20.
INTRODUCTION Telomeres are distinctive DNA-protein struc-tures that cap the ends of linear chromosomes.It is very important to keep the chromosomes stabilization.Telomerase activity is closely linked to attainment of cellular immortality,a step in carcinogenesis,while lack of such activity contributes to cellular senes-cence.Telomerase is activated in more than85%ofmalignant tumors(Hiayma et al.,1997).Human te-lomeric repeat binding factor1(TRF1)is a telomere associated with proteins a… 相似文献