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目的:通过对兔背部真皮下血管网皮瓣断蒂时及断蒂后10d血流量的监测,分析血流量变化与皮瓣成活的关系,探求皮瓣断蒂指征,提出皮瓣成活的客观标准,为临床治疗提供依据。方法:以兔为实验动物,行背部真皮下血管网皮瓣成形术,术后7d断蒂,断蒂前使用激光多普勒血流仪(Laser Doppler flowmetry,LDF)测定皮瓣阻断实验前后皮瓣血流灌注量(Perfuse unit,PU),并对皮瓣断蒂后10d的PU进行连续监测并与周围正常皮区PU值进行比较,10d后处死动物取皮瓣组织行病理检查,按坏死与否将皮瓣分为两组:成活组与坏死组。分析两组皮瓣血流量变化情况并得出结论。结果:成活组断蒂时阻断试验前后PU比值(阻断比值)明显高于坏死组,且成活组PU值在断蒂后1~10d均显著高于坏死组(P<0.01);成活组与坏死组断蒂后10d周边皮区的PU值无统计学差异(P>0.05);成活组断蒂后10d皮瓣与周围正常皮区PU比值(瓣周比值)为70.1±11.2。结论:真皮下血管网皮瓣断蒂后皮瓣血流灌注量随皮瓣断蒂时阻断实验前后PU比值增高而增高;皮瓣的最佳断蒂时机为:①皮瓣成形术后7d以上。②肉眼观察皮瓣存活。③LDF测量阻断比值大于44.6%。皮瓣成活的标准为:断蒂术后10d肉眼观察成活且皮瓣与周围正常皮区灌注量比值大于58.9%。 相似文献
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Qin Zhang Wei-zhen Wu Yuan-qiang Lu Jie-zan Wang An-dong Shang Feng Yao Yan Chen 《Journal of Zhejiang University. Science. B》2012,13(5):413-418
Objective
To report on three patients with paraquat (PQ) intoxication surviving after combined therapy with hemoperfusion (HP), cyclophosphamide (CTX), and glucocorticoid. 相似文献3.
孙亦兵 《河北北方学院学报(医学版)》2007,24(4):13-15
目的：探讨血液灌流加血液透析对慢性肾衰患者血清中瘦素（Leptin）、同型半胱氨酸（tHcy）及甲状旁腺素（iPTH）的清除作用,并与单纯血液透析清除Leptint、Hcy、iPTH的效果比较。方法：在25例慢性肾衰患者常规血液透析中增加一次血液透析加灌流治疗,在透析及透析加灌流前后分别检测其Leptint、Hcy、iPTH血清水平,结果表明血透加灌流治疗后较治疗前明显降低（P〈0.01）,且较单纯血液透析明显降低（P〈0.05）,而单纯血液透析前后血清Leptint、Hcyi、PTH水平没有改变（P〉0.05）。结论：血液灌流可以明显降低慢性肾衰患者血清中的Leptin、tHcyi、PTH水平,从而改善透析患者的生活质量,减少营养不良、心血管疾病和肾性骨病和异位钙化并发症的发生。 相似文献
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Gao JP Huang M Li N Wang PF Chen HL Xu QP 《Journal of Zhejiang University. Science. B》2011,12(4):264-272
A novel adsorber, polyvinylidene fluoride matrix immobilized with L-serine ligand (PVDF-Ser), was developed in the present
study to evaluate its safety and therapeutic efficacy in septic pigs by extracorporeal hemoperfusion. Endotoxin adsorption
efficiency (EAE) of the adsorber was firstly measured in vitro. The biocompatibility and hemodynamic changes during extracorporeal
circulation were then evaluated. One half of 16 pigs receiving lipopolysaccharide (Escherichia coli O111:B4, 5 μg/kg) intravenously in 1 h were consecutively treated by hemoperfusion with the new adsorber for 2 h. The changes
of circulating endotoxin and certain cytokines and respiratory function were analyzed. The 72 h-survival rate was assessed
eventually. EAE reached 46.3% (100 EU/ml in 80 ml calf serum) after 2 h- circulation. No deleterious effect was observed within
the process. The plasma endotoxin, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels were decreased during
the hemoperfusion. Arterial oxygenation was also improved during and after the process. Furthermore, the survival time was
significantly extended (>72 h vs. 47.5 h for median survival time). The novel product PVDF-Ser could adsorb endotoxin with
high safety and efficacy. Early use of extracorporeal hemoperfusion with the new adsorber could reduce the levels of circulating
endotoxin, IL-6, and TNF-α, besides improve respiratory function and consequent 72 h-survival rate of the septic pigs. Endotoxin
removal strategy with blood purification using the new adsorber renders a potential promising future in sepsis therapy. 相似文献
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Objective
To report clinical features and treatment of 16 cases of acute 2,4-dinitrophenol poisoning. 相似文献6.
Xue-hong Zhao Jiu-kun Jiang Yuan-qiang Lu 《Journal of Zhejiang University. Science. B》2015,16(8):720-726
Objective: The intoxications caused by 2,4-dinitrophenol (2,4-DNP), even death, have been frequently reported in recent years. This study aims to investigate the dynamic changes of plasma toxin concentration and explore the clinical value of resin hemoperfusion (HP) in the treatment of patients with acute 2,4-DNP poisoning. Methods: We reported 16 cases of acute 2,4-DNP poisoning through occupational exposure due to ignoring the risk of poisoning. The blood samples were collected from the 14 survivors. According to the different treatments of resin HP, the survivors were divided into routine HP (n=5) and intensive HP (n=9) groups. Ultra high performance liquid chromatography/tandem mass spectroscopy (UPLC-MS/MS) was used to detect the 2,4-DNP concentration in plasma in this study. Results: The 14 survivors recovered very well after treatment. The initial plasma 2,4-DNP concentrations (C
1) of survivors ranged from 0.25 to 41.88 µg/ml (mean (12.56±13.93) µg/ml). A positive correlation existed between initial plasma 2,4-DNP concentration (C
1) and temperature. The elimination of 2,4-DNP was slow and persistent, and the total clearance rates of plasma toxin from the 1st to 3rd day (R
3), the 3rd to 7th day (R
3–7), and the 1st to 7th day (R
7), were only (53.03±14.04)%, (55.25±10.50)%, and (78.29±10.22)%, respectively. The plasma toxin was cleared up to 25 d after poisoning in most of the patients. The R
3, R
3–7, and R
7 in the intensive HP group were all apparently higher than those in the routine HP group, with statistical significance (P<0.05). Simultaneously, the elimination half-life (t
1/2) of 2,4-DNP in the intensive HP group was apparently shorter than that in the routine HP group, with statistical significance (P<0.05). Conclusions: The clinicians should be aware of this slow and persistent process in the elimination of plasma 2,4-DNP. Higher initial plasma toxin concentration resulted in a more severe fever for the patient. According to the limited data, longer and more frequent resin HP may accelerate to eliminate the poison. 相似文献
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目的：观察急性中毒病人应用HA型树脂血液灌流的疗效。方法：在采用常规抢救措施的同时，应用血泵机先做预冲，再与动静脉穿刺导管连接．开始血流量从50～100ml／min的小流量开始，待病人生命体征平稳，逐渐加大至150。200ml／min治疗时间2—2．5h。灌流时全身肝素化。结果：36例病人共灌流40次，其中4例2次。救治成功33例，占91．7％，死亡3例，占8．3％。结论：血液灌流是利用固态吸附剂解除血液内的某些代谢产物、外源性或内源性毒物，可以用于临床有效救治多种中毒病人。 相似文献
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