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find Keyword "吸入" 75 results
  • Evidence-Based Treatment for a Newborn with Meconium Aspiration Syndrome Combined with Persistent Pulmonary Hypertension

    Objective To make an individualized treatment plan concerning a newborn with meconium aspiration syndrome combined with persistent pulmonary hypertension. Methods Based on the clinical questions raised by a newborn with meconium aspiration syndrome combined with persistent pulmonary hypertension, we searched The Cochrane Library (Issue 3, 2009), MEDLINE (1980 to June 2009), ACP Journal Club (1991 to June 2009), and Chinese Journal Fulltext Database (1994 to June 2009) for systematic reviews, randomized controlled trials (RCTs) and case-control studies. The quality of the included studies was assessed. Results A total of 9 RCTs, 1 health economic evaluation, 1 meta analysis, and 2 systematic reviews were considered eligible. The evidence indicated that the use of ECMO in infants of PPHN had shown a decreased risk of death, but not cost-saving from a societal perspective; iNO treatment could improve the PaO2 and resulted in a reduction in the incidence of requirement for ECMO; there were not randomized controlled trials regarding the treatment of PPHN by hyperventilation, high-frequency ventilation, alkali infusion, pulmonary vasodilators (magnesium sulfate, tolazoline, prostaglandin or prostacyclin, milrinone), surfactant therapy; oral sildenafil could lower oxygenation index (OI) and result in a reduction in the incidence of death. The individualized treatment plans of oral sildenafil were developed based on the available evidence, existing conditions of the hospital, and the values of children with families. After 1 month of treatment, the FiO2 returned to normal and symptoms were alleviated. Conclusion The treatment efficacies and the survival rates in meconium aspiration syndrome combined with PPHN have been improved by determining an individualized treatment plan according to evidence-based methods.

    Release date:2016-08-25 03:36 Export PDF Favorites Scan
  • Clinical Observation of Sevoflurane Inhalation and Remifentanil Combined with Propofol Total Intravenous Anesthesia in Pediatric Operation

    目的:比较七氟醚吸入麻醉和丙泊酚、瑞芬太尼静脉麻醉用于小儿手术的临床效果。方法:100例1~8岁的患儿随机分为丙泊酚、瑞芬太尼组(A组)与七氟醚吸入组(B组)。麻醉诱导后,A组持续输注丙泊酚和瑞芬太尼维持麻醉,B组吸入七氟醚维持麻醉。术中根据生命体征调整丙泊酚、瑞芬太尼的输注速度及七氟醚的吸入浓度,记录术中循环变化、术后麻醉恢复情况。结果:与B组相比,A组术中MAP下降明显(Plt;005)。结论:与A组相比,B组术中生命体征控制平稳;术后清醒迅速、完全、平稳,拔管时间无明显差异。

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • 雾化吸入速尿防治运动性哮喘的临床研究

    在运动医学界,有一种运动作为诱发哮喘唯一因素的运动性疾病,称为运动性哮喘(EIA),是哮喘的特殊类型,发病地点多在运动场,起病较急,可危及运动员的生命,其发病机制至今尚未完全明了。速尿是一种袢利尿剂,也是15-羟前列腺素脱氢酶抑制剂,吸入速尿后对特应性和非特应性哮喘所致的支气管收缩有对抗作用[1]。目前国内尚未见应用速尿防治EIA的临床报道。我们通过观察患者吸入速尿前后、运动前后肺功能指标第1秒用力呼气容积(FEV1)占预计值百分比(FEV1%pred)及峰流速(PEF)的变化,探讨雾化吸入速尿对EIA的防治作用。

    Release date:2016-08-30 11:35 Export PDF Favorites Scan
  • Experimental study of high frequency oscillatory ventilation combined with exogenous pulmonary surfactant for the treatment of acute lung injury with acute respiratory failure induced by vapour inhalation

    Objective To compare the effects of high frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) whith or without pulmonary surfactant(PS) supplement on water vapour inhalation injury.Methods New Zealand rabbits model of severe acute lung injury with acute respiratory failure caused by steam inhalation was established.Then the animals were treated by CMV,HFOV,CMV+PS or HFOV+PS,respectively while animals in control group did not ventilated and supplemented with PS.Femoral arterial blood samples were obtained at 1,2,3,4 h after treatment for blood gas analysis.4 h after treatment ,the lowest lobe of right lung was weighed for calculating wet-to-dry weight ratio (W/D).Four different parts including dependent areas and non-dependent areas of the middle lobe of right lung were excised for histological observation.Results (A) After ALI established PaO2 in the five groups decreased below 60mmHg (Plt;0.01) but intergroup differences were found.Meanwhile the change of PaCO2 showd no statistical significance(Pgt;0.05).(B) PaO2 in the four treatment groups had increased since one hour after treatmentand sustained at favorite levels during treatment period.PaO2 in the HFOV and HFOV+PS groups were higher than those in CMV and CMV+PS groups,respectively (Plt;0.01,Plt;0.05).PaO2 in the CMV+PS group at 2 h and HFOV+PS group at 2 h and 3 h were significantly higher than those in corresponding non-PS groups at the same timepoints (Plt;0.05).P(A-a)O2 in the HFOV and HFOV+PS groups were lower than those in CMV and CMV+PS groups (Plt;0.05).P(A-a)O2 in the two groups with PS at 2 h,3 h and 4 h t were statistically lower than those in the two corresponding groups without PS (Plt;0.05).The pH and PaCO2 as well as circulatory function in the four groups were not significantly different at different treatment timepoints (Pgt;0.05).(C) Lung W/D was not different between CMV and HFOV groups (Pgt;0.05),or CMV+PS and HFOV+PS.But lung W/D in the two groups treated with PS showed statistically decrement than that in non-PS groups (Plt;0.05).(D) Histological injury score was lowest in HFOV+PS group and highest in CMV group.Conclusion HFOV combined with exogenous PS supplement can improve arterial oxygenation and alleviate pulmonary edema and injury,which may be a optimal method for the treatment of acute lung injury with acute respiratory failure caused by water vapour inhalation.

    Release date:2016-08-30 11:35 Export PDF Favorites Scan
  • 吸入激素在支气管扩张症中的应用

    支气管扩张症(简称支扩)是以进行性和不可逆性气道破坏和扩张为特征的慢性气道炎症性疾病[1],大多表现为长期咳嗽、咳脓性痰,反复急性发作,肺功能受损,后者主要表现为阻塞性通气功能障碍,气道反应性增高,晚期患者常常出现劳力性呼吸困难,严重影响患者生活质量[2,3] 。大部分支扩患者第1秒用力呼气容积(FEV )每年下降大约50mL [4] 。在我国支扩的发病率为0.3‰~0.5‰。2005年美国成人支扩发病率约为52.3/100 000。发病率随年龄而增加,在所有年龄阶段女性发病率均较男性高,预计在美国有18岁以上的支扩患者110 000例,每年医疗费用约6.3亿美元[5]。

    Release date:2016-08-30 11:35 Export PDF Favorites Scan
  • 雾化吸入抗生素在支气管扩张症中的应用

    支气管扩张症(简称支扩)是一种慢性肺部疾病,特征性地表现为支气管异常、持久的扩张和破坏,临床处理困难。虽然支扩的病因多种多样,但细菌性感染和持续性炎症是其典型病变,且反复发生,导致病情不断恶化。临床表现主要为发热、咯脓性痰,并常伴有胸痛和咯血。在支扩患者的痰中最常分离培养出的细菌是流感嗜血杆菌、肺炎链球菌、金黄色葡萄球菌和铜绿假单胞菌,其中铜绿假单胞菌是病程晚期最常见也是最难处理的感染病原体,往往难以清除,并与病情的加重和恶化密切相关,与其他病原体感染相比可导致更快的肺功能和生活质量的下降[1]。

    Release date:2016-08-30 11:35 Export PDF Favorites Scan
  • Changes of Angiotensin-Converting Enzyme and Angiotensin-Converting Enzyme 2 in Lung and Kidney of Rats after Smoke Inhalation Injury

    Objective To observe the expression of angiotensin-converting enzyme( ACE) and ACE2 in rat lung and kidney at different time point after smoke inhalation injury and to explore the possible mechanism. Methods Thirty healthy male SD rats were randomly divided into five groups( n = 6 in each group) , ie. a normal control group, and 4 injury groups of 1 h, 4 h, 10 h and 24 h respectively after 30 min of dense smoke inhalation. The rats were sacrificed at different time point. Lung and kidney tissue samples were collected for measurement of lung wet/dry weight ratio( W/D) , pathological study by HE staining, and ACE and ACE2 expression by immunochemistry staining. Results The inhaled rats all displayed acute lung injury symptoms. The lung W/D in the injury groups were significantly higher compared to the normal control group ( P lt; 0. 05, P lt; 0. 01) . ACE and ACE2 were expressed on cellular membrane of normal lung and kidney. The expression of ACE in lung was increased immediately after injury and the expression of ACE2 in lung was increased at 4 h after injury. No significant changes of the expression of ACE and ACE2 in kidney were observed in the five groups. Conclusion The imbalances of expression of ACE and ACE2 in lung might play an important role in the pathogenesis of smoke inhalation injury.

    Release date:2016-09-14 11:22 Export PDF Favorites Scan
  • A pilot study of acid inhalation-induced pulmonary fibrosis in rats

    Objective To study the pathology and possible mechanism of experimental hydrochloric acid(HCl) inhalation-indued pulmonary fibrosis in rats.Methods 120 male SD rats were randomly divided into a nomal control group,a bleomycin group,a high dose HCl group,a middle dose HCl group and a low dose HCl group.The bleomycin group was intratracheally injected with bleomycin once to induce pulmonary fibrosis.The three HCl groups were intratracheally injected with HCl once per week.The control group was given saline by the same way.Six rats of each group were randomly sacrificed on day 7,14,28 and 42 respectively.The histological changes of lung tissue were studied by HE and Masson’s trichrome staining.Hydroxyproline level in lung tissue was measured by digestion method.Protein and mRNA expression of transforming growth factor-β1(TGF-β1) were assayed by immunohistochemistry and RT-PCR respectively.Results Alveolitis in three HCl groups was significantl compared to control group,most severe at the second week,then remained at a high level which was equivalent to or exceeded the level of the bleomysin group after 28 days.Pulmonary fibrosis in three HCl groups was also significantly more severe than that in the control group,but milder than that in the bleomysin group.The high-dose and middle-dose HCl groups were not significantly different from the bleomysin group on day 42.There was no difference between three HCl groups in the earlier period,but the high-dose HCl group has a significantly difference from low-dose group on day 42.The content of hydroxyproline in high-dose and middle-dose HCl groups was also significantly higher than that in the control group.On day 42 hydroxyproline content in high-dose HCl dose rather middle –or low dose group was similiar with the level of bleomysin group.Content of TGF-β1 mRNA in three HCl groups was comparable to the level of bleomysin group on day 28 and exceeded on day 42.The expression of TGF-β1 in three HCl groups was not significantly different from the bleomysin group on day 42.Conclusion Experimental acid aspiration might contribute to pulmonary fibrosis in rats.Acid induced alveolar epithelial cell damage,abnormal proliferation and repair and fibrosis could be involved..

    Release date:2016-09-14 11:57 Export PDF Favorites Scan
  • 吸入性肺炎的研究进展

    吸人性肺炎是指口咽部分泌物和胃内容物反流吸入至喉部和下呼吸道, 引起的多种肺部综合征, 吸入量较大时可引起急性化学性吸入性肺炎, 如果吸入量小且将咽部寄植菌带入肺内, 可导致细菌性吸入性肺炎, 常见于老年人、患有神经系统疾病或脑血管病的患者, 是导致老年人死亡的主要危险因素。其他吸入综合征包括气道阻塞、肺脓肿、外源性类脂质综合征、慢性间质性肺炎和偶发分枝杆菌性肺炎等。现将细菌性吸入性肺炎( 简称吸入性肺炎) 的研究进展综述如下。

    Release date:2016-08-30 11:53 Export PDF Favorites Scan
  • Clinical Significance of Combined Use of Incentive Spirometry and Aerosol Inhalation in Patients after Abdominal Surgery in General Anesthesia

    Objective To evaluate the therapeutic effects of different airway management strategies early used for patients after abdominal surgery in general anesthesia. Methods According to gender, age,and operation location,200 patients after abdominal surgery in general anesthesia were randomly assigned to four groups, ie. a conventional treatment group ( Group A) , an incentive spirometry ( IS) therapy group ( Group B) , an aerosol inhalation group ( Group C) , a combination of inhalation and IS therapy group ( Group D) . Inhalation drugs included Budesonide, Terbutaline, and Ambroxol. The index of pulmonary function test ( FVC, FEV1 , PEF) and arterial blood gases analysis ( ABG) were measured, and the effect of secretions clearance and the improvement of respiratory symptoms were evaluated at 0.5 h,24 h, 48 h after extubation.Intratracheal intubation of the patients after leaving ICUwas followed up. Results FVC, FEV1 , PEF, ABG,sputumvolume, the effect of secretions clearance, clinical efficacy, and intratracheal intubation rate in group B, C and D were improved more significantly than those in group A. And the therapeutic effect was best in group D ( P lt;0. 05) . The secretions clearance was improved more better in group C and D, especially in those high-risk patients with advanced age, smoking history, and pulmonary cormobidities ( P lt; 0. 05) .Conclusions The combined use of IS training and inhalation therapy can improve airway secretions clearance and pulmonary function particularly for those patients after abdominal surgery in general anesthesia, especially for those high-risk patients.

    Release date:2016-08-30 11:53 Export PDF Favorites Scan
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