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find Author "王晓" 28 results
  • Effectiveness and Safety of 5-HT3 Receptor Antagonists in Preventing Propofol Injection Induced Pain: A Meta-Analysis

    Objective To systematically assess the effectiveness and safety of 5-HT3 receptor antagonists in preventing propofol injection induced pain. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2012), CNKI, CBM, VIP and WanFang Data were searched from their inception to September, 2012 to collect the randomized controlled trials (RCTs) about 5-HT3 receptor antagonists in preventing propofol injection induced pain. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality of methodology. Then meta-analysis was performed using RevMan 5.2 software. Results A total of 15 RCTs involving 1 413 patients were included. The results of meta-analysis showed that: a) the incidence of propofol injection induced pain in the 5-HT3 group was obviously lower than the control group (RR=0.14, 95%CI 0.09 to 0.21, Plt;0.000 01); b) as to the severity of pain, there was no statistical difference between the two groups (RR=0.84, 95%CI 0.56 to 1.26, P=0.39); the 5-HT3 group was obviously lower that the control group in the incidence of both moderate pain (RR=0.25, 95%CI 0.19 to 0.34, Plt;0.000 01) and severe pain (RR=0.16, 95%CI 0.10 to 0.24, Plt;0.000 01); and c) as to the incidence of postoperative adverse reaction: the 5-HT3 group was obviously lower that the control group in the incidence of nausea and vomiting (RR=0.19, 95%CI 0.11 to 0.34, Plt;0.000 01) and shivering (RR=0.20, 95%CI 0.12 to 0.33, Plt;0.000 01) as well. Conclusion 5-HT3 receptor antagonists can effectively prevent the propofol injection induced pain, alleviate its severity, and reduce the postoperative adverse reactions. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.

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  • 麻醉医师主导的快速康复技术在日间手术中的应用

    麻醉医师主导的快速康复技术是指麻醉医师在已有临床证据的基础上,通过改进患者术前准备、优化术中管理、加快患者术后恢复等一系列围手术期管理措施,加速患者康复。将该技术应用于日间手术的围手术期管理,可以进一步加快患者术后恢复,缩短在院时间,减少整体医疗费用,进而促进医疗资源的合理利用,提高患者满意度。现就麻醉医师主导的快速康复技术在日间手术的应用作一综述,以便更多的临床医生了解快速康复技术并应用于日间手术的管理。

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  • 最适镇静/麻醉深度在消化内镜无痛技术中的价值和实施

    目前消化内镜的镇静/麻醉随着舒适化医疗的发展得到普及和推广。消化内镜通常在无人工气道条件下实施镇静镇痛,监护和抢救设备、人员配比远不及手术室内保障性高。镇静/麻醉技术虽然减少了患者痛苦,但同时增加了镇静相关不良反应的发生率。镇静/麻醉实施应该滴定给药以实现一个安全、舒适、顺利的过程。不同的患者需要不同的镇静水平,最适镇静/麻醉深度是患者安全、舒适、无记忆、内镜操作易于实施,从清醒镇静到全身麻醉不等。对于一些特殊患者,深度镇静可能引起严重后果,甚至致命,清醒镇静不失为一种安全舒适的无痛技术。该文就探讨消化内镜最适镇静/麻醉深度并对清醒镇静的实施进行了综述。

    Release date:2017-06-22 02:01 Export PDF Favorites Scan
  • BIOMECHANICAL EFFECT OF ANTERIOR CRUCIATE LIGAMENT RUPTURE ON POSTERIOR HORN OF LATERAL MENISCUS

    Objective Anterior cruciate l igament (ACL) is an important forward stable structure of knees, when its function impaired, the normal mechanical environment of joint will be destroyed. Now, to explore the effect of ACL rupture on the posterior horn of lateral meniscus by measuring biomechanics. Methods Ten specimens of knee joints (5 left and 5 right sides asymmetrically) were donated voluntarily from 10 normal fresh adult male cadavers, aged 26-35 years with anaverage of 31.4 years. The straining of lateral meniscus posterior horn in 10 knee joint specimens before and after resection of ACL were tested when the knee joints loaded from 0 to 200 N at a velocity of 0.5 mm per second at 0, 30, 60, and 90° of flexion and recorded at the moment when the load was 200 N, the ratio of straining before and after resection of ACL were connted. All the specimens were anatomied and observed in general so as to find injuries such as deformation and tearing in lateral meniscus after test. Results The straining of lateral meniscus posterior horn were as follows: intact ACL group, (—11.70 ± 0.95) με at 0° flexion, (—14.10 ± 1.95) με at 30° flexion, (—20.10 ± 1.20) με at 60° flexion, and (—26.50 ± 1.58) με at 90° flexion; ACL rupture group, (—6.20 ± 1.55) με at 0° flexion, (—26.30 ± 1.89) με at 30° flexion, (—37.70 ± 1.64) με at 60° flexion, and (—46.20 ± 2.78) με at 90° flexion. There were significant differences between intact ACL group and ACL rupture group (P lt; 0.05). The straining ratio of the posterior horn of lateral meniscus rupture ACL to intact ACL were 0.53 ± 0.12, 1.90 ± 0.31, 1.88 ± 0.15, and 1.75 ± 0.16 at 0, 30, 60, and 90° of flexion. The lateral meniscus were intact in general and no injuries such as deformation and tearingwere found. Conclusion ACL has a significant biomechanical effect on posterior horn of lateral meniscus. Consequently, the posterior horn of lateral meniscus is overloaded with ACL rupture at 30, 60, and 90° of flexion, and thereby, it will have the high risk of tear.

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • 脱细胞异体真皮支架加自体刃厚皮移植治疗深度创面的临床观察

    Release date:2016-09-01 09:24 Export PDF Favorites Scan
  • Effects of Isoflurane on Learning and Memory in Aged Rats

    目的 探讨异氟醚吸入麻醉对(SD)老年大鼠学习和记忆的影响。 方法 36只SD健康雄性大鼠随机分为异氟醚麻醉组和对照组,每组各18只。麻醉组给予2%异氟醚和40%氧气诱导及维持麻醉3 h,对照组单纯吸入含40%氧气的空氧混合气体3 h。麻醉组或对照组干预结束24 h后开始为期1周的盲法测试学习记忆能力。 结果 麻醉组大鼠与对照组大鼠相比,Y-迷宫测试成绩错误反应次数差异无统计学意义(P>0.05);除第7天麻醉组大鼠起步电压高于对照组(P<0.05)外,其余时间两组大鼠起步电压差异均无统计学意义(P>0.05);除第3天麻醉组大鼠跑步电压高于对照组(P<0.05)外,其余时间两组大鼠跑步电压差异均无统计学意义(P>0.05)。 结论 2%单纯异氟醚吸入麻醉不改变老年大鼠麻醉后学习和记忆能力。

    Release date:2016-09-08 09:13 Export PDF Favorites Scan
  • 无痛胃肠镜检查患者麻醉苏醒期并发症及护理

    【摘要】 目的 探讨无痛胃肠镜检查麻醉苏醒期常见并发症及其护理。 方法 对2003年7月-2009年3月行无痛胃肠镜检查术患者在麻醉苏醒期出现的各种并发症状况及护理方法进行分析总结。 结果 呼吸道不通畅导致的低氧血症是行无痛胃肠镜检查术患者在麻醉苏醒期间最常见的并发症,有756例,其次为因呼吸道分泌物致呛咳(421例)、恶心呕吐(131例)、低血糖(45例)等。经过积极处理后,无一例患者死亡。 结论 低氧血症是行无痛胃肠镜检查术患者在麻醉苏醒期间最常见的并发症,其次为因呼吸道分泌物致呛咳、恶心呕吐、低血糖等。加强麻醉苏醒期的护理可以预防和减少麻醉相关并发症的发生。

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  • 自控镇静镇痛在胃肠内镜诊疗中的应用

    胃肠内镜作为胃肠道疾患的重要诊疗手段,其侵袭性操作所带来的痛苦和紧张焦虑等是妨碍许多患者接受内镜检查的主要原因。实施镇静镇痛会增加患者的耐受性,抵抗焦虑并减少疼痛不适,但同时也增加了心肺系统并发症的风险及检查的费用。因此根据不同患者进行个性化镇静镇痛的自控方式被引入胃肠内镜诊疗的镇静镇痛中,其使用专用的输液泵,通过易于操纵的按钮,由患者自己决定用药时间及药量,体现了按需给药和个体化用药的原则。自控镇静镇痛较传统的镇静镇痛模式可为胃肠内镜诊疗提供更为安全高效的镇静镇痛。

    Release date:2017-05-18 01:09 Export PDF Favorites Scan
  • 纳布啡在日间手术预防性多模式镇痛中的优势

    纳布啡作为阿片受体激动-拮抗剂,主要激动 κ 受体,拮抗 μ 受体,减轻了对心血管及呼吸的抑制作用,更好地发挥了镇静、镇痛的作用。同时纳布啡的起效时间快,持续时间长,与其他激动 μ 受体阿片类药物相比,纳布啡的不良反应较少,甚至可拮抗 μ 受体相关的副作用。该文通过回顾纳布啡的机制特点、药理作用,以及近些年来它在国内外日间手术麻醉中的应用,希望为实施日间手术麻醉提供一个新的思路。

    Release date:2017-11-24 10:58 Export PDF Favorites Scan
  • Research on extubation time and arterial blood gas analysis of ex vivo liver resection followed by autotransplantation in patients with advanced hepatic alveolar echinococcosis

    Objective To explore the correlations between the time of tracheal extubation and the intraoperative basic factors of ex vivo liver resection followed by autotransplantation in patients with advanced hepatic alveolar echinococcosis (HAE), and analyze the change trend of blood gas analysis during operation. Methods The data of 24 patients with advanced HAE who underwent ex vivo liver resection followed by autotransplantation in West China Hospital of Sichuan University between February 2014 and August 2017 were retrospectively analyzed. Results There were significant correlations between the extubation time and the duration of anesthesia (r=0.472, P=0.031), the amount of bleeding (r=0.524, P=0.015), the amount of erythrocyte suspensions infusion (r=0.627, P=0.002), and the amount of plasma infusion (r=0.617, P=0.003). There was no statistical difference in extubation time between patients with and without pulmonary complications in 3 months postoperatively [(23.74±15.84), (15.52±19.40) h, P=0.327]. Compared with those arterial blood gas results before the interruption, the pH value, blood glucose, lactic acid and base excess were statistically significantly different (P<0.05) at each time point after the interruption. Blood potassium increased at the end of operation compared with that before interruption (P<0.05); and the free calcium after blocking and opening increased with a temporary decrease (P<0.05); the hemoglobin decreased significantly after interruption and clamping (P<0.05). Conclusions Anesthesia length and bleeding should be reduced in ex vivo liver resection followed by autotransplantation, thus the extubation time would be shortened and the prognosis of the patients might be improved. Because of the longer anhepatic phase, the blood gas analysis varies largely. During operation, blood gas analysis and monitoring should be strengthened, and the acid-base balance and electrolytes should be maintained in time.

    Release date:2018-03-26 03:32 Export PDF Favorites Scan
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