目的 探讨热性惊厥患儿血清电解质和血糖的变化及其临床意义。 方法 选取2009 年6月－2010 年12月儿科住院的呼吸道感染并发热性惊厥患儿38例和呼吸道感染无惊厥患儿42例，分别作为观察组和对照组，测定和比较两组患儿血清电解质和血糖值。 结果 观察组血清钠离子浓度为（133.05 ± 1.74）mmol/L、氯离子浓度为（100.37 ± 1.79）mmol/L；对照组血清钠离子浓度为（142.19 ± 1.85）mmol/L、氯离子浓度为（104.57 ± 1.55）mmol/L，差异均有统计学意义（P＜0.01）；观察组和对照组血糖浓度依次为（6.93 ± 0.87）、（5.12 ± 0.55）mmol/L，差异有统计学意义（P＜0.01）。观察组在治疗后的血清钠离子、氯离子浓度分别为（140.89 ± 2.68）、（103.29 ± 1.94）mmol/L，均高于发生惊厥时的浓度（P＜0.01）；观察组在治疗后的血糖浓度为（5.31 ± 0.68）mmol/L，明显低于发生惊厥时，差异有统计学意义（P＜0.01）。 结论 婴幼儿发生热性惊厥时存在血钠、血氯水平降低和血糖升高，在热性惊厥患儿的治疗中应纠正血钠水平和高血糖。Objective To explore the clinical significance of the changes in serum electrolytes and blood glucose in the children with febrile convulsion. Methods Thirty-eight children with respiratory infection combined with febrile convulsion and 42 children with single respiratory infection diagnosed between June 2009 and December 2010 were selected as the observation group and control group, respectively. Serum electrolytes and blood glucose concentration were assayed and compared between the two groups. Results The concentrations of serum sodium and chloride were (133.05 ± 1.74) mmol/L and (100.37 ± 1.79) mmol/L in the observation group, while (142.19 ± 1.85) and (104.57 ± 1.55) mmol/L in the control group; the differences between the two groups were significant (Plt;0.01). The concentrations of blood glucose were (6.93 ± 0.87) mmol/L in the observation group and (5.12 ± 0.55)mmol/L in the control group; the difference was significant (Plt;0.01). After the treatment, the serum concentrations of sodium and chloride were (140.89 ± 2.68) and (103.29 ± 1.94)mmol/L in the observation group, which were higher than those before treatment (Plt;0.01). After treatment, the blood glucose concentration was (5.31 ± 0.68）mmol/L in the observation group, which was lower than that before the treatment (Plt;0.01). Conclusion Hyponatremia, low serum chlorine and hyperglycemia occurre in the febrile convulsion in children, which should be corrected in the treatment of febrile convulsion.
In order to observe electrolyte changes before and after scheduled abdominal surgery and effect of prompt potassium supplement on the recovery of gastrointestinal function, electrolytes in 69 patients were tested before and after surgery, and the recovery of the gastrointestinal function was observed.The results showed that after surgery the levels of K＋, Na＋ and Cl＋ were decreased dramatically (Ｐ＜0.05) but still within the normal range, with no distinctive change in Ca２＋ and Mg２＋. No correlation between the amount of blood transfusion and potassium was detected. Prompt potassium supplement contributed to the quick recovery of gastrointestinal function.This suggests that with normal renal function, blood transfusion during the operation will not cause hyperkalemia, potassium supplement might begin on the first day when the patient begins to urinale.
Objective To evaluate the difference of oral sodium phosphate (NaP) and polyethylene glycol-electrolyte lavage solution (PEG-ELS) in the aspects of cleansing efficacy, tolerance, and safety in clinical practice, so as to provide evidence for clinical practice. Methods A systematic review of all the relevant randomized controlled trials (RCTs) was performed according the handbook of the Cochrane Collaboration. RCTs were identified from The Cochrane Library(Issue1,2004) MEDLINE(1980-2004), EMBASE(1984-2004),and CBM(1978-2004).Handsearching was also performed .RCTs comparing the two methods were selected .Tow reviewers independently assessed the quality of included trials and extracted data independently .Results Eighteen trials involving 3668 patients were included .Sub-group analysis was performed. Nap tablet had higher rate of adequate cleansing quality (RR1.08,95%CI1.02 to 1.05,p=0.01).Two-day ,divided-dose oral Nap was superior in the rate of adequate cleansing quality (RR1.27,95%CI1.06 to 1.52,p=0.009). .The. rate of adequate cleansing quality in right colon of Nap was lower than PEG-ELS(RR0.79,95%CI 0.64 to 0.98,p=0.03).The rate of abdominal cramps (RR 0.84,95%CI 0.72 to 0.99),the rate of abdominal fullness (RR 0.48,95%CI 0.26 to 0.89),the rate of nausea (RR 0.65,95%CI 0.56 to 0.76)and the percentage of patients who didn’t finished their prescribed regimen (RR 0.23,95%CI0.14 to 0.36)in Nap group were lower (plt;0.05).Conclusions Compared with PEG-ELS,Nap is superior in cleansing efficacy , patients’ tolerance ,safety and economy . It is possible to promote the use of Nap in clinical practice in China .
摘要:目的: 研制贝克曼CX系列全自动生化分析仪电解质配套试剂盒。方法 评价自配电解质试剂盒的主要性能指标:准确度、精密度、线性范围、稳定性和相关性,并与原装试剂进行临床标本测定结果比较。结果 自配试剂盒测定定值血清Na+、K+、Cl平均相对偏差均小于2%;批内精密度、批间精密度较好,变异系数(%)均小于2%;与原装试剂测定结果高度正相关,相关系数〖WTBX〗r 均大于099。结论 自配试剂完全可以取代进口试剂进行临床应用。Abstract: Objective: To develop ISE(ion selective electrode) reagent for Beckman CX series automatic chemistry analyzer. Methods : Validation the main performances of selfmade reagent, including accuracy, precision, linear range, stability, and relevance, and carried clinical comparison test with the original reagent kit. Results : The main performances of selfmade reagent achieved the experimental anticipated request. As analyzing the valued serum, the average relative deviations of Na+,K+,Clwere less than 2%; withinrun precision and betweenrun precision were good,coefficient of variations were less than 2%; the selfmade reagent was highly correlated with the original reagent kit,correlation coefficient was greater than 099 Conclusion : Selfmade reagent could substitute the original reagent kit for clinical laboratory.
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.
Safe and effective anticoagulation is the key to successful blood purification. Compared with traditional systemic anticoagulation, regional citrate anticoagulation (RCA) has the advantages of prolonging the life of extracorporeal circulation and reducing bleeding complications. However, the complex protocol, the disorder of electrolyte and acid-base status and the accumulation risk in special populations have dissuaded many clinicians. This review starts with the clinical monitoring of RCA, then analyzes the causes and treatments of complications. The risk assessments in special populations were also introduced in order to the widely promotion of RCA in critically ill patients.
Objective To observe the clinical effect of vitrectomy, inner limiting membrane (ILM) peeling, subretinal injection of compound electrolyte intraocular irrigation solution (CEIIS) and conbercept in the treatment of diabetic macular edema (DME) with hard exudate (HE) (DME-HE). MethodsA prospective clinical study. Thirty-three patients with DME-HE diagnosed by examination in Weifang Eye Hospital from June 2020 to February 2022 were included in the study. Among them, there were 15 males (16 eyes) and 18 females (20 eyes), with the mean age of (62.00±6.54) years. All patients underwent the examinations of best corrected visual acuity (BCVA), scanning laser ophthalmoscope, optical coherence tomography (OCT), and multifocal electroretinography (mf-ERG). Snellen visual acuity chart was used for BCVA examination, which was converted into logarithm of the minimum angle of resolution (logMAR) BCVA for statistic analysis. Macular foveal retinal thickness (CMT) and macular volume (MV) were measured by OCT. The 1 ring P1 wave amplitude density was measured by mf-ERG. The patients were randomly divided into group A and group B, with 17 patients (18 eyes) and 16 patients (18 eyes), respectively. There were no significant differences in age, logMAR BCVA, HE area, CMT, MV, and 1 ring P1 wave amplitude density between the two groups (t=0.403, 0.972, 0.291, 0.023, －0.268, －0.206; P＞0.05). Group A was treated with vitrectomy, ILM peeling, and subretinal injection of CEIIS and conbercept (combined therapy). Group B was treated with intravitreal injection of conbercept (IVC). Follow-up was 12 months after treatment. The changes of BCVA, HE area, CMT, MV, 1 ring P1 wave amplitude density were compared between groups and groups after treatment. The times of injection and complications after treatment were observed. Independent sample t test was used for comparison between the two groups. ResultsAt 12 months after treatment, compared to before treatment, there were significant differences in logMAR BCVA (F=14.837), HE area (χ2=94.522), CMT (χ2=199.212), MV (χ2=81.914) and 1 ring P1 wave amplitude density (F=8.933) in group A (P＜0.05); there were significant differences in CMT (F=5.540) and MV (F=7.836) in group B (P＜0.05). Compared between the two groups, logMAR BCVA: 1 week and 6 and 12 months after treatment, the difference was statistically significant (t=2.231, －2.122, －3.196; P＜0.05); HE area: except 1 week after treatment, there were statistically significant differences at other times after treatment (t=－2.422, －3.107, －3.540, －4.119; P＜0.05). CMT, MV, 1 ring P1 wave amplitude density: 12 months after treatment, the differences were statistically significant (t=－2.653, －2.455, 2.204; P＜0.05). During the follow-up period, the injection times of group A and group B were (3.06±1.89) and (5.56±2.04), respectively, and the difference was statistically significant (t=－3.815, P＜0.05). Macular hole and vitreous hematoma were found in 1 eye in group A and 1 eye in group B. ConclusionVitrectomy, ILM peeling, subretinal injection of CEIIS and conbercept to treat DME-HE can effectively remove HE, alleviate macular edema, improve BCVA, and reduce CMT and MV. Combination therapy can reduce the number of IVC re-treatments.