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"魏新川" 5 results
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食管引流型喉罩又称为双管喉罩,为第三代喉罩。目前临床上广泛应用的食管引流型喉罩包括3种:Proseal喉罩,在Proseal喉罩基础上加以改进的Supreme喉罩以及无套囊的I-gel喉罩。食管引流型喉罩的主要特点为增加了一根对胃肠道起到密封和引流作用的引流管,并对通气罩进行了改进。因此食管引流型喉罩具备防止返流误吸的作用,并改善了通气功能。目前,食管引流型喉罩除了广泛应用于全身麻醉下成人、儿童的短小体表和四肢手术,还进一步应用到腹腔镜手术、腹部外科开放性手术、肥胖患者的手术、困难气管等领域。其应用的有效性和安全性大大提高, 将逐渐取代普通喉罩。本文就食管引流型喉罩的应用进展作一综述,便于临床医生更方便、更快捷的掌握食管引流型喉罩使用技术,并在临床上进一步推广。
Release date:2016-09-07 02:34
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脉搏灌注指数变异是新一代脉氧饱和度监测仪上集成的参数。它在预测患者的扩容反应性上敏感性好,特异性高,并且能够无创、自动、连续地在床旁对患者进行监测,临床应用前景巨大。现就脉搏灌注指数变异的研究背景、基本原理和测量方法、临床应用研究进展、局限性等方面作一综述。
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ObjectiveTo evaluate the ultrasonic pre locating internal jugular venous cannulation in infants, comparison with the external landmark technique.MethodsSixty two infants scheduled for cardiac surgery were randomized prospectively into two groups. In the anatomic landmarks group( n =30), the patient’s internal jugular vein(IJV) were cannulated by using the traditional method of palpation of carotid pulsation and identification of other anatomic landmarks. In the ultrasonic pre locating group ( n =32), an two dimensional ultrasound scanner image made for locating the puncture site of vessels was used with an operative probe of HP SONOS 4500 system. The number of attempts, success rate, and incidence of complications were compared for two groups.ResultsThe success rate was 100% vs 80% in the ultrasonic pre locating group vs anatomic landmarks group, with a 3.1% vs 26 7% incidence of carotid artery punctures and the number of attempts 1.57±1.04 vs 2.55±1.76. All differences were statistically significant ( P lt;0.05,0.05,0.01). Conclusion Ultrasonographic pre-localization of the IJV is superior to the anatomic landmarks technique in terms of overall success , and decreases incidence of carotid artery puncture.
Release date:2016-08-30 06:24
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摘 要 目的 观察参附注射液对体外循环(CPB)中肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的影响。方法 将20例人工心脏瓣膜置换术患者随机分成参附组和对照组(每组10例)。参附组分别于麻醉诱导前、CPB前及主动脉开放10分钟内分别静脉滴注参附注射液20ml、40ml和40ml,于CPB前、主动脉阻断前、主动脉阻断30分钟,主动脉开放15分钟和60分钟时采用放射免疫法测定两组血心中TNF-α和IL-6的含量。结果 主动脉阻断前、主动脉阻断30分钟、主动脉开放后15分钟和60分钟,对照组TNF-α值均明显高于参附组(P<0.05),各时点IL-6组间比较差别无显著性意义(P>0.05)。结论 参附注射液可降低主动脉开放后血浆TNF-α的含量,具有对抗CPB所致的炎性反应的作用,而对CPB中IL-6作用不明显。
Release date:2016-08-30 06:32
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即时检验(POCT)技术具有简便、快速、准确、方便等特点,近年来广泛应用于临床各个领域,在围手术期的应用包括动脉血气检测,凝血功能检测,心肌标志物检测,输血相关指标检测,甲状旁腺激素监测等。以POCT技术为基础的围手术期移动实验室会在不久的将来得到广泛的应用,为降低围手术期死亡率发挥重要作用。现就POCT技术在围手术期的应用进展作一综述,便于临床医生更多地了解POCT 技术,并推广应用于临床。