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        west china medical publishers
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        find Author "何元兵" 3 results
        • Application of HFOV and PLV in ALI/ARDS

          急性肺損傷( ALI) 及急性呼吸窘迫綜合征( ARDS) 是各種肺內外致病因素導致的急性呼吸衰竭, 以進行性呼吸困難和頑固性低氧血癥為特征, 常繼發于休克、創傷、嚴重感染以及大面積燒傷等疾病。病理以雙肺彌漫性的滲出為特點。病情進展迅速, 預后極差, 具有很高死亡率。治療時需要糾正缺氧, 以保證組織氧供。傳統的常規機械通氣( CMV) 在改善氧合、呼吸力學參數以及肺內炎癥反應的同時, 導致肺損傷, 即呼吸機相關性肺損傷( VALI) 。近年認為, 采用高頻振蕩通氣( HFOV) 代替CMV 能明顯避免產生VALI, 并能改善ALI/ARDS的呼吸系統順應性和氧合作用, 減輕肺內炎癥反應和VALI, 利于急性損傷肺內塌陷和閉塞的小氣道和肺泡重新開放。并且有人提出HFOV 與部分液體通氣( PLV)聯用( HFOV-PLV) 可進一步改善氣體交換, 抑制肺組織的炎性反應, 減少肺損傷及氟碳化合物( PFCs) 用量, 穩定全身血液循環, 減少中樞神經系統( CNS) 并發癥[ 1] 。

          Release date:2016-08-30 11:52 Export PDF Favorites Scan
        • Analysis of risk factors of prethrombotic state of obstructive sleep apnea and hyponea syndrome

          Objective To analyze the risk factors of prethrombotic state of obstructive sleep apnea and hyponea syndrome (OSAHS), providing basis and reference for the prevention of prethrombotic state of OSAHS. Methods Two hundred and thirty-eight patients excluding the presence of possible effects of coagulation factors from June 2014 to July 2016 were diagnosed as OSAHS by polysomnography (PSG) and underwent coagulation, thrombosis, fibrinolysis, and inflammatory factors testing. Fifty-six patients met the standard of prethrombotic state (prethrombotic state group) and 59 patients randomly selected from the remaining 182 patients did not meet the standard (non-prethrombotic state group). The age, sex, body mass index (BMI), sleep apnea and hypopnea index (AHI), interleukin-6 (IL-6), complicating chronic obstructive pulmonary disease (COPD) and hypertension were compared between two groups. Results Non conditional Logistic regression analysis showed that the risk factors of prethrombotic state of OSAHS were age (OR=1.202, 95%CI: 1.107 to 1.305), IL-6 (OR=1.127, 95%CI: 1.014 to 1.252), AHI (OR=1.151, 95%CI: 1.055 to 1.256), and complicating COPD (OR=4.749, 95%CI: 1.046 to 21.555). Conclusion Age, AHI, IL-6, and complicating COPD may be the risk factors of prethrombotic state of OSAHS, among which complicating COPD may be the most important risk factor.

          Release date:2017-09-25 01:40 Export PDF Favorites Scan
        • 血清降鈣素原及C 反應蛋白在社區獲得性肺炎和肺結核中的診斷價值

          目的 探討血清降鈣素原( PCT) 及C 反應蛋白( CRP) 在社區獲得性肺炎( CAP) 和肺結核中的臨床應用價值。方法 分析2011 年4 月至2011 年12 月新疆醫科大學第一附屬醫院呼吸內科收住的明確診斷的CAP患者134 例, 同期收住的明確診斷為肺結核患者86 例。收集患者入院24 h 內的血常規、PCT、CRP、紅細胞沉降率( ESR) 、病原學等指標。結果 PCT 及CRP在CAP 患者中的水平高于肺結核患者[ PCT: M( Q) 0. 30( 1. 54) 比0. 05( 0. 11) ng/mL, P lt; 0. 01; CRP: M( Q) 57. 85( 87. 43) 比21. 15( 55. 75) mg/L, P lt;0. 01] 。通過ROC 曲線分析, 與CRP 相比, PCT 能較好的區別CAP和肺結核[ PCT 的ROC 曲線下面積0. 736( 95% CI 0. 668 ~0. 803) , CRP 的ROC 曲線下面積為0. 652( 95% CI 0. 576 ~0. 727) ] 。PCT 在肺結核患者痰涂陽與痰涂陰兩組中無顯著性差異。結論 CAP患者的PCT 及CRP水平較肺結核患者高; 肺結核患者的PCT 水平不高, 對于肺結核痰涂陽及涂陰患者無診斷價值, 但對于結核高發地區有助于區別CAP 與肺結核。

          Release date:2016-09-13 03:50 Export PDF Favorites Scan
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