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        west china medical publishers
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        find Author "王泉云" 6 results
        • 體外循環術中小劑量抑肽酶對急性炎性反應的作用

          目的 探討體外循環(ECC)術中小劑量抑肽酶是否能減輕ECC所致的急性炎性反應。 方法 將28例首次心瓣膜置換術患者隨機分為抑肽酶組和對照組,各14例。于麻醉誘導前、ECC前、ECC后1小時和24小時測定血漿中白細胞介素-10(IL-10)、腫瘤壞死因子-α(TNF-α)和白細胞計數。 結果 兩組IL-10 ECC后1小時比麻醉誘導前明顯升高(P<0.01),且抑肽酶組明顯高于對照組(P<0.01);對照組TNF-α和白細胞計數在ECC后1小時和24小時較麻醉誘導前明顯升高,且高于抑肽酶組(P<0.05)。 結論 小劑量抑肽酶可抑制ECC所致的炎性反應。

          Release date:2016-08-30 06:33 Export PDF Favorites Scan
        • 心肺轉流術在犬心肺腦復蘇中的應用

          目的 觀察犬在高鉀停搏10分鐘后行心肺轉流術(CPB)復蘇,并與常規心肺復蘇(CPR)比較其自主循環恢復和腦復蘇的效果. 方法 將雜種家犬12只,以10%KCl靜脈給藥致心臟停搏(CA)10分鐘后隨機分為兩組,每組6只.組1:用常規CPR法復蘇;組2:用自行研制的心肺轉流裝置復蘇. 兩組于CA前、CA10分鐘、復蘇后5分鐘、10分鐘和30分鐘監測平均動脈壓(MAP)、心率(HR)、心臟復跳時間、瞳孔大小、72小時存活率和動靜脈血氣并計算腦氧攝取率(CEO2)和腦氧耗量(Ca-jvO2). 結果 組1中6只犬僅2只在CPR后10分鐘、15分鐘恢復自主心跳,但不穩定,并在60分鐘內死亡;組 2均于CPB 后6~10分鐘恢復自主心跳,CPB 10分鐘后MAP>80mmHg,明顯高于組1(P<0.05),其自主循環恢復率為100%,明顯大于組1(P<0.05).兩組CEO2和 Ca-jvO2在CA10分鐘、復蘇后5分鐘和10分鐘均明顯升高(P<0.05),且復蘇后5分鐘、10分鐘和30分鐘時組1明顯高于組2 (P<0.05).組2犬的瞳孔于復蘇后第9~19分鐘開始縮小,30分鐘后恢復至正常,全組均存活72小時以上,72小時存活率為100%,明顯高于組1(P<0.05). 結論 CA10分鐘后,用CPB復蘇其自主循環恢復明顯優于常規CPR,并有益于腦復蘇.

          Release date:2016-08-30 06:34 Export PDF Favorites Scan
        • Changes of Somatosensory Evoked Potentials During Graded Spinal Cord Ischemia/reperfusion Injury in Rabbits

          Objective To investigate the relationship between graded spinal cord ischemia/reperfusion injury and somatosensory evoked potentials(SEP),neurologic function score(NFS)and the histopathological changes of spinal cord. Methods Forty rabbits were randomized and equally divided into 4 groups: shamoperation group, ischemia for 30min, 45min and 60min groups. The spinal cord ischemiareperfusion injury model was created by occlusion of the abdominal aorta in rabbits. SEP was monitored before ischemia,5,10minutes after ischemia, 15, 30 minutes, 1,2, 24 and 48 hours after reperfusion. NFS was evaluated at 6,12,24 and 48 hours after reperfusion.The pathological changes of spinal cord were observed after reperfusion 48 hours. Results The pathological characters with mild,moderate and severe spinal cord ischemia/reperfusion injury could be simulated by declamping after 30, 45 and 60 minutes infrarenal aorta crossclamping. SEP amplitude returned to normal after reperfusion 15 minutes(Pgt;0.05)and SEP latency returned to normal after reperfusion 30 minutes(Pgt;0.05)during mild spinal cord ischemia/reperfusion injury.SEP amplitude returned to normal after reperfusion 30 minutes(Pgt;0.05)and SEP latency returned to normal after reperfusion 60 minutes(Pgt;0.05)during moderate spinal cord ischemia/reperfusion injury. SEP latency increased and SEP amplitude decreased during severe spinal cord ischemia/reperfusion injury,compared with other groups, there were significant differences in SEP latency and SEP amplitude by clamping the infrarenal aorta for 60min(Plt;0.01). With graded spinal cord ischemia/reperfusion injury, compared with shamoperation group, spinal cord ischemiareperfusion groups had significant differences in NFS(Plt;0.01). Conclusion SEP is much quicker in the recovery of amplitude than latency during spinal cord ischemia/reperfusion. SEP is a sensitive and accurate index for spinal cord function during ischemia/reperfusion injury. SEP monitoring spinal cord ischemia/reperfusion injury during operation provides experimental basis for clinical application.

          Release date:2016-08-30 06:16 Export PDF Favorites Scan
        • THE EFFECTS OF DIFFERENT ANAESTHESIA ON STRESS REACTION DURING LAPAROSCOPIC CHOLECYSTECTOMY

          Objective To observe the effects of epidural anaesthesia (EA) and general anaesthesia (GA) on the changes of plasma epinephrine (E) and norepinephrine (NE) during laparoscopic cholecystectomy (LC). Methods Thirty patients undergoing elective LC were randomly divided into GA group (n=15) and EA group (n=15). The concentrations of plasma NE and E were measured at the following phases: before anaesthesia, before introducing pneumoperitoneum, during pneumoperitoneum, and at the end of operation. Results In EA group, the concentrations of NE weren′t significantly different at each phase, the concentrations of E significantly increased before and during pneumoperitoneum (P<0.05) and returned to the baseline at the end of operation (P>0.05). In GA group, the concentrations of NE and E didn′t change significantly before pneumoperitoneum, but increased during pneumoperitoneum (P<0.05) and E didn′t return to the baseline at the end of operation (P<0.05). The E concentrations of EA group was higher than that of GA group before pneumoperitoneum, but the NE concentration of EA group was lower than that of GA group during pneumoperitoneum (P<0.05). Conclusion Both groups has significant stress reaction, but the stress reaction of EA group is weaker than that of GA group during LC.

          Release date:2016-09-08 01:59 Export PDF Favorites Scan
        • 術前輸注含鎂極化液對術中血清和紅細胞內電解質的影響

          目的 減少心肺轉流術(CPB)中心瓣膜置換患者電解質紊亂及由此導致的心律失常.方法 風濕性心臟病心瓣膜置換患者20例隨機分為實驗組和對照組,實驗組術前7天輸注含鎂極化液,對照組輸注無鎂極化液.CPB中兩組均根據尿量及血清鉀含量補鉀,檢測術前、CPB開始5分鐘、30分鐘、主動脈開放、CPB結束和術畢時血清電解質及紅細胞內電解質. 結果 兩組血清電解質基本維持在正常范圍,但兩組紅細胞內鉀、鎂有明顯差別. 結論 風濕性心臟病心瓣膜置換術患者術前輸注含鎂極化液有利于維持CPB術中電解質平衡,從而減少心律失常的發生;紅細胞內電解質較血清電解質更能敏感地反映體內電解質的改變.

          Release date:2016-08-30 06:35 Export PDF Favorites Scan
        • EFFECT OF PROPOFOL ON SPINAL EXCITATORY AMINO ACID ACCUMULATION

          To investigate the protective effect of propofol on ischemia/reperfusion induced spinal cord injury in rabbits and its influence on excitatory amino acid (EAA). Methods Sixty New Zealand white rabbits weighing 2.0-2.5 kg, half males and half females, were selected. The infrarenal circumaortic clamping model was used. And 6 mL/kg different fluids were continuously infused through a catheter into the aorta distal to the clamping site at a speed of 12 mL/(kg?h) during the 30 minutes ischemia period. According to the different infusing l iquids, the rabbits were randomized into 6 groups(n=10 per group): group A, normal sal ine; group B, 10% intral ipid; group C, propofol 30 mg/kg; group D, propofol 40 mg/kg; group E, propofol 50 mg/kg; group F, propofol 60 mg/kg. At 0, 6, 24, and 48 hours after reperfusion, neurologic outcomes were scored on a Tarlov scale system. At 48 hours after reperfusion, the number of normal neurons in the anterior spinal cord was counted, and concentration of EAA in the lumbar spinal cord was measured by high performance l iquid chromatography. Results The neuroethological score was better in groups C, D, E and F than that of groups A and B (P lt; 0.05), the score of group E was the highest (P lt; 0.05), and there was no significant difference between group A and group B (P gt; 0.05). The number of normal neurons in the anterior spinal cord of groups C, D, E and F was greater than that of groups A and B (P lt; 0.05), and group E was greater than groups C, D and F (P lt; 0.05). The concentration of EAA in groups A, B, C, D, E and F was greater than that of normal tissue, the group E was the lowest (P lt; 0.05), the groups A and B were the highest (P lt; 0.05), and there was no significant difference between group A and group B (P gt; 0.05). Concentrations of glutamate and aspartic acid were negatively correlated to normal neuron numbers in the anterior spinal cord and neuroethological scores 48 hours after reperfusion, and the corresponding correlation coefficient was — 0.613, — 0.536, — 0.874 and — 0.813, respectively (P lt; 0.01). Conclusion Propofol can significantly inhibit the accumulation of EAA in spinal cord and provide a protective effect against the ischemia/reperfusion injury induced spinal cord in rabbits.

          Release date:2016-09-01 09:07 Export PDF Favorites Scan
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