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1.
目的:探究不同浓度右美托咪啶对小儿麻醉后肌钙蛋白I、C反应蛋白以及补体变化的影响。方法:收集我院下腹股沟斜疝、急性阑尾炎以及肠套叠手术患儿75例,根据治疗方法不同分为三组,每组25例,其中A组实施0.5μg/kg负荷剂量右美托咪啶治疗,B组实施0.25μg/kg负荷剂量右美托咪啶治疗,C组实施右美托咪啶0.2~0.7μg/kg/h持续泵入。对比三组患者苏醒情况、血清肌钙蛋白I、C反应蛋白、补体水平、镇定及躁动评分。结果:手术后,B组自主呼吸恢复时间、气管导管拔管时间、解除监护时间明显缩短,且与其他两组比较,差异有统计学意义(P0.05);与A、C两组相比,B组手术后C反应蛋白及血清肌钙蛋白I水平较低,而C3及C4水平较高,差异具有统计学意义(P0.05);B组镇静、躁动评分明显降低,差异有统计学意义(P0.05)。结论:0.25μg/kg负荷剂量右美托咪啶能够有效减轻患儿术后炎性反应,缓解麻醉后神经损伤,有助于脏器功能的恢复。 相似文献
2.
目的:探讨不同浓度右美托咪啶对小儿麻醉后血清肌钙蛋白I、C反应蛋白(CRP)及补体水平的影响。方法:选取我院收治的拟行手术的患儿60例,根据应用右美托咪定的浓度随机分为A、B、C三组,每组各20例。A、B组患儿予右美托咪啶0.5、0.25μg/kg的负荷剂量静脉推注给药10分钟,然后以0.2-0.7μg/kg/h的速度持续静脉微量泵入维持患者镇静状态,C组直接以右美托咪啶0.2-0.7μg/kg/h的速度持续泵入维持镇静状态。比较三组患儿麻醉术后的苏醒情况,麻醉前后不同时点血清肌钙蛋白I、C反应蛋白及补体水平的变化。结果:治疗前,三组患儿的各项指标比较均无统计学差异(P0.05);治疗后,与A、C两组比较,B组患者自主呼吸恢复时间、气管导管拔管时间、解除监护时间显著缩短(P0.05),术后24、72 h血清CRP水平更低,术后1、6、24 h血清肌钙蛋白I水平较低(P0.05),术后1、24、72 h血清补体水平较高(P0.05)。结论:0.25μg/kg浓度的右美托咪啶对于对小儿麻醉后血清肌钙蛋白I、C反应蛋白及补体水平的影响明显,且有助于患儿术后的苏醒。 相似文献
3.
目的:观察右美托咪定术后持续泵注对老年肺癌患者术后心律失常的影响。方法:选取在我院胸科接受手术治疗的肺癌患者100例,随机分成2组(n=50):地佐辛+氟比洛芬酯组(A组)和地佐辛+氟比洛芬酯+右美托咪定组(B组)。手术结束前半小时静注地佐辛5 mg和氟比洛芬酯100 mg,术毕连接患者自控镇痛泵(PCIA)。A组中加入地佐辛20 mg和氟比洛芬酯300 mg,而B组中加入地佐辛20 mg和氟比洛芬酯300 mg和80μg的右美托咪定。观察并记录患者术后4 h,8 h,24 h和48 h的VAS疼痛评分、Ramsay镇静评分及不良反应(维持VAS评分≤4分,Ramsay评分2~4分),监测心电图,记录心律失常发生情况。结果:A、B两组术后疼痛、镇静分级、不良反应发生率的差异无统计学意义。A组中17例患者术后发生心律失常,明显高于B组(4例)(P0.05)。结论:右美托咪定可减少老年肺癌患者术后心律失常的发生,且无明显不良反应。 相似文献
4.
目的:探讨右美托咪定联合舒芬太尼对脊柱手术患者术后镇痛效果的影响。方法:选择2013年1月至2016年8月在我院行脊柱手术的患者70例,随机分为两组,每组35例。对照组患者术后静脉注入舒芬太尼3μg/kg·h镇痛,观察组患者静脉注入右美托咪定1.5μg/kg·h联合1.5μg/kg·h舒芬太尼。分别记录患者术后6 h,12 h,24 h以及48 h的VAS评分、Ramsay评分、MAP、HR以及SpO_2等生命指征;记录患者术后苏醒期10 min,20 min,30 min以及60 min的RSAS躁动评分;同时记录患者术后48 h不良反应发生的情况。结果:监护仪监护两组患者围手术期的相关生命指征,统计分析结果显示两组患者术后HR,MAP以及SpO_2等指征没有明显的差异(P0.05);比较两组患者结束手术苏醒期的躁动情况,RSAS躁动评分显示实验组患者术后30 min之后较对照组相对安静,没有较明显的躁动行为(P0.05);实验组患者术后的VAS疼痛评分明显低于对照组(P0.05);比较两组患者的Ramsay评分发现实验组患者术后镇静程度显著优于对照组(P0.05);两组患者术后0-24 h使用镇痛泵的有效按压次数存在差异(P0.05);实验组患者术后48 h发生恶心呕吐和寒颤的不良反应发生率明显低于对照组(P0.05)。结论:右美托咪定联合舒芬太尼用于脊柱手术术后镇痛可以显著改善患者镇静状态,降低患者术后发生不良反应的发生率,值得临床上进一步推广应用。 相似文献
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摘要 目的:观察不同剂量右美托咪定静脉维持在重型颅脑损伤患者中的应用价值。方法:选取2018年9月~2020年9月期间江苏大学附属宜兴市人民医院麻醉与重症医学科接收的重型颅脑损伤患者96例,根据随机数字表法分为三组:A组(右美托咪定剂量为0.3μg/kg?h)、B组(右美托咪定剂量为0.5 μg/kg?h)和C组(右美托咪定剂量为0.7 μg/kg?h),各32例。观察三组患者不同时间点的生命体征、免疫功能、镇静镇痛情况、血清神经细胞因子,记录三组不良反应发生情况。结果:B组、C组术后24 h、术后72 h的心率(HR)、呼吸频率(RR)、平均动脉压(MAP)低于A组(P<0.05)。B组、C组术后24 h、术后72 h的Ramsay镇静评分、视觉模拟评分法(VAS)评分低于A组(P<0.05)。B组、C组术后24 h、术后72 h的CD3+、CD4+/CD8+高于A组(P<0.05)。B组、C组术后24 h、术后72 h的神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S100β)低于A组(P<0.05)。C组的不良反应总发生率高于A组、B组(P<0.05)。结论:重型颅脑损伤患者术中给予右美托咪定剂量为0.5 μg/kg?h、0.7 μg/kg?h维持,可有效维持患者生命体征平稳,促进患者免疫功能和血清神经细胞因子水平改善,但0.7 μg/kg?h剂量的右美托咪定使用后不良反应发生率相对更高。 相似文献
6.
目的:探寻患儿室间隔缺损封堵术中右美托咪定(dexmedetomidine,Dex)联合氯胺酮的最佳麻醉浓度。方法:选择4~11岁拟行VSDO的室间隔缺损患儿120例,随机分为A、B、C三组(n=40)。静脉注射阿托品及氯胺酮(1.0mg·kg-1)行麻醉诱导后,输注10min右美托咪定负荷量0.5μg·kg~(-1),然后对A、B、C三组分别静脉输注0.8、1.0、1.2μg·kg-1·h-1的右美托咪定。术中若麻醉变浅,单次追加氯胺酮0.5mg·kg-1。分别记录入室(T_0)、氯胺酮给药后1min(T_1)、5min(T_2)、输注完毕(T_3)、输注维持量15min(T_4)、术毕(T_5)、苏醒时(T_6)的BIS、BP、HR和SpO2,手术时间、苏醒时间,呼吸抑制和术后躁动等不良反应,氯胺酮总用量,氯胺酮和阿托品的追加情况。结果:与同组T_0时相比,三组在T_4和T_5的BIS值降低,三组的BP值、SpO2值在T_1~T_6无统计学差异。A组的HR在T_4、T_5无统计学差异(t=0.525,P=0.601)。三组手术时间和苏醒时间无统计学差异。B、C组的氯胺酮总用量和追加率、呼吸抑制发生率无统计学差异,均低于A组。B、C两组之间阿托品追加率有统计学差异,均高于A组。三组的苏醒期躁动发生率均为零。结论:4~11岁患儿室间隔缺损封堵术中,采用1.0mg·kg~(-1)氯胺酮行麻醉诱导,再以右美托咪定0.5μg·kg~(-1)的负荷量输注、1.0μg·kg~(-1)·h~(-1)的浓度维持,可使麻醉效果良好,且不良反应少,是最佳的联合麻醉浓度。 相似文献
7.
目的:比较右美托咪啶与咪达唑仑用于重症破伤风患者镇静中效果。方法:选取2012年1月~2015年12月间在我院治疗的重症破伤风患者72例,通过随机数表法分为右美托咪啶组与咪达唑仑组,各36例,给予右美托咪啶组静脉泵入右美托咪啶1μg/kg持续时间为10 min,之后以0.3~0.6μg/kg进行维持,咪达唑仑组静脉泵入咪达唑仑0.05 mg/kg,持续时间为1 min,之后以0.02~0.1/kg·h进行维持。监测两组患者用药前及用药12 h后平均动脉压(MAP)、呼吸频率(RR)、血氧饱和度(SpO_2)和心率(HR)深用Ramasy评分法评估镇静程度。结果:两组患者治疗后HR、RR、MAP水平明显降低而SpO_2明显上升且右美托咪啶组HR、RR、及SpO_2改善更显著差异均有统计学意义(P0.05);两组用药后4 h、8 h、12 h时Ramasy评分在组间、组内比较差异均无统计学意义(P0.05);右美托咪啶组不良反应发生率为5.56%,低于咪达唑仑组的16.67%,差异有统计学意义(P0.05)。结论右美托咪啶有助于维持患者血流动力学的稳定减少重症破伤风患者心动过速、心率增快、呼吸抑制等不良反应情况的发生。 相似文献
8.
目的:研究不同浓度罗哌卡因复合右美托咪定在肛肠疾病日间手术中的麻醉效果。方法:选取2016年5月~2018年5月期间于我院行肛肠疾病日间手术的患者123例为研究对象。根据随机数字表将患者分成A、B、C三组,每组各41例,其中A组麻醉时注入右美托咪定复合0.375%罗哌卡因20 m L,B组麻醉时注入右美托咪定复合0.5%罗哌卡因20 m L,C组注入右美托咪定复合0.75%罗哌卡因20 m L。比较三组患者麻醉后镇痛效果,比较三组麻醉前、麻醉30 min后的呼吸循环指标,比较三组患者感觉神经、运动神经阻滞情况,记录三组患者术后不良反应发生情况。结果:B组、C组镇痛优良率显著高于A组(P0.05),但B组、C组镇痛优良率组间比较差异无统计学意义(P0.05)。三组患者麻醉前、麻醉30 min后心率(HR)、收缩压(SBP)、舒张压(DBP)、血氧饱和度(SPO2)整体比较差异均无统计学意义(P0.05)。B组、C组感觉神经阻滞起效时间均较A组短,且C组短于B组(P0.05),而B组、C组感觉神经阻滞持续时间均较长,且C组长于B组(P0.05);B组、C组Bromage评分1分人数均较A组少,且C组少于B组(P0.05),B组、C组Bromage评分2分人数均较A组多,但C组较B组少(P0.05),C组Bromage评分3分人数较A组和B组多(P0.05),三组Bromage评分4分人数整体比较差异均无统计学意义(P0.05)。C组患者术后不良反应总发生率高于A组、B组(P0.05),但A组、B组不良反应总发生率组间比较差异无统计学意义(P0.05)。结论:0.5%、0.75%罗哌卡因复合右美托咪定应用于肛肠疾病日间手术的镇痛效果、麻醉效果优于0.375%罗哌卡因复合右美托咪定,但是0.75%罗哌卡因复合右美托咪定的不良反应发生率偏高,0.5%罗哌卡因复合右美托咪定是肛肠疾病日间手术中更为合适的麻醉方案。 相似文献
9.
目的探究右美托咪啶与芬太尼对七氟醚麻醉术后躁动的预防作用。方法选择我院自2014年1月-2015年12月需做外科手术的183例患者,将其随机分为A、B、C三组,每组61例,所有患者均行七氟醚诱导和维持麻醉。结果三组患者自主呼吸恢复时间、拔管时间相比无明显差异,P0.05;A组患者躁动发生率为8.2%(5/61),B组患者为16.39%(10/61),C组患者为63.93%(39/61),由此可知,组间对比,P0.05;A、B两组患者苏醒时间对比明显差异,P0.05;A、B、C三组患者离开麻醉后恢复室时间对比差异不明显,P0.05。结论采用七氟醚进行全身麻醉的患者,在手术结束前10min给予右美托咪啶与给予芬太尼相比,可将患者发生躁动的机率明显下降,明显将患者苏醒的时间缩短,因此可选择给予右美托咪啶来预防患者发生躁动。 相似文献
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目的:观察右美托咪定术前滴鼻对行扁桃体腺样体切除术患儿在围术期血流动力学和苏醒期躁动的影响。方法:择期行扁桃体腺样体切除术的患儿60例,随机分为右美托咪定组(D组)和生理盐水组(C组)。在麻醉诱导前30 min,D组患儿经鼻滴入右美托咪定,C组患儿经鼻滴入生理盐水。给药30 min后,进行静脉麻醉诱导。记录患儿的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2),患儿滴鼻接受程度、手术时间、拔管时间以及并发症的发生情况;根据麻醉苏醒期躁动量化评分表(PEAD)和改良加拿大东安大略儿童医院疼痛评分量表(m-CHEOPS)对患儿进行评分并记录术后苏醒期躁动发生率。结果:与C组相比,D组各个时间点的MAP、HR有统计学差异(P0.05),D组围术期生命体征变化相对平稳;两组患儿SpO_2、滴鼻接受程度、患儿手术时间比较均无统计学意义(P0.05);两组患儿拔管时间比较有差异(P0.05);D组患儿苏醒期PAED评分和m—CHEOPS评分均低于C组患儿(P0.05);两组患儿在围术期均无恶心呕吐,喉痉挛等不良反应的发生。结论:右美托咪定滴鼻可安全、有效的用于小儿患者,并且可使围术期血流动力学平稳及减少苏醒期躁动的发生。 相似文献
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Pushkar Shejwalkar 《Inorganica chimica acta》2011,366(1):209-218
New sulfur derivatives of phosphoramidite ligands were synthesized and the impact of the sulfur unit on the spectroscopic properties of their rhodium and iridium complexes was investigated. The new ligands Bn2NPSCH2CH2Sa(P-Sa) (Bn = benzyl, 4), Bn2NPSCHCHSa(CH2)3CaH2(P-Sa)(Ca-Sa) (6) and Bn2NP(4-XC6H4OMe)2 (X = S, 7a; X = O, 7b) were converted to the rhodium and iridium complexes trans-[Rh(CO)Cl(L)2] (L = 4, 6, 7), [RhCl(COD)(L)] (L = 4, 6, 7), [IrCl(COD)(7a)] and [IrCl2Cp∗(6)]. For comparison, some phosphoramidite complexes of these formulations also were synthesized. The new metal complexes were spectroscopically analyzed. For the carbonyl complexes, the νCO IR stretching frequencies were lower than for the corresponding phosphite and phosphoramidite ligands. The 1JPRh coupling constants for the rhodium complexes with the new ligands were also smaller than for the respective phosphoramidite and phosphite complexes. Finally, the 1JPSe coupling constants of the selenides of the new ligands were lower than those of the phosphoramidite ligands but higher than for PPh3. The spectroscopic data reveal that the new thio ligands 4, 6 and 7a are more electron donating than phosphites and phosphoramidites but less electron donating than PPh3. 相似文献
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Astrocytes transport the monocarboxylate acetate, but synaptosomes do not. The reason for this is unknown, because both preparations express monocarboxylate transporters (MCT). The transport and metabolism of lactate, another monocarboxylate, was examined in these two preparations, and the results were compared to those for acetate. Lactate transport is more rapid in astrocytes than in synaptosomes, but of lower affinity (Kms of 17 and 4 mM, respectively). Lactate (0.2 mM) is metabolized to CO2 more rapidly in synaptosomes than in astrocytes (rates of 0.37 and 0.07 nmol x mg protein(-1) x min(-1), respectively). The reason for this is unclear, but cellular differences in lactate dehydrogenase isotype expression may be involved. Acetate is metabolized to CO2 more rapidly in astrocytes than in synaptosomes (rates of 0.43 and 0.02 nmol x mg protein(-1) x min(-1), respectively). This is likely due to cellular differences in the expression of monocarboxylate transporter subtypes. 相似文献
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Hand JW 《Progress in biophysics and molecular biology》2007,93(1-3):192-194
The first and second sessions of the Workshop focussed on the basics of ultrasound and infrasound, their applications in both industry and medicine, and metrology and protection standards for ultrasound applications. 相似文献
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Gonzalez-Reimers E Rodriguez-Moreno F Martinez-Riera A Mas-Pascual A Delgado-Ureta E Galindo-Martin L Arnay-de la Rosa M Santolaria-Fernandez F 《Biological trace element research》1999,68(1):41-49
To elucidate accumulation of minerals in human iliac arteries with aging, the content of minerals was analyzed by inductively
coupled plasma atomic emission spectrometry. Bilateral common, internal, and external iliac arteries of 16 men and 8 women,
ranging ages from 65 to 93 yr, were examined. It was found that an extremely high accumulation of calcium and phosphorus occurred
in the common iliac artery at old age, being higher than that of the internal and external iliac arteries. It should be noted
that the accumulation of calcium and phosphorus is the highest in the common iliac artery among the human arteries examined
to date.
Regarding sexual differences, the content of calcium and phosphorus in the common and internal iliac arteries was higher in
women than in men, whereas their content in the external iliac artery was lower in women than in men. 相似文献
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18.
J. Morley M.A. Bray R.W. Jones D.H. Nugteren D.A. van Dorp 《Prostaglandins & other lipid mediators》1979,17(5):729-736
The ability of partially purified human and guinea-pig haematogenous cell populations, when cultured in vitro, to metabolise arachidonic acid (AA) has been studied. Supernatants from 24 hour cell culture have been subjected to analysis for products of AA metabolism by gas chromatography with electron-capture detection.The cell types studied were human peripheral blood monocytes (both glass adherent and non-adherent), neutrophils, eosinophils and leukemic leucocytes; thoracic duct lymphocytes and lung alveolar macrophages. From the guinea-pig, induced and non-induced macrophage or neutrophil enriched peritoneal exudate populations, lymph node cells, peritoneal eosinophils and peripheral blood platelets were examined. Supernatants were assayed for the presence of PGE2, PGD2, PGF2α, TXB2 and 6-keto-PGF1α. In all types studied PGE2 and TXB2 were the major products formed. The identification of PGE2 and TXB2 was confirmed by GC/MS with multiple ion monitoring.The results have been compared with other reports and their possible significance discussed in relation to the proposed role of prostaglandins as mediators and modulators in immunopathology. 相似文献
19.
Allergic asthma can be precipitated by many factors. For the atopic person, fungus, pollen, dust mites, cockroach antigens, and diesel exhaust are all agents that may trigger an allergic attack. Cytokines and chemokines are integral mediators of fungal asthma. From the earliest time points, they recruit and activate the cells required for the clearance of fungus as well as being critical factors involved in the immunopathology of this disease. In the final analysis, it is clear that these mediators can act to the benefit or the detriment of the host. 相似文献
20.
Sandra M. Vaz 《Archives of biochemistry and biophysics》2009,484(2):127-431
In spite of the many studies on protein modifications by reactive species, knowledge about the products resulting from the oxidation of protein-aromatic residues, including protein-derived radicals and their stable products, remains limited. Here, we compared the oxidative modifications promoted by peroxynitrite and myeloperoxidase/hydrogen peroxide/nitrite in two model proteins, ribonuclease (6Tyr) and lysozyme (3Tyr/6Trp). The formation of protein-derived radicals and products was higher at pH 5.4 and 7.4 for myeloperoxidase and peroxynitrite, respectively. The main product was 3-nitro-Tyr for both proteins and oxidants. Lysozyme rendered similar yields of nitro-Trp, particularly when oxidized by peroxynitrite. Hydroxylated and dimerized products of Trp and Tyr were also produced, but in lower yields. Localization of the main modified residues indicates that peroxynitrite decomposes to radicals within the proteins behaving less specifically than myeloperoxidase. Nitrogen dioxide is emphasized as an important protein modifier. 相似文献