目的:比较芬太尼与利多卡因宫旁阻滞麻醉在人工流产术中的疗效。方法:选择我院2009年3月~2009年5月门诊终止妊娠早孕妇女100例,分为两组。芬太尼组50例,利多卡因组50例。比较两组宫旁阻滞麻醉镇痛效果及人流综合征发生率。结果:芬太尼组的镇痛效果明显优于利多卡因组,人流综合征的发生率明显低于利多卡因组。结论:芬太尼宫旁阻滞麻醉具有镇痛效果明显，人流综合征发生率低等优点，优于利多卡因麻醉效果。
目的:把布托啡诺与曲马多联合用于分娩镇痛,观察其效果、副作用及安全性。方法:足月初产妇共40例,随机分为两组。在宫口开大3~4 cm时于腰2~3硬膜外穿刺置管,1%利多卡因4 mL做试探剂量,待出现麻醉平面后,布托啡诺组产妇在硬膜外接受布托啡诺1 mg(2 mL)+0.05%曲马多与0.15%罗哌卡因混合液8 mL;曲马多组接受曲马多100 mg(2 mL)+0.05%曲马多与0.15%罗哌卡因混合液8 mL。记录用药前、用药后5、10、30 min宫缩时疼痛VAS评分、镇静Ramesay评分,新生儿Apgar评分,观察副作用发生率。结果:布托啡诺组在给药后5、10、30 min VAS评分都明显低于曲马多组(P＜0.05);镇静Ramesay评分在给药10 min时布托啡诺组明显大于曲马多组(P＜0.05);恶心、呕吐发生率曲马多组明显大于布托啡诺组。结论:硬膜外1 mg布托啡诺与曲马多、罗哌卡因混合液用于分娩镇痛效果好,对新生儿安全,减少副作用的发生。
目的:对照研究在全麻剖宫产术中应用瑞芬太尼和氯胺酮诱导对母婴的影响。方法:选择100例禁忌椎管内麻醉而须行全麻剖宫产手术的患者,分为两组,氯胺酮组静注异丙酚1.5mg/kg+氯胺酮1mg／kg+琥珀胆碱1.5mg／kg;瑞芬太尼组静注异丙酚1.5mg/kg+瑞芬太尼1μg/kg+琥珀胆碱1.5mg／kg诱导插管,胎儿娩出后均静注芬太尼2g／kg、泵注异丙酚3mg/(kg·h)和吸入异氟醚0.5MAC维持麻醉,阿曲库铵维持肌松。结果:瑞芬太尼组插管(切皮)后血压、心率升高幅度显著小于氯胺酮组,两组新生儿1min、5min Apgar评分无明显差异。结论:瑞芬太尼用于产科全麻优于氯胺酮,安全可行。
ObjectiveTo investigate the protective effect of atomized inhalation of nano-luteolin preparation on acute lung injury caused by extracorporeal circulation, and to explore the anti-inflammatory mechanism of luteolin, so as to provide study basis for clinical application.MethodsThirty male SD rats aged 5-6 weeks and weighting 160-190 g, were randomly divided into a preoperative baseline (BL) group, arteriovenous partial diversion (ECC) group, luteolin atomization pretreatment for 1 h group, 2 h group, and 3 h group by random number method, with 6 rats in each group. In the BL group, lung tissue samples were collected directly without any treatment. The ECC group received mechanical ventilation, and the whole body was heparinized after the jugular arteriovenous intubation. The flow was transferred for 30 minutes, followed by observation for 60 minutes, then lung tissue samples were collected. Subjects in the 1 h, 2 h and 3 h groups were placed in a small animal atomizer 1 h, 2 h and 3 h before flow transfer respectively, and the subsequent operation was the same as that in the ECC group. The inflammatory level of lung tissue was detected to evaluate the degree of pathological injury of lung tissue. Western blotting (WB) was used to detect the contents of p65, IKKα, IKKβ and IKKγ in the cytoplasm of lung tissue samples of each group.ResultsCompared with the ECC group, the levels of IL-6 and TNF-α in lung tissues and the degree of pathological injury in the 1 h, 2 h and 3 h groups decreased, and the difference between the 3 h group and the ECC group was statistically different (P<0.05). WB results showed that compared with the ECC group, the levels of p65 in lung tissue of the 1 h, 2 h and 3 h groups decreased; the levels of IKKβ in the lung tissue increased in the 1 h, 2 h and 3 h groups, and the difference of the 3 h group was statistically different from the ECC group (P<0.05).ConclusionLuteolin has a protective effect on acute lung injury induced by ECC, and atomization 3 h in advance has the best protective effect on lung. The mechanism plays a protective role in ECC-induced acute lung injury, may be through inhibition of IKKβ phosphorylation, thereby inhibiting the classical NF-κB signaling pathway.
ObjectiveTo investigate the feature of the angulation between left pulmonary artery (LPA) and main pulmonary artery (MPA) and its relationship to pulmonary artery development in patients with tetralogy of Fallot (TOF).MethodsA total of 101 TOF patients in West China Hospital from 2014 to 2018 were enrolled in a TOF group, including 62 males and 39 females, aged 6.8 (0.3-45.8) years, and another 20 patients without basic cardiac diseases at the same stage were enrolled in a control group, including 10 males and 10 females, aged 6.9 (0.3-54.0) years. Diameters of LPA, right pulmonary artery (RPA) and MPA, the angulation between LPA and MPA (MPA-LPA), McGoon ratio, and Nakata index were measured and compared between the two groups. The relationship between the above data and MPA-LPA angulation was also analyzed.ResultsThe average MPA-LPA angulation was smaller in the TOF group than that in the control group (113.63° vs. 128.45°, P=0.001 8). The MPA Z score was also smaller in the TOF group than that in the control group (0.46 vs. 2.75, P=0.000 4). No relationship was found by correlation analysis between the MPA-LPA angulation and MPA Z score or LPA Z score in the control group (P=0.239 6, 0.114 7) and the TOF group (P=0.759 3, 0.242 7). The McGoon ratios (2.22±0.72, 2.43±0.94, P=0.340 0) and Nakata index (359.3±294.24, 395.52±329.31, P=0.650 0) were not significantly different between the two groups.ConclusionThe angulation of LPA-MPA and MPA Z score are smaller in the TOF group than those in the control group. There is no relationship between MPA-LPA angulation and pulmonary artery diameters. The LPA-MPA angulation should not be considered as an influence factor for LPA development and trans-annular patch surgery.