【摘要】 目的 分析宜宾市第二人民医院2009年门、急诊麻醉药品的使用情况，促进麻醉药品使用的合理化和规范化。 方法 对2009年门急诊1 420张麻醉药品处方进行统计，统计处方总数，麻醉药品临床使用分布情况，根据药品分类分别统计麻醉药品的用药总量，各种麻醉药品的处方所占的比例，实际用药总天数等。对非癌症处方以用药频率及药物利用指数（DUI）为指标，癌症处方以用药天数及平均日用药量为指标进行进行统计、分析、评价。 结果 门急诊的麻醉药品有8种，盐酸吗啡缓释片的总用量居首位，盐酸哌替啶针在急诊处方中出现频率较高，芬太尼透皮贴剂的用药频度较小，药物利用指数均≤1。 结论 宜宾市第二人民医院的急诊麻醉药品使用基本合理。A total of 1 420 pieces of narcotic drugs prescriptions for the outpatient in our hospital in 2009 were extracted. The total number of prescriptions, the distribution of the clinical use of narcotic drugs, the total amount of narcotic drugs according to different types, the proportion of each kind of narcotic drug prescription and the actual number of medication durations were counted and analyzed. Defined daily dose (DDD) and drug use index (DUI) of the non-cancer drugs prescription; meanwhile, the number of drug-using days and average daily amount of cancer drug prescription were statistically analyzed. Results There were eight kinds of narcotic drugs for the outpatients. The most total amount of narcotic drugs was morphine hydrochloride sustained release tablets; the medication frequency of pethidine injection in the emergency prescription was high and the medication frequency of transdermal fentanyl was low. The narcotic drugs utilization index was lower than one. Conclusion The use of narcotic drugs in our hospital is rational.
ObjectiveTo evaluate the efficiency and safety of intraprocedural valve-in-valve deployment for treatment of aortic regurgitation following transcatheter aortic valve replacement (TAVR).MethodsConsecutive patients (n=333) who diagnosed with severe aortic stenosis and underwent TAVR in Zhongshan Hospital affiliated to Fudan University from October 3rd, 2010 to April 21st, 2021 were included. There were 208 males and 125 females aged 76.0±7.0 years. There were 316 patients underwent simple TAVR (simple TAVR group) and 17 patients underwent intraprocedural valve-in-valve deployment following TAVR (valve-in-valve group). Their clinical and echocardiographic outcomes were evaluated and compared.ResultsThere was no significant difference between the two groups of patients at postoperative 30 d and 1 year in all-cause mortality (4.4% vs. 0, P=1.000; 6.3% vs. 0, P=1.000), incidence of pacemaker implantation (10.4% vs. 17.6%, P=1.000; 11.8% vs. 17.6%, P=1.000), incidence of ischemic stroke (1.3% vs. 0, P=1.000; 1.3% vs. 0, P=1.000), mean trans-aortic pressure gradient (11.4±6.4 mm Hg vs. 8.9±4.9 mm Hg, P=0.099; 10.5±7.6 mm Hg vs. 11.2±5.2 mm Hg, P=0.432), left ventricular ejection fraction (62.0%±9.0% vs. 57.0%±12.0%, P=0.189; 63.0%±7.0% vs. 60.0%±8.0%, P=0.170), and incidence of mitral valve dysfunction (0.6% vs. 5.9%, P=1.000; 0.6% vs. 5.9%, P=1.000).ConclusionIt is feasible to treat perivalvular leakage with valve-in-valve technology in the procedure of TAVR, and the short and medium-term effects are satisfied.
Tricuspid regurgitation is the most prevalent valvular disease, and one its primary treatment was surgical tricuspid valve biological valve replacement. Catheter tricuspid valve-in-valve implantation is a novel interventional alternative for biological valve failure. The non-invasive pulmonary water measuring device ReDSTM has been increasingly incorporated into clinical practice as a means of monitoring chronic heart failure in recent years. This report describes the process and outcomes of the first instance of perioperative lung fluid volume evaluation following transcatheter tricuspid valve implantation utilizing ReDS technology. The patient had a short-term, substantial increase in postoperative lung fluid volume as compared to baseline.