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国家自然科学基金(30772074)

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老年髋关节置换应用等比重布比卡因复合腰丛阻滞被引量:9
2010年
背景:以往老年患者行髋关节置换的麻醉主要为全麻,腰麻,硬膜外麻醉。单纯腰麻容易造成麻醉平面和麻醉时间的局限。目的:对比观察等比重布比卡因腰麻复合腰丛阻滞和连续硬膜外阻滞联合小剂量布比卡因腰麻在老年髋关节手术中的应用效果。方法:行髋关节置换术高龄患者46例,随机分为两组,分别给予患侧腰丛阻滞复合等比重布比卡因腰麻和连续硬膜外阻滞联合小剂量布比卡因腰麻,比较麻醉前、麻醉后5,10,15,20,30min收缩压、舒张压、心率及血氧饱和度,观察两侧痛觉阻滞平面,温度觉及触觉平面,Bromage运动阻滞评分,术中不良反应,患肢有效的镇痛时间及有效的阻滞时间。结果与结论:采用等比重腰麻复合腰丛麻醉,麻醉前与麻醉后各时间点收缩压、舒张压、心率、血氧饱和度比较差异无显著性意义(P>0105),患侧痛觉阻滞平面,温度觉及触觉阻滞平面,Bormage运动阻滞评分与健侧比较差异有显著性意义(P<0.01)。等比重布比卡因腰麻复合腰丛阻滞患肢的有效镇痛时间及有效阻滞时间均长于连续硬膜外阻滞联合小剂量布比卡因腰麻。提示等比重布比卡因腰麻复合腰丛阻滞用于高龄髋关节置换术起效快、不改变麻醉体位、循环稳定,减少了腰麻用药量,麻醉平面更易控制,更安全。
康凯张西京熊利泽
关键词:髋关节置换腰麻腰丛阻滞老年等比重布比卡因
不同强度吸氧预处理对大鼠脑缺血再灌注损伤的保护效应被引量:2
2010年
目的:探讨不同强度吸氧预处理对大鼠脑缺血再灌注损伤的保护效应以及吸氧预处理引起的"脑缺血耐受"持续时间的研究。方法:56只雄性SD大鼠随机分为7组(n=8),按吸纯氧的持续时间不同分为6组,对照组吸空气。各组动物均行大脑中动脉阻闭(MCAO)120min后再灌注,24h后行神经功能学评分(Garcia评分),处死动物行TTC染色测定脑梗死容积百分比,检测各组评分及百分比。从上7组中选择梗死容积百分比最小的一组按该方式进行吸氧预处理,进一步实验将40只雄性SD大鼠以吸氧预处理和MCAO之间的间隔时间不同,随机分为5组(n=8)对照组吸空气,MCAO24h后进行Garcia评分和测定脑梗死容积百分比。结果:吸100%O2、8h、3次,1次/d,和吸100%O2、8h、1周,1次/d,Carcia评分明显高于对照组7.5±0.37(P<0.05)分别为11.7±0.32和12.4±0.36而且脑梗死容积比明显低于对照组0.48±0.057(P<0.05)分别为0.21±0.07与0.20±0.09;吸氧8h、1周,1次/d1周后缺血前24h强化一次预处理再进行MCAO与对照组相比Carcia评分高于对照组,脑梗死容积比低于对照组,而吸氧8h、1周,1次/d1周后进行MCAO处理与对照组无差异。结论:吸100%O28h、3次1次/d和吸100%O2、8h、1周,1次/d可以有效地减轻脑缺血再灌注损伤,起到很好的脑保护作用。吸氧预处理引起"脑缺血耐受"有持续效应,但随时间延长呈减弱趋势,1周后需强化1次预处理进行"唤醒"。
康凯鲁瑶张西京
关键词:脑缺血再灌注损伤脑保护效应
Effect of Electroacupuncture Preconditioning on Serum S100 β and NSE in Patients undergoing Craniocerebral Tumor Resection被引量:14
2010年
Objective:To investigate the effect of electroacupuncture preconditioning on the serum level of S100 calcium-binding protein beta(S100β)and neuron-specific enolase(NSE)in patients undergoing craniocerebral tumor operation.Methods:A total of 32 patients,who would go through craniocerebral tumor resection under general anesthesia,were randomly assigned to two groups,16 in each group.Patients in the electroacupuncture(EA)group received electroacupuncture on Fengfu acupoint(Du16)and Fengchi acupoint (GB20)for 30 min,2 h before operation.The stimulus is 1-4 mA with a density wave frequency of 2/15 Hz. Patients in the control group received no pretreatment.Anesthesia was maintained with remifentanil at the dose of 4-8 mg/kg per hour,pumped intravenous drip of vecuronium at 1.0-2.0μg/kg each hour,and discontinuous intravenous dripped with vecuronium bromide at 0.5-1 mg.The serum levels of S100βand NSE were measured with ELISA before operation,before skin incision,after tumor removal,at the end of operation,and at 24 h after operation.Results:The serum level of S100βand NSE did not change before skin incision.The serum level of NSE increased significantly and the level of S100βincreased insignificantly after the tumor resection. The serum levels of S100βand NSE in the EA group and the control group were 1.16±0.28μg/L vs 1.47±0.33μg/L,24.7±13.3μg/L vs 31.4±14.1μg/L at the end of the operation,respectively.Twenty-four h after operation,the correspondence indices were 1.18±0.31μg/L vs 1.55±0.26μg/L,and 25.5±12.4μg/L vs 32.4±11.7μg/L.The two indices at these two time points were significantly increased than those before operation, respectively(P〈0.05).At the end of the operation and 24 h post-operation,the serum levels of S100βand NSE in the EA group were significantly lower than those in the control group(P〈0.05).Conclusion:Electroacupuncture Fengchi and Fengfu for 30 min before craniocerbral tumor operation could decrease the serum level of S100βand NSE,thus m
路志红白晓光熊利泽王永徵王异王强
关键词:ELECTROACUPUNCTUREPRECONDITIONINGCRANIOTOMY
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