论著

出院后营养管理对新生儿肠道术后体格追赶的效果及其相关因素分析

Effect and correlative factor analysis of post-discharge nutrition management on neonate physical catch up growth after bowel surgery

:18-23
 
目的 探讨科学的出院后营养管理对肠道术后新生儿体格追赶的效果,分析影响体格追赶的相关因素。方法 通过营养门诊对出院术后婴儿及社区婴儿进行个体化营养喂养指导和营养咨询,比较两组每月体质量、身长及头围,并随访至生后9月龄。两组生后半年生长趋势行重复测量检验。结果 第1月龄时,手术组患儿体质量、身长、头围均落后于对照组婴儿(P<0.001, P=0.004, P=0.008),第2月龄时,手术组患儿体质量、头围仍落后于对照组(P=0.003,P=0.031),第4月龄时,手术组体质量低于对照组(P=0.012),第5~9月龄,两组体格指标均无明显差异。生后半年内两组的生长趋势差异无统计学意义。前半年身长的增长与出生身长、父母文化以及父亲的不良习惯存在负相关关系,头围的增长与住院天数呈明显负相关关系、与出生以及首诊时的体格状况呈正相关关系。结论 合理喂养对新生儿肠道术后体格追赶有利,帮助其接近正常生长曲线。再次手术可能是导致体质量增长下降的主要因素,但未明显影响身长、头围的正常增长。出生时和就诊时的体格状况、父母教育程度和不良习惯以及住院天数均是影响体格追赶的相关因素。
Objective To investigate the effect of scientific nutrition management after discharge on neonatal physical catch-up after intestinal operation, and to analyze the related factors affecting physical catch-up. Methods Individualized nutritional feeding instruction and nutrition consultation were performed on infants and community infants after discharge from hospital through nutrition clinic. The monthly body weight, body length and head circumference were compared between the two groups, and followed up to 9 months old. The growth trend of the two groups in half a year after birth was tested by repeated measurement. Results At the first month of age, the body weight, body length and head circumference of the patients in the operation group were lower than those in the control group (P<0.001, P=0.004, P=0.008). At the second month, the body weight and head circumference of the operation group were still behind those of the control group (P=0.003, P=0.031), and at the fourth month of age, the weight and head circumference of the patients in the operation group were still lower than those in the control group. The body weight of the operation group was lower than that of the control group (P=0.012), and there was no diffence in the physical indexes between the two groups at the age of 5~9 months. There was no statistical significance in growth trend between the two groups within half a year after birth. The growth of body length in the first half of the year had a negative correlation with the length of birth, parents' culture and father's bad habits. The growth of head circumference had a negative correlation with the length of stay in hospital, and had a positive correlation with the physical condition at birth and at first visit. Conclusion Reasonable feeding is beneficial to the physical catch-up of the newborn after intestinal operation and helps them approach the normal growth curve. Reoperation may be the main cause of weight loss, but it does not affect the normal growth of body length and head circumference. The physical condition at birth and medical visit, parents' education level, bad habit and hospitalization days were all related factors of physical catch-up.
论著

黏附因子E-cadherin和TLR9在系统性红斑狼疮发病机制中的作用

Effect of adhesion molecule E-cadherin and TLR9 in the pathogenesis of systemic lupus erythematosus

:5-8
 
目的 探讨黏附因子E-钙粘蛋白(E-cadherin)和Toll样受体9(TLR9)在系统性红斑狼疮(SLE)发病机制中的作用。方法 随机选取SLE患者41例,健康对照组18例,采用酶联免疫吸附试验(ELISA)法检测血清中sE-cadherin的表达,采用流式细胞技术(FCM)检测外周血单核细胞上TLR9的表达。分析 sE-cadherin,TLR9与系统性红斑狼疮患者病情的活动性。结果 SLE组血清中sE-cadherin的表达水平高于正常组(P=0.00),差异有统计学意义;SLE活动组血清中sE-cadherin表达水平高于稳定组(P=0.06),但差异无统计学意义;SLE组TLR9表达高于健康组(P=0.00),活动组高于稳定期组(P=0.00),差异均有统计学意义;SLE患者TLR9表达与SLEDI呈正相关(r=0.727,P=0.00),差异有统计学意义。结论 血清中sE-cadherin和外周血单核细胞内TLR9均参与了SLE患者病情发展的过程,并且二者在SLE发病机制中可能具有协调作用。
Objective To explore the effect of adhesion molecule E-cadherin and Toll-like receptor-9(TLR9) in the pathogenesis of systemic lupus erythematosus(SLE). Methods 41 patients with SLE and 18 healthy controls were selected randomly.Expression of TLR9 in peripheral blood mononuclear cells determined by FCM. SE-cadherin levels were measured in the serum by ELISA analysis. The correlation between sE-cadherin、TLR9 and the patient's condition of SLE was analyzed. Results Compared with healthy subjects,the expression of sE-cadherin in serum was higher among SLE patients(P=0.00),there was statistically significant between two groups;activity group was higher than inactivity group and healthy controls(P=0.06),but there was no statistically significant between activity group and inactivity group. Compared with healthy subjects,the expression of TLR9 in peripherql blood mononuclear cells was higher among SLE patients(P=0.00);activity group was higher than inactivity group(P=0.00),there was all statistically significant between two groups.The positive correlation was observed between TLR9 expression levels and clinical measure of the SLEDAI(r=0.727,P=0.00),there was statistically significant between two groups. Conclusion SE-cadherin and TLR9 may play an important role in SLE,and may interact with each other which needed further study.
论著

自体心包膜移植对心肌梗死大鼠心功能的影响

Effect of autologous pericardial patch transplantation to cardiac function after treating the myocardial infarction in experimental rats

:1-4
 
目的 探讨自体心包膜组织对急性心肌梗死大鼠心脏功能的影响。方法 筛选合格的模型动物随机分为三组:心包去除组:仅去除心包膜;心梗组:前降支结扎法建立大鼠心肌梗死模型3周后仅开胸;移植组:前降支结扎法建立大鼠心肌梗死模型,3周后将心包膜移植于心肌梗死及周边区。实验4周后,通过心动图评价实验动物心脏功能,使用Masson染色检测动物心肌梗死大小,通过免疫荧光评价动物心肌存活率、观察血管新生状况,Western blot检测Caspase-3蛋白/Bcl-2基因表达情况。结果 4周后,心包去除组大鼠的心电图监测结果未见有室性颤动;而心梗组、心梗+移植组均有非致死性室性颤动。相比心梗组,心梗+移植组改善了心功能,降低了心肌凋亡指数,免疫Bcl-2蛋白表达升高,而Caspase-3蛋白表达降低。结论 提示自体心包膜移植不会导致恶性室性心律失常,相对有较高的安全性;并能促进心肌梗死细胞恢复心功能,其改善机制可能与通过修补心室重构途径同时抑制缺血区域细胞凋亡有关。
Objective To explore the effect of autologous pericardial transplantation for treating the myocardial infarction (MI) in experimental rats. Methods 30 SD rats were randomly divided in to three equal parts: Pericardial removal group (PR group): only pericardium tissue was removed; Myocardial infarction group (MI group): the anterior descending branch ligation method established a rat model of myocardial infarction and only opened the chest after 3 weeks. Autologous pericardium transplantation (APT group): After established the MI model of SD rats, 3 weeks later, the autologous pericardial patch was harvested and transplanted to infarcted zone. Four weeks after the surgery, the cardiac function and serum biochemistry were analyzed for all the experimental rats. The cardiac function was evaluated by echocardiography, which the size of the infarction were examined by Masson staining, the survival time of transplanted autologous pericardial and angiogenesis were measured by immunohistochemistry, the protein expressions of Caspase and the gene expressions of Bcl were examined by Western blot analysis. Results 4 week after the 2nd operation, no ventricular fibrillation was detected in the ECG of PR group. Fatal ventricular fibrillation wasn't detected in the ECG of MI group and APT group. Compared with MI group, APT group improved cardiac function and decreased myocardial apoptosis index(P<0.05),which similar to PR group. APT group has the higher density of angiogenesis at infracted area to MI group but less than that of PR group. PT group had decreased protein expressions of Caspase-3 and the expressions of Bcl-2 were decreased. Conclusion Autologous pericardial transplantation could recover myocardial infarction cells, which will improve the cardiac function in experimental rats with MI.
论著

家庭式康教结合模式对脑瘫儿童发育情况的影响

The effect of the model of family rehabilitation education on the development of children with cerebral palsy

:50-53
 
目的 观察家庭式康复教育结合模式对脑瘫儿童发育情况的影响。方法 采用随机数字表法将38例脑瘫患儿分为实验组及对照组。2组患儿均给予常规日常康复,康复治疗师、引导式教师、特殊教育教师组成的团队共同对实验组内儿童功能情况进行评估,设计引导式教育课程,对无康复教育知识背景的专职护理人员进行课程培训,完成培训的护理员具体执行引导式教育课程,每天2次,每次60min,每周介入6日,持续半年。于治疗前、治疗后采用Gesell发展量表进行评测。结果 治疗前,两组患儿适应性行为、大运动、精细动作、语言、个人-社会行为5个领域指标组间差异无统计学意义(P>0.05);经介入半年后,两组患儿的适应性行为、大运动、精细动作、语言、个人-社会行为5个领域评分均优于组内治疗前水平(P <0.05),且实验组优于对照组(P <0.05)。结论 家庭式康复教育结合模式,对改善脑瘫患儿的多方面功能发展有重要意义,值得在专业人才资源缺乏的机构和社会中推广、应用。
Objective To observe the effect of the model of family rehabilitation education on the development of children with cerebral palsy. Methods 38 children with cerebral palsy were divided into experimental group and control group by random digital table method. Two groups of children were given routine daily rehabilitation. A team of rehabilitation therapists,guided teachers and special education teachers assessed the children's function in the experimental group,and designed guiding education course. The team offered curriculum training for full-time nurses without background knowledge of rehabilitation education,and the trained nurses implemented the guiding education course twice each day,60 minutes each time,6 days per week. The training lasted for six months. The Gesell development scale was used for evaluation before and after treatment. Results Before treatment,there was no statistically difference between 2 groups of children in 5 areas of adaptive behavior,exercise,fine motor,language and personal social behavior (P >0.05). After six months' intervention,2 groups of children were better than the pre-treatment level (P <0.05). The experimental group was superior to the control group (P <0.05). Conclusion The model of family rehabilitation education is of great significance to the improvement of the multifaceted function of children with cerebral palsy. It is worthy of popularization and application in institutions and societies which are lack of professional talent resources.
论著

守护APP应用于社区严重精神障碍管理治疗工作中的效果观察

Observation of clinical effect of guarding APP in mental patients monitoring

:40-44
 
目的 对江门市新会区会城街道的严重精神障碍患者监护人进行守护APP干预并评价干预效果影响。方法 以会城街道辖区内登记在国家精神障碍信息系统1 488在册精神障碍患者作为研究对象,随机抽取分为安装守护APP组1 084例和无安装守护APP组404例。安装组通过监护人使用守护APP实现责任医生对患者进行动态监护和实时监护,提供免费咨询、心理干预、服药指导及随访管理服务;无安装组采用常规随访康复管理措施干预。干预满一年后对比分析两组患者康复措施落实情况、服药依从性(治疗率)、病情及社交改善情况、复发住院率、肇事肇祸率及家属疾病知识知晓情况等指标。结果 安装守护App组患者服药依从性(治疗率)及康复措施落实率高于无安装组,家属对精神疾病知识知晓良好率较高;干预后安装组患者的SCL-90评分及心理社交功能评估表评分改善情况优于无安装组,复发住院率和肇事肇祸率明显较低,以上差异均有统计学意义。结论 守护APP平台帮助医生与监护人把严重精神障碍患者的监护工作真正落到实处,康复效果优于传统的康复方法,值得进一步推广应用。
Objective Guardianship APP intervention was conducted for the guardians of severe mental disorders in Huicheng,Xinhui district,Jiangmen city and the effect of intervention was evaluated. Methods 1 488 psychiatric patients in the unit area were taken as the research objects,which were randomly divided into the guardian APP installation group of 1084 cases and the non - installation group of 404 cases. The installation group uses guardian APP to realize the dynamic guardianship and real-time monitoring of the patients,and we provided free charge consultation,psychological intervention,medication guide,case tracking and follow-up management services. The non installation group adopted the routine rehabilitation management measures after discharge. After a year the implementation of rehabilitation measures,compliance,condition and social improvement,relapse rate of hospitalization,accident rate and knowledge of family disease between the two groups of patients were compared and analyzed. Results The compliance and rehabilitation measures of the patients in the App group were higher than those in the non installation group. The rate of knowledge about mental illness was higher in family members,and the improvement of SCL-90 score and psychosocial function assessment score after intervention was better than that of non installation group. The rate of relapse hospitalization and cause trouble were lower. The differences above were statistically significant. Conclusion The guardian APP platform helps doctors and guardians to make the monitoring work of patients with severe mental disorder really practical,and the rehabilitation effect is better than the traditional rehabilitation method,which is worthy of further promotion and application.
论著

静脉泵注不同剂量右旋美托咪定对患者呼吸力学及镇静深度的影响

The effect of intravenous injection of different doses of dexmedetomidine on respiratory mechanics and the depth of sedation in patients

:17-23
 
目的 本研究旨在采用连续气道监测法对患者呼吸力学指标进行动态观察,同时监测脑电双频指数(Bispectral index,BIS)和清醒镇静评分(The Observer's Assessment of Alertness/Sedation Scale,OAA/S),全面系统地评估右旋美托咪定(dexmedetomidine ,Dex)对患者自主呼吸功能和镇静深度的影响,为Dex临床安全应用提供参考依据。方法 80例患者随机分为四组,Dex 0.5 μg/kg组(D1组),1.0 μg/kg组(D2组),1.5 μg/kg组(D3组)和对照组(D0组),每组病人20例。麻醉诱导前35min分别静脉泵注Dex或0.9%生理盐水10 mL。记录预先给药前(T0 )、预处理后5min(T1)、10min(T2)、15min(T3)、20min(T4)、25min(T5)和30min(T6)患者的潮气量(VT)、分钟通气量(MV)、呼气末二氧化碳分压(PETCO2)、呼吸频率(RR)、第一秒呼出率(FEV1%)、顺应性环(PV环)、阻力环(FV环)、脉搏氧饱和度(SpO2)、心率(HR)、平均动脉压(MAP)等呼吸力学参数和循环参数及脑电双频谱指数(BIS)及警觉/镇静评分(OAA/S),并于T0、T1、T3和T6抽取动脉血行血气分析记录PaO2、PaCO2和pH值。结果 与对照组相比,D1组的VT、RR、MV、PETCO2、FEV1%、PaCO2和SpO2均无变化(P>0.05),PV环和FV环形态基本正常;D2组和D3组MV分别降低16.9%和27.0%;PaCO2分别升高11.0%和19.9%;FEV1%分别下降11.0%和14.9%。四组患者均无发生呼吸暂停,而且所有患者SpO2均在98%或以上。D3组自主呼吸的PV环和FV环图形面积明显缩小(P<0.05)。D1组BIS值均在85以上,OAA/S 4分为65%,镇静满意率低,OAA/S 3分仅20%;D2组镇静满意率最高,OAA/S 3分达70%,且无出现过度镇静;D3组有60%患者OAA/S评分小于或等于2。结论 静脉泵注Dex所产生的的镇静效应及其对呼吸力学的影响,随着泵注Dex剂量增大,患者镇静程度加深,虽然SpO2仍在正常范围,但呼吸会受到一定抑制(PV环和FV环图形面积缩小,PaCO2 均上升),临床推荐静脉泵注Dex剂量为0.5 μg/kg~1 μg/kg以策安全。
Objective The purpose of this study was to observe the dynamic indexes of respiratory mechanics in patients with continuous airway monitoring,and to monitor the Bispectral index (BIS) and the Observer's Assessment of Alertness/Sedation Scale (OAA/S). We evaluated the effect of dexmedetomidine (Dex) on the autonomic respiratory function and the sedative depth of the patients in a comprehensive and systematic way,so as to provide reference for the clinical safety of Dex. Methods In the study,we randomly divided 80 patients into four groups,Dex 0.5,group g/kg (group D1),1 group g/kg (group D2),1.5 g/kg group (D3 group) and control group (D0 group). There were 20 cases in each group. At about 35min before anesthesia induction,Dex or 0.9% saline 10 mL was injected intravenously. The following time points were selected: pre- administration (T0),pre-treated 5min (T1),pre-treated 10min (T2),pre-processed 15min (T3),pre-processed 20min (T4),pre -treated 25min (T5) and pre-treated 30min. The following experimental parameters were recorded at the above time point: tidal volume (VT),minute ventilation (MV),end expiratory carbon dioxide partial pressure (PETCO2),respiratory frequency (RR),first second exhalation rate (FEV1%),compliance ring (PV ring),resistance ring (FV ring),pulse oxygen saturation (SpO2),heart rate (HR),and respiratory mechanics parameters and circulatory parameters such as mean arterial pressure (MAP),bispectral index (BIS) and vigilance / sedation score (OAA/S). At the same time at T0,T1,T3 and T6,arterial blood gas was extracted,and PaO2,PaCO2 and pH values were recorded. Results Compared with the control group,the value of VT,RR,MV,PETCO2,FEV1%,PaCO2 and SpO2 in group D1 did not change significantly (P>0.05),and the morphology of PV ring and FV ring were basically normal. In group D2 and group D3,MV decreased by 16.9% and 27% respectively;PaCO2 increased by 11% and 19.9% respectively;FEV1% decreased by 11% and 14.9% respectively. No apnea occurred in the four groups,and all patients had SpO2 at 98% or above. The area of PV rings and FV rings of spontaneous breathing in group D3 was reduced (P<0.05). The BIS values in group D1 were above 85,OAA/S 4 was 65%,sedative satisfaction rate was low,20% patients had a score of 3 in OAA/S;group D2 had the highest sedative satisfaction rate,70% of patients had a score of 3 in OAA/S,and no excessive sedation;60% of patients in group D3 with an OAA/S score that was less than or equal to 2. Conclusion The sedation effect that was caused by intravenous infusion of Dex and its effect on respiratory mechanics are as follows: with the increase of Dex's dose,the degree of sedation is deepened. Although SpO2 is still in the normal range,the respiration will be restrained (the area of PV ring and FV ring is narrowed,the value of PaCO2 is increased),and the clinical recommendation of intravenous infusion Dex is at a dose of 0.5µg /kg~1µg /kg for safety reasons. .
论著

Wnt-1信号通路蛋白-3(WISP-3)在高氧诱导肺上皮细胞凋亡中的保护作用

The protective effect of Wnt-1 inducible signaling pathway protein-3 (WISP-3) in hyperoxia-induced apoptosis in lung epithelial Cells

:6-12
 
目的 在原来研究的基础上进一步研究Wnt-1信号通路蛋白-3(WISP-3)在高氧诱导肺上皮细胞凋亡中的作用。方法 通过Western blot检测和免疫组化检测不同肺上皮细胞中WISP-3的蛋白表达量。利用质粒转染和siRNA的方法在Beas-2B细胞中高表达和基因沉默WISP-3,通过细胞活性检测和流式细胞学技术检测高氧刺激后细胞的凋亡情况。结果 与空气对照相比,高氧刺激使肺上皮细胞的WISP-3蛋白表达量下降;WISP-3基因沉默或高表达使高氧诱导的肺上皮细胞凋亡增加或减少。结论 高氧刺激下,肺上皮细胞中WISP-3表达下降,WISP-3对高氧诱导的肺上皮细胞凋亡具有保护作用。
Objective To explore how Wnt-1 inducible signaling pathway protein-3 (WISP-3) participate in and play a regulatory role in the process of hyperoxia induced apoptosis in lung epithelial cells. Methods The expression of WISP-3 was detected via Western blot and immunohistochemistry. High expression and low expression of WISP-3 were performed by plasmid transfection and siRNA. Cell viability and flow cytometry were executed to detect the hyperoxia-induced apoptosis in Beas-2B. Results Compared to the group of air control,the expression of WISP-3 protein in lung epithelial cells decreased obviously after hyperoxia. Cell survival decrease and apoptosis increased after hyperoxia in Beas-2B cells with low expression of WISP-3. Vice versa. Conclusion The expression of WISP-3 decreased after hyperoxia in lung epithelial cells. The role of WISP-3 in this process may be protective.
论著

胆碱能受体激动剂尼古丁对子痫前期大鼠的治疗作用及机制研究

The effects and mechanism of cholinergic receptor agonist nicotine in preeclampsia rats

:1-5
 
目的 探讨胆碱能受体激动剂尼古丁对子痫前期大鼠的治疗作用及机制。方法 将30只妊娠SD大鼠分为对照组(n =10)、子痫前期组(n =10)和尼古丁治疗组(n =10)。子痫前期组中,大鼠妊娠第14天注射内毒素(l.0 μg/kg);对照组给予等量生理盐水2 mL,研究组妊娠第14 天开始皮下注射尼古丁1 mg/(kg·d)至妊娠第19天。检测各组干预前后收缩压、24小时蛋白、妊娠结局和大鼠外周血IL-6,TNF-α,IFN-γ和IL-1β的表达水平。结果 和对照组相比,大鼠动脉收缩压妊娠第14天注射LPS后升高,治疗组中在尼古丁注射后,妊娠第16天、第18天较子痫前期组血压下降(14.99±0.48 vs 16.61±0.55 kPa,15.01±0.60 vs 17.04±0.49 kPa,P<0.05);大鼠24 h蛋白尿在子痫前期组中妊娠第17、19天升高(P<0.05),尼古丁治疗组尿蛋白较子痫前期组降低(P <0.05)。妊娠第20天,子痫前期组胎儿重量和对照组相比下降(P <0.05),尼古丁治疗组较子痫前期模型组胎儿重量增加(P <0.05)。各组间存活胎儿数、胎盘重量差异无统计学意义(P >0.05)。子痫前期组炎性因子IL-6,TNF-α,IFN-γ和IL-1β 较对照组升高,差异有统计学意义;尼古丁治疗组IL-6,TNF-α,IFN-γ 和IL-1β 降低(P <0.05)。结论 胆碱能受体激动剂尼古丁通过降低炎性反应来改善子痫前期大鼠的妊娠结局。
Objective To examine the effects and mechanism of cholinergic receptor agonist nicotine on preeclampsia rats. Methods 30 pregnant SD rats were divided into control group(n=10),preeclampsia group(n=10) and nicotine treatment group(n=10).In preeclampsia group,rats were injected LPS(l.0 μg/kg) on the day 14th of gestation,the control rats were injected 2 mL of physical saline on the day 14th of gestation,the rats in nicotine treatment group were injected nicotine 1mg/(kg·d) from the day 14th to the day 19th of gestation. The systolic blood pressure,24 hour urine protein,pregnancy outcome and serum levels of IL-6,TNF-α,IFN-γ and IL-1β were compared between each groups. Results Compared to control group,the systolic blood pressure rose after LPS injection on the day 14th of gestation,the systolic blood pressure in nicotine treatment group decreased on the day 16th and the day 18th of gestation compared to preeclampsia group(14.99±0.48 vs 16.61±0.55 kPa,15.01±0.60 vs 17.04±0.49 kPa,P<0.05).The 24 hour urine in preeclampsia group rose on day 17 and day 19 of gestation(P <0.05),which decreased in nicotine group(P <0.05). The fetal weight were higher in nicotine treatment group compared to the preeclampsia group,there were no statisitical difference in viable fetal number and placental weight among groups. The serum levels of IL-6,TNF-α,IFN-γ IL-1β were higher in preeclampsia group compared to the control group,while nicotine decreased the levels of IL-6,TNF-α,IFN-γ IL-1β(P <0.05). Conclusion Nicotine improved pregnancy outcome of LPS induced preeclampsia rats by decreasing inflammatory levels.
临床诊疗

不同剂量右美托咪定对腰硬联合麻醉下经皮肾镜碎石术患者的镇静效应和安全性研究

Safety and sedative effect of different dose of Dexmedetomidine in percutaneous nephrolithotomy under combined spinal epidural anesthesia

:76-80
 
目的 探讨不同剂量右美托咪定(Dex)对腰硬联合麻醉下经皮肾镜碎石术患者的镇静效应和安全性。方法 腰硬联合麻醉下行俯卧位经皮肾镜碎石术患者80例,随机分成4组。D1组、D2组、D3组俯卧位后静脉泵注负荷剂量DEX 0.5 μg/kg,输注的时间为10min,随后分别静脉泵注DEX 0.3 μg/(kg·h)、0.5 μg/(kg·h)、 0.7 μg/(kg·h)至术毕;C组俯卧位后静脉泵注生理盐水10 mL/h至术毕。记录T0~T6共7个时点的HR、MAP、p(O2)和BIS值;在T0、T3~T6等时点对患者静息Ramesay镇静评分;观察患者不良反应发生情况;询问综合满意度。结果 D2组和D3组的HR、MAP、BIS、Ramesay镇静评分在T3~T6等时点明显慢于C组(P<0.05);D3组心动过缓和头晕等不良反应的发生率明显高于D1组、D2组和C组(P<0.05),D2组和D3组术中躁动的发生率明显低于D1组和C组(P<0.05),D1组、D2组和D3组高血压、寒战和恶心呕吐的发生率明显低于C组(P<0.05),且综合满意度明显高于C组。结论 DEX本药物用于该类手术的镇静疗效及安全性均优于对比的药物。建议临床使用剂量为DEX负荷剂量0.5 μg/kg,随后以0.5 μg/(kg·h)维持。
临床诊疗

通窍活血汤配合舒血宁注射液在单纯型糖尿病视网膜病变中的治疗效果

Therapeutic effect of Tongqiao Huoxue Decoction combined with Shexuening injection in treatment of simple type diabetic retinopathy

:66-69
 
目的 分析并探讨应用通窍活血汤配合舒血宁注射液在治疗糖尿病视网膜病变(单纯型)中的临床效果。方法 80例患者(80只眼)按照随机的方式将其列入对照组(40只眼)和治疗组(40只眼)两组,对照组给以调节血糖、饮食控制、运动疗法等常规治疗控制血糖稳定并口服通窍活血汤,治疗组在对照组的基础上,口服通窍活血汤再配合舒血宁注射液离子导入,所有患者均由同一位眼科专科医生分别在治疗前后对所选患者行眼压、视力、眼底镜检查,同时观察其治疗前后血液流变学、血脂变化情况,观察治疗效果。结果 治疗前后血糖、糖化血红蛋白改变无差异,治疗组视力、眼底均较对照组明显改善(P<0.01),血液流变学,血及血脂各指标的改善较对照组比较有统计学意义(P<0.01)。结论 通窍活血汤配合舒血宁注射液在单纯型糖尿病视网膜病变中的治疗效果显著,可有明显改善患者的血脂及血液流变学,安全可靠,适合临床长期推广应用,具有较高的社会效益和经济效益,值得临床推广应用。
出版者信息








《广州医药》公众号