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find Author "王晓" 28 results
  • 最适镇静/麻醉深度在消化内镜无痛技术中的价值和实施

    目前消化内镜的镇静/麻醉随着舒适化医疗的发展得到普及和推广。消化内镜通常在无人工气道条件下实施镇静镇痛,监护和抢救设备、人员配比远不及手术室内保障性高。镇静/麻醉技术虽然减少了患者痛苦,但同时增加了镇静相关不良反应的发生率。镇静/麻醉实施应该滴定给药以实现一个安全、舒适、顺利的过程。不同的患者需要不同的镇静水平,最适镇静/麻醉深度是患者安全、舒适、无记忆、内镜操作易于实施,从清醒镇静到全身麻醉不等。对于一些特殊患者,深度镇静可能引起严重后果,甚至致命,清醒镇静不失为一种安全舒适的无痛技术。该文就探讨消化内镜最适镇静/麻醉深度并对清醒镇静的实施进行了综述。

    Release date:2017-06-22 02:01 Export PDF Favorites Scan
  • 麻醉医师主导的快速康复技术在日间手术中的应用

    麻醉医师主导的快速康复技术是指麻醉医师在已有临床证据的基础上,通过改进患者术前准备、优化术中管理、加快患者术后恢复等一系列围手术期管理措施,加速患者康复。将该技术应用于日间手术的围手术期管理,可以进一步加快患者术后恢复,缩短在院时间,减少整体医疗费用,进而促进医疗资源的合理利用,提高患者满意度。现就麻醉医师主导的快速康复技术在日间手术的应用作一综述,以便更多的临床医生了解快速康复技术并应用于日间手术的管理。

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  • Effectiveness and Safety of 5-HT3 Receptor Antagonists in Preventing Propofol Injection Induced Pain: A Meta-Analysis

    Objective To systematically assess the effectiveness and safety of 5-HT3 receptor antagonists in preventing propofol injection induced pain. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2012), CNKI, CBM, VIP and WanFang Data were searched from their inception to September, 2012 to collect the randomized controlled trials (RCTs) about 5-HT3 receptor antagonists in preventing propofol injection induced pain. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality of methodology. Then meta-analysis was performed using RevMan 5.2 software. Results A total of 15 RCTs involving 1 413 patients were included. The results of meta-analysis showed that: a) the incidence of propofol injection induced pain in the 5-HT3 group was obviously lower than the control group (RR=0.14, 95%CI 0.09 to 0.21, Plt;0.000 01); b) as to the severity of pain, there was no statistical difference between the two groups (RR=0.84, 95%CI 0.56 to 1.26, P=0.39); the 5-HT3 group was obviously lower that the control group in the incidence of both moderate pain (RR=0.25, 95%CI 0.19 to 0.34, Plt;0.000 01) and severe pain (RR=0.16, 95%CI 0.10 to 0.24, Plt;0.000 01); and c) as to the incidence of postoperative adverse reaction: the 5-HT3 group was obviously lower that the control group in the incidence of nausea and vomiting (RR=0.19, 95%CI 0.11 to 0.34, Plt;0.000 01) and shivering (RR=0.20, 95%CI 0.12 to 0.33, Plt;0.000 01) as well. Conclusion 5-HT3 receptor antagonists can effectively prevent the propofol injection induced pain, alleviate its severity, and reduce the postoperative adverse reactions. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.

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  • BIOMECHANICAL EFFECT OF ANTERIOR CRUCIATE LIGAMENT RUPTURE ON POSTERIOR HORN OF LATERAL MENISCUS

    Objective Anterior cruciate l igament (ACL) is an important forward stable structure of knees, when its function impaired, the normal mechanical environment of joint will be destroyed. Now, to explore the effect of ACL rupture on the posterior horn of lateral meniscus by measuring biomechanics. Methods Ten specimens of knee joints (5 left and 5 right sides asymmetrically) were donated voluntarily from 10 normal fresh adult male cadavers, aged 26-35 years with anaverage of 31.4 years. The straining of lateral meniscus posterior horn in 10 knee joint specimens before and after resection of ACL were tested when the knee joints loaded from 0 to 200 N at a velocity of 0.5 mm per second at 0, 30, 60, and 90° of flexion and recorded at the moment when the load was 200 N, the ratio of straining before and after resection of ACL were connted. All the specimens were anatomied and observed in general so as to find injuries such as deformation and tearing in lateral meniscus after test. Results The straining of lateral meniscus posterior horn were as follows: intact ACL group, (—11.70 ± 0.95) με at 0° flexion, (—14.10 ± 1.95) με at 30° flexion, (—20.10 ± 1.20) με at 60° flexion, and (—26.50 ± 1.58) με at 90° flexion; ACL rupture group, (—6.20 ± 1.55) με at 0° flexion, (—26.30 ± 1.89) με at 30° flexion, (—37.70 ± 1.64) με at 60° flexion, and (—46.20 ± 2.78) με at 90° flexion. There were significant differences between intact ACL group and ACL rupture group (P lt; 0.05). The straining ratio of the posterior horn of lateral meniscus rupture ACL to intact ACL were 0.53 ± 0.12, 1.90 ± 0.31, 1.88 ± 0.15, and 1.75 ± 0.16 at 0, 30, 60, and 90° of flexion. The lateral meniscus were intact in general and no injuries such as deformation and tearingwere found. Conclusion ACL has a significant biomechanical effect on posterior horn of lateral meniscus. Consequently, the posterior horn of lateral meniscus is overloaded with ACL rupture at 30, 60, and 90° of flexion, and thereby, it will have the high risk of tear.

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • 右侧胸腔巨大占位伴右全肺不张行右全肺切除术中大出血的围手术期管理一例

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  • 脱细胞异体真皮支架加自体刃厚皮移植治疗深度创面的临床观察

    Release date:2016-09-01 09:24 Export PDF Favorites Scan
  • Clinical advances in prognostic factors and predictive methods of liver transplantation

    ObjectiveTo figure out the factors affecting the prognosis of liver transplantation and the research progress on methods for predicting the prognosis of liver transplantation so as to provide guidance and reference for the distribution of liver sources and the perioperative treatment of liver transplantation.MethodThe literatures related to the factors influencing the prognosis of liver transplantation and the methods in predicting the prognosis were searched in the PubMed, CNKI, Wanfang, and other databases and the results were analyzed and summarized.ResultsThe liver transplantation was an effective method in the treatment of end-stage liver diseases. The main factors affecting the prognosis of liver transplantation included the change of internal environment, systemic inflammatory response, and general systemic conditions. On the basis of Model for End-stage Liver Disease (MELD), the new prediction model built in combination with the blood sodium ion, lactate, muscle mass, or reticulocyte count and hemoglobin concentration had improved the prognostic prediction ability of liver transplantation.ConclusionsIt is possible to predict the prognosis of patients with liver transplantation more accurately by selecting a more targeted prediction model combined with the factors affecting the prognosis of liver transplantation. It might provide a reference for perioperative management and treatment and make the limited liver source play the most role and save more lives.

    Release date:2020-03-30 08:25 Export PDF Favorites Scan
  • 纳布啡在日间手术预防性多模式镇痛中的优势

    纳布啡作为阿片受体激动-拮抗剂,主要激动 κ 受体,拮抗 μ 受体,减轻了对心血管及呼吸的抑制作用,更好地发挥了镇静、镇痛的作用。同时纳布啡的起效时间快,持续时间长,与其他激动 μ 受体阿片类药物相比,纳布啡的不良反应较少,甚至可拮抗 μ 受体相关的副作用。该文通过回顾纳布啡的机制特点、药理作用,以及近些年来它在国内外日间手术麻醉中的应用,希望为实施日间手术麻醉提供一个新的思路。

    Release date:2017-11-24 10:58 Export PDF Favorites Scan
  • Research progress of in vivo bioreactor for bone tissue engineering

    ObjectiveTo review the research progress of in vivo bioreactor (IVB) for bone tissue engineering in order to provide reference for its future research direction.MethodsThe literature related to IVB used in bone tissue engineering in recent years was reviewed, and the principles of IVB construction, tissue types, sites, and methods of IVB construction, as well as the advantages of IVB used in bone tissue engineering were summarized.ResultsIVB takes advantage of the body’s ability to regenerate itself, using the body as a bioreactor to regenerate new tissues or organs at injured sites or at ectopic sites that can support the regeneration of new tissues. IVB can be constructed by tissue flap (subcutaneous pocket, muscle flap/pocket, fascia flap, periosteum flap, omentum flap/abdominal cavity) and axial vascular pedicle (axial vascular bundle, arteriovenous loop) alone or jointly. IVB is used to prefabricate vascularized tissue engineered bone that matched the shape and size of the defect. The prefabricated vascularized tissue engineered bone can be used as bone graft, pedicled bone flap, or free bone flap to repair bone defect. IVB solves the problem of insufficient vascularization in traditional bone tissue engineering to a certain extent.ConclusionIVB is a promising method for vascularized tissue engineered bone prefabrication and subsequent bone defect reconstruction, with unique advantages in the repair of large complex bone defects. However, the complexity of IVB construction and surgical complications hinder the clinical application of IVB. Researchers should aim to develop a simple, safe, and efficient IVB.

    Release date:2021-06-07 02:00 Export PDF Favorites Scan
  • Effects of Isoflurane on Learning and Memory in Aged Rats

    目的 探讨异氟醚吸入麻醉对(SD)老年大鼠学习和记忆的影响。 方法 36只SD健康雄性大鼠随机分为异氟醚麻醉组和对照组,每组各18只。麻醉组给予2%异氟醚和40%氧气诱导及维持麻醉3 h,对照组单纯吸入含40%氧气的空氧混合气体3 h。麻醉组或对照组干预结束24 h后开始为期1周的盲法测试学习记忆能力。 结果 麻醉组大鼠与对照组大鼠相比,Y-迷宫测试成绩错误反应次数差异无统计学意义(P>0.05);除第7天麻醉组大鼠起步电压高于对照组(P<0.05)外,其余时间两组大鼠起步电压差异均无统计学意义(P>0.05);除第3天麻醉组大鼠跑步电压高于对照组(P<0.05)外,其余时间两组大鼠跑步电压差异均无统计学意义(P>0.05)。 结论 2%单纯异氟醚吸入麻醉不改变老年大鼠麻醉后学习和记忆能力。

    Release date:2016-09-08 09:13 Export PDF Favorites Scan
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