吡拉西坦氯化钠注射液治疗脑出血的临床疗效分析

目的 研究分析对脑出血患者使用吡拉西坦氯化钠注射液进行治疗的效果.方法 在本院治疗的脑出血患者中选取70例作为研究对象,将其中35例分为对照组,另外35例分为观察组.对照组患者使用甘露醇治疗,观察组患者使用吡拉西坦氯化钠治疗,对比两组患者治疗后的效果、不良反应发生率,以及治疗前后的神经肽Y、颅内压变化情况.结果 治疗前,两组患者的神经肽Y、颅内压情况比较差异无统计学意义(P＞0.05).治疗后,两组患者的治疗总有效率观察组(94.29％)高于对照组(77.14％);两组患者的不良反应发生率观察组(2.86％)低于对照组(17.14％);两组患者的神经肽Y、颅内压改善情况比较,观察组优于对照组,差异有统计学意义(P＜0.05).结论 脑出血使用呲拉西坦氯化钠治疗,能够有效提升治疗有效率,减少不良反应发生,改善神经肽Y和颅内压情况,可取得较佳的治疗效果,值得推广应用.     

阿昔洛韦致头痛3例

1病历摘要2例患者,男,20,21岁,皮肤损伤均在躯干左、右旁侧.1例患者,女,20岁,皮肤损伤为右下肢内侧.既往史健康,化验肝功、胸部X透视、心电图正常.诊断带状疱疹.3例患者在静滴阿昔洛韦液0.9%氯化钠300ml 阿昔洛韦0.5g,滴注过程均无不良反应,滴注后12h,1例女患者出现头痛剧烈,伴有恶心、呕吐、胃肠不适感.另2例男患者分别在滴注后24h,前后出现为前额、两侧颞部持续头痛,不能入睡.     

不同液体术前急性高容量血液稀释对深静脉血栓病人血液流变学的影响

Objective To investigate the effects of acute hypervolemic hemodilution (AHH) with different fluids on blood rheology in patients with deep vein (femoral and iliac) thrombosis. Methods Thirty ASA I or II patients aged 40-64 yr who had developed deep vein thrombosis in 48 h and were scheduled for embolectomy were randomly divided into 3 groups ( n = 10 each) ; group I normal saline (NS) ; group II 6 % HES 200/0.5 ( HES) ; group IE gelofusine (GEL). AHH was performed with normal saline, 6% HES or gelofusine infusion at 20 ml·kg-1 ·h-1 for 40 min. MAP, HR and SpO2 were monitored. Blood loss, volume of blood transfusion and fluid infused and urine output during operation were recorded. Anesthesia was induced with fentanyl 3-5 fig/kg, etomidate 0.15-0.30 mg/kg, propofol 1-2 mg/kg and succinylcholine 1-2 mg/kg and maintained with 2% isoflurane and propofol infusion at 5-8 mg·kg-1·h-1 and intermittent iv boluses of vecuronium. The patients were mechanically ventilated (VT 8 ml/kg, RR 12 bpm). PaO2 and PaCO2 were maintained within normal range. Venous blood samples were obtained before and after AHH for measurement of hematocrit (Hct), whole blood viscocity (WBV) at low or high shear rates, plasma viscosity, RBC aggregation and RBC deformation. RBC aggregation index and RBC deformation index were calculated. Results MAP and HR were stable in all patients. The amount of blood transfusion and fluid infused was significantly less in group HES and GEL than in group NS. The WBV at low or high shear rates in group HES and GEL, Hct in all 3 groups and RBC aggregation index in group HES were significantly decreased after AHH, but the RBC deformation index was significantly increased in group HES. Conclusion Colloid is better than crystalloid and HES is better than gelofusine in improving intraoperative hypercoagulability and sluggish blood flow.     

硬膜外高渗氯化钠溶液术后镇痛的临床双盲研究

为观察高渗盐水硬膜外注射术后镇痛效果,用双盲法对60例病人进行了研究。生理盐水对照级术后镇痛优良率为3.33％,镇痛有效率为10％,均需用镇痛药;高渗盐水组术后镇痛优良率为86.67％,有效率为96.67％,很少使用镇痛药。两组差别显著(P<0.05,P<0.01)。对其他感觉和运动功能无明显影响。高渗盐水组与吗啡组比较镇痛效果相同(P>0.05),副作用少(P<0.01)。说明硬膜外高渗氯化钠溶液是一种安全有效的镇痛方法,有较高推广应用价值。     

NariSO3和NaCl联合增敏光度法测定碘盐中微量碘

研究亚硫酸氢钠和氯化钠配伍使用的增敏性,建立了NaHSO3—NaCl—KIO3—KI四元无机体系测定碘盐中碘含量的新方法。测定碘的最佳条件:磷酸介质,pH 3~4,最大吸收波长479 nm,ε479=1.5×105L/(mol/cm),碘含量(以KIO3中I计)在0~2.24mg/L内符合比尔定律。用于测定食盐中碘的含量,回收率为99.49%~101.3%,结果满意。     

已酮可可碱氯化钠注射液细菌内毒素检查法的研究

目的 建立已酮可可碱氯化钠细菌内毒素检查方法。方法 对已酮可可碱氯化钠注射液的1～2（0．2mg／ml）、1～4（0．1mg／ml）进行了干扰试验。结果 已酮可可碱氯化钠注射液经1～4（0．1mg／ml）稀释后对细菌内毒素检查法无干扰作用。结论 已酮可可碱氯化钠注射液建立细菌内毒素检查法是可行的。     

超声引导下犬肝注射醋酸高渗氯化钠混合液对射频消融毁损体积的影响

目的探讨超声引导下活体犬肝注射不同剂量的醋酸高渗氯化钠液(acetic acid hypertonic saline solution,AHS)后行射频消融(RFA),观察犬肝一次性毁损体积的变化。方法使用LDRF-120S多极RFA系统联合AHS对活体犬肝行RFA。健康成年杂种犬30只,随机分为5组(n=6)。A组:注射2ml AHS后立即行RFA;B组:注射2ml AHS后延时5min行RFA;C组:注射4ml AHS后立即行RFA;D组:注射4ml AHS后延时5min行RFA;E组:注射6ml AHS后立即行RFA。结果5组间平均起始阻抗差异无统计学意义(P>0.05);5组间平均消融时间差异有统计学意义(F=83.831,P<0.001),LSD-t检验分析各组间两两比较差异有统计学意义(P<0.001),在观察范围内E组平均消融时间最长;5组间平均毁损直径差异有统计学意义(F=53.488,P<0.001),在观察范围内E组平均毁损直径最大,LSD-t检验分析除D与E组间差异无统计学意义(P>0.05)外,其余各组间两两比较差异有统计学意义(P<0.001);网状纤维染色显示凝固坏死区及其邻近的正常肝组织均可见血管内血栓形成;E组在AHS注射过程中出现不同程度的外溢;A、B、C及D组14d内无动物死亡,E组死亡4只。结论活体犬肝局部注射AHS4ml后延时5min行RFA即可达到较理想的毁损体积。