Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae
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Zhongguo Yi Xue Ke Xue Yuan Xue Bao · Jun 2019
[Dose-response Relationship of Dexmedetomidine Combined with Sufentail for Postoperative Intravenous Analgesia in Video-assisted Thoracoscopic Surgery].
Objective To investigate the 50% effective dose(ED50)and 95% effective dose(ED95)of dexmedetomidine(DEX)combined with 0.032 μg/(kg·h)sufentanil as well as its analgesic effect for patient-controlled intravenous analgesia(PCIA)after video-assisted thoracoscopic surgery(VATS). Methods Totally 25 patients undergoing elective VATS were enrolled. DEX and 0.032 μg/(kg·h)sufentanil were used for postoperative PCIA. ⋯ No adverse reaction such as vomiting,respiratory depression,or bradycardia occurred. The average Visual Analogue Scale(VAS)scores at rest(Z=-5.128,P=0.000)and cough(Z=-6.642,P=0.000)and the Ramsay sedation score(Z=-2.335,P=0.020)within 6 hours after surgery were higher than those after 6 hour. Conclusion DEX combined with 0.032 μg/(kg·h) sufentanil are effective for postoperative PCIA in patients undergoing VATS when the ED50 and ED95 are 0.0346 μg/(kg·h)and 0.0459 μg/(kg·h),respectively.
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Zhongguo Yi Xue Ke Xue Yuan Xue Bao · Dec 2018
[Gadolinium Ethoxybenzyl Diethylene-triamine-pentaacetic-acid-enhanced Magnetic Resonance Imaging Perfusion and Multiple Hepatobiliary-phase Imaging for Quantitative Assessment of Liver Fibrosis in Rat Models].
Objective To investigate the value of gadolinium ethoxybenzyl diethylene-triamine-pentaacetic-acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) in detecting different stages of liver fibrosis in rats. Methods Rat models of liver fibrosis were induced by carbon tetrachloride intraperitoneal injection for 4 - 12 weeks (n=45). The control group was applied with 0.9% saline (n=15). ⋯ There were statistical significant differences of Tmax,TRE1/2 and REchange among groups(F=6.633,P=0.005;F=5.493,P=0.010;F=5.343,P=0.014). Compared to normal and mild fibrosis groups,advanced fibrosis group had significantly longer Tmax and TRE1/2 (P=0.005,P=0.004;P=0.008,P=0.008)and significantly lower REchange(P=0.007,P=0.012). Conclusion Perfusion and multi-hepatobiliary-phase parameters such as K trans,Ve,Tmax, TREI/2 and REchange obtained from Gd-EOB-DTPA-enhanced MRI,may be valuable for detecting and staging liver fibrosis.
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Zhongguo Yi Xue Ke Xue Yuan Xue Bao · Oct 2018
[Perioperative Evaluation of Obstructive Sleep Apnea in Bariatric Surgery Population].
Objective To evaluate the prevalence and clinical characteristics of obstructive sleep apnea (OSA) in bariatric surgery population. Methods Consecutive patients undergoing preoperative evaluation for bariatric surgery and referred for sleep monitoring in Peking Union Medical College Hospital from January 2009 to December 2015 were retrospectively analyzed. Age,gender,symptoms of snoring,fatigue,apnea and somnolence,apnea hyponea index (AHI),arterial blood gas,pulmonary function,sleep respiratory monitoring,positive airway therapy of OSA,and postoperative complications were recorded. ⋯ Partial correlation analysis showed that,after age and BMI were adjusted,AHI was not correlated with FEV1% predicted(r=-0.287,P=0.125)and FVC%predicted(r=-0.241,P=0.200). Conclusion The incidence and underdiagnosis rate of OSA are high in bariatric surgery population. OSA should be routinely screened in bariatric population to reduce the postoperative complication.
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Zhongguo Yi Xue Ke Xue Yuan Xue Bao · Aug 2018
Comparative Study[Comparisons of Clinical Effectiveness and Survival between Continuous and Interrupted Chest Compressions in Out-of-hospital Cardiac Arrest].
Objective To compare the clinical outcomes of continuous chest compressions (CCP) or interrupt chest compression (ICP) for the cardiac arrest patients. Methods Totally 114 adult patients with out-of-hospital non-trauma-related cardiac arrest that needed cardiopulmonary resuscitation (CPR) in Quzhou People's Hospital from January 2014 to January 2017 were enrolled in this study. Patients who divided into CCP group (n=70) and ICP group (n=44) according to the maneuvers. ⋯ The time from cardiac arrest to CPR (HR=1.047,95% CI=1.003-1.093,P=0.034),the time from CPR to ROSC (HR=1.021,95% CI=1.003-1.038,P=0.020),and Glasgow Coma Scale (GCS) 1 score (HR=1.551,95% CI=1.022-2.355,P=0.039) were the independent risk factor for deaths within 180 days after discharge. Conclusion Long interval from cardiac arrest to CPR,long interval from CPR to ROSC,and a Glasgow Coma Scale score of>1 are the independent risk factors of deaths within 180 days after discharge. Therefore,the survival outcomes of CCP may not be superior to ICP in patients with out-of-hospital cardiac arrest.
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Zhongguo Yi Xue Ke Xue Yuan Xue Bao · Jun 2018
[Adding Ondansetron in Morphine Intravenous Analgesia Pump for Prevention of Postoperative Nausea and Vomiting in Women].
Objective To evaluate the application of adding ondansetron in morphine intravenous analgesia pump for prevention of postoperative nausea and vomiting(PONV)in women. Methods Data of surgical female inpatients who received general anesthesia and postoperative intravenous analgesia with morphine in our center from January 1st,2013 to December 31st,2014 were retrospectively analyzed. Based on whether ondansetron was added,patients were divided into the observation group(n=834) and the control group(n=856). ⋯ Logistic regression analysis showed that adding ondansetron in morphine intravenous analgesia pump was an independent influencing factor of reduced postoperative nausea. The probability of nausea during the first post-operative day was 0.781 time(P=0.015)of that in the control group and 0.736 time(P=0.030)during the second post-operative day. Conclusion Adding ondansetron in morphine intravenous analgesia pump may reduce PONV in women.