异丙酚用于老年病人全麻诱导对HR、SBP、DBP的影响

目的探讨异丙酚在老年病人全麻诱导中对HR、SBP、DBP的影响.方法选择ASAⅠ～Ⅱ级老年手术病人,无电解质紊乱及低蛋白血症,比较诱导前与注射异丙酚后1min插管时及插管后5minHR、SBP、DBP变化.结果注药后1minHR稍增加,SBP、DBP略降低,插管时HR、SBP、DBP较注药后增加,插管后5minHR恢复正常.SBP、DBP较注药前略降低.结论异丙酚对心血管扰乱小,为老年病人全麻诱导时较为理想的药物.     

气管内插管的应激反应及氟芬合剂的作用

30例全麻诱导气管插管病人,随机分为两组即组Ⅰ硫喷妥钠,琥珀胆硷诱导气管插管和组Ⅱ氟芬合剂,硫喷妥钠,琥珀胆硷诱导气管插管。两组病例均对麻醉诱导前和气管插管后1-2min所测的SBP、DBP、MAP、HR,等几项血流动力学参数和血浆肾素活性、血管紧张素、醛固酮及皮质醇的变化进行自身对照,结果显示两组气管插管后和诱导前自身对比,组Ⅰ SBP、DBP、MAP、均升高40％以上,HR,增加18％(P<0.01)有非常显著性差异。组ⅡSBP、DBP、MAP较诱导前增高20％,HR增加10％(P<0.05)但无显著性差异。血浆肾活性、血管紧张素Ⅱ、醛固酮及皮质醇的变化,两组气管插管后与诱导前对照,均在正常值范围(P>0.05)无显著性差异、结果表明组Ⅱ选用氟芬合剂诱导前用药,能减轻气管内插管过程中的应激反应。     

腰硬联合麻醉在不孕症宫腹腔镜联合手术中的应用

目的:探讨腰硬联合麻醉与静吸复合全麻用于不孕症宫腹腔镜联合手术的优劣不同.方法:择期行不孕症宫腹腔镜联合手术女性病人50例随机分成气管内佥麻组(G组)与腰硬联合麻醉组(C组),每组25例.G组行常规气管插管静吸复合全麻,C组选L2～3间隙穿刺行腰硬联合麻醉.连续监测两组患者BP、HR、SpO2、PET-CO2,分别于麻醉前(T0)、CO2气腹前5min(T1)、CO2气腹后10min(T2)、20min(T3)、术毕5min(T4)和术后120min (T5)记录各组数据.记录两组病人术后完全清醒时间(min).结果:两组患者BP、HR、SpO2变化不大,充气后两组PETCO2均明显增高,G组较C组在术后120min(T5)增高、且G组术后完全清醒时间(min)也显著延长.结论:只要加强对呼吸的观察和管理,腰硬联合麻醉可作为不孕症宫腹腔镜联合手术的首选麻醉方法.     

布托啡诺复合丙泊酚在无痛人工流产手术中的应用

目的观察布托啡诺复合丙泊酚麻醉在无痛人工流产手术中的应用。方法选择60例无痛人工流产手术的患者随机分为三组,布托啡诺＋丙泊酚组（A组）、舒芬太尼＋丙泊酚组（B组）、单纯丙泊酚组（C组）,每组20例。观察记录各组术前、术中、术后3min的SBP、DBP、HR、Sp02,同时记录苏醒时间及丙泊酚用量。结果与术前比较,三组患者术中SBP、DBP下降、HR．减慢（P〈0．05）,与C组比较,A、B组患者术后3minSBP、DBP下降、HR减慢明显（P〈0．05）,且A组与B组比较,各时间点的SBP、DBP、HR的差异无统计学意义（P〉0．05）。A组的唤醒时间短于B、C组（P〈0．05）,丙泊酚用量A、B组明显少于C组（P〈0．05）。结论布托啡诺复合丙泊酚应用于无痛人工流产手术麻醉,可明显减少丙泊酚的用量,麻醉效果确切,术毕苏醒迅速而安全。     

预防阑尾手术牵拉反应的研究

阑尾炎病人行阑尾切除术麻醉时如不采取积极的预防措施,则均有不同程度的牵拉反应,笔者尝试着用不同方法来预防牵拉反应,现报道如下。 1 临床资料 阑尾切除术130例,其中男71例,女59例,年龄12～68岁之间,体重21～78kg,ASAⅠ～Ⅱ级。随机分成三组,A组50例,T_(11～12)连硬麻下,并于手术切皮前加静注杜氟合剂(度冷丁100mg和氟哌利多5mg合     

电视胸腔镜下行肺大泡手术的麻醉处理

目的:研究电视胸腔镜下肺大泡手术的麻醉处理。方法:择期手术病人10例,ASAⅠ～Ⅱ级。芬太尼、氟哌啶、异丙酚、琥珀胆碱诱导后,插入双腔气管导管,吸入2％～3％异氟醚及维库溴胺维持麻醉。肺大泡钳夹过程中行健侧单肺通气。监测Bp、HR、SpO_2、ECG、ETCO_2及血气分析。结果:全组病人术中Bp、HR平稳,单肺通气期间SpO_2 99％～100％,血气分析各参数正常。结论:肺大泡手术的病人选用异氟醚及维库溴胺静脉吸入复合麻醉,能够保证单肺通气期间电视胸腔镜下行肺大泡手术的要求。     

TAT皮肤试验致过敏性休克1例报道

1 病例介绍 患者男性,37岁,因右手中指刀割伤清创缝合术后,在左前臂内侧常规消毒后,皮内注射新鲜配制TAT(精制破伤风抗毒素)试验液0.1ml,5min后病人突然胸憋、气短、呼吸困难、面色苍白、脉细速,110次/min,呼吸24次/min。既往无过敏史。心电图示:窦性心动过速,大致正常心电图。诊断为过敏性休克,立即使病人平卧,吸氧,皮下注射0.1％肾上腺素1mg,氟美松5mg,非那根25mg,并建立两条静脉通道,给予多巴胺,阿拉明及氢考静点等抗休克抗过敏治疗,1h后血压回升至15/10kPa,脉搏90次/min,呼吸19次/min,全身症状明显好转,留观3h后,生命体征平稳出院。     

微泵输注双异丙酚用于全麻诱导插管

观察微量推注泵输注双异丙酚在全麻诱导插管期间脑电双频谱指数(BIS)和血液动力学的变化。把40例择期行腹部手术病人随机分成2组,每组各20例,Ⅰ组为老年人组,Ⅱ组为成年人组。结果表明:两组病例气管插管前及气管插管后BIS、SBP、DBP及RPP均较麻醉诱导前低(P!0.01),两组间气管插管前及气管插管后BIS、SBP、DBP及RPP变化差异无统计学意义;麻醉诱导期间的心率变化各参数差异无统计学意义。微量推注泵静脉输注国产双异丙酚复合咪达唑仑、拘橼酸芬太尼和罗库溴铵用于全麻诱导插管,不论在成年人或老年人均可维持足够的麻醉深度,并可减轻或消除气管插管时心血管的不良反应。     

硬膜外阻滞复合Proseal喉罩通气在妇科腹腔镜手术中的应用

目的:评价Proseal喉罩在妇科腹腔镜手术中应用的安全性和可行性。方法:40例女性患者,ASAⅠ~Ⅱ级,年龄18~62岁,择期行腹腔镜下输卵管造口术,腹腔镜下行腹腔镜检查、卵巢囊肿剔除术和盆腔粘连松解术,随机分为两组,LMA组(A组)和气管插管组(B组),每组20人,两组患者均于T12-L1硬膜外腔穿刺置管给于局麻药镇痛,A组予以丙泊酚、芬太尼诱导,术中保留自主呼吸并吸入异氟醚维持麻醉,B组予以丙泊酚、咪唑安定、芬太尼、阿曲库胺诱导,术中以丙泊酚、阿曲库胺并吸入异氟醚维持麻醉。术中监测并记录两组喉罩或插管前1分钟、LMA置入或拔管后即刻、取出后1分钟的HR、SBP、DBP及两组气腹前、气腹后5min的Paw和PETCO2的变化。结果:A组三个时间段HR、DBP、SBP无显著性差异(P>0.05),B组后两个时间段HR、DBP、SBP波动明显,有极显著性差异(P<0.01);两组气腹后的Paw和PETCO2均显著高于气腹前(P<0.01),两组之间无显著性差异(P>0.05)。结论:妇科腹腔镜手术中使用Proseal喉罩具有操作简便,对呼吸、循环影响小,术后并发症少的优点,可以推广应用。     

瑞芬太尼和芬太尼分别复合丙泊酚对全麻诱导期心血管反应的影响

目的：比较瑞芬太尼和芬太尼分别复合丙泊酚对患者全麻诱导期心血管反应的影响。方法：60例胆囊切除术患者随机分为F组（芬太尼复合丙泊酚麻醉）和R组（瑞芬太尼复合丙泊酚麻醉）。入室后常规监测心率（HR）、无创血压（SBP、DBP和MBP）、脉搏血氧饱和度（SPO2）。分别记录入室后（T0）、气管插管前即刻（T1）、气管插管后1min（T2）和5min（T3）时患者的HR、SBP、MBP、DBP数值。结果：两组患者基础值差异无统计学意义（P〉0．05）。患者诱导前后自身比较,在插管后1min时,F组患者的HR、SBP、MBP、DBP各数值均显著上升,同时R组各指标差异无统计学意义（P〉0．05）。组间比较,R组患者T1、T2、L时的HR、SBP、MBP、DBP均显著低于F组差异具有统计学意义（P〈0．05）。结论：相比芬太尼,瑞芬太尼可显著抑制患者全麻诱导期的心血管反应。     

卡思卡特城堡

It is worthy of noting that, whilst Crookston Castle witnessed the earlier and happier portion of Mary's variegated life,     

不同的吃喝玩乐

一、吃和喝吃苹果 eat an apple, 吃药 take medicine,吃糖 have some sweets,吃饭 have one's meals,吃馆子 dine out,吃惊 be surprised/     

漏洞百出的教育

Many college freshmen arrive woefully unprepared to do college work, and as disadvantaged populations continue to grow, the share of the American work force that has made it through college is expected to plummet. Many experts blame that educational failure not just on high schools but also on colleges. School & College, a special report by The Chronicle, looks at efforts to fix the system. What reforms would better prepare students for college? What should schools and colleges be doing differently? How should state and federal officials help?     

Western and Eastern culture differences in commercial field

The communication of people partially is the communication of cultures. Culture has a direct effect on international commercial activities in all aspects. Different conceptions about time, space, equality, law and the like, lead people to deal with things in different ways. So to know cultures of the counterpart is to facil-itate our enterprises so as to have a smooth and successful communication in commercial activity.     

只要努力,不要后悔

There are numbers of crossroads on our long and unpredictable life journey where we totally have no idea about which direction to choose. No matter what our decision is, we should not turn back, but face the music and go ahead instead. I am this kind of girl who always does try without regretting, one example is how I dealt with my love.     

浅谈移民问题

Migration occurs behind a variety of reasons and has a great effect on the whole world. People may migrate in order to improve their economic situation, or in order to escape civil strife, persecution, and environmental disasters. The impact of migration is complex, bringing both benefits anddisadvantages. This paper briefly talks about the causes of migration, the allocation of benefits, and the ways in which individual countries and the international community deal with this important subject.     

Sister Carrie, an Adherent of Desires

Sister Carrie is one of the most controversial characters in American literature.Thought as a "fallen woman" firstly,she was defined as a "new woman" by some critics later. However, by digging into the motivaton behind the whole process of Carrie's "success", the relationship between Carrie and her creator (the author), the social conditions of then American, it can be found that Carrie has never been free-standing on her thought and she has never found her real-sdf even after becoming a famous actress. In a society dominated by mass consumerism Carrie is only an adherent of her own desires. She also is a representative of all those country girls flooded into cities, a symbol and a sacrifice of the urbanization of America in a time countryside was overcome by cities.     

Improvement of one-cycle controller by use of proportional integral differential controller

1.IntroductionOne-cyclecontrolmethod,whichwasproposedaboutonedecadeago[1],hasbecomeanattractivemethodinspecialfieldssuchaspowerfactorcorrection[2-6],switchingamplifiers[7,8],etc.Themainideaofthiscontrollerisbasedonintegrationofdiodevoltageinone-cycleandforcesittobeexactlyequaltothereferencevalue.Themainadvantageofthiscontrollerisitsrealtimeabilitytorejectthevariationofinputvoltage[1].Despitethisgreatability,ithasnogoodperformancesinrejectingofloaddisturbanceandfollowingreferencecommands.Espec…     

风的曲线

Rosco and I wait for the fishermen to return.I sit at a wooden bench near the store at Mt.Baker Resort and watch the clouds change shape. Rosco has my belt around his neck and an eight foot tow chain hooked to a tree. Dogs must be on a leash. Ducks and rabbits are loose.