腹股沟疝是通过先天缺损或者老年人腹股沟区腹壁力量减弱造成腹腔脏器通过缺损移位,造成腹股沟区坠胀感、甚至造成肠梗阻、肠坏死等症状,严重影响患者生命安全。据相关统计学资料统计,我国每年有超过100万例的腹股沟疝修补术需要开展,...腹股沟疝是通过先天缺损或者老年人腹股沟区腹壁力量减弱造成腹腔脏器通过缺损移位,造成腹股沟区坠胀感、甚至造成肠梗阻、肠坏死等症状,严重影响患者生命安全。据相关统计学资料统计,我国每年有超过100万例的腹股沟疝修补术需要开展,数量甚至大于欧美和美国相同疾病的总和。目前采用的主要微创的手术方式为TEP、TAPP,但TEP、TAPP两种手术方式创建的操作空间不同,多项研究发现两者对二氧化碳气腹的反应存在差异,本综述就二氧化碳对机体的循环、呼吸、消化系统等方面的影响,以及通过麻醉药物的选择、手术方式的选择、气腹压的选择、术后镇痛、呼吸道管理等围手术的管理来降低二氧化碳气腹的影响。Inguinal hernia is caused by congenital defect or the weakening of abdominal wall strength in the inguinal region of the elderly, which causes the displacement of abdominal organs through the defect, resulting in a sense of bulge in the inguinal region, even causing intestinal obstruction, intestinal necrosis and other symptoms, which seriously affects the life safety of patients. According to relevant statistical data, there are more than 1 million cases of inguinal hernia repair in China every year, and the number is even greater than the sum of the same diseases in Europe, America and the United States. The main minimally invasive surgical methods currently used are TEP and TAPP, but the operating space created by the two surgical methods of TEP and TAPP is different. A number of studies have found that there are differences in the response to carbon dioxide pneumoperitoneum. This review focuses on the effects of carbon dioxide on the body’s circulation, respiration, digestive system and other aspects, as well as the choice of anesthetic drugs, the choice of surgical methods, the choice of pneumoperitoneum pressure, postoperative analgesia, respiratory management and other perioperative management to reduce the impact of carbon dioxide pneumoperitoneum.展开更多
文摘腹股沟疝是通过先天缺损或者老年人腹股沟区腹壁力量减弱造成腹腔脏器通过缺损移位,造成腹股沟区坠胀感、甚至造成肠梗阻、肠坏死等症状,严重影响患者生命安全。据相关统计学资料统计,我国每年有超过100万例的腹股沟疝修补术需要开展,数量甚至大于欧美和美国相同疾病的总和。目前采用的主要微创的手术方式为TEP、TAPP,但TEP、TAPP两种手术方式创建的操作空间不同,多项研究发现两者对二氧化碳气腹的反应存在差异,本综述就二氧化碳对机体的循环、呼吸、消化系统等方面的影响,以及通过麻醉药物的选择、手术方式的选择、气腹压的选择、术后镇痛、呼吸道管理等围手术的管理来降低二氧化碳气腹的影响。Inguinal hernia is caused by congenital defect or the weakening of abdominal wall strength in the inguinal region of the elderly, which causes the displacement of abdominal organs through the defect, resulting in a sense of bulge in the inguinal region, even causing intestinal obstruction, intestinal necrosis and other symptoms, which seriously affects the life safety of patients. According to relevant statistical data, there are more than 1 million cases of inguinal hernia repair in China every year, and the number is even greater than the sum of the same diseases in Europe, America and the United States. The main minimally invasive surgical methods currently used are TEP and TAPP, but the operating space created by the two surgical methods of TEP and TAPP is different. A number of studies have found that there are differences in the response to carbon dioxide pneumoperitoneum. This review focuses on the effects of carbon dioxide on the body’s circulation, respiration, digestive system and other aspects, as well as the choice of anesthetic drugs, the choice of surgical methods, the choice of pneumoperitoneum pressure, postoperative analgesia, respiratory management and other perioperative management to reduce the impact of carbon dioxide pneumoperitoneum.
文摘目的评价广场舞、tango等舞蹈运动对轻中度帕金森(parkinson disease,PD)患者影响,从平衡功能、运动能力、步行能力、认知功能、生存质量5个方面来对帕金森患者的干预情况进行综合评定。方法根据预先制定的文献检索、筛选与录入方法对文献进行筛选,建立纳入排除标准,从中国知网(CNKI)、万方、Web of science、PubMed、Embase等数据库以关键词的方式检索舞蹈运动对帕金森患者不同指标的研究文献,运用Revman 5.3软件对最终纳入文献进行统计学分析。结果纳入文献包括广场舞1篇、探戈5篇、爱尔兰舞1篇、其他自编舞蹈3篇,共计10篇包括328名受试者。Meta分析显示,舞蹈运动可有效提高患者运动能力[MD=-5.63,95%CI(-9.70,-1.55),p=0.007]、平衡能力[(Berg平衡量表)MD=4.77,95%CI(3.56,5.99),p<0.00001;(TUG起走-计时测试)MD=-1.89,95%CI(-3.22,-0.56),p=0.005]、6MWT步行能力[MD=46.48,95%CI(18.39,74.56),p=0.001]、生存质量[MD=-8.33,95%CI(-9.25,-7.14),p<0.00001]以及认知功能[MD=1.75,95%CI(0.80,2.70),p=0.0003]。结论广场舞、tango等舞蹈运动可有效提高轻中度帕金森患者的平衡功能、运动能力以及步行能力、并对患者的生存质量以及认知功能也起到很好的改善作用。
