目的比较3种麻醉方式在老年髋部骨折手术治疗中的应用效果。方法将60例老年髋部骨折手术患者随机分为3组,每组20例:N-B组采取腰丛+坐骨神经阻滞麻醉,G-A组采取气管插管全身麻醉,G-N组采取气管插管全身麻醉联合腰丛+坐骨神经阻滞麻醉。比...目的比较3种麻醉方式在老年髋部骨折手术治疗中的应用效果。方法将60例老年髋部骨折手术患者随机分为3组,每组20例:N-B组采取腰丛+坐骨神经阻滞麻醉,G-A组采取气管插管全身麻醉,G-N组采取气管插管全身麻醉联合腰丛+坐骨神经阻滞麻醉。比较:①3组手术时间、术中出血量;②3组血流动力学指标;③3组术后不良反应发生例数;④G-A组和G-N组的全身麻醉用药总量、拔管时间及拔管后躁动率;⑤3组不同时段的VAS评分。结果①3组手术时间、术中出血量比较差异无统计学意义(P>0.05)。②T4时,N-B组动脉压、心率均高于G-A组和G-N组(P<0.05),G-A组动脉压、心率均高于G-N组(P<0.05);T5时,N-B组动脉压、心率仍均高于G-A组和G-N组(P<0.05)。③G-N组、N-B组术后不良反应总发生例数均低于G-A组(P<0.05)。④全身麻醉用药总量和拔管时间G-N组均低于G-A组(P<0.05)。⑤G-N组术后12、24 h VAS评分均低于N-B组和G-A组(P<0.05)。结论老年髋部骨折患者手术采用气管插管全身麻醉联合腰丛+坐骨神经阻滞麻醉,术中血流动力学稳定,术后不良反应发生率低,可提供比较确切的术后镇痛,麻醉效果安全可靠。展开更多
The remarkable ability of rapid self-renewal makes the intestinal epithelium an ideal model for the study of adult stem cells. The intestinal epithelium is organized into villus and crypt, and a group of intestinal st...The remarkable ability of rapid self-renewal makes the intestinal epithelium an ideal model for the study of adult stem cells. The intestinal epithelium is organized into villus and crypt, and a group of intestinal stem cells located at the base of crypt are responsible for this constant self-renewal throughout the life. Identification of the intestinal stem cell marker Lgr5, isolation and in vitro culture of Lgr5+ intestinal stem cells and the use of transgenic mouse models have significantly facilitated the studies of intestinal stem cell homeostasis and differentiation, therefore greatly expanding our knowledge of the regulatory mechanisms underlying the intestinal stem cell fate determination. In this review, we summarize the current understanding of how signals of Wnt, BMP, Notch and EGF in the stem cell niche modulate the intestinal stem cell fate.展开更多
文摘目的比较3种麻醉方式在老年髋部骨折手术治疗中的应用效果。方法将60例老年髋部骨折手术患者随机分为3组,每组20例:N-B组采取腰丛+坐骨神经阻滞麻醉,G-A组采取气管插管全身麻醉,G-N组采取气管插管全身麻醉联合腰丛+坐骨神经阻滞麻醉。比较:①3组手术时间、术中出血量;②3组血流动力学指标;③3组术后不良反应发生例数;④G-A组和G-N组的全身麻醉用药总量、拔管时间及拔管后躁动率;⑤3组不同时段的VAS评分。结果①3组手术时间、术中出血量比较差异无统计学意义(P>0.05)。②T4时,N-B组动脉压、心率均高于G-A组和G-N组(P<0.05),G-A组动脉压、心率均高于G-N组(P<0.05);T5时,N-B组动脉压、心率仍均高于G-A组和G-N组(P<0.05)。③G-N组、N-B组术后不良反应总发生例数均低于G-A组(P<0.05)。④全身麻醉用药总量和拔管时间G-N组均低于G-A组(P<0.05)。⑤G-N组术后12、24 h VAS评分均低于N-B组和G-A组(P<0.05)。结论老年髋部骨折患者手术采用气管插管全身麻醉联合腰丛+坐骨神经阻滞麻醉,术中血流动力学稳定,术后不良反应发生率低,可提供比较确切的术后镇痛,麻醉效果安全可靠。
基金supported by the National Natural Science Foundation of China(31330049,31221064)National Basic Research Program of China(2011CB943803,2011CBA01104,2010CB833706)to Chen Ye-Guang
文摘The remarkable ability of rapid self-renewal makes the intestinal epithelium an ideal model for the study of adult stem cells. The intestinal epithelium is organized into villus and crypt, and a group of intestinal stem cells located at the base of crypt are responsible for this constant self-renewal throughout the life. Identification of the intestinal stem cell marker Lgr5, isolation and in vitro culture of Lgr5+ intestinal stem cells and the use of transgenic mouse models have significantly facilitated the studies of intestinal stem cell homeostasis and differentiation, therefore greatly expanding our knowledge of the regulatory mechanisms underlying the intestinal stem cell fate determination. In this review, we summarize the current understanding of how signals of Wnt, BMP, Notch and EGF in the stem cell niche modulate the intestinal stem cell fate.
