目的评估术前超声引导竖脊肌平面阻滞对胸腔镜肺叶切除术早期恢复质量的影响。方法纳入2019年4月至2020年11月在福建省立医院择期全身麻醉下行单侧胸腔镜下肺叶切除术患者68例,年龄18~65岁,美国麻醉医师协会(American society of anesth...目的评估术前超声引导竖脊肌平面阻滞对胸腔镜肺叶切除术早期恢复质量的影响。方法纳入2019年4月至2020年11月在福建省立医院择期全身麻醉下行单侧胸腔镜下肺叶切除术患者68例,年龄18~65岁,美国麻醉医师协会(American society of anesthesiologists,ASA)分级为Ⅰ~Ⅱ级,采用随机数字表将患者分为竖脊肌组(n=34)和对照组(n=34)。竖脊肌组采用0.5%罗哌卡因30ml行竖脊肌平面阻滞,对照组采用0.9%氯化钠溶液30ml行竖脊肌平面阻滞。主要观察指标为患者术后24h恢复质量(QoR-40问卷量表评分),次要观察指标包括:术后疼痛评分曲线下面积、术后24h舒芬太尼用量、恶心呕吐发生率以及患者镇痛满意度。结果与对照组比较,竖脊肌组患者术后24h QoR-40评分升高[173.0(170.0,177.0)比161.0(160.0,164.3)],差异有统计学意义(Z=﹣6.921,P<0.05);竖脊肌组患者术后24h疼痛评分曲线下面积减少(静息状态中位数差值为15.0,95%CI:11.25~18.25;运动状态中位数差值为13.50,95%CI:8.25~18.50),差异均有统计学意义(静息状态Z=﹣6.080;运动状态Z=﹣4.876,P<0.05);术后24h舒芬太尼用量减少(中位数差值为18.0μg,95%CI:16.0~20.0μg),差异有统计学意义(Z=﹣7.110,P<0.05);术后24h恶心呕吐发生率降低,差异有统计学意义(χ^(2)=4.221,P=0.04);患者满意度提高(中位数差值为2.0,95%CI:1.0~2.0),差异有统计学意义(Z=﹣6.240,P<0.05)。结论术前单次竖脊肌阻滞可以减轻胸腔镜肺叶切除术患者术后急性疼痛程度、减少术后阿片药物用量、降低恶心呕吐等不良反应发生率,从而提高患者术后早期恢复质量。展开更多
Nessler's reagent spectrophotometry,gas phase molecular absorption spectrometry and ion chromatography were respectively used to determine ammonia nitrogen in surface water.The detection limit,precision,accuracy a...Nessler's reagent spectrophotometry,gas phase molecular absorption spectrometry and ion chromatography were respectively used to determine ammonia nitrogen in surface water.The detection limit,precision,accuracy and recovery rate of the three methods were compared,and the determination results of the actual water samples were analyzed by t test.The results showed that the three methods all could meet the requirement of the laboratory quality control,and there was no significant difference in the determination results.Compared with Nessler's reagent spectrophotometry,the operation of gas phase molecular absorption spectrometry and ion chromatography operation was more convenient and fast and has no pollution,which can be used for the determination of ammonia nitrogen content in a large quantity of surface water samples.展开更多
文摘目的评估术前超声引导竖脊肌平面阻滞对胸腔镜肺叶切除术早期恢复质量的影响。方法纳入2019年4月至2020年11月在福建省立医院择期全身麻醉下行单侧胸腔镜下肺叶切除术患者68例,年龄18~65岁,美国麻醉医师协会(American society of anesthesiologists,ASA)分级为Ⅰ~Ⅱ级,采用随机数字表将患者分为竖脊肌组(n=34)和对照组(n=34)。竖脊肌组采用0.5%罗哌卡因30ml行竖脊肌平面阻滞,对照组采用0.9%氯化钠溶液30ml行竖脊肌平面阻滞。主要观察指标为患者术后24h恢复质量(QoR-40问卷量表评分),次要观察指标包括:术后疼痛评分曲线下面积、术后24h舒芬太尼用量、恶心呕吐发生率以及患者镇痛满意度。结果与对照组比较,竖脊肌组患者术后24h QoR-40评分升高[173.0(170.0,177.0)比161.0(160.0,164.3)],差异有统计学意义(Z=﹣6.921,P<0.05);竖脊肌组患者术后24h疼痛评分曲线下面积减少(静息状态中位数差值为15.0,95%CI:11.25~18.25;运动状态中位数差值为13.50,95%CI:8.25~18.50),差异均有统计学意义(静息状态Z=﹣6.080;运动状态Z=﹣4.876,P<0.05);术后24h舒芬太尼用量减少(中位数差值为18.0μg,95%CI:16.0~20.0μg),差异有统计学意义(Z=﹣7.110,P<0.05);术后24h恶心呕吐发生率降低,差异有统计学意义(χ^(2)=4.221,P=0.04);患者满意度提高(中位数差值为2.0,95%CI:1.0~2.0),差异有统计学意义(Z=﹣6.240,P<0.05)。结论术前单次竖脊肌阻滞可以减轻胸腔镜肺叶切除术患者术后急性疼痛程度、减少术后阿片药物用量、降低恶心呕吐等不良反应发生率,从而提高患者术后早期恢复质量。
文摘Nessler's reagent spectrophotometry,gas phase molecular absorption spectrometry and ion chromatography were respectively used to determine ammonia nitrogen in surface water.The detection limit,precision,accuracy and recovery rate of the three methods were compared,and the determination results of the actual water samples were analyzed by t test.The results showed that the three methods all could meet the requirement of the laboratory quality control,and there was no significant difference in the determination results.Compared with Nessler's reagent spectrophotometry,the operation of gas phase molecular absorption spectrometry and ion chromatography operation was more convenient and fast and has no pollution,which can be used for the determination of ammonia nitrogen content in a large quantity of surface water samples.
