目的探讨超声引导下腰方肌阻滞对老年下腹部手术患者应激反应及炎症因子的影响。方法前瞻性收集2021年3月至2022年3月在浙江中医药大学附属金华中医院收治的行老年下腹部手术患者90例,按随机数字表法分为研究组和对照组,每组45例。两组...目的探讨超声引导下腰方肌阻滞对老年下腹部手术患者应激反应及炎症因子的影响。方法前瞻性收集2021年3月至2022年3月在浙江中医药大学附属金华中医院收治的行老年下腹部手术患者90例,按随机数字表法分为研究组和对照组,每组45例。两组患者均采用全凭静脉麻醉,研究组联合应用超声引导下腰方肌阻滞术(0.5%利多卡因30 m L+0.2%罗哌卡因20 m L+0.9%氯化钠溶液5 mL)后进行手术。比较两组患者手术前后应激反应指标[心率(HR)、舒张压(DBP)、收缩压(SBP)、心输出量(CO)]、炎症因子(IL-6、CRP、TNF-α)、静息和运动时视觉模拟评分法(VAS)、术后相关指标、术后3 d不良反应发生情况。结果研究组术后24、72 h的IL-6、CRP、TNF-α水平及HR、DBP、SBP、CO均低于对照组,差异均有统计学意义(均P<0.05)。研究组患者静息和运动时VAS评分均低于对照组,差异均有统计学意义(均P<0.05)。与对照组比较,研究组术后排气时间、术后初次走路时长变化水平均降低,差异均有统计学意义(均P<0.05)。研究组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论应用超声引导下腰方肌阻滞能够有效改善老年下腹部手术患者术后疼痛感,调节应激反应,降低炎症因子的水平,安全性较高。展开更多
Reservoir classification is a key link in reservoir evaluation.However,traditional manual means are inefficient,subjective,and classification standards are not uniform.Therefore,taking the Mishrif Formation of the Wes...Reservoir classification is a key link in reservoir evaluation.However,traditional manual means are inefficient,subjective,and classification standards are not uniform.Therefore,taking the Mishrif Formation of the Western Iraq as an example,a new reservoir classification and discrimination method is established by using the K-means clustering method and the Bayesian discrimination method.These methods are applied to non-cored wells to calculate the discrimination accuracy of the reservoir type,and thus the main reasons for low accuracy of reservoir discrimination are clarified.The results show that the discrimination accuracy of reservoir type based on K-means clustering and Bayesian stepwise discrimination is strongly related to the accuracy of the core data.The discrimination accuracy rate of TypeⅠ,TypeⅡ,and TypeⅤreservoirs is found to be significantly higher than that of TypeⅢand TypeⅣreservoirs using the method of combining K-means clustering and Bayesian theory based on logging data.Although the recognition accuracy of the new methodology for the TypeⅣreservoir is low,with average accuracy the new method has reached more than 82%in the entire study area,which lays a good foundation for rapid and accurate discrimination of reservoir types and the fine evaluation of a reservoir.展开更多
文摘目的探讨超声引导下腰方肌阻滞对老年下腹部手术患者应激反应及炎症因子的影响。方法前瞻性收集2021年3月至2022年3月在浙江中医药大学附属金华中医院收治的行老年下腹部手术患者90例,按随机数字表法分为研究组和对照组,每组45例。两组患者均采用全凭静脉麻醉,研究组联合应用超声引导下腰方肌阻滞术(0.5%利多卡因30 m L+0.2%罗哌卡因20 m L+0.9%氯化钠溶液5 mL)后进行手术。比较两组患者手术前后应激反应指标[心率(HR)、舒张压(DBP)、收缩压(SBP)、心输出量(CO)]、炎症因子(IL-6、CRP、TNF-α)、静息和运动时视觉模拟评分法(VAS)、术后相关指标、术后3 d不良反应发生情况。结果研究组术后24、72 h的IL-6、CRP、TNF-α水平及HR、DBP、SBP、CO均低于对照组,差异均有统计学意义(均P<0.05)。研究组患者静息和运动时VAS评分均低于对照组,差异均有统计学意义(均P<0.05)。与对照组比较,研究组术后排气时间、术后初次走路时长变化水平均降低,差异均有统计学意义(均P<0.05)。研究组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论应用超声引导下腰方肌阻滞能够有效改善老年下腹部手术患者术后疼痛感,调节应激反应,降低炎症因子的水平,安全性较高。
基金funded by the National Key Research and Development Program(Grant No.2018YFC0807804-2)。
文摘Reservoir classification is a key link in reservoir evaluation.However,traditional manual means are inefficient,subjective,and classification standards are not uniform.Therefore,taking the Mishrif Formation of the Western Iraq as an example,a new reservoir classification and discrimination method is established by using the K-means clustering method and the Bayesian discrimination method.These methods are applied to non-cored wells to calculate the discrimination accuracy of the reservoir type,and thus the main reasons for low accuracy of reservoir discrimination are clarified.The results show that the discrimination accuracy of reservoir type based on K-means clustering and Bayesian stepwise discrimination is strongly related to the accuracy of the core data.The discrimination accuracy rate of TypeⅠ,TypeⅡ,and TypeⅤreservoirs is found to be significantly higher than that of TypeⅢand TypeⅣreservoirs using the method of combining K-means clustering and Bayesian theory based on logging data.Although the recognition accuracy of the new methodology for the TypeⅣreservoir is low,with average accuracy the new method has reached more than 82%in the entire study area,which lays a good foundation for rapid and accurate discrimination of reservoir types and the fine evaluation of a reservoir.
