目的:探讨左心室功能受损患者[左心室射血分数(LVEF <50%)]冠状动脉(冠脉)旁路移植术(CABG)后补钾经验。方法:回顾性分析2015-01至2017-06收治的体外循环下CABG患者200例,选取LVEF <50%患者术后理想补钾目标5.0 mmol/L作为心力衰...目的:探讨左心室功能受损患者[左心室射血分数(LVEF <50%)]冠状动脉(冠脉)旁路移植术(CABG)后补钾经验。方法:回顾性分析2015-01至2017-06收治的体外循环下CABG患者200例,选取LVEF <50%患者术后理想补钾目标5.0 mmol/L作为心力衰竭(心衰)理想高补钾组(n=41),LVEF<50%患者术后理想补钾目标4.5 mmol/L为心衰正常补钾组(n=46),选取同期正常LVEF患者术后理想补钾目标4.5 mmol/L为心功能正常补钾组(n=113)。主要终点是需要使用利多卡因和盐酸胺碘酮治疗的房性和室性心律失常发生率。结果:心衰理想高补钾组有13例(31.7%)发生需要使用利多卡因和盐酸胺碘酮治疗的房性和室性心律失常,而心衰正常补钾组有28例(62.2%)需要使用这两种药物治疗(P=0.005)。心衰理想高补钾组的血压明显高于心衰正常补钾组[(135.87±11.32) mm Hg vs (111.21±31.31) mmHg,1 mmHg=0.133 kPa,P<0.001]。心衰理想高补钾组患者监护室停留时间[(3.92±0.98)d vs (5.12±1.12) d,P<0.001)]及住院时间[(10.54±2.14) d vs (13.54±2.01)d,P<0.001)较短。两组术后24尿量、血氧分压,术后24h出血量及术后相关并发症发生率比较差异无统计学意义(P>0.05)。结论:LVEF<50%CABG患者术后理想补钾目标值5.0 mmol/L能够减少围术期需要使用利多卡因和盐酸胺碘酮干预的心律失常发生率,缩短监护室停留时间。展开更多
In order to meet the precision requirements and tracking performance of the continuous rotary motor electro-hydraulic servo system under unknown strong non-linear and uncertain strong disturbance factors,such as dynam...In order to meet the precision requirements and tracking performance of the continuous rotary motor electro-hydraulic servo system under unknown strong non-linear and uncertain strong disturbance factors,such as dynamic uncertainty and parameter perturbation,an improved active disturbance rejection control(ADRC)strategy was proposed.The state space model of the fifth order closed-loop system was established based on the principle of valve-controlled hydraulic motor.Then the three parts of ADRC were improved by parameter perturbation and external disturbance;the fast tracking differentiator was introduced into linear and non-linear combinations;the nonlinear state error feedback was proposed using synovial control;the extended state observer was determined by nonlinear compensation.In addition,the grey wolf algorithm was used to set the parameters of the three parts.The simulation and experimental results show that the improved ADRC can realize the system frequency 12 Hz when the tracking accuracy and response speed meet the requirements of double ten indexes,which lay foundation for the motor application.展开更多
文摘目的:探讨左心室功能受损患者[左心室射血分数(LVEF <50%)]冠状动脉(冠脉)旁路移植术(CABG)后补钾经验。方法:回顾性分析2015-01至2017-06收治的体外循环下CABG患者200例,选取LVEF <50%患者术后理想补钾目标5.0 mmol/L作为心力衰竭(心衰)理想高补钾组(n=41),LVEF<50%患者术后理想补钾目标4.5 mmol/L为心衰正常补钾组(n=46),选取同期正常LVEF患者术后理想补钾目标4.5 mmol/L为心功能正常补钾组(n=113)。主要终点是需要使用利多卡因和盐酸胺碘酮治疗的房性和室性心律失常发生率。结果:心衰理想高补钾组有13例(31.7%)发生需要使用利多卡因和盐酸胺碘酮治疗的房性和室性心律失常,而心衰正常补钾组有28例(62.2%)需要使用这两种药物治疗(P=0.005)。心衰理想高补钾组的血压明显高于心衰正常补钾组[(135.87±11.32) mm Hg vs (111.21±31.31) mmHg,1 mmHg=0.133 kPa,P<0.001]。心衰理想高补钾组患者监护室停留时间[(3.92±0.98)d vs (5.12±1.12) d,P<0.001)]及住院时间[(10.54±2.14) d vs (13.54±2.01)d,P<0.001)较短。两组术后24尿量、血氧分压,术后24h出血量及术后相关并发症发生率比较差异无统计学意义(P>0.05)。结论:LVEF<50%CABG患者术后理想补钾目标值5.0 mmol/L能够减少围术期需要使用利多卡因和盐酸胺碘酮干预的心律失常发生率,缩短监护室停留时间。
基金Project(51975164)supported by the National Natural Science Foundation of ChinaProject(2019-KYYWF-0205)supported by the Fundamental Research Foundation for Universities of Heilongjiang Province,China。
文摘In order to meet the precision requirements and tracking performance of the continuous rotary motor electro-hydraulic servo system under unknown strong non-linear and uncertain strong disturbance factors,such as dynamic uncertainty and parameter perturbation,an improved active disturbance rejection control(ADRC)strategy was proposed.The state space model of the fifth order closed-loop system was established based on the principle of valve-controlled hydraulic motor.Then the three parts of ADRC were improved by parameter perturbation and external disturbance;the fast tracking differentiator was introduced into linear and non-linear combinations;the nonlinear state error feedback was proposed using synovial control;the extended state observer was determined by nonlinear compensation.In addition,the grey wolf algorithm was used to set the parameters of the three parts.The simulation and experimental results show that the improved ADRC can realize the system frequency 12 Hz when the tracking accuracy and response speed meet the requirements of double ten indexes,which lay foundation for the motor application.
