羟考酮复合右美托咪定对≥75岁老年结肠癌患者术后自控静脉镇痛的效果分析

目的评价羟考酮复合右美托咪定用于≥75岁老年结肠癌患者术后自控静脉镇痛(PCIA)的效果。方法选取2017年10月-2018年10月在天津市第三中心医院分院择期全身麻醉腹腔镜结肠癌手术的90例老年患者作为研究对象。采用随机数字表法分为A、B及C组,每组30例。手术结束前15 min时分别静脉注射托烷司琼4 mg和羟考酮0.1 mg/kg,同时连接PCIA泵。A、B及C组药物配制分别用羟考酮0.6、0.4及0.2 mg/kg+右美托咪定2μg/kg+托烷司琼4 mg。用生理盐水配成100 ml,患者自控单次给药剂量0.5 ml,锁定时间15 min,背景输注速率2 ml/h,维持视觉模拟评分≤4分。记录术后<48 h PCIA泵有效按压次数和镇痛补救情况,计算镇痛补救率;记录术后恶心、呕吐、头晕、嗜睡、呼吸抑制、皮肤瘙痒、心动过缓、低血压及过度镇静的发生情况;记录术后72 h镇痛满意度。结果3组患者术后未出现呕吐、呼吸抑制、皮肤瘙痒、过度镇静、心动过缓及低血压等不良反应。3组患者头晕发生率比较,差异无统计学意义(P>0.05)。A组患者恶心、嗜睡发生率高于B、C组(P<0.05);C组PCIA泵有效按压次数和镇痛补救率高于A、B组(P<0.05);C组镇痛满意度低于A、B组(P<0.05)。结论羟考酮0.4 mg/kg复合右美托咪定2μg/kg更适合≥75岁老年结肠癌患者术后自控静脉镇痛。

Attosecond pulse trains driven by IR pulses spectrally broadened via supercontinuum generation in solid thin plates

We utilized a set of fused silica thin plates to broaden the spectrum of 1kHz,30 fs Ti:sapphire amplified laser pulses to an octave.Following the compression by chirped mirror pairs,the generated few-cycle pulses were focused onto an argon filled gas cell.We detected high order harmonics corresponding to a train of 209 as pulses,characterized by the reconstruction of attosecond beating by interference of two-photon transition(RABITT)technique.Compared with the conventional attosecond pulse trains,the broad harmonics in such pulse trains cover more energy range,so it is more efficient in studying some typical cases,such as resonances,with frequency resolved RABITT.As the solid thin plates can support high power supercontinuum generation,it is feasible to tailor the spectrum to have different central wavelength and spectral width,which will make the RABITT source work in different applications.