目的 比较罗哌卡因复合不同剂量右美托咪定在中老年胸腰椎手术超声引导下双侧竖脊肌平面阻滞(ESPB)中的应用效果。方法 应用前瞻性研究方法,按照随机数字表法和1:1:1实验设计原则,将2020年10月至2022年3月保定市第二医院收治的156例需...目的 比较罗哌卡因复合不同剂量右美托咪定在中老年胸腰椎手术超声引导下双侧竖脊肌平面阻滞(ESPB)中的应用效果。方法 应用前瞻性研究方法,按照随机数字表法和1:1:1实验设计原则,将2020年10月至2022年3月保定市第二医院收治的156例需行胸腰椎手术治疗的中老年患者分为A、B、C组,每组52例。3组均行罗哌卡因复合右美托咪定超声引导下双侧ESPB,其中A、B、C组右美托咪定剂量分别为0.5、1.0、1.5μg·kg^(-1)。比较3组入室前(T_(1))、手术切皮时(T_(2))、术毕时(T_(3))、气管拔管时(T_(4))血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))]及应激指标[醛固酮(ALD)、皮质醇(Cor)],术后各时间点舒适度评分(BCS评分),术后舒芬太尼用量,术后48 h患者自控静脉镇痛(PCIA)按压次数、补救镇痛次数和疼痛程度[采用视觉模拟评分法(VAS)评价],术后各时间点匹兹堡睡眠质量指数(PSQI)评分及不良反应发生情况。结果 B、C组T_(2)、T_(3)、T_(4)时点HR、MAP值及血清ALD、Cor水平均显著低于A组(P<0.05),术后2、4、6、12、24、48 h BCS评分均显著高于A组(P<0.05),术后舒芬太尼用量、术后48 h PCIA按压次数和补救镇痛次数、术后48 h VAS评分及术后第1、2天PSQI评分均显著低于A组(P<0.05);但B组与C组上述各指标比较差异均无统计学意义(P>0.05)。A、B组不良反应发生率分别为3.85%、5.77%,显著低于C组的19.23%(P<0.05),但A组与B组不良反应发生率比较差异无统计学意义(P>0.05)。结论 中老年胸腰椎手术超声引导下双侧ESPB中采用罗哌卡因复合右美托咪定,推荐右美托咪定剂量为1.0μg·kg^(-1),可获得良好的麻醉效果,且安全性高。展开更多
Soil erosion becomes a serious environmental problem in the world, especially in western China. An effective management practice called the Grain for Green Program(GGP), which was launched in 1999, aims to reduce soil...Soil erosion becomes a serious environmental problem in the world, especially in western China. An effective management practice called the Grain for Green Program(GGP), which was launched in 1999, aims to reduce soil and water loss and alleviate the ecological environment problem in western China. Two typical counties in western China, the Zhongxian(in Chongqing Municipality) and Ansai(in Shaanxi Province) were chosen to evaluate the dynamic changes of land use and agricultural production structure before and after the implementation of the Program in this paper. The results showed that the cultivated land area was reduced by 7.08% from 1989 to 2003. The cultivated land per person was decreased by 8.42% during 1999-2003. Moreover, the stability index of the secondary sector of the economy was increased from 0.91 in the period 1990-1999 to 0.94 in the following ten years. In addition, the stability index of tertiary economic sector increased from 0.88 to 0.92 in Zhongxian county. Meanwhile, the cultivated land area was reduced by 15.48% from 1990 to 1999. The soil erosion modulus was decreased by 33.33% from 1999 to 2006. Also, the stability index of secondary and tertiary economic sectors was 0.86 in the period 1998-2002. However, it decreased by 77% during 2002 to 2007 in Ansai County. These results imply that the Grain for Green Program had different impact on the two regions. Several effective strategies of soil and water conservation have been carried out to ameliorate the sustainable development of ecological environment and economy in these two counties of western China.展开更多
文摘目的 比较罗哌卡因复合不同剂量右美托咪定在中老年胸腰椎手术超声引导下双侧竖脊肌平面阻滞(ESPB)中的应用效果。方法 应用前瞻性研究方法,按照随机数字表法和1:1:1实验设计原则,将2020年10月至2022年3月保定市第二医院收治的156例需行胸腰椎手术治疗的中老年患者分为A、B、C组,每组52例。3组均行罗哌卡因复合右美托咪定超声引导下双侧ESPB,其中A、B、C组右美托咪定剂量分别为0.5、1.0、1.5μg·kg^(-1)。比较3组入室前(T_(1))、手术切皮时(T_(2))、术毕时(T_(3))、气管拔管时(T_(4))血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))]及应激指标[醛固酮(ALD)、皮质醇(Cor)],术后各时间点舒适度评分(BCS评分),术后舒芬太尼用量,术后48 h患者自控静脉镇痛(PCIA)按压次数、补救镇痛次数和疼痛程度[采用视觉模拟评分法(VAS)评价],术后各时间点匹兹堡睡眠质量指数(PSQI)评分及不良反应发生情况。结果 B、C组T_(2)、T_(3)、T_(4)时点HR、MAP值及血清ALD、Cor水平均显著低于A组(P<0.05),术后2、4、6、12、24、48 h BCS评分均显著高于A组(P<0.05),术后舒芬太尼用量、术后48 h PCIA按压次数和补救镇痛次数、术后48 h VAS评分及术后第1、2天PSQI评分均显著低于A组(P<0.05);但B组与C组上述各指标比较差异均无统计学意义(P>0.05)。A、B组不良反应发生率分别为3.85%、5.77%,显著低于C组的19.23%(P<0.05),但A组与B组不良反应发生率比较差异无统计学意义(P>0.05)。结论 中老年胸腰椎手术超声引导下双侧ESPB中采用罗哌卡因复合右美托咪定,推荐右美托咪定剂量为1.0μg·kg^(-1),可获得良好的麻醉效果,且安全性高。
基金the Foundation of National Key Science and Technology Program (2011BAD31B03)the National Natural Science Foundation of China (41001163)+1 种基金Western Light Western Doctor of CAS, the international cooperation program of Sichuan province (2013HH0016)CAS West Action: Experimental and Demonstrational study on soil and water losses and non-point pollution in the Three Gorges (KZCX2-XB3-09)
文摘Soil erosion becomes a serious environmental problem in the world, especially in western China. An effective management practice called the Grain for Green Program(GGP), which was launched in 1999, aims to reduce soil and water loss and alleviate the ecological environment problem in western China. Two typical counties in western China, the Zhongxian(in Chongqing Municipality) and Ansai(in Shaanxi Province) were chosen to evaluate the dynamic changes of land use and agricultural production structure before and after the implementation of the Program in this paper. The results showed that the cultivated land area was reduced by 7.08% from 1989 to 2003. The cultivated land per person was decreased by 8.42% during 1999-2003. Moreover, the stability index of the secondary sector of the economy was increased from 0.91 in the period 1990-1999 to 0.94 in the following ten years. In addition, the stability index of tertiary economic sector increased from 0.88 to 0.92 in Zhongxian county. Meanwhile, the cultivated land area was reduced by 15.48% from 1990 to 1999. The soil erosion modulus was decreased by 33.33% from 1999 to 2006. Also, the stability index of secondary and tertiary economic sectors was 0.86 in the period 1998-2002. However, it decreased by 77% during 2002 to 2007 in Ansai County. These results imply that the Grain for Green Program had different impact on the two regions. Several effective strategies of soil and water conservation have been carried out to ameliorate the sustainable development of ecological environment and economy in these two counties of western China.
