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心理干预对老年结直肠癌患者术后认知功能及焦虑的影响 被引量:7
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作者 高晓军 王胜 +5 位作者 代志刚 高元丽 张印龙 于海 葛明月 邢文龙 《中国现代医学杂志》 CAS 2018年第28期95-101,共7页
目的探讨围术期心理干预对老年结直肠癌患者术后认知功能及焦虑的影响。方法选取全身麻醉下行结直肠癌手术患者50例,年龄65~75岁,ASAⅠ、Ⅱ级,采用随机数字表法分为心理干预组(I组)和对照组(C组),每组25例。C组进行常规术前访视和术后随... 目的探讨围术期心理干预对老年结直肠癌患者术后认知功能及焦虑的影响。方法选取全身麻醉下行结直肠癌手术患者50例,年龄65~75岁,ASAⅠ、Ⅱ级,采用随机数字表法分为心理干预组(I组)和对照组(C组),每组25例。C组进行常规术前访视和术后随访,I组于术前、入手术室后、麻醉清醒后、术后2 d、术后5 d随访同时进行心理干预。记录术前2 d、入室后静卧5 min、麻醉诱导前即刻、切皮、术中2 h、术毕、拔管、术后1 d、术后3 d、术后7 d等10个时间点的血压(BP)、心率(HR);记录术前2 d、入室后静卧5 min、术后7 d、术后2周的焦虑自评量表(SAS)评分;于术前2 d、麻醉诱导前即刻、术毕、术后1、2、3 d收集血液标本,测定神经元特异性烯醇化酶(NSE)含量;于术前2 d、术后1、3、7 d,术后2周随访登记简易精神智能状态量表(MMSE)评分、连线测验(TMT)完成时间。结果与I组比较,C组入室后静卧5 min、术后7 d、术后2周的SAS评分升高且差异有统计学意义(P<0.05);术后1、3、7 d I组的MMSE评分高于C组,术后1、3、7 d I组的TMT完成时间短于C组,麻醉前诱导前即刻、术毕、术后1、2、3 d I组NSE含量低于C组,术后1、3、7 d C组POCD发生率高于I组,差异均有统计学意义(P<0.05)。结论围术期心理干预可改善老年结直肠癌患者焦虑状况,减少认知功能障碍的发生。 展开更多
关键词 围术期 心理干预 老年结直肠癌患者 术后认知功能障碍 焦虑
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腹横肌阻滞对老年结肠癌患者应激及术后认知功能的影响 被引量:18
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作者 赵春辉 高元丽 +1 位作者 代志刚 王胜 《中国现代医学杂志》 CAS 2019年第2期63-69,共7页
目的对行结肠癌手术的老年患者实施腹横肌阻滞(TAP),探讨其对应激反应及术后认知功能的影响。方法选择拟在全身麻醉(以下简称全麻)下行结肠癌手术的老年患者50例,随机分为腹横肌阻滞联合全麻组和单纯全麻组。腹横肌阻滞联合全麻组于入室... 目的对行结肠癌手术的老年患者实施腹横肌阻滞(TAP),探讨其对应激反应及术后认知功能的影响。方法选择拟在全身麻醉(以下简称全麻)下行结肠癌手术的老年患者50例,随机分为腹横肌阻滞联合全麻组和单纯全麻组。腹横肌阻滞联合全麻组于入室后10 min常规进行双侧肋缘下TAP。测定入室10 min、麻醉诱导后5 min、切皮5 min、切皮2 h及手术结束即刻的血糖(GLU)、C-反应蛋白(CRP)浓度。测定术前1 d、入室10 min、手术结束即刻、术后1和2 d血清中神经元特异性烯醇化酶(NSE)含量。采用蒙特利尔认知评定量表(MoCA)、简易精神状态量表(MMSE)进行认知评估,记录两组患者围手期发生认知功能损伤的情况。结果两组患者平均动脉压、心率静态视觉模拟评分、GLU、NSE、MoCA及MMSE评分比较,差异有统计学意义(P <0.05);两组患者不良反应发生率比较,差异有统计学意义(P <0.05);两组患者术后静脉自控镇痛泵按压次数比较,差异有统计学意义(P <0.05);两组患者术后1 d术后认知功能障碍发生率比较,差异有统计学意义(P <0.05)。结论 TAP应用于老年结肠癌手术患者,可降低机体围手术期不良应激反应及认知功能损伤的发生率。 展开更多
关键词 腹横肌阻滞/神经肌肉阻滞 结肠肿瘤 认知障碍 应激障碍 创伤后 老年
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压力控制容量保证通气中不同吸气流速对单肺通气患者呼吸功能的影响 被引量:12
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作者 陈平 邵秀芝 +1 位作者 代志刚 殷姜文 《中国现代医学杂志》 CAS 2020年第1期87-92,共6页
目的探讨在压力控制容量保证通气下不同吸气流速对胸科单肺通气患者呼吸功能的影响。方法择期行单侧肺病损切除术的单肺通气全身麻醉患者75例。随机分为3组,吸气流速30 L/min组(A组),吸气流速50 L/min组(B组),吸气流速70 L/min组(C组),... 目的探讨在压力控制容量保证通气下不同吸气流速对胸科单肺通气患者呼吸功能的影响。方法择期行单侧肺病损切除术的单肺通气全身麻醉患者75例。随机分为3组,吸气流速30 L/min组(A组),吸气流速50 L/min组(B组),吸气流速70 L/min组(C组),每组25例。分别于单肺通气前5 min(T0)、单肺通气后30 min(T1)、60 min(T2)、120 min(T3)记录气道峰压(Ppeak)、气道平台压(Pplat)并行血气分析,计算动态肺顺应性(Cdyn)、死腔率(VD/VT)、氧合指数(Pa O2/Fi O2)和分流率(Qs/Qt)。结果不同时间点的动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、中心静脉血氧饱和度(ScvO2)、Ppeak、Pplat、呼气末正压(PEEP)、VD/VT、Cdyn、PaO2/Fi O2、Qs/Qt有差异(P<0.05);3组间PaCO2、Ppeak、Pplat、PEEP、VD/VT、Cdyn有差异(P<0.05);3组间PaCO2、Ppeak、Pplat、PEEP、VD/VT变化趋势有差异(P<0.05)。结论在压力控制容量保证的单肺通气中,适当增加吸气流速可以在降低气道压的同时促使更有效的气体弥散,减少死腔率并改善肺动态顺应性。 展开更多
关键词 单肺通气 吸气流速 压力控制 死腔率 肺动态顺应性
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Dual Isoflurane-induced Preconditioning Improves Neuroprotection in Rat Brain In Vitro and the Role of Extracellular Signal-regulated Protein Kinase
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作者 Sheng Wang Su-xiang Guo +4 位作者 zhi-gang dai Xi-wei Dong Yang Liu Shan Jiang Zhi-ping Wang 《Chinese Medical Sciences Journal》 CAS CSCD 2011年第1期36-42,共7页
Objective To test the ability of isoflurane-induced preconditioning against oxygen and glucose dep- rivation (OGD) injury in vitro. Methods Rat hippocampal slices were exposed to 1 volume percentage (vol%), 2vo1%... Objective To test the ability of isoflurane-induced preconditioning against oxygen and glucose dep- rivation (OGD) injury in vitro. Methods Rat hippocampal slices were exposed to 1 volume percentage (vol%), 2vo1% or 3vo1% isoflurane respectively for 20 minutes under normoxic conditions (95% O2/5% CO2) once or twice (12 slices in each group) before OGD, with 15-minute washout after each exposure. During OGD experiments, hippocampus slices were bathed with artificial cerebrospinal fluid (ACSF) lacking glucose and perfused with 95% N2 and 5% CO2 for 14 minutes, followed by a 30-minute reperfusion in normal ACSF. The CA1 population spike (PS) was measured and used to quantify the degree of neuronal function recovery after OGD. To assess the role of mitogen-activated protein kinases (MAPKs) in isoflurane preconditioning, U0126, an inhibitor of extracellular signal-regulated protein kinase (ERK1/2), and SB203580, an inhibitor of p38 MAPK, were used before two periods of 3vol% isoflurane exposure. Results The degree of neuronal function recovery of hippocampal slices exposed to 1 vol%, 2vol%, or 3vol% isoflurane once was 41.88%±9.23%, 55.05%±11.02%, or 63.18%±10.82% respectively. Moreover, neuronal function recovery of hippocampal slices exposed to 1 vol%, 2vo1%, or 3vo1% isoflurane twice was 53.75%±12.04%, 63.50%±11.06%, or 76.25%±12.25%, respectively. Isoflurane preconditioning increased the neuronal function recovery in a dose-dependent manner. U0126 blocked the preconditioning induced by dual exposure to 3vo1% isoflurane (6.13%±1.56%, P〈0.01) and ERK1/2 activities. Conclusions Isoflurane is capable of inducing preconditioning in hippocampal slices in vitro in a dose-dependent manner, and dual exposure to isoflurane with a lower concentration is more effective in triggering preconditioning than a single exposure. Isoflurane-induced neuroprotection might be involved with ERK 1/2 activities. 展开更多
关键词 ELECTROPHYSIOLOGY hippocampal slice ISOFLURANE PRECONDITIONING oxygen andglucose deprivation mitogen-activated protein kinase
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Partial Label Learning via Conditional-Label-Aware Disambiguation
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作者 Peng Ni Su-Yun Zhao +2 位作者 zhi-gang dai Hong Chen Cui-Ping Li 《Journal of Computer Science & Technology》 SCIE EI CSCD 2021年第3期590-605,共16页
Partial label learning is a weakly supervised learning framework in which each instance is associated with multiple candidate labels,among which only one is the ground-truth label.This paper proposes a unified formula... Partial label learning is a weakly supervised learning framework in which each instance is associated with multiple candidate labels,among which only one is the ground-truth label.This paper proposes a unified formulation that employs proper label constraints for training models while simultaneously performing pseudo-labeling.Unlike existing partial label learning approaches that only leverage similarities in the feature space without utilizing label constraints,our pseudo-labeling process leverages similarities and differences in the feature space using the same candidate label constraints and then disambiguates noise labels.Extensive experiments on artificial and real-world partial label datasets show that our approach significantly outperforms state-of-the-art counterparts on classification prediction. 展开更多
关键词 DISAMBIGUATION partial label learning similarity and dissimilarity weak supervision
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