目的采用随机对照的方法对变体位、变角度两点法与传统一点法应用于腋路臂丛神经阻滞,评估变体位、变角度两点法腋路臂丛神经阻滞的临床效果。方法选择100例拟行前臂和手部手术的急诊病人,随机分为变体位、变角度两点法组(Variable post...目的采用随机对照的方法对变体位、变角度两点法与传统一点法应用于腋路臂丛神经阻滞,评估变体位、变角度两点法腋路臂丛神经阻滞的临床效果。方法选择100例拟行前臂和手部手术的急诊病人,随机分为变体位、变角度两点法组(Variable posture and angle two-point method,VTP组,n=50)和传统一点法组(The traditional one point method,TOP组,n=50),分别采用变体位、变角度两点法和传统一点法进行腋路臂丛神经阻滞,局麻药皆采用0.375%盐酸罗哌卡因45 mL。阻滞后观察对肘部远端5支神经(肌皮神经、桡神经、正中神经、尺神经和前臂内侧皮神经)支配区域的感觉和运动阻滞效果,臂丛阻滞成功被定义为注射20min后,肘部远端5支神经支配区域的感觉阻滞完全,比较两组在臂丛阻滞成功率、时效、止血带耐受和并发症等方面的差异。结果 VTP组阻滞成功率要高于TOP组(92.0%对74.0%,P<0.05),VTP肌皮神经和桡神经的阻滞成功率显著高于TOP组(P值分别为0.017和0.021)。VTP组起效、达到阻滞完善的时间明显短于TOP组(P<0.05),VTP组手术等待时间明显短于TOP组(P<0.05)。VTP组较TOP组病人能较好的耐受止血带痛(P<0.05)。结论变体位、变角度两点法腋路臂丛神经阻滞法是一种良好的阻滞方法,较传统一点法更为有效。其优点为较好的阻滞桡神经和肌皮神经,缩短麻醉起效时间和外科医师等待时间,对急诊手术具有一定的价值;有助于提高病人的满意度,减少病人止血带不适。展开更多
The phase field method was applied to study the microstructure evolution of Ni4Ti3 precipitates during stress-free and stress-assisted aging of bi-crystalline NiTi shape memory alloys （SAMs） with two different initi...The phase field method was applied to study the microstructure evolution of Ni4Ti3 precipitates during stress-free and stress-assisted aging of bi-crystalline NiTi shape memory alloys （SAMs） with two different initial Ni-contents of 51.5% and 52.5% （mole fraction）, respectively. The simulation results show that, during stress-free aging of the NiTi alloy with a low supersaturation of Ni （i.e., Ti-51.5%Ni）, the Ni4Ti3 precipitates exhibit a heterogeneous distribution with a high number density of particles at the grain boundary, leaving most of the grain interiors free of precipitates; while for the NiTi alloy with a high supersaturation of Ni （i.e., Ti-52.5%Ni）, the Ni4Ti3 precipitates show a homogeneous distribution across the entire simulation system. The stress-assisted aging can give rise to homogeneous distribution of the precipitates, regardless of the initial Ni-content; however, the distribution of variant type within the two grains is heterogeneous.展开更多
文摘目的采用随机对照的方法对变体位、变角度两点法与传统一点法应用于腋路臂丛神经阻滞,评估变体位、变角度两点法腋路臂丛神经阻滞的临床效果。方法选择100例拟行前臂和手部手术的急诊病人,随机分为变体位、变角度两点法组(Variable posture and angle two-point method,VTP组,n=50)和传统一点法组(The traditional one point method,TOP组,n=50),分别采用变体位、变角度两点法和传统一点法进行腋路臂丛神经阻滞,局麻药皆采用0.375%盐酸罗哌卡因45 mL。阻滞后观察对肘部远端5支神经(肌皮神经、桡神经、正中神经、尺神经和前臂内侧皮神经)支配区域的感觉和运动阻滞效果,臂丛阻滞成功被定义为注射20min后,肘部远端5支神经支配区域的感觉阻滞完全,比较两组在臂丛阻滞成功率、时效、止血带耐受和并发症等方面的差异。结果 VTP组阻滞成功率要高于TOP组(92.0%对74.0%,P<0.05),VTP肌皮神经和桡神经的阻滞成功率显著高于TOP组(P值分别为0.017和0.021)。VTP组起效、达到阻滞完善的时间明显短于TOP组(P<0.05),VTP组手术等待时间明显短于TOP组(P<0.05)。VTP组较TOP组病人能较好的耐受止血带痛(P<0.05)。结论变体位、变角度两点法腋路臂丛神经阻滞法是一种良好的阻滞方法,较传统一点法更为有效。其优点为较好的阻滞桡神经和肌皮神经,缩短麻醉起效时间和外科医师等待时间,对急诊手术具有一定的价值;有助于提高病人的满意度,减少病人止血带不适。
基金Project (50871039) supported by the National Natural Science Foundation of ChinaProject (2011ZB0007) supported by the Fundamental Research Funds for Central Universities of ChinaProject (201104090881) support by China Postdoctoral Science Foundation
文摘The phase field method was applied to study the microstructure evolution of Ni4Ti3 precipitates during stress-free and stress-assisted aging of bi-crystalline NiTi shape memory alloys （SAMs） with two different initial Ni-contents of 51.5% and 52.5% （mole fraction）, respectively. The simulation results show that, during stress-free aging of the NiTi alloy with a low supersaturation of Ni （i.e., Ti-51.5%Ni）, the Ni4Ti3 precipitates exhibit a heterogeneous distribution with a high number density of particles at the grain boundary, leaving most of the grain interiors free of precipitates; while for the NiTi alloy with a high supersaturation of Ni （i.e., Ti-52.5%Ni）, the Ni4Ti3 precipitates show a homogeneous distribution across the entire simulation system. The stress-assisted aging can give rise to homogeneous distribution of the precipitates, regardless of the initial Ni-content; however, the distribution of variant type within the two grains is heterogeneous.
