芬太尼联合曲马多用于小儿泌尿外科术后镇痛的观察

[目的]为观察芬太尼联合曲马多用于小儿泌尿外科术后镇痛的效果。[方法]选择ASA分级Ⅰ～Ⅱ级择期行泌尿外科手术，手术时间在1～3h之间，年龄为5～14岁的手术患儿60例。芬太尼组及芬太尼联合曲马多组各30例。术后镇痛均采用连续恒量静脉注射方法。芬太尼联合曲马多组选用药物为曲马多与芬太尼复合枢丹，持续量：曲马多1mg／kg＋芬太尼0．01mg／kg＋枢丹0．1mg／kg，芬太尼组维持量予芬太尼0．015mg／kg＋枢丹0．1mg／kg。将持续量药物加生理盐水至120ml注入福尼亚WZ-6523C-4型注射泵内，以2mL／h恒速静脉注射给药。手术结束前5～10min将负荷量曲马多静脉缓注，静脉接注射泵。采用视觉模拟评分法（VAS）评估术后48h患儿的情况，比较两组患儿镇痛药物的用量及不良反应。[结果]镇痛效果：两组患儿术后镇痛效果各时段差异均有显著性（P〈0．05），芬太尼联合曲马多组镇痛效果较好。两组患儿术后镇痛药物的用量差异有显著性（P〈0．05），芬太尼联合曲马多组镇痛药物的用量较少。不良反应：两组患儿24h眩晕、恶心、呕吐、皮肤瘙痒发生率差异无显著性（P〉0．05）。术后SpO2均≥95％，无呼吸抑制发生。[结论]曲马多复合芬太尼应用于小儿术后PCIA较单纯应用芬太尼，镇痛效果良好，安全可行。

后腹腔镜下肾切除术12例

目的：探讨后腹腔镜肾切除术的方法与适应证。方法：施行后腹腔镜下肾切除术12例,其中肾结石重度肾积水2例,肾结核1例,先天性肾盂输尿管连接部梗阻重度肾积水8例,马蹄肾一侧重度积水1例。1例肾输尿管结核抗结核治疗9个月,随访无复发。结果：手术全部成功,无严重并发症发生。手术时间30~165min,平均85min;出血20~270 ml,平均120 ml。结论：后腹腔镜单纯性肾切除术创伤小,住院时间短,病人康复快,是单纯性肾切除的金标准术式。

Anethum graveolens Linn.(dill) extract enhances the mounting frequency and level of testicular tyrosine protein phosphorylation in rats

Objective:To investigate the effect of Anethum graveolens(AG) extracts on the mounting frequency,histology of testis and epididymis,and sperm physiology.Methods:Male rats induced by cold immobilization before treating with vehicle or AG extracts [50,150,and 450 mg/kg body weight(BW)] via gastric tube for consecutive 1,7,and 14 d were examined for mounting frequency,testicular phosphorylation level by immunoblotting,sperm concentration,sperm acrosome reaction,and histological structures of testis and epididymis,respectively.Results:AG(50 mg/kg BW) significantly increased the mounting frequency on Days 1 and 7 compared to the control group.Additionally,rat testis treated with 50 mg/kg BW AG showed high levels of phosphorylated proteins as compared with the control group.In histological analyses,AG extract did not affect the sperm concentration,acrosome reaction,and histological structures of testis and epididymis.Conclusions:AG extract enhances the aphrodisiac activity and is not harmful to sperm and male reproductive organs.