长期饮酒对下腹部手术患者术中麻醉抗药及术后认知功能的影响

目的:发现长期饮酒对下腹部手术患者术中麻醉抗药及术后认知功能的影响。方法:118例接受下腹部手术的患者纳入研究,分为长期饮酒组43例,对照组75例。对比两组患者的围麻醉期血流动力学指标、应激指标,术后血清氨基酸递质、神经功能指标含量差异。结果:长期饮酒组患者的划皮时(T2)、切口缝合时(T3)血流动力学指标CO、VO2值大于对照组患者,SV值小于对照组患者,应激指标Glu、Cor、AngⅡ、E、NE含量高于对照组患者;长期饮酒组患者的术后血清Glu、Asp、Gly、GABA、Ala、Tau含量高于对照组患者,NSE、S100β、MMP-9含量高于对照组患者,BDNF、ADP含量低于对照组患者。结论:长期饮酒可增加下腹部手术患者的麻醉抗药性,增加术后认知功能障碍发生率。

饮酒习惯与麻醉抗药相关性研究

目的：研究饮酒习惯与麻醉抗药性之间的联系。方法：选择2013年9月~2014年7月来我院需要进行麻醉手术的患者50例,分为A组和B组,其中A组不饮酒,B组有饮酒习惯。观察两组患者使用丙泊酚、瑞芬太尼等麻醉药物的实际用量。结果：A组麻药用量明显小于B组,P〈0.05。结论：A组麻醉效果明显优于B组。

Eradication of Helicobacter pylori significantly reduced gastric damage in nonsteroidal anti-inflammatory drug-treated Mongolian gerbils

AIM: To examine the effect of eradication of Hellcobacter pylori prior to usage of NSAIDs, by investigating gastric inflammatory activity, myeloperoxidase (MPO) activity, prostaglandin (PG) E_2 synthesis in H Pylori-infected, and H pylori-eradicated gerbils followed by administration of indomethacin and rofecoxib. METHODS: Six-week-old male gerbils were orally inoculated with H pylori. Seven weeks later, anti-H pylori triple therapy and vehicle were given to gerbils respectively and followed by oral indomethacin (2 mg/kg·d) or rofecoxib (10 mg/kg·d) for 2 wk. We examined the area of lesions, gastric inflammatory activity, PGE_2 synthesis and MPO activity in the stomach. RESULTS: In indomethacin and rofecoxib-treated gerbils, the following results were obtained in H pylori-infected group vs H pylori-eradicated group respectively: hyperplasia area of the stomach (mm^2): 82.4±9.2 vs 13.9±3.5 (P＜0.05), 30.5±5.1 vs 1.3±0.6 (P＜0.05); erosion and ulcer area (mm^2): 14.4±4.9 vs 0.86±0.5 (P＜0.05), 1.3±0.6 vs0.4±0.3 (P＜0.05); score of gastritis: 7.0±0.0 vs3.6±0.5 (P＜0.05), 7.0±0.0 vs 2.7±0.5 (P＜0.05); MPO activity (μmol H_2O_2/min/g tissue): 104.7±9.2 vs9.0±2.3(P＜0.05), 133.5±15.0 vs2.9±0.7 (P＜0.05); PGE_2 synthesis (pg/mg wet weight/min): 299.2±81.5 vs102.8±26.2 (P＜0.05), 321.4±30.3 vs 11.9±4.8(P＜0.05). CONCLUSION: Eradication of H pylori reduced gastric damage of NSAID-treated Mongolian gerbils. Rofecoxib caused less severe gastric damage than indomethacin in H pylori-eradicated gerbils.

纳洛酮催醒后呼吸意识再抑制2例报告

1一般资料 患者1,男,62岁,54kg,食道中段癌行食道癌切除术.术前30 min肌注阿托品0.5 mg,安定10mg,氟哌啶4 mg,芬太尼0.1 mg,异丙酚2 mg/kg,司可林1.5 mg/kg,快诱导气管插管后,以1%普鲁卡因500 mL内含哌替啶200 mg、司可林300 mg维持麻醉.术毕20 min因病人意识及自主呼吸未恢复而静注纳洛酮0.4 mg,2 min后病人意识及自主呼吸恢复,潮气量8～10 mL/kg,充分吸痰后拔管.10 min后病人意识消失,呼吸停止.立即气管插管人工呼吸,20 min后病人清醒,呼吸满意.拔管安返病房.