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Low-pressure pneumoperitoneum with abdominal wall lift in laparoscopic total mesorectal excision for rectal cancer:initial experience 被引量:4
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作者 Ping-Tian Xia Maimaiti Yusofu +4 位作者 Hai-Feng Han Chun-Xiao Hu San-Yuan Hu Wen-Bin Yu Shao-Zhuang Liu 《World Journal of Gastroenterology》 SCIE CAS 2018年第11期1278-1284,共7页
AIM To evaluate the safety and feasibility of a new technology combining low-pressure pneumoperitoneum(LPP) and abdominal wall lift(AWL) in laparoscopic total mesorectal excision(TME) for rectal cancer.METHODS From No... AIM To evaluate the safety and feasibility of a new technology combining low-pressure pneumoperitoneum(LPP) and abdominal wall lift(AWL) in laparoscopic total mesorectal excision(TME) for rectal cancer.METHODS From November 2015 to July 2017,26 patients underwent laparoscopic TME for rectal cancer using LPP(6-8 mm Hg) with subcutaneous AWL in Qilu Hospital of Shandong University,Jinan,China.Clinical data regarding patients' demographics,intraoperative monitoring indices,operation-related indices andpathological outcomes were prospectively collected.RESULTS Laparoscopic TME was performed in 26 cases(14 anterior resection and 12 abdominoperineal resection) successfully,without conversion to open or laparoscopic surgery with standard-pressure pneumoperitoneum.Intraoperative monitoring showed stable heart rate,blood pressure and paw airway pressure.The mean operative time was 194.29 ± 41.27 min(range:125-270 min) and 200.41 ± 20.56 min(range:170-230 min) for anterior resection and abdominoperineal resection,respectively.The mean number of lymph nodes harvested was 16.71 ± 5.06(range:7-27).There was no positive circumferential or distal resection margin.No local recurrence was observed during a median follow-up period of 11.96 ± 5.55 mo(range:5-23 mo).CONCLUSION LPP combined with AWL is safe and feasible for laparoscopic TME.The technique can provide satisfactory exposure of the operative field and stable operative monitoring indices. 展开更多
关键词 Laparoscopic surgery ABDOMINAL wall LIFT low-pressure pneumoperitoneum RECTAL cancer Total mesorectal EXCISION
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Photoionization Mass Spectrometric and Kinetic Modeling of Low-pressure Pyrolysis of Benzene 被引量:2
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作者 杨玖重 赵龙 +2 位作者 蔡江淮 齐飞 李玉阳 《Chinese Journal of Chemical Physics》 SCIE CAS CSCD 2013年第3期245-251,I0003,共8页
Pyrolysis of benzene at 30 Torr was studied from 1360 K to 1820 K in this work. Synchrotron vacuum ultraviolet photoionization mass spectrometry was employed to detect the pyroly- sis products such as radicals, isomer... Pyrolysis of benzene at 30 Torr was studied from 1360 K to 1820 K in this work. Synchrotron vacuum ultraviolet photoionization mass spectrometry was employed to detect the pyroly- sis products such as radicals, isomers and polycyclic aromatic hydrocarbons, and measure their mole fraction profiles versus temperature. A low-pressure pyrolysis model of benzene was developed and validated by the experimental results. Rate of production analysis was performed to reveal the major reaction networks in both fuel decomposition and aromatic growth processes. It is concluded that benzene is mainly decomposed via H-abstraction reaction to produce phenyl and partly decomposed via unimolecular decomposition reac- tions to produce propargyl or phenyl. The decomposition process stops at the formation of acetylene and polyyne species like diacetylene and 1,3,5-hexatriyne due to their high thermal stabilities. Besides, the aromatic growth process in the low-pressure pyrolysis of benzene is concluded to initiate from benzene and phenyl, and is controlled by the even carbon growth mechanism due to the inhibited formation of C5 and C7 species which play important roles in the odd carbon growth mechanism. 展开更多
关键词 BENZENE low-pressure pyrolysis PAH formation Synchrotron vacuum ultra-violet photoionization mass spectrometry Kinetic model
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Process Optimization for AZ91 Mg-alloy Low-pressure EPC Process 被引量:2
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作者 吴和保 《Journal of Wuhan University of Technology(Materials Science)》 SCIE EI CAS 2005年第2期42-44,共3页
The influence of a key process variable on the mold filling characteristics of AZ91 Mg-alloy was studied in the low pressure EPC process.The applied flow quantity of insert gas from 1 to 5 m~3/h associated with the pr... The influence of a key process variable on the mold filling characteristics of AZ91 Mg-alloy was studied in the low pressure EPC process.The applied flow quantity of insert gas from 1 to 5 m~3/h associated with the pressurizing rate in the low pressure EPC casting process was considered for rectangle and L-shape plate casting. The experimental results show that there is an optimal flow quantity of insert gas for good mold filling characteristics in AZ91 Mg-alloy low-pressure EPC process. The optimal flow quantity of insert gas for the specimens is 3 to 4 m~3/h. Either less or higher than the optimal flow quantity of insert gas would lead to misrun defects or folds, blisters and porosity defects. The practice of hub casting confirmed that the low-pressure EPC process with an optimal processing variable exemplified as 4 m~3/h gas flow quantity was capable of producing complicated magnesium castings without misrun defects. 展开更多
关键词 magnesium alloy low-pressure casting expandable pattern casting process optimization
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Numerical simulation and analysis of lithium plasma during low-pressure DC arc discharge 被引量:1
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作者 Runhui WU Song CHAI +2 位作者 Jiaqi LIU Shiyuan CONG Gang MENG 《Plasma Science and Technology》 SCIE EI CAS CSCD 2019年第4期16-21,共6页
Alkali metal DC arc discharge has the characteristics of easy ionization,low power consumption,high plasma temperature and ionization degree,etc,which can be applied in aerospace vehicles in various ways.In this paper... Alkali metal DC arc discharge has the characteristics of easy ionization,low power consumption,high plasma temperature and ionization degree,etc,which can be applied in aerospace vehicles in various ways.In this paper,we calculate the physical property parameters of lithium vapor,one of the major alkali metals,and analyze the discharge characteristics of lithium plasma with the magnetohydrodynamic(MHD)model.The discharge effects between constant current and voltage sources are also compared.It is shown that the lithium plasma of DC arc discharge has relatively high temperature and current density.The peak temperature can reach tens of thousands of K,and the current density reaches 6 x 107 A m 2.Under the same rated power,the plasma parameters of the constant voltage source discharge are much higher than those of the constant current source discharge,which can be used as the preferred discharge mode for aerospace applications. 展开更多
关键词 DC DISCHARGE LITHIUM PLASMA NUMERICAL simulation low-pressure ARC
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An Experimental and Numerical Study on the Cleaning of Pleated Bag Filters Using Low-Pressure Pulsed-Jets 被引量:1
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作者 Lumin Chen Wanying Sun +5 位作者 Fuping Qian Can Fang Zhimin Zheng Qianshuang Zhuang Yunlong Han Jinli Lu 《Fluid Dynamics & Materials Processing》 EI 2022年第1期41-56,共16页
Pulsed-jet cleaning is recognized as the most efficient method to regenerate bag dust collectors traditionally used in industrial processes to control the emission of particulates.In this study,non-woven needle felt f... Pulsed-jet cleaning is recognized as the most efficient method to regenerate bag dust collectors traditionally used in industrial processes to control the emission of particulates.In this study,non-woven needle felt filter bags with and without a film coating material have been analyzed considering different geometries(different number N of pairs of pleated filter bag sides)in the frame of dedicated low-pressure pulsed-jet cleaning experiments.The flow structure inside the bag and the response characteristics of its wall have also been analyzed numerically through a computational fluid-dynamics/structural-dynamics(CFD-CSD)unidirectional fluid-solid coupling method.As shown by the experiments,the peak pressure(P_(0))on the wall of the filter bag with N=8 and 12 is higher,which indicates dust can be removed more effectively in these cases.The peak pressure on the wall increases first and then decreases along the direction of the bag length,while the peak pressure of the pleated filter bag with nonwoven needled felt film coating is greater than that without film coating.A comprehensive analysis of the time variation of acceleration,deformation,strain,stress and other factors,has led to the conclusion that the pleated filter bag with N=12 would be the optimal choice. 展开更多
关键词 Pleated filter bag dust cleaning performance low-pressure pulsed-jet cleaning peak pressure unidirectional fluidstructure coupling
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Effect of Low-pressure Carbonation on the Heat Inactivation and Cytoplasmic Acidification of Saccharomyces cerevisiae 被引量:1
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作者 Wannaporn Klangpetch Tomoe Nakail +3 位作者 Kei Nishiyama Seiji Noma Noriyuki Igura Mitsuya Shimoda 《Journal of Food Science and Engineering》 2012年第12期712-718,共7页
Effect of low-pressure carbonation (LPC) on heat inactivation of Saccharomyces cerevisiae was investigated. The cell suspension was carbonated at 1 MPa and 4℃ for 15 min and subsequently heated from 51 to 61 ℃ and... Effect of low-pressure carbonation (LPC) on heat inactivation of Saccharomyces cerevisiae was investigated. The cell suspension was carbonated at 1 MPa and 4℃ for 15 min and subsequently heated from 51 to 61 ℃ and 5 s to 5 min (heating with LPC). As a control experiment, cell suspension was heat-treated under atmospheric pressure without LPC (heating). The inactivation ratio of heating at 53℃ and 55℃ for l rain with LPC was approximately 1 log order higher than heating alone. Extending heating time to 5 min did not widen the difference in the inactivation ratio between heating with LPC and heating alone at both heating temperatures. At 57℃, the difference in inactivation ratio increased from 1 to 2.5 log order with extending treatment time from 5 to 15 s. The results suggested that the enhanced inactivation effect by LPC was obtained at the higher temperature with short time treatment than the lower temperature with longer time treatment. Under fluorescence microscope observation of LPC-treated cell stained with LysoSensor probe, it seemed that LPC was hardly able to acidify the cytoplasm ofS. cerevisiae. It is considered that the ability orS. cerevisiae ceils to keep their cytoplasmic pH during LPC resulted in the inferior increase in heat inactivation ratio by LPC as compared with bacteria in the previous studies. 展开更多
关键词 Saccharomyces cerevisiae low-pressure carbonation heat inactivation heat sensitivity.
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Neutrons in a nanosecond low-pressure discharge in deuterium
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作者 Victor F.Tarasenko Mikhail I.Lomaev +3 位作者 Dmitry A.Sorokin Boris A.Nechaev Vladimir N.Padalko Gennady N.Dudkin 《Matter and Radiation at Extremes》 SCIE EI CAS 2016年第4期207-212,共6页
Stable neutron generation with a yield of ~1.2×10^(4) neutrons per pulse was obtained during d(d,n)^(3)He reaction initiated by the high-voltage nanosecond discharge in a gap with a potential tungsten cylinder(an... Stable neutron generation with a yield of ~1.2×10^(4) neutrons per pulse was obtained during d(d,n)^(3)He reaction initiated by the high-voltage nanosecond discharge in a gap with a potential tungsten cylinder(anode)and a grounded deuterated zirconium plate(cathode)filled with deuterium at a pressure of ~10^(2) Pa.Estimated duration of the neutron pulse was ~1.5 ns.Less intensive neutron emission was registered without deuterated plate.Splashing of material of the tungsten electrode was observed during the high-voltage nanosecond discharge in the deuterium,hydrogen,helium and argon at pressures of 10^(2)-10^(4) Pa. 展开更多
关键词 Neutrons DEUTERIUM High-voltage nanosecond discharge low-pressure Thermonuclear reaction
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A LOW-PRESSURE AND ONE-STEP METHOD FOR THE SYNTHESIS OF ALKYLIDYNETRICOBALT NONACARBONYL CLUSTERS:RCCo_8(CO)_9
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作者 Cheng Guo JIA Yun Pu WANG Han Yu FENG 《Chinese Chemical Letters》 SCIE CAS CSCD 1993年第2期121-122,共2页
Metal clusters RCCo_3(CO)_9(R-H,C1,Br,CH_3,Ph) were prepared in 18.8-57.3% yields from the reaction of cobalt(Ⅱ)salt and RCX_a under mild PTC conditions(latm CO,25℃).The cobalt salt was reduced to Co(CO)_4 in the pr... Metal clusters RCCo_3(CO)_9(R-H,C1,Br,CH_3,Ph) were prepared in 18.8-57.3% yields from the reaction of cobalt(Ⅱ)salt and RCX_a under mild PTC conditions(latm CO,25℃).The cobalt salt was reduced to Co(CO)_4 in the presence of Na_3S_2O_4. 展开更多
关键词 CO CO A low-pressure AND ONE-STEP METHOD FOR THE SYNTHESIS OF ALKYLIDYNETRICOBALT NONACARBONYL CLUSTERS STEP WANG
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The mechanism study of low-pressure air plasma cleaning on large-aperture optical surface unraveled by experiment and reactive molecular dynamics simulation
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作者 Yuhai LI Qingshun BAI +9 位作者 Yuheng GUAN Hao LIU Peng ZHANG Buerlike BATELIBIEKE Rongqi SHEN Lihua LU Xiaodong YUAN Xinxiang MIAO Wei HAN Caizhen YAO 《Plasma Science and Technology》 SCIE EI CAS CSCD 2022年第6期77-87,共11页
Low-pressure air plasma cleaning is an effective method for removing organic contaminants on large-aperture optical components in situ in the inertial confinement fusion facility.Chemical reactions play a significant ... Low-pressure air plasma cleaning is an effective method for removing organic contaminants on large-aperture optical components in situ in the inertial confinement fusion facility.Chemical reactions play a significant role in plasma cleaning,which is a complex process involving abundant bond cleavage and species generation.In this work,experiments and reactive molecular dynamics simulations were carried out to unravel the reaction mechanism between the benchmark organic contaminants of dibutyl phthalate and air plasma.The optical emission spectroscopy was used to study the overall evolution behaviors of excited molecular species and radical signals from air plasma as a reference to simulations.Detailed reaction pathways were revealed and characterized,and specific intermediate radicals and products were analyzed during experiments and simulation.The reactive species in the air plasma,such as O,HO_(2)and O_(3)radicals,played a crucial role in cleaving organic molecular structures.Together,our findings provide an atomic-level understanding of complex reaction processes of low-pressure air plasma cleaning mechanisms and are essential for its application in industrial plasma cleaning. 展开更多
关键词 organic contaminants large-aperture optical components low-pressure air plasma plasma cleaning reactive species reactive molecular dynamics
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Simulation of propagation of the HPM in the low-pressure argon plasma
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作者 李志刚 袁忠才 +1 位作者 汪家春 时家明 《Plasma Science and Technology》 SCIE EI CAS CSCD 2018年第2期110-114,共5页
The propagation of the high-power microwave(HPM) with a frequency of 6 GHz in the lowpressure argon plasma was studied by the method of fluid approximation.The two-dimensional transmission model was built based on t... The propagation of the high-power microwave(HPM) with a frequency of 6 GHz in the lowpressure argon plasma was studied by the method of fluid approximation.The two-dimensional transmission model was built based on the wave equation,the electron drift-diffusion equations and the heavy species transport equations,which were solved by means of COMSOL Multiphysics software.The simulation results showed that the propagation characteristic of the HPM was closely related to the average electron density of the plasma.The attenuation of the transmitted wave increased nonlinearly with the electron density.Specifically,the growth of the attenuation slowed down as the electron density increased uniformly.In addition,the concrete transmission process of the HPM wave in the low-pressure argon plasma was given. 展开更多
关键词 low-pressure argon plasma high-power microwave protection application
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Microstructure and Properties of Low-pressure Cold Sprayed Al-based Composite Coatings on Magnesium Alloy Surface
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作者 LIU Hongjin DING Minghui +1 位作者 WANG Haoxuan YAN Pengwei 《上海航天(中英文)》 CSCD 2022年第1期84-91,共8页
Pure Al and Al-30%Al_(2)O_(3)composite coatings are prepared on the surface of AZ31B magnesium alloy by low-pressure cold spraying.The morphology and structure of the coatings are analyzed by scanning electron microsc... Pure Al and Al-30%Al_(2)O_(3)composite coatings are prepared on the surface of AZ31B magnesium alloy by low-pressure cold spraying.The morphology and structure of the coatings are analyzed by scanning electron microscope (SEM),energy dispersive spectroscopy (EDS),and X-ray diffraction (XRD),and the effects of the addition of Al_(2)O_(3)on the microstructure of the Al-based coatings are discussed.The mechanical properties and corrosion resistance of the coatings are fully evaluated by the micro-hardness tester,electronic tensile machine,and electrochemical workstation.The results show that the coating structure is more uniform and denser,and the porosity is significantly reduced after the addition of Al_(2)O_(3).The interfaces between the coatings and the magnesium alloy substrate are distinct,and the coatings and the substrate are mechanically combined.Compared with the pure Al coating,the microhardness of the Al-Al_(2)O_(3)composite coating is increased to 61.1 HV_(0.2),and the bonding strength reaches above 53.1 MPa.The self-corrosion potential of the two coatings is higher than that of the magnesium alloy,and the self-corrosion current density is significantly lower than that of the magnesium alloy substrate.The Al-based coatings prepared by low-pressure cold spraying have high hardness,good bonding strength,and good corrosion resistance,which can be used for the repair and protection of magnesium alloy structural parts. 展开更多
关键词 AL Al-Al_(2)O_(3) low-pressure cold spray mechanical property corrosion resistance
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不同CO_(2)气腹压力对老年腹腔镜直肠癌根治术后谵妄及认知功能的影响
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作者 刘勇 仲明杰 +2 位作者 陈悦 耿莹 吴浩 《局解手术学杂志》 2024年第10期867-870,共4页
目的探讨术中不同的CO_(2)气腹压力对行腹腔镜下直肠癌根治术的老年患者谵妄和认知功能的影响。方法选择92例行腹腔镜下直肠癌根治术的老年患者作为研究对象,随机分为H组与L组,每组46例。H组患者术中使用15 mmHg的CO_(2)气腹压力,L组患... 目的探讨术中不同的CO_(2)气腹压力对行腹腔镜下直肠癌根治术的老年患者谵妄和认知功能的影响。方法选择92例行腹腔镜下直肠癌根治术的老年患者作为研究对象,随机分为H组与L组,每组46例。H组患者术中使用15 mmHg的CO_(2)气腹压力,L组患者术中使用11 mmHg的CO_(2)气腹压力。比较2组患者的认知功能评分、术后谵妄发生情况、血气分析结果、生命体征及麻醉苏醒期不良反应的发生情况。结果L组患者术后6 h、24 h的认知功能评分显著高于H组(P<0.05);L组患者术后6 h、24 h的谵妄发生率显著低于H组(P<0.05);2组患者气腹建立前及气腹结束时的平均动脉压(MAP)、心率以及血氧饱和度(SpO_(2))比较,差异均无统计学意义(P>0.05);2组患者气腹结束时的pH和CO_(2)分压(PaCO_(2))比较,差异均有统计学意义(P<0.05),H组患者苏醒延迟和苏醒期躁动的发生率显著高于L组(P<0.05)。结论使用11 mmHg CO_(2)气腹压力对行腹腔镜下直肠癌根治术的老年患者术后认知功能的影响更小,术后谵妄和苏醒期不良反应发生率更低,这可能与患者血液中的PaCO_(2)水平有关,应引起关注。 展开更多
关键词 气腹压力 Trendelenburg体位 腹腔镜手术 术后谵妄 认知功能
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经脐无气腹单孔腔镜联合罗哌卡因局部浸润麻醉在妊娠合并卵巢肿瘤中的应用
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作者 朱诚程 罗永红 +2 位作者 丁锦 程慧娴 倪观太 《中国临床药理学与治疗学》 CAS CSCD 北大核心 2024年第5期561-568,共8页
目的:研究妊娠合并卵巢肿瘤患者应用经脐无气腹单孔腔镜联合罗哌卡因局部浸润麻醉的临床疗效及安全性。方法:28例妊娠患者合并卵巢肿瘤行经脐无气腹单孔腔镜手术,按随机数字表分2组,观察组16例采用腰麻联合缝皮前罗哌卡因浸润麻醉,对照... 目的:研究妊娠合并卵巢肿瘤患者应用经脐无气腹单孔腔镜联合罗哌卡因局部浸润麻醉的临床疗效及安全性。方法:28例妊娠患者合并卵巢肿瘤行经脐无气腹单孔腔镜手术,按随机数字表分2组,观察组16例采用腰麻联合缝皮前罗哌卡因浸润麻醉,对照组12例采用腰麻,比较两组孕妇术后首次下床时间、通气时间、术后住院天数,术后6 h无创血压、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2),Ramsay镇静评分、术后6、24、48 h静息和运动状态下的疼痛评分,SAS焦虑评分、术后并发症、患者满意度、恢复质量表QoR15。结果:两组比较,术后住院天数、Ramsay评分、RR、SpO2及并发症发生率差异无统计学意义(P>0.05);观察组下床时间、通气时间缩短,无创血压、HR、疼痛评分、焦虑评分低于对照组,患者满意度、QoR15评分优于对照组,差异有统计学意义(P<0.05)。结论:妊娠合并卵巢肿瘤患者应用经脐无气腹单孔腔镜联合罗哌卡因局部浸润麻醉,可以减轻术后疼痛,减少孕妇焦虑,临床效果良好,值得推广应用。 展开更多
关键词 单孔腹腔镜 无气腹手术 罗哌卡因 妊娠 卵巢肿瘤
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开腹手术与腹腔镜二氧化碳气腹对患者鼻咽温度的影响
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作者 张志慧 韦金翠 季萍 《河北医药》 CAS 2024年第2期261-263,共3页
目的探讨开腹手术与腹腔镜二氧化碳气腹对患者鼻咽温度的影响。方法选择收治的择期行腹部手术治疗的患者96例为研究对象,根据患者手术方式的不同分为开腹组和腹腔镜组,每组48例。比较2组鼻咽温度、苏醒时间、去甲肾上腺素和肾上腺素水... 目的探讨开腹手术与腹腔镜二氧化碳气腹对患者鼻咽温度的影响。方法选择收治的择期行腹部手术治疗的患者96例为研究对象,根据患者手术方式的不同分为开腹组和腹腔镜组,每组48例。比较2组鼻咽温度、苏醒时间、去甲肾上腺素和肾上腺素水平及躁动、寒颤和低体温发生率。结果手术开始时,2组鼻咽温度比较,差异无统计学意义(P>0.05);手术1、2 h和术毕时,开腹组鼻咽温度高于腹腔镜组(P<0.05)。开腹组苏醒时间短于腹腔镜组(P<0.05)。手术开始时,2组去甲肾上腺素和肾上腺素水平比较,差异无统计学意义(P>0.05);手术2 h和术毕时,开腹组去甲肾上腺素和肾上腺素水平低于腹腔镜组(P<0.05)。开腹组躁动、寒颤和低体温发生率低于腹腔镜组(P<0.05)。结论相比于开腹手术,腹腔镜手术中的二氧化碳气腹更易导致患者出现低温现象。 展开更多
关键词 腹腔镜 开腹手术 二氧化碳气腹 鼻咽温度
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智能气腹系统在机器人根治性前列腺切除术中的应用
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作者 何茫茫 喻晓芬 +2 位作者 洪敏 张琦 张大宏 《浙江临床医学》 2024年第3期356-358,共3页
目的 探讨AirSeal智能气腹系统在机器人辅助腹腔镜根治性前列腺切除手术中的应用效果。方法 选择2019年12月至2022年12月机器人辅助腹腔镜根治性前列腺切除手术患者100例,随机分成观察组与对照组各50例,观察组术中采用AirSeal智能气腹... 目的 探讨AirSeal智能气腹系统在机器人辅助腹腔镜根治性前列腺切除手术中的应用效果。方法 选择2019年12月至2022年12月机器人辅助腹腔镜根治性前列腺切除手术患者100例,随机分成观察组与对照组各50例,观察组术中采用AirSeal智能气腹系统维持气腹,对照组术中采用STORZ或OLYMPUS等标准系统自动气腹机维持气腹,比较两组手术持续时间、术中出血量、术后住院时间、住院总费用、术后4h、8h、24h肩部疼痛程度及医师满意度。结果 两组患者手术均顺利完成,无严重并发症,观察组手术持续时间(150.76±32.47)min,短于对照组(163.32±29.54)min,差异有统计学意义(P=0.046);术后8 h观察组肩部疼痛程度比对照组轻,差异有统计学意义(P=0.041);观察组各维度满意度均高于对照组,差异有统计学意义(P<0.05)。结论 AirSeal智能气腹系统在机器人辅助腹腔镜根治性前列腺切除手术中能缩短手术时间,缓解患者术后肩部疼痛,提高术者满意度,有一定的临床应用价值。 展开更多
关键词 达芬奇机器人手术 根治性前列腺癌切除 气腹压力 智能气腹系统 二氧化碳
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右美托咪定对腹腔镜下妇科恶性肿瘤根治术患者视神经鞘直径的影响
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作者 卢彦 杨白雪 +3 位作者 王乙茹 郭航 杨冬梅 马丽 《武警医学》 CAS 2024年第6期525-530,共6页
目的探讨右美托咪定对腹腔镜下妇科恶性肿瘤根治术患者视神经鞘直径(ONSD)的影响。方法本研究为单中心、前瞻性、随机、双盲、对照临床试验。纳入2022-11至2023-06在解放军总医院第七医学中心行腹腔镜下妇科恶性肿瘤根治术的患者62例,... 目的探讨右美托咪定对腹腔镜下妇科恶性肿瘤根治术患者视神经鞘直径(ONSD)的影响。方法本研究为单中心、前瞻性、随机、双盲、对照临床试验。纳入2022-11至2023-06在解放军总医院第七医学中心行腹腔镜下妇科恶性肿瘤根治术的患者62例,采用随机数字表法分为试验组和对照组,每组31例。两组患者麻醉诱导方案一致,试验组麻醉诱导后静脉给予右美托咪定负荷剂量1μg/kg,持续泵注10 min,然后以0.4μg/(kg·h)持续泵注至手术结束前30 min;对照组给予等容量生理盐水。记录患者的年龄、身高、体重、ASA分级、麻醉时间、手术时间、输液量、出血量、拔管时间、住院时间;测量两组患者麻醉诱导后(T_(0))、泵入右美托咪定负荷剂量后(T_(1))、气腹10 min(T_(2))、30 min(T_(3))、1 h(T_(4))、2 h(T_(5))、3 h(T_(6))及改回平卧位并关闭气腹后10 min(T_(7))各时点的ONSD、平均动脉压(MAP)、心率(HR);并记录两组患者术中发生心动过缓、术后3 h内恶心呕吐及头痛的发生情况。结果试验组T_(2)至T_(7)时点的ONSD均小于对照组,差异有统计学意义(P<0.05)。试验组T_(1)、T_(3-6)时点的MAP高于对照组,差异有统计学意义(P<0.05)。试验组T_(1),T_(5-7)时点的HR低于对照组,差异有统计学意义(P<0.05)。试验组术后3 h内头痛的发生率为3.2%(1/31),低于对照组的29.0%(9/31),差异有统计学意义(P<0.05)。结论右美托咪定可有效减缓腹腔镜下妇科恶性肿瘤根治术患者ONSD的增加,降低术后头痛的发生率。 展开更多
关键词 右美托咪定 视神经鞘直径 头低脚高位 腹腔镜手术 气腹
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右美托咪定对腹腔镜气腹大鼠肠屏障功能及肠道菌群的影响
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作者 宁夏青 王会英 +5 位作者 张暖暖 王佳琦 李雪琴 蒋聪聪 翟帆 张士霞 《中国畜牧兽医》 CAS CSCD 北大核心 2024年第7期3176-3184,共9页
【目的】探究右美托咪定(dexmedetomidine, DEX)对腹腔镜气腹大鼠肠屏障功能及肠道菌群的影响。【方法】试验将30只SD大鼠随机分为3组:假手术组(Sham)(n=6)、CO_(2)气腹组(CO_(2))(n=12)、DEX组(n=12)。CO_(2)和DEX组大鼠在气腹前30 mi... 【目的】探究右美托咪定(dexmedetomidine, DEX)对腹腔镜气腹大鼠肠屏障功能及肠道菌群的影响。【方法】试验将30只SD大鼠随机分为3组:假手术组(Sham)(n=6)、CO_(2)气腹组(CO_(2))(n=12)、DEX组(n=12)。CO_(2)和DEX组大鼠在气腹前30 min分别腹腔注射1 mL/kg生理盐水和50μg/kg右美托咪定,随后在15 mmHg气腹压力下维持90 min建立气腹模型。Sham组不通气腹,其余操作同CO_(2)组。气腹结束后12、24 h采集大鼠回肠组织,观察其组织病理形态学变化,并通过试剂盒测定大鼠回肠组织中丙二醛(MDA)、谷胱甘肽(GSH)、白细胞介素6(IL-6)、IL-1β、肿瘤坏死因子-α(TNF-α)含量以及髓过氧化物酶(MPO)活性;利用实时荧光定量PCR检测闭锁小带蛋白-1(ZO-1)、封闭蛋白1(Claudin-1)、闭合蛋白(Occludin)的mRNA相对表达量;采集回肠组织内容物,通过高通量双端测序检测大鼠回肠菌群的变化。【结果】与Sham组相比,CO_(2)组大鼠回肠组织结构紊乱,肠绒毛变形,出现炎性细胞浸润等现象;结肠中MDA、IL-6、IL-1β、TNF-α含量及MPO活性均极显著升高(P<0.01),GSH含量以及ZO-1、Occludin、Claudin-1基因mRNA表达量均极显著降低(P<0.01);肠道菌群多样性减少,门水平上,厚壁菌门(Firmicutes)相对丰度有降低趋势(P>0.05),放线菌门(Actinobacteria)、变形菌门(Proteobacteria)相对丰度有增加趋势(P>0.05)。属水平上,乳杆菌属(Lactobacillus)和异杆菌属(Allobaculum)相对丰度有降低趋势(P>0.05),而双歧杆菌属(Bifidobacterium)相对丰度有增加趋势(P>0.05)。与CO_(2)组相比,DEX组大鼠回肠组织结构紊乱及肠绒毛变形情况缓解,炎性细胞浸润减少。结肠中GSH含量及ZO-1、Claudin-1、Occludin基因mRNA表达量均极显著或显著升高(P<0.01;P<0.05),MDA、IL-6、IL-1β、TNF-α含量及MPO活性均显著或极显著降低(P<0.05;P<0.01);肠道菌群多样性增加,门水平上,厚壁菌门相对丰度有增加趋势(P>0.05),放线菌门、变形菌门相对丰度有降低趋势(P>0.05)。属水平上,乳杆菌属相对丰度有增加趋势(P>0.05),双歧杆菌属和异杆菌属相对丰度有降低趋势(P>0.05)。【结论】DEX可以通过改善机体氧化应激、炎症因子的释放、肠道菌群结构等,增加肠道菌群丰度及多样性,从而缓解腹腔镜气腹所致的肠损伤。 展开更多
关键词 右美托咪定 CO_(2)气腹 氧化应激 肠屏障 肠道菌群
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CT诊断高原肠气囊肿症伴气腹两例
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作者 张波莉 阿白 杨杰 《中国CT和MRI杂志》 2024年第5期185-186,共2页
肠气囊肿症(pneumatosis cystoides intestinalis,PCI)又称囊样肠积气症、肠壁囊样积气症,是一种罕见的消化道疾病,目前国内外相关文献报道较少,大多以个案报道为主,本文报道四川省甘孜藏族自治州德格县人民医院CT诊断的PCI伴气腹2例,... 肠气囊肿症(pneumatosis cystoides intestinalis,PCI)又称囊样肠积气症、肠壁囊样积气症,是一种罕见的消化道疾病,目前国内外相关文献报道较少,大多以个案报道为主,本文报道四川省甘孜藏族自治州德格县人民医院CT诊断的PCI伴气腹2例,结合相关文献资料,对其流行病学特点、病因及发病机制、临床表现、诊断、治疗及预后等方面进行了深入探讨,以期提高临床医生对该病的认识。 展开更多
关键词 肠气囊肿症 气腹 高原 计算机体层摄影术
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不同气腹压下的腹腔镜阑尾切除术对急性阑尾炎患儿应激反应、胃肠功能的影响
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作者 刘锋 王勇 陈佩 《中国当代医药》 CAS 2024年第3期116-119,124,共5页
目的探讨急性阑尾炎患儿给予不同气腹压下的腹腔镜阑尾切除术(LA)对应激反应、胃肠功能的影响。方法选取2020年7月至2022年2月在九江市妇幼保健院接受LA治疗的90例急性阑尾炎患儿作为研究对象,采用随机数字表法分成A组(30例)、B组(30例)... 目的探讨急性阑尾炎患儿给予不同气腹压下的腹腔镜阑尾切除术(LA)对应激反应、胃肠功能的影响。方法选取2020年7月至2022年2月在九江市妇幼保健院接受LA治疗的90例急性阑尾炎患儿作为研究对象,采用随机数字表法分成A组(30例)、B组(30例)、C组(30例),A组术中二氧化碳(CO_(2))气腹压维持在8.0~9.0 mmHg,B组维持在>9.0~10.0 mmHg,C组维持在>10.0~11.0 mmHg,比较三组术野清晰度、应激反应及胃肠功能、局部疼痛。结果B组患儿的术野清晰度总优良率高于A组、C组,差异有统计学意义(P<0.017);A组、C组患儿术野清晰度总优良率比较,差异无统计学意义(P>0.017)。三组患儿T_(0)时的促肾上腺皮质激素(ACTH)、皮质醇(Cor)水平比较,差异无统计学意义(P>0.05);三组患儿T_(1)、T_(2)时的ACTH、Cor水平均高于本组T_(0)时,T_(2)时的ACTH、Cor水平均低于本组T_(1)时,差异有统计学意义(P<0.05);但B组T_(1)、T_(2)时的ACTH、Cor水平均低于A组、C组,差异有统计学意义(P<0.05);A组、C组T_(1)、T_(2)时的ACTH、Cor水平比较,差异无统计学意义(P>0.05)。B组患儿的肠鸣音恢复时间、肛门首次排气、排便时间均短于A组、C组,差异有统计学意义(P<0.05);A组、C组患儿肠鸣音恢复时间、肛门首次排气、排便时间比较,差异无统计学意义(P>0.05)。B组患儿局部疼痛评估总优良率高于A组、C组,差异有统计学意义(P<0.017);A组、C组患儿局部疼痛评估总优良率比较,差异无统计学意义(P>0.017)。结论急性阑尾炎患儿给予>9.0~10.0 mmHg气腹压下的LA,能够改善术野清晰度,促使胃肠功能恢复,对应激反应影响更小,局部疼痛感轻。 展开更多
关键词 小儿急性阑尾炎 气腹压 腹腔镜阑尾切除术 应激反应 胃肠功能
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气腹压变化对腹腔镜胆囊切除术老年患者颈动脉血流的影响
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作者 杨弼君 李彩霞 王爱桃 《内蒙古医学杂志》 2024年第5期537-542,共6页
目的经颈动脉多普勒超声(carotid doppler ultrasound,CDU)评估气腹压(pneumoperitoneum pressure,PP)变化对腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)老年患者颈动脉血流量的影响。方法选择2022年12月至2023年9月在内蒙古自... 目的经颈动脉多普勒超声(carotid doppler ultrasound,CDU)评估气腹压(pneumoperitoneum pressure,PP)变化对腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)老年患者颈动脉血流量的影响。方法选择2022年12月至2023年9月在内蒙古自治区人民医院行择期LC的患者90例。随机分为S1组、S2组和S3组,设置PP分别为10 mm Hg、12 mm Hg和14 mm Hg。在麻醉前(T_(1))、插管后2 min(T_(2))、PP建立后2 min(T_(3))和PP结束后2 min(T_(4)),利用CDU测量患者颈总动脉(common carotid artery,CCA)左右侧直径和血流量。测量时患者均为水平仰卧位。同时记录患者心率(heart rate,HR)和平均动脉压(mean arterial pressure,MAP)。结果与T_(1)时比较,T_(2)~T_(4)时各组CCA左右侧直径及左右侧血流量均降低(P<0.05)。与T_(2)时比较,T_(3)时各组CCA左右侧血流量均降低(P<0.05)。与S1组比较,T_(3)时S3组CCA左右侧血流量降低(P<0.05)。与T_(1)时比较,T_(2)~T_(4)叶各组MAP均降低(P<0.05);与T_(2)时比较,T_(3)时S2组和S3组MAP均升高(P<0.05);与T_(3)时比较,T_(4)时S2组和S3组MAP均降低(P<0.05)。与S1组比较,T_(3)时其余各组MAP均升高(P<0.05),T_(4)时S3组MAP升高(P<0.05);与S2组比较,T_(3)~T_(4)时S3组MAP升高(P<0.05)。结论PP变化对LC老年患者颈动脉血流的影响有差异,S1组和S2组对LC老年患者颈动脉血流量的影响小于S3组。 展开更多
关键词 颈动脉 人工气腹 腹腔镜胆囊切除术
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