Pressure stimulated current in progressive failure process of combined coal-rock under uniaxial compression:Response and mechanism

Effective monitoring of the structural health of combined coal-rock under complex geological conditions by pressure stimulated currents(PSCs)has great potential for the understanding of dynamic disasters in underground engineering.To reveal the effect of this way,the uniaxial compression experiments with PSC monitoring were conducted on three types of coal-rock combination samples with different strength combinations.The mechanism explanation of PSCs are investigated by resistivity test,atomic force microscopy(AFM)and computed tomography(CT)methods,and a PSC flow model based on progressive failure process is proposed.The influence of strength combinations on PSCs in the progressive failure process are emphasized.The results show the PSC responses between rock part,coal part and the two components are different,which are affected by multi-scale fracture characteristics and electrical properties.As the rock strength decreases,the progressive failure process changes obviously with the influence range of interface constraint effect decreasing,resulting in the different responses of PSC strength and direction in different parts to fracture behaviors.The PSC flow model is initially validated by the relationship between the accumulated charges of different parts.The results are expected to provide a new reference and method for mining design and roadway quality assessment.

Effects of combined spinal-epidural anesthesia on anxiety,labor analgesia and motor blocks in women during natural delivery

BACKGROUND The background of this study was analgesia in natural delivery.The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor,and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases.AIM To study the effects of combined spinal-epidural anesthesia on anxiety,labor analgesia,and motor blocks in parturients during natural delivery.METHODS A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included;a random number table approach was employed to divide the women into a control group and a joint group,with each group consisting of 60 women.The control group was given epidural anesthesia,while the joint group was given combined spinal-epidural anesthesia.The visual analog scale(VAS)was used to evaluate the degree of maternal pain.Comparisons were made between the two groups’conditions of childbirth and the duration of labor.Apgar scores were used to evaluate the status of the newborns at birth;Self-rating Anxiety Scale(SAS)and General Self-Efficacy Scale(GSES)scores,umbilical artery blood gas analysis indices and stress indices were compared between the two groups;and the frequencies of motor block and postpartum complications were analyzed.RESULTS In comparison to the control group,in the joint group,the VAS scores for the first,second,and third stages of labor were lower(P<0.05).The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group(P<0.05).No significant differences were observed in the Apgar score,the duration of the first stage of labor,or the total duration of labor between the two groups(P>0.05).The second and third stages of labor in the joint group were shorter than those in the control group(P<0.05).When compared to the control group,the postpartum SAS score of the joint group was lower,while the GSES score was greater(P<0.05).Between the control group and the joint group,the differences observed in pH,arterial carbon dioxide partial pressure,arterial oxygen partial pressure,or arterial hydrogen ion concentration were not significant(P>0.05).Nitric oxide,cortisol,and adrenaline levels were lower in the joint group than in the control group(P<0.05).There were no substantial differences in Bromage grade or rate of complications between the two groups(P>0.05).CONCLUSION For parturients during natural delivery,combined spinal-epidural anesthesia can reduce anxiety,provide labor analgesia,shorten labor time,and reduce postoperative stress levels but did not result in a motor block.

Analytical determination of flow resistance characteristic for combination channel inside hydraulic manifold block

Computational fluid dynamics(CFD)was used in conjunction with BP neural network to study theflow resistance characteristic of the combination-channel inside hydraulic manifold block(HMB).The in-put parameters of the combination-channel model were confirmed to have effect on the pressure-drop bythe numerical method,and a BP neural network model was accordingly constructed to predict the channelpressure-drops.The flow resistance characteristic curves of various channels were achieved,and a perfor-mance parameter was given to evaluate the through-flow characteristic of the channel according to thecurves.The predictions are' in agreement with the numerical computation,indicating that the method canbe utilized to accurately determine the flow characteristic of the combination channel with high efficiency.

An Optimized Convolutional Neural Network with Combination Blocks for Chinese Sign Language Identification

(Aim)Chinese sign language is an essential tool for hearing-impaired to live,learn and communicate in deaf communities.Moreover,Chinese sign language plays a significant role in speech therapy and rehabilitation.Chinese sign language identification can provide convenience for those hearing impaired people and eliminate the communication barrier between the deaf community and the rest of society.Similar to the research of many biomedical image processing(such as automatic chest radiograph processing,diagnosis of chest radiological images,etc.),with the rapid development of artificial intelligence,especially deep learning technologies and algorithms,sign language image recognition ushered in the spring.This study aims to propose a novel sign language image recognition method based on an optimized convolutional neural network.(Method)Three different combinations of blocks:Conv-BN-ReLU-Pooling,Conv-BN-ReLU,Conv-BN-ReLU-BN were employed,including some advanced technologies such as batch normalization,dropout,and Leaky ReLU.We proposed an optimized convolutional neural network to identify 1320 sign language images,which was called as CNN-CB method.Totally ten runs were implemented with the hold-out randomly set for each run.(Results)The results indicate that our CNN-CB method gained an overall accuracy of 94.88±0.99%.(Conclusion)Our CNN-CB method is superior to thirteen state-of-the-art methods:eight traditional machine learning approaches and five modern convolutional neural network approaches.

Effects of water intrusion and loading rate on mechanical properties of and crack propagation in coal–rock combinations

Tackling the problems of underground water storage in collieries in arid regions requires knowledge of the effect of water intrusion and loading rate on the mechanical properties of and crack development in coal–rock combinations. Fifty-four coal–rock combinations were prepared and split equally into groups containing different moisture contents(dry, natural moisture and saturated) to conduct acoustic emission testing under uniaxial compression with loading rates ranging from 0.1 mm/min to 0.6 mm/min. The results show that the peak stress and strength-softening modulus, elastic modulus, strain-softening modulus, and post-peak modulus partly decrease with increasing moisture content and loading rate. In contrast, peak strain increases with increasing moisture content and fluctuates with rising loading rate. More significantly, the relationship between stiffness and stress, combined with accumulated counts of acoustic emission, can be used to precisely predict all phases of crack propagation. This is helpful in studying the impact of moisture content and loading rate on crack propagation and accurately calculating mechanical properties. We also determined that the stress thresholds of crack closure, crack initiation, and crack damage do not vary with changes of moisture content and loading rate, constituting 15.22%, 32.20%, and 80.98% of peak stress, respectively. These outcomes assist in developing approaches to water storage in coal mines, determining the necessary width of waterproof coal–rock pillars, and methods of supporting water-enriched roadways, while also advances understanding the mechanical properties of coal–rock combinations and laws of crack propagation.

Effect of epidural block combined intravenous general anesthesia stress on the stress response and T lymphocyte subsets in patients with breast cancer undergoing radical mastectomy

Objective: To investigate the effect of epidural block combined with intravenous anesthesia on stress response and T lymphocyte subsets in patients with breast cancer undergoing radical mastectomy. Methods: In our hospital from July 2016 to June 2017 undergoing radical mastectomy for breast cancer of 88 patients were randomly divided into observation group and control group of 44 cases, 2 patients underwent routine preoperative preparation, and routine blood pressure, heart rate, pulse, oxygen saturation, ECG monitoring, control group with intravenous anesthesia. The observation group was treated with epidural block combined with intravenous anesthesia. 2 groups of patients before anesthesia, 30 MIM (T0), 1 h after skin incision (T1), 4 h after operation (T2), 24 h after operation (T3), 48 h after operation (T4) from peripheral venous blood were measured by interleukin-8 (IL-8) and interferon gamma (IFN-γ), cortisol (Cor), prolactin (PRL), growth hormone (GH) and T lymphocyte subsets (CD3+, CD4+, CD8+), the calculation of CD4+/CD8+ value. Results: the serum IL-8 level of T1, T2, T3and T4 decreased gradually, were lower than at T0, and the control group at each time point had no significant difference, T1, T2, T3group, T4IL-8 levels lower than the control group;the 2 groups of serum IFN-γ levels T1 and T2had no significant change, T3and T4increased gradually, was higher than that of T0, but no significant difference between the 2 groups of IFN-γ levels. 2 serum Cor levels peaked at T1, decreased at T2, was higher than that of T0, T3, T4returned to T0, the observation group T1, T2Cor level lower than the control group;the serum PRL levels of 2 groups reached a peak at T1, T2, T3at the time of T4decreased gradually, was higher than that of T0, T1, T2, T3of the observation group at the PRL level is lower than the control group;the serum level of GH 2 in group T1increased gradually, reached a peak at T2, T3and T4 decreased gradually, was higher than that of T0, the observation group T1, T2, T3, T4, GH levels lower than the control group. 2 groups of CD3+ decreased gradually in T1, T2, were lower than T0, T3, T4returned to T0, the observation group T1, T2CD3+ was higher than the control group;group CD4+ decreased gradually in T1, T2, T3and T4were lower than control, T0when, and the observation group CD4+ in T1, T2, T3, T4, no significant changes were observed in group T1, T2, T3, T4and CD4+ higher than that of the control group;the 2 group CD8+ had no obvious changes in T1, T2, T3, T4;observation group CD4+/CD8+ decreased gradually in T1, T2, were lower than T0, T3, T4returned to T0, the observation group T1, T2CD4+/CD8+ was higher than the control group. Conclusion: epidural block combined with intravenous anesthesia for breast cancer radical mastectomy can effectively relieve the stress and inflammatory reaction, alleviate the immunosuppression, and help to restore the postoperative immune function.

神经刺激仪引导下腰丛联合骶丛神经阻滞麻醉在股骨颈骨折患者中的应用

目的:探讨在股骨颈骨折患者中应用神经刺激仪引导下腰丛联合骶丛神经阻滞麻醉的效果。方法:选取2020年1月—2023年6月桂林市中医医院收治的98例股骨颈骨折患者作为研究对象,按照随机数表法将其分为对照组和研究组,各49例。对照组采用传统的腰硬联合麻醉,研究组采用神经刺激仪引导下腰丛联合骶丛神经阻滞麻醉。比较两组麻醉效果、平均动脉压(MAP)、心率(HR)、皮质醇(Cor)和儿茶氨酚(CA)及不良反应。结果:两组麻醉效果比较,差异无统计学意义(P>0.05)。研究组麻醉后15 min(T_(2))、麻醉后30 min(T_(3))时MAP高于对照组,差异有统计学意义(P<0.05);研究组麻醉后5 min(T_(1))、T_(2)、T_(3)、手术结束后(T_(4))时HR高于对照组,差异有统计学意义(P<0.05)。研究组术中(Tb)时CA、Cor低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:股骨颈骨折患者应用神经刺激仪引导下腰丛联合骶丛神经阻滞麻醉能稳定血流动力学,缓解应激反应,具有良好的麻醉效果和较高的安全性。

股神经阻滞联合关节腔浸润麻醉在膝关节镜手术中的应用效果

目的评价股神经阻滞联合关节腔浸润麻醉在膝关节镜手术中的安全性和有效性。方法选择滨州医学院附属医院骨关节外科2022年1月至6月因半月板损伤、游离体、骨性关节炎计划行单侧膝关节镜手术患者120例,随机分为股神经阻滞联合关节腔浸润麻醉组(F/I组)和腰硬联合麻醉组(CSEA组),每组60例。F/I组中男32例,女28例,年龄(38.75±11.35)岁;CSEA组中男25例,女35例,年龄(37.80±10.85)岁。比较两组术中补救例数、术后视觉模拟评分法(VAS)评分、术后感觉恢复时间及首次下地活动时间、术后并发症、住院花费及住院天数等指标的差异。采用t检验、χ^(2)检验、Fisher确切概率法。结果F/I组术后6 h VAS评分低于CSEA组[(2.08±0.61)分比(2.54±0.64)分],差异有统计学意义(t=-2.484,P=0.018)。F/I组感觉恢复时间长于CSEA组[(6.25±0.40)h比(3.60±0.31)h,首次下地活动时间短于CESA组[(2.99±1.05)h比(8.14±1.88)h],差异均有统计学意义(t=14.095、-12.263,均P<0.001)。术后并发症:F/I组术中加用麻醉发生率3.3%(2/60)、尿潴留发生率0、下肢静脉血栓发生率1.7%(1/60)、恶心呕吐发生率3.3%(2/60),CSEA组术中加用麻醉发生率0、尿潴留发生率10.0%(6/60)、下肢静脉血栓发生率5.0%(3/60)、恶心呕吐发生率16.7%(10/60),两组尿潴留、恶心呕吐发生率比较差异均有统计学意义(均P<0.05)。F/I组住院时间为(3.90±0.63)d、住院费用为(9612.67±507.15)元,CESA组分别为(5.27±0.75)d、(11401.52±530.01)元,差异均有统计学意义(t=-8.862、-15.425,均P<0.001)。结论股神经阻滞联合关节腔浸润麻醉在膝关节镜手术中能够减少术后并发症、缩短住院时间、降低住院费用,并提供良好的麻醉效果。

分析星状神经节阻滞对老年髋关节置换术患者术后睡眠及谵妄的影响

目的:研究星状神经节阻滞(SGB)对老年髋关节置换术(THA)患者术后睡眠及谵妄的影响。方法:选取2020年1月至2023年3月福建省泉州市惠安县医院内行髋关节置换术的老年患者84例作为研究对象,按照随机数字表法分为对照组和观察组,每组42例,2组均行腰硬联合阻滞麻醉,观察组同时行右侧星状神经节阻滞治疗。比较2组患者的术中情况,记录2组手术时间、术中出血量、术中输液量,采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后睡眠质量的变化,采用视觉模拟评分法(VAS)比较2组患者干预前后的疼痛感受,并比较2组患者术后睡眠障碍(POSD)及术后谵妄(POD)的发生率。结果:观察组术后当天、术后第1天的PSQI得分显著低于对照组,观察组在术后当天、术后第1天的POSD发生率和POD发生率均显著低于对照组,观察组在术后当天、术后第1天的VAS评分显著低于对照组,差异有统计学意义(P<0.05)。结论:SGB在老年THA中的应用效果显著,可有效改善患者睡眠质量,对降低POSD、POD发生率有积极作用,并减轻了术后疼痛,有利于加快康复进程,值得推广应用。

大东沟泥石流勘查与治理应用

查明泥石流的地质环境条件、分布范围、规模、危害、影响因素和诱发因素等,评价与预测其稳定性,查明拟建防治工程部位工程地质条件,为下一步地质灾害治理提供依据并减小泥石流发生频率。运用地质测量地质测绘和山地工程在拟建工程部位钻孔开挖浅井和探槽综合有效的勘查方法确定地质参数。结果表明,泥石流的物源成分为安山岩,分布在形成区的主沟内和四道沟部分支沟内,危害对象为当地1100人,潜在财产损失高达9480.25万元。此外,泥石流为暴雨诱发大型低频稀性水石型沟谷泥石流,其危害性等级为中型,潜在危险性是特大型。通过对泥石流的治理,可成功保护环境,减少财产损失,促进地方的社会稳定,促进当地经济的快速发展。

腰硬联合麻醉加腰方肌阻滞在腹股沟疝无张力疝修补术中的临床应用

目的研究腰硬联合麻醉加腰方肌阻滞在腹股沟疝无张力疝修补术中的临床应用效果。方法70例接受无张力疝修补手术治疗的腹股沟疝患者为研究对象,采用随机数字表法将其分为传统组以及新式组,各35例。传统组患者接受腰硬联合麻醉,新式组接受腰硬联合麻醉加腰方肌阻滞。比较两组手术相关情况、疼痛情况、心率及平均动脉压、不良事件发生情况。结果新式组患者的麻醉起效时间、手术时间、术后下地活动时间以及住院时间分别为(4.03±1.57)min、(44.05±10.05)min、(3.81±1.17)h、(3.35±1.33)d,均显著短于传统组的(6.14±2.70)min、(59.03±13.18)min、(5.77±1.44)h、(4.72±1.71)d,差异有统计学意义(P<0.05)。术后30 min,新式组患者的视觉模拟评分法(VAS)评分(2.35±0.73)分显著低于传统组的(3.06±0.67)分,差异有统计学意义(P<0.05)。麻醉后15、30 min,新式组患者的心率及平均动脉压均显著低于传统组,差异有统计学意义(P<0.05)。新式组术后不良事件发生率为2.86%,传统组为20.00%;新式组患者术后不良反应发生率显著低于传统组(P<0.05)。结论相对于传统的腰硬联合麻醉,腰硬联合麻醉加腰方肌阻滞的方式镇痛效果更好、安全性更高、术后恢复效果更佳,值得在临床上推广使用。

超声引导下胸椎旁神经阻滞复合全身麻醉在乳腺癌根治术中的应用及对疼痛、血流动力学的影响

目的:分析在乳腺癌根治术中应用超声引导下胸椎旁神经阻滞复合全身麻醉的效果。方法:采用回顾分析法开展研究,根据不同麻醉方案,将2021年6月—2023年7月于武汉大学中南医院兴山医院行乳腺癌根治术的70例患者分为参照组与研究组,将实施全身麻醉加用超声引导下胸椎旁神经阻滞的35例纳入研究组,仅实施全身麻醉的35例纳入参照组。对比两组围手术期入室时(T_(0))、麻醉时(T_(1))、插管时(T_(2))、切皮时(T_(3))、腋窝清扫时(T_(4))、拔管时(T_(5))、出室时(T_(6))的麻醉效果、血流动力学变化情况和术后不同时间点的疼痛评分。结果:在T_(3)、T_(4)时,研究组的脑电双频指数均低于参照组,差异均有统计学意义(P<0.05)。在T_(1)、T_(2)、T_(3)、T_(4)、T_(5)、T_(6)时,研究组心率、平均动脉压均低于参照组,差异均有统计学意义(P<0.05);研究组各时间点的心率、平均动脉压对比,差异无统计学意义(P>0.05);参照组T_(0)后各时间点的心率、平均动脉压均高于T_(0)时,差异均有统计学意义(P<0.05)。研究组术后2、6、8、12 h的疼痛评分均低于参照组,差异均有统计学意义(P<0.05)。结论:超声引导下胸椎旁神经阻滞复合全身麻醉可增强麻醉效果,且减少患者围手术期血流动力学的波动,还可维持长期术后镇痛效果。

博孜2402井钻井提速关键技术

目前塔里木博孜1区块部署的井多为五开井身结构,平均井深7000m以上。地质构造复杂,施工难度大,事故复杂频发,周期普遍在400d以上。该区块吉迪克组、库姆格列木群盐层段以及目的层事故频发成为区块钻井难题,尤其是上部巨厚砾石层严重制约区域资源高效勘探开发,实钻表现为机械钻速慢、单只钻头行程进尺低、因憋跳钻引发井下钻具事故频发。博孜2402井从井身质量优化、钻头选型技术、钻具组合优化技术、钻井液体系优选、盐层卡层技术等方面着手,形成了博孜2402井钻井提速关键技术,该井最终以钻井周期253.88d,钻完井周期303.88d,创博孜1区块钻完井周期记录,博孜2402井关键钻井技术,可为博孜1区块钻井提供技术支持,建议进行推广。

全身麻醉复合颈浅丛神经阻滞对甲状腺癌根治术患者的影响

目的:探讨全身麻醉复合颈浅丛神经阻滞对甲状腺癌根治术患者的影响。方法:选取2022年1月—2023年2月毕节市中医医院收治的88例甲状腺癌根治术患者为研究对象。根据随机数表法将其分为对照组和观察组,各44例。对照组给予全身麻醉,观察组给予全身麻醉复合颈浅丛神经阻滞。比较两组麻醉苏醒情况,术前及术后血流动力学指标、应激指标。结果:两组睁眼时间、恢复自主呼吸时间及拔管时间比较,差异无统计学意义(P>0.05)。术后,观察组平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)均低于对照组,差异有统计学意义(P<0.05)。术后,观察组皮质醇(cortisol,Cor)、肾上腺素(epinephrine,EPI)、去甲肾上腺素(norepinephrine,NE)水平均低于对照组,差异有统计学意义(P<0.05)。结论:在甲状腺癌根治术患者中应用全身麻醉复合颈浅丛神经阻滞效果显著,能够确保麻醉苏醒质量,维持血流动力学稳定,降低患者机体内应激激素水平。

超声引导下臂丛联合颈中丛神经阻滞复合全麻对锁骨骨折患者术后短期认知功能及睡眠质量的影响

目的:分析超声引导下臂丛联合颈中丛神经阻滞复合全麻对锁骨骨折患者术后短期认知功能及睡眠质量的影响。方法:选取2022年3月至2023年7月福建省福清市第二医院收治的锁骨骨折患者80例作为研究对象,按照随机数字表法分为对照组和观察组,每组40例。对照组给予单纯全麻方式干预,观察组给予超声阻滞复合全麻干预。采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后睡眠质量的变化,采用简易精神状态检查(MMSE)比较2组患者的认知功能,并比较2组患者的麻醉率。结果:干预后,观察组麻醉优良率显著高于对照组,观察组术后1 d、3 d的MMSE评分均高于对照组,观察组患者术后5 d的PSQI各因子得分均显著低于对照组,差异均有统计学意义(均P<0.05)。结论:对于锁骨骨折患者采取超声引导下臂丛联合颈中丛神经阻滞复合全麻的麻醉效果较为理想,可减轻对患者术后短期认知功能的影响,改善患者术后睡眠状况,值得推广应用。

单线双方向区间自动闭塞结合电路工程设计优化方案

在单线双方向四显示自动闭塞区间,计算机联锁控显终端界面同一进站口的接近/离去表示灯存在同时点红灯的情形,给行车指挥带来不便。根据车站运营维护单位的实际需求,在不改变计算机联锁软件的前提下,引入四线制方向电路中区间正方向继电器QZJ、区间反方向继电器QFJ条件,提出2种JGJ、LQJ励磁电路优化设计方案。从电路原理、实现效果、施工工作量等角度对2种方案进行比选,推荐采用QZJ/QFJ接点与GJF接点并联的优化方案。该优化方案中,JGJ、LQJ的继电器状态包含相应闭塞分区占用情况和区间实际运行方向双重含义,可实现计算机联锁控显终端按区间开通方向分别显示接近/离去表示灯,同时不影响JGJ、LQJ参与的其他继电电路,可为后续类似项目的工程设计提供参考。

腰硬联合麻醉与全麻联合神经阻滞麻醉运用于下肢远端骨折患者的比较

目的对比分析下肢远端骨折患者手术治疗前采用腰硬联合麻醉方案与全麻联合神经阻滞麻醉方案的效果与安全性。方法选择2021年1月—2022年8月在本院接受手术治疗的下肢远端骨折患者60例作为观察对象,根据麻醉方式的不同划分对照组(30例)与观察组(30例),对照组采取腰硬联合麻醉方案,观察组实施全麻联合神经阻滞麻醉方案,观察对比两组患者麻醉效果,记录两组患者麻醉期间及术后恢复情况,分别监测各组患者麻醉期间血压、心率指标变化,观察各组患者麻醉后出现不良反应的具体表现,统计总发生概率。结果观察组患者麻醉效果明显高于对照组(P<0.05),同时观察组患者感觉阻滞维持时间、运动阻滞维持时间、术后镇痛持续时间均长于对照组,下床活动时间短于对照组(P<0.05)。麻醉10min、30min及手术结束时观察组患者平均动脉压、心率测定值均高于对照组(P<0.05)。两组患者麻醉后不良反应总发生率比较差异无统计学意义(P>0.05)。结论临床手术治疗下肢远端骨折疾病可采取全麻联合神经阻滞麻醉方案,相比腰硬联合麻醉效果更佳,优点是术后疼痛轻,可早期进行功能锻炼,无需留置导尿管等,值得推广。

超声联合神经刺激仪定位髂筋膜联合腰骶丛神经阻滞与椎管内麻醉对高龄骨科手术患者的影响

目的探讨超声联合神经刺激仪定位髂筋膜联合腰骶丛神经阻滞与椎管内麻醉对高龄骨科手术患者的影响。方法选取2021年11月至2023年1月我院收治的高龄骨科手术治疗患者60例为研究对象,遵循随机对照原则分为观察组和对照组,各组30例。对照组采用椎管内麻醉方式,观察组采用超声联合神经刺激仪定位髂筋膜联合腰骶丛神经阻滞。统计两组应激反应、MMSE评分、VAS评分。结果T0,两组应激反应指标比较,P>0.05,T1~T4,观察组患者应激反应指标水平均低于对照组患者,P<0.05;术前,两组患者MMSE评分比较,P>0.05,术后第1d、第3d、第7d,观察组MMSE评分均高于对照组患者,P<0.05;术后6h、12h、24h,观察组VAS评分均低于对照组VAS评分,P<0.05。结论超声联合神经刺激仪定位髂筋膜联合腰骶丛神经阻滞在高龄骨科手术中应用效果显著,能够降低术后应激反应和疼痛,提高患者认知能力,是一种值得推广的麻醉方式。

锁骨骨折手术患者中臂丛联合颈浅丛阻滞麻醉的临床应用分析

将臂丛联合颈浅丛阻滞麻醉应用于锁骨骨折患者的手术中以探讨其临床麻醉效果及应用价值。选取2020年8月—2022年8月于黔西南布依族苗族自治州人民医院接受手术的120例锁骨骨折患者作为分析对象,按不同的麻醉方法将患者分成对照组与观察组,每组各60例。对照组采用臂丛神经阻断法,观察组采用臂丛、颈浅静脉丛阻滞,对比两组患者的血流动力学指标、应激反应、术后不良反应发生情况及镇静效果等差异。结果显示,观察组患者术后1 h、3 h、5 h的镇痛评分较对照组低(P<0.05);骨折复位时观察组患者的SBP、DBP、MAP等指标均优于对照组(P<0.05);观察组的并发症总发生率为15.00%,对照组的并发症总发生率为30.00%,观察组患者并发症总发生率低于对照组(P<0.05)。研究发现,在对锁骨骨折患者实施外科手术时,采用臂丛和颈浅神经丛神经阻滞麻醉是一种有效的方法,可以提高患者的镇痛效果,还能降低患者的不良反应发生率,值得临床推广。

小剂量腰麻-硬膜外联合阻滞麻醉在高龄剖宫产产妇中的麻醉效果分析

目的探讨小剂量腰麻-硬膜外联合阻滞麻醉在高龄剖宫产产妇中的麻醉效果及对生命体征、并发症的影响。方法选择50例高龄剖宫产产妇为研究对象,按照随机数字表法分为对照组和研究组,每组25例。对照组实施硬膜外麻醉,研究组实施小剂量腰麻-硬膜外联合阻滞麻醉,比较两组麻醉效果、不同时间点生命体征、术后并发症发生率。结果研究组麻醉起效时间短于对照组,Bromage评分高于对照组,麻黄碱用量少于对照组(P<0.05);麻醉前,两组心率、平均动脉压比较差异无统计学意义(P>0.05);麻醉后5min、麻醉后10min、胎儿娩出时,研究组心率、平均动脉压均高于对照组(P<0.05);两组并发症总发生率比较差异无统计学意义(P>0.05)。结论高龄剖宫产产妇中采用小剂量腰麻-硬膜外联合阻滞麻醉的麻醉效果较好,对产妇生命体征影响较小,并发症发生率较低,值得临床推广与应用。