目的:研究吲哚菁绿荧光造影(Indocyanine green video angiography,ICGA)和诱发电位(Combined monitoring of evoked potentials,CMEP)联合监测在前交通动脉瘤夹闭术中的应用价值和意义。方法:我科2014年1月至2017年1月收治的前交通动...目的:研究吲哚菁绿荧光造影(Indocyanine green video angiography,ICGA)和诱发电位(Combined monitoring of evoked potentials,CMEP)联合监测在前交通动脉瘤夹闭术中的应用价值和意义。方法:我科2014年1月至2017年1月收治的前交通动脉瘤患者47例,其中ICGA+CMEP联合监测组28例,单纯CMEP监测组19例,对两组患者手术时间、术后有无脑缺血情况、动脉瘤夹闭情况、术后2周GOS评分进行比较。结果:两组患者手术时间比较,差异无统计学意义(P>0.05);两组患者术后CT、脑血管CTA/DSA、住院天数、术后2周GOS评分进行比较,差异均有统计学意义(P<0.05)。结论:前交通动脉瘤夹闭术中进行ICGA和CMEP联合监测,可降低术后脑缺血及神经功能障碍的发生,缩短住院时间,增加手术的安全性,提高手术疗效和患者术后生活质量。展开更多
Background： Early goal-directed therapy （EGDT） has become an important therapeutic management in early salvage stage of septic shock. However, splenic organs possibly remained hypoperfused and hypoxic despite fluid...Background： Early goal-directed therapy （EGDT） has become an important therapeutic management in early salvage stage of septic shock. However, splenic organs possibly remained hypoperfused and hypoxic despite fluid resuscitation. This study aimed to evaluate the effect of EGDT on hepatic perfusion in septic shock patients. Methods： A prospective observational study was carried out in early septic shock patients who were admitted to Intensive Care Unit within 24 h after onset and who met all four elements of the EGDT criteria after treatment with the standard EGDT procedure within 6 h between December 1, 2012 and November 30, 2013. The hemodynamic data were recorded, and oxygen metabolism and hepatic functions were monitored. An indocyanine green clearance test was applied to detect the hepatic perfusion. The patients＇ characteristics were compared before treatment （TO）, immediately after EGDT （T 1 ）, and 24 h after EGDT （T2）. This study is registered at ClinicalTrials.org, NCT02060773. Results： Twenty-one patients were included in the study; however, the hepatic perfusion data were not included in the analysis for two patients： therefore, 19 patients were eligible for the study. Hemodynamics data, as monitored by pulse-indicator continuous cardiac output, were obtained from 16 patients. There were no significant differences in indocyanine green plasma disappearance rate （ICG-PDR） and 15-min retention rate （Rl 5） at TO （ 11.9 ±5.0%/min and 20.0 ±13.2%）, T1 （ 11.4 ± 5.1%/min and 23.6 ± 14.9%）, and T2 （ 11.0 ±4.5%/rain and 23.7 ± 15.3%） （all P 〉 0.05）. Both of the alterations of ICG-PDR and R l 5 showed no differences at TO, T1, and T2 in the patients of different subgroups that achieved different resuscitation goal numbers when elected （P 〉 0.05）.展开更多
文摘目的:研究吲哚菁绿荧光造影(Indocyanine green video angiography,ICGA)和诱发电位(Combined monitoring of evoked potentials,CMEP)联合监测在前交通动脉瘤夹闭术中的应用价值和意义。方法:我科2014年1月至2017年1月收治的前交通动脉瘤患者47例,其中ICGA+CMEP联合监测组28例,单纯CMEP监测组19例,对两组患者手术时间、术后有无脑缺血情况、动脉瘤夹闭情况、术后2周GOS评分进行比较。结果:两组患者手术时间比较,差异无统计学意义(P>0.05);两组患者术后CT、脑血管CTA/DSA、住院天数、术后2周GOS评分进行比较,差异均有统计学意义(P<0.05)。结论:前交通动脉瘤夹闭术中进行ICGA和CMEP联合监测,可降低术后脑缺血及神经功能障碍的发生,缩短住院时间,增加手术的安全性,提高手术疗效和患者术后生活质量。
文摘Background： Early goal-directed therapy （EGDT） has become an important therapeutic management in early salvage stage of septic shock. However, splenic organs possibly remained hypoperfused and hypoxic despite fluid resuscitation. This study aimed to evaluate the effect of EGDT on hepatic perfusion in septic shock patients. Methods： A prospective observational study was carried out in early septic shock patients who were admitted to Intensive Care Unit within 24 h after onset and who met all four elements of the EGDT criteria after treatment with the standard EGDT procedure within 6 h between December 1, 2012 and November 30, 2013. The hemodynamic data were recorded, and oxygen metabolism and hepatic functions were monitored. An indocyanine green clearance test was applied to detect the hepatic perfusion. The patients＇ characteristics were compared before treatment （TO）, immediately after EGDT （T 1 ）, and 24 h after EGDT （T2）. This study is registered at ClinicalTrials.org, NCT02060773. Results： Twenty-one patients were included in the study; however, the hepatic perfusion data were not included in the analysis for two patients： therefore, 19 patients were eligible for the study. Hemodynamics data, as monitored by pulse-indicator continuous cardiac output, were obtained from 16 patients. There were no significant differences in indocyanine green plasma disappearance rate （ICG-PDR） and 15-min retention rate （Rl 5） at TO （ 11.9 ±5.0%/min and 20.0 ±13.2%）, T1 （ 11.4 ± 5.1%/min and 23.6 ± 14.9%）, and T2 （ 11.0 ±4.5%/rain and 23.7 ± 15.3%） （all P 〉 0.05）. Both of the alterations of ICG-PDR and R l 5 showed no differences at TO, T1, and T2 in the patients of different subgroups that achieved different resuscitation goal numbers when elected （P 〉 0.05）.
