目的观察右美托咪定联合复方利多卡因乳膏浸润膨胀海绵用于功能性鼻内镜手术苏醒期的镇静镇痛效应。方法选择全身麻醉下行功能性鼻内镜手术患者90例,将患者随机分为3组:红霉素组,手术结束后,常规用红霉素眼膏涂抹膨胀海绵填塞鼻腔,经鼻...目的观察右美托咪定联合复方利多卡因乳膏浸润膨胀海绵用于功能性鼻内镜手术苏醒期的镇静镇痛效应。方法选择全身麻醉下行功能性鼻内镜手术患者90例,将患者随机分为3组:红霉素组,手术结束后,常规用红霉素眼膏涂抹膨胀海绵填塞鼻腔,经鼻滴入生理盐水2 m L;右美托咪定组,用1μg/kg右美托咪定2 m L替代生理盐水滴鼻;联合组,用复方利多卡因乳膏替代红霉素眼膏涂抹膨胀海绵,用1μg/kg右美托咪定2 m L滴鼻。分别记录3组患者诱导前(t0)、拔管时(t1)、拔管后15 min(t2)、拔管后30 min(t3)平均动脉压(MAP)和心率(HR)的变化;记录t1~t33组患者Ramsay镇静评分和视觉模拟镇痛评分(VAS);记录3组患者苏醒时间、拔管时间,观察鼻腔不适、躁动不良反应发生情况。结果联合组的血压、心率波动明显低于红霉素组、右美托咪定组,Ramsay镇静评分联合组、右美托咪定组明显高于红霉素组,联合组VAS明显低于红霉素组和右美托咪定组。联合组不良反应明显少于红霉素组、右美托咪定组,苏醒时间无明显延长。结论右美托咪定联合复方利多卡因乳膏浸润膨胀海绵用于全身麻醉下行功能性鼻内镜手术患者,可减轻其苏醒期血流动力学的波动,减少不良反应,具有较好的镇静、镇痛效果,提高苏醒期质量。展开更多
It was shown that expansion of porcine cumulus did not depend on oocyte-secreted factor(s), and it is therefore presumed that porcine CEEF may not be produced exclusively by the oocyte. In this experiment, we used mou...It was shown that expansion of porcine cumulus did not depend on oocyte-secreted factor(s), and it is therefore presumed that porcine CEEF may not be produced exclusively by the oocyte. In this experiment, we used mouse oocytectomized complexes (OOX), which were incapable of CEEF production, to assess the secretion of CEEF by evacuated zona, oocytes of different quality and somatic cells in the porcine follicles. The results showed that: (i) Evacuated zonae from both porcine and mouse oocytes did not produce CEEF. (ii) Porcine oocytes of A, B and C types from 3-6 mm follicles were not significantly different in both production and activity of CEEF. (iii) Both porcine OOX from 3-6 mm follicles and granulose cells from 【 1 mm follicles secreted CEEF in a large quantity, independent of gonadotro-pins; mural granulose cells from 3-6 mm follicles, however, produced neglectable amount of CEEF. (iv) The follicular fluid from 3-6 mm porcine follicles contained CEEF activity that was concentration-dependent,展开更多
文摘目的观察右美托咪定联合复方利多卡因乳膏浸润膨胀海绵用于功能性鼻内镜手术苏醒期的镇静镇痛效应。方法选择全身麻醉下行功能性鼻内镜手术患者90例,将患者随机分为3组:红霉素组,手术结束后,常规用红霉素眼膏涂抹膨胀海绵填塞鼻腔,经鼻滴入生理盐水2 m L;右美托咪定组,用1μg/kg右美托咪定2 m L替代生理盐水滴鼻;联合组,用复方利多卡因乳膏替代红霉素眼膏涂抹膨胀海绵,用1μg/kg右美托咪定2 m L滴鼻。分别记录3组患者诱导前(t0)、拔管时(t1)、拔管后15 min(t2)、拔管后30 min(t3)平均动脉压(MAP)和心率(HR)的变化;记录t1~t33组患者Ramsay镇静评分和视觉模拟镇痛评分(VAS);记录3组患者苏醒时间、拔管时间,观察鼻腔不适、躁动不良反应发生情况。结果联合组的血压、心率波动明显低于红霉素组、右美托咪定组,Ramsay镇静评分联合组、右美托咪定组明显高于红霉素组,联合组VAS明显低于红霉素组和右美托咪定组。联合组不良反应明显少于红霉素组、右美托咪定组,苏醒时间无明显延长。结论右美托咪定联合复方利多卡因乳膏浸润膨胀海绵用于全身麻醉下行功能性鼻内镜手术患者,可减轻其苏醒期血流动力学的波动,减少不良反应,具有较好的镇静、镇痛效果,提高苏醒期质量。
基金This work was supported by the "973" Project of the Ministry of Science and Technology (Grant No. G200016107) the National Natural Science Foundation of China (Grant No. 30170679).
文摘It was shown that expansion of porcine cumulus did not depend on oocyte-secreted factor(s), and it is therefore presumed that porcine CEEF may not be produced exclusively by the oocyte. In this experiment, we used mouse oocytectomized complexes (OOX), which were incapable of CEEF production, to assess the secretion of CEEF by evacuated zona, oocytes of different quality and somatic cells in the porcine follicles. The results showed that: (i) Evacuated zonae from both porcine and mouse oocytes did not produce CEEF. (ii) Porcine oocytes of A, B and C types from 3-6 mm follicles were not significantly different in both production and activity of CEEF. (iii) Both porcine OOX from 3-6 mm follicles and granulose cells from 【 1 mm follicles secreted CEEF in a large quantity, independent of gonadotro-pins; mural granulose cells from 3-6 mm follicles, however, produced neglectable amount of CEEF. (iv) The follicular fluid from 3-6 mm porcine follicles contained CEEF activity that was concentration-dependent,
