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Severe hypoxemia after radiofrequency ablation for atrial fibrillation in palliatively repaired tetralogy of Fallot: A case report
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作者 Zhi-Hang Li Lian Lou +3 位作者 Yu-Xiao Chen Wen Shi Xuan Zhang Jian Yang 《World Journal of Cardiology》 2024年第3期161-167,共7页
BACKGROUND Patients with tetralogy of Fallot(TOF)often have arrhythmias,commonly being atrial fibrillation(AF).Radiofrequency ablation is an effective treatment for AF and does not usually cause severe postoperative h... BACKGROUND Patients with tetralogy of Fallot(TOF)often have arrhythmias,commonly being atrial fibrillation(AF).Radiofrequency ablation is an effective treatment for AF and does not usually cause severe postoperative hypoxemia,but the risk of complications may increase in patients with conditions such as TOF.CASE SUMMARY We report a young male patient with a history of TOF repair who developed severe hypoxemia after radiofrequency ablation for AF and was ultimately confirmed to have a new right-to-left shunt.The patient subsequently underwent atrial septal occlusion and eventually recovered.CONCLUSION Radiofrequency ablation may cause iatrogenic atrial septal injury;thus possible complications should be predicted in order to ensure successful treatment and patient safety. 展开更多
关键词 Atrial fibrillation Radiofrequency ablation Tetralogy of Fallot Right-to-left shunt hypoxemia Medical decision Case report
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Incidence and Management of Early Postoperative Hypoxemia after Abdominal Surgery at Teaching Hospital
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作者 Nga Nomo Serge Vivier Mpeyou Sani Mohamed +8 位作者 Kuitchet Aristide Binam Bikoi Charles Maiwong Betila Venloah Dominique Djomo Tamchom Iroume Bifouna Cristella Raissa Ngouatna Serge Jemea Bonaventure Metogo Mbengono Junette Fidèle Binam 《Open Journal of Anesthesiology》 2024年第10期209-220,共12页
Background: Oxygen saturation refers to the quantity of oxygenated hemoglobin in the blood, that is to say the level of oxygen measurable in the red blood cells when they have passed through the lungs. The aim of this... Background: Oxygen saturation refers to the quantity of oxygenated hemoglobin in the blood, that is to say the level of oxygen measurable in the red blood cells when they have passed through the lungs. The aim of this study was to describe the management of early postoperative hypoxemia after abdominal surgery at the Yaounde General Hospital (YGH). Method: This is a quantitative, observational study, with a descriptive aim, which took place in the anesthesiology department of the YGH, over a period of 2 months from August 1st to October 1st, 2023. The study included all the patients ≥18 years, of both sexes who had abdominal surgery under general anesthesia and were willing to participate during the time of data collection. The variables studied were the sociodemographic and clinical characteristics, risk factors for oxygen desaturation, postoperative variations in SPO2 and therapeutic tools. Results: We collected 30 patients among whom 11 presented with early postoperative hypoxemia i.e. a frequency of 36.7%. The age of the patients ranged from 18 to 63 years and the mean was 42.47 ± 13.5 years on average. The sex ratio was 0.5. Hysterectomy was the most commonly performed surgery (23.3%). The most common comorbidity was high blood pressure (30%). Half of the patients had midline incision. Supra-umbilical surgery predominated (56.7%), intraoperative blood loss ≥500 ml in 46.7% of cases. Upper abdominal surgery with, subcostal incision and blood loss ≥500 ml are statistically significant risk factors for the occurrence of early postoperative hypoxemia (P Conclusion: Hypoxemia is the result of impaired respiratory function favored by the conditions encountered during the early postoperative period. 展开更多
关键词 Abdominal Surgery Postoperative hypoxemia INCIDENCE MANAGEMENT
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Venopulmonary ECMO Improved Hypoxemia and Supported the Right Ventricle in a Patient with Decompensated Eisenmenger Syndrome
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作者 Daniel Manzur-Sandoval Gian Manuel Jiménez-Rodríguez +5 位作者 Edgar García-Cruz Ramón Espinosa-Soto Erika Yamali Ramirez-Marcano Yessenia Máyory Téllez-López José Luis Elizalde-Silva Gustavo Rojas-Velasco 《World Journal of Cardiovascular Surgery》 2024年第1期7-19,共13页
Mechanical circulatory and/or respiratory assistance with extracorporeal membrane oxygenation (ECMO) has become a standard of care for patients with circulatory (venoarterial) and/or respiratory (venovenous) failure r... Mechanical circulatory and/or respiratory assistance with extracorporeal membrane oxygenation (ECMO) has become a standard of care for patients with circulatory (venoarterial) and/or respiratory (venovenous) failure refractory to standard therapies. Adult patients with congenital heart disease are an increasingly recognized and growing population and include various groups, such as undiagnosed cases in childhood and palliated and/or corrected cases, which require subsequent care because of residual lesions, cardiac arrest/insufficiency, and arrhythmias, among other conditions. In addition, these patients are prone to developing pathologies that are typical of adulthood with a generally increased risk of morbidity and mortality because of their low reserves and organic damage associated with the underlying heart disease, which makes them candidates for ECMO. These patients represent an additional challenge in this therapy because malformations and the presence of a shunt can generally affect the usual cannulation methods and hemodynamic and oximetry monitoring. Thus, the configuration decision must be made on a case-by-case basis. Here, we present a cannulation method, venopulmonary artery ECMO, which provides hemodynamic and respiratory support, and may be ideal for patients with shunts and/or right ventricular dysfunction. To our knowledge, this is the first report of this configuration in patients with congenital heart diseases. 展开更多
关键词 Eisenmenger Syndrome Venopulmonary Artery ECMO Refractory hypoxemia Right Ventricular Dysfunction
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Chronic permanent hypoxemia predisposes to mild elevation of liver stiffness 被引量:5
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作者 Mohamed Tahiri Abdenasser Drighil +7 位作者 Yasmine Jalal Dounia Ghellab Wafaa Hliwa Haddad Fouad Wafaa Badre Ahmad Bellabah Rachida Habbal Rhimou Alaoui 《World Journal of Gastroenterology》 SCIE CAS 2014年第30期10564-10569,共6页
AIM:To evaluate the impact of long term permanent hypoxemia noticed in patients with non operated congenital cyanogenic cyanotic cardiopathy on liver stiffness.METHODS:We included ten adult patients with non operated ... AIM:To evaluate the impact of long term permanent hypoxemia noticed in patients with non operated congenital cyanogenic cyanotic cardiopathy on liver stiffness.METHODS:We included ten adult patients with non operated inoperate cyanotic cardiopathy and ten matched patients for age and gender admitted to the gastroenterology department for proctologic diseases;Clinical and laboratory data were collected[age,gender,body mass index,oxygen saturation,glutamate oxaloacetate transaminase(GOT),glutamate pyruvate transaminase(GPT),glycemia and cholesterol].Measurement of hepatic stiffness by transient elastography was carried out in all patients using the Fibroscan device.All patients underwent an echocardiography to eliminate congestive heart failure.RESULTS:Among the patients with cyanotic cardiopathy,median liver stiffness 5.9±1.3 kPa was greater than control group(4.7±0.4 kPa)(P=0.008).Median levels of GOT,GPT,gamma-glutamyltransferase,glycemia and cholesterol were comparable in cardiopathy and control group.In regression analysis including age,gender,body mass index,oxygen saturation,GOT,GPT,glycemia,cholesterol showed that only oxygen saturation was related to liver stiffness(r=-0.63 P=0.002).CONCLUSION:Chronic permanent hypoxemia can induce mild increase of liver stiffness,but further studies are needed to explore the histological aspects of liver injury induced by chronic permanent hypoxemia. 展开更多
关键词 Liver CARDIOPATHY hypoxemia Stiffness CYANOTIC
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Hypoxemia without persistent right-to-left pressure gradient across a patent foramen ovale:A clinical challenge 被引量:1
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作者 Sadip Pant Kevin Hayes +1 位作者 Abhishek Deshmukh David L Rutlen 《World Journal of Cardiology》 CAS 2013年第7期254-257,共4页
Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure fo... Patent foramen ovale (PFO) closure for systemic hypoxemia is controversial. The first systematic, albeit retrospective, study was recently presented which showed good procedural and clinical success for PFO closure for this indication. We present a case of acute right to left intra-cardiac shunt across PFO where the shunting is not persistent. Hence making a decision on PFO closure based on the aforementioned promising trial may not have been the right decision for the patient. This case highlights that the decision on PFO closure for such indication needs to be individualized. We also review the sparse literature on PFO closure for this indication and discuss how the decision making for such indication needs to be individualized. 展开更多
关键词 Patent foramen ovale hypoxemia Right-to-left SHUNT SHUNT closure Pulmonary EMBOLISM Atrial SEPTAL defect
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Postoperative secondary aggravation of obstructive sleep apneahypopnea syndrome and hypoxemia with bilateral carotid body tumor:A case report 被引量:2
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作者 Xi Yang Xiao-Guang He +2 位作者 Dong-Hui Jiang Chun Feng Rui Nie 《World Journal of Clinical Cases》 SCIE 2020年第23期6150-6157,共8页
BACKGROUND Carotid body tumor(CBT)is a chemoreceptor tumor located in the carotid body,accounting for approximately 0.22%of head and neck tumors.Surgery is the main treatment method for the disease.CASE SUMMARY We rev... BACKGROUND Carotid body tumor(CBT)is a chemoreceptor tumor located in the carotid body,accounting for approximately 0.22%of head and neck tumors.Surgery is the main treatment method for the disease.CASE SUMMARY We reviewed the diagnosis and treatment of one patient who had postoperative secondary aggravation of obstructive sleep apnea–hypopnea syndrome(OSAHS)and hypoxia after surgical resection of bilateral CBTs.This patient was admitted,and relevant laboratory and imaging examinations,and polysomnography(PSG)were performed.After the definitive diagnosis,continuous positive airway pressure(CPAP)treatment was given,which achieved good efficacy.CONCLUSION This case suggested that aggravation of OSAHS and hypoxemia is possibly caused by the postoperative complications after bilateral CBTs,and diagnosis by PSG and CPAP treatment are helpful for this patient. 展开更多
关键词 Carotid body tumor Continuous positive airway pressure hypoxemia Obstructive sleep apnea-hypopnea syndrome Head and neck Case report
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Continuous positive airway pressure for treating hypoxemia due to pulmonary vein injury:A case report 被引量:1
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作者 Chao Zhou Shan Song +4 位作者 Jian-Feng Fu Xue-Lian Zhao Hua-Qin Liu Huan-Shuang Pei Hong-Bo Guo 《World Journal of Clinical Cases》 SCIE 2023年第8期1830-1836,共7页
BACKGROUND Vascular injury during thoracoscopic surgery for esophageal cancer is a rare but life-threatening complication that can lead to severe hypotension and hypoxemia.Anesthesiologists need to provide rapid and e... BACKGROUND Vascular injury during thoracoscopic surgery for esophageal cancer is a rare but life-threatening complication that can lead to severe hypotension and hypoxemia.Anesthesiologists need to provide rapid and effective treatment to save patients'lives.CASE SUMMARY A 54-year-old male patient was scheduled to undergo a thoracoscopic-assisted radical resection of esophageal cancer through the upper abdomen and right chest.While dissociating the esophagus from the carina through the right chest,unexpected profuse bleeding occurred from a suspected pulmonary vascular hemorrhage.While the surgeon attempted to achieve hemostasis,the patient developed severe hypoxemia.The anesthesiologist implemented continuous positive airway pressure(CPAP)using a bronchial blocker(BB),which effectively improved the patient’s oxygenation and the operation was completed success-fully.CONCLUSION CPAP using a BB can resolve severe hypoxemia caused by accidental injury of the left inferior pulmonary vein during surgery. 展开更多
关键词 Vascular injury Continuous positive airway pressure hypoxemia Bronchial blocker Esophageal carcinoma resection Case report
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The clinical features of idiopathic pulmonary hypertension with nocturnal hypoxemia
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作者 Lu Yan 《中国循环杂志》 CSCD 北大核心 2018年第S01期165-165,共1页
Objective Hypoxemia is one of the main factors of pulmonary hypertension,and it can also be a complication of pulmonary hypertension,and it is a risk factor for many cardiovascular diseases,which increases the adverse... Objective Hypoxemia is one of the main factors of pulmonary hypertension,and it can also be a complication of pulmonary hypertension,and it is a risk factor for many cardiovascular diseases,which increases the adverse prognosis of patients.At present,there are some controversies about the diagnosis and treatment of sleep apnea disorder in patients with pulmonary hypertension. 展开更多
关键词 IDIOPATHIC PULMONARY HYPERTENSION NOCTURNAL hypoxemia risk FACTOR
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Phrenic Nerve Injury Is a Differential Diagnosis of Hypoxemia after Video-Assisted Thoracoscopic Thymectomy:2 Cases Report and Literature Review
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作者 Lulu Ma Yuguang Huang 《Chinese Medical Sciences Journal》 CAS CSCD 2020年第2期191-194,共4页
Hypoxemia after general anesthesia is not uncommon.For patients after thoracotomy,the differential diagnosis is usually difficult.Surgical,anesthetic,and patient-associated factors may contribute to postoperative hypo... Hypoxemia after general anesthesia is not uncommon.For patients after thoracotomy,the differential diagnosis is usually difficult.Surgical,anesthetic,and patient-associated factors may contribute to postoperative hypoxemia.We described two patients who underwent videassisted thoracoscopic thymectomy and developed hypoxemia immediately after extubation.Phrenic nerve injury was suspected in both patients.One case recovered spontaneously without intervention.The second case who had been demonstrated as bilateral phrenic nerve injury after the operation was continuously on ventilator after physical therapy and respiratory training for 2 months. 展开更多
关键词 Phrenic nerve injury hypoxemia video-assisted thoracoscopic surgery
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Effect of improving prehospital hypotension and hypoxemia on the prognosis of patients with traumatic brain injury
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作者 Liang Liang Liwei Wu +3 位作者 Yaowen Hu Xin Li Haiqing Dong Xiaofeng Sun 《Journal of Translational Neuroscience》 2020年第2期34-39,共6页
Objective:to investigate the effect of improving prehospital hypotension and hypoxemia on the prognosis of different subgroups of patients with traumatic brain injury(TBI).Methods:medical staff were trained about the ... Objective:to investigate the effect of improving prehospital hypotension and hypoxemia on the prognosis of different subgroups of patients with traumatic brain injury(TBI).Methods:medical staff were trained about the prehospital first aid for 2 months to fully master the methods of improving prehospital hypotension and hypoxemia,then the prognosis of TBI patients pre-and post-training for 12 months was collected and recorded.The prognostic differences of different TBI subgroups were discussed through data analysis.Results:after the training,the proportion of prehospital hypotension and hypoxemia in TBI patients decreased by 77%(8.5%vs.1.9%)and 63%(9.9%vs.3.6%,P<0.05),respectively.However,only the prognosis of moderate and severe TBI patients was improved,the proportion of patients with"good prognosis^increased by 14%(61.4%vs.70.5%,respectively)and 62%(35.6%vs.58%),and no significant effect showed in mild and critical TBI patients.Conclusion:reducing the incidence of prehospital hypoxemia and hypotension can improve the prognosis of moderate and severe TBI patients,while no significant effect on mild and critical TBI patients. 展开更多
关键词 traumatic brain injury(TBI) prehospital hypotension and hypoxemia Glasgow outcome scale(GOS) management guide
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THE EFFECT OF OXYGEN APPLIEDTHROUGH DRID SHIP CONSTANT HEADVESSEL TO DLALYSATE ONDIALYSIS HYPOXEMIA
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作者 Zhenguo Mi, Yusheng Bao,Chun Liu, Xi Cao, Jiasheng Deng, Jin TongDepartment of Urology,First Affiliated Hospital of Shanxi Medical CollegeTaiyuan, 030001, ChinaHui Liang(Clinic of Taiyuan Industrial and Commercial Bank,Taiyuan. 030001,China) 《Chinese Journal of Biomedical Engineering(English Edition)》 1994年第1期35-37,共3页
Thgrough experimental and clinical observation of the effect or oxygensupplyed in grid shape through constant head vessel on the PaO2 and Sao2 or bloodthrough dialyser, the result suggested that supplying oxygen throu... Thgrough experimental and clinical observation of the effect or oxygensupplyed in grid shape through constant head vessel on the PaO2 and Sao2 or bloodthrough dialyser, the result suggested that supplying oxygen through constant head vessel in grid shape is one good way to treat dialysis hypoxemia. 展开更多
关键词 CONSTANT head VESSEL DIALYSIS hypoxemia.
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Treatment of Hypoxemia in Septic Shock
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作者 WANGYu 《外文科技期刊数据库(文摘版)医药卫生》 2022年第6期201-204,共4页
Objective: to study the treatment of hypoxemia in patients with septic shock. Methods: 150 patients with septic shock treated in our hospital from January 2020 to July 2021 were divided into 3 groups according to the ... Objective: to study the treatment of hypoxemia in patients with septic shock. Methods: 150 patients with septic shock treated in our hospital from January 2020 to July 2021 were divided into 3 groups according to the severity of hypoxemia. All patients received comprehensive treatment, and the blood gas indexes of patients before and after treatment were compared;Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) before resuscitation, 1d and 7d after resuscitation. Results: compared with that before treatment, the above index levels of patients after treatment were significantly improved, P < 0.05. Conclusion: in the clinical treatment of patients with hypoxemia caused by concentration shock, comprehensive treatment methods, especially oxygen therapy, non-invasive intermittent positive pressure breathing therapy, fluid resuscitation therapy and hyperbaric oxygen chamber treatment, can quickly correct the hypoxemia of patients and reduce the body damage, which is worth learning from. 展开更多
关键词 septic shock hypoxemia treatment experience oxygen therapy noninvasive ventilation intermittent
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老年患者全麻后恢复室低氧血症列线图模型的建立与验证 被引量:1
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作者 王君 李武兰 +1 位作者 郑业英 郭飞 《临床麻醉学杂志》 北大核心 2025年第1期40-45,共6页
目的建立老年患者全麻后恢复室低氧血症风险预测模型并进行验证。方法选择2022年2月至2023年5月行全麻手术的老年患者492例,男271例,女221例,年龄≥65岁,BMI 18.0~29.9 kg/m^(2),ASAⅠ—Ⅲ级。将患者按7∶3比例分为训练集(n=344)和验证... 目的建立老年患者全麻后恢复室低氧血症风险预测模型并进行验证。方法选择2022年2月至2023年5月行全麻手术的老年患者492例,男271例,女221例,年龄≥65岁,BMI 18.0~29.9 kg/m^(2),ASAⅠ—Ⅲ级。将患者按7∶3比例分为训练集(n=344)和验证集(n=148)。收集患者一般资料、术前指标及手术相关指标。恢复室低氧血症的定义为拔除气管导管或喉罩后30 min呼吸空气时PaO_(2)<60 mmHg或SpO_(2)<90%。LASSO回归筛选变量后行多因素Logistic分析,并建立列线图预测模型,采用受试者工作特征(ROC)曲线、校准曲线对模型进行验证。结果训练集中共有139例(40.4%)患者出现恢复室低氧血症,验证集中共有61例(41.2%)患者出现恢复室低氧血症。多因素Logistic回归分析结果显示,BMI、ASA分级、吸烟史、手术类型、术后使用镇痛泵、进入恢复室时体温为老年患者全麻后恢复室低氧血症影响因素(P<0.05)。根据多因素Logistic分析结果建立老年患者全麻后恢复室低氧血症列线图预测模型。ROC曲线显示,在训练集中,该预测模型预测老年患者全麻后恢复室低氧血症风险的曲线下面积(AUC)为0.739(95%CI 0.686~0.792),验证集中AUC为0.733(95%CI 0.679~0.788)。校准曲线显示,训练集与验证集的预测曲线与标准曲线基本拟合。结论老年患者全麻后恢复室低氧血症的影响因素包括BMI、ASA分级、吸烟史、手术类型、术后使用镇痛泵、进入恢复室时体温,基于以上因素建立的列线图模型可有效预测老年患者全麻后恢复室低氧血症风险。 展开更多
关键词 老年 全身麻醉 低氧血症 列线图
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改良重症超声快速管理方案在心脏外科术后ICU患者低氧血症病因诊断中的应用研究
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作者 韦树旺 韦张旭 +5 位作者 廖世锋 韦珊珊 韦柳江 兰婕燕 韦玉璇 谢玲玲 《陕西医学杂志》 CAS 2025年第1期93-96,共4页
目的:探讨改良重症超声快速管理方案(M-CCUE)在心脏外科术后重症监护室(ICU)患者低氧血症病因诊断中的应用。方法:选择86例转入ICU低氧血症患者,采用M-CCUE方案进行病因分析,并与最终诊断结果进行匹配,对比分析M-CCUE方案诊断效能。结果... 目的:探讨改良重症超声快速管理方案(M-CCUE)在心脏外科术后重症监护室(ICU)患者低氧血症病因诊断中的应用。方法:选择86例转入ICU低氧血症患者,采用M-CCUE方案进行病因分析,并与最终诊断结果进行匹配,对比分析M-CCUE方案诊断效能。结果:86例常规检查诊断肺水肿30例,胸腔积液17例,肺实变/肺不张25例,气胸12例。经M-CCUE方案诊断肺水肿33例,胸腔积液16例,肺实变/肺不张26例,气胸11例。进一步评估,最终确诊肺水肿34例,胸腔积液16例,肺实变/肺不张26例,气胸10例。常规检查对气胸诊断特异度为92.10%,灵敏度为60.00%,肺水肿诊断特异度为84.61%,灵敏度为64.70%,对胸腔积液、肺实变/肺不张诊断灵敏度均为超过60.00%。M-CCUE方案对胸腔积液、肺实变/肺不张、气胸诊断的特异度、灵敏度均高于80.00%。结论:M-CCUE方案对心脏外科术后低氧血症患者病因诊断灵敏度、特异度较高。 展开更多
关键词 改良重症超声快速管理方案 超声 心脏手术 ICU 低氧血症
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StanfordA型主动脉夹层术后低氧血症预测模型的构建
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作者 郭迎春 张雪亚 李晓召 《郑州大学学报(医学版)》 北大核心 2025年第5期703-707,共5页
目的:构建Stanford A型主动脉夹层术后低氧血症预测模型。方法:收集2022年1月至2024年10月河南省胸科医院Stanford A型主动脉夹层术后患者2347例,按3∶1随机分为训练集(1760例)和验证集(587例)。基于训练集数据,采用Logistic回归构建Sta... 目的:构建Stanford A型主动脉夹层术后低氧血症预测模型。方法:收集2022年1月至2024年10月河南省胸科医院Stanford A型主动脉夹层术后患者2347例,按3∶1随机分为训练集(1760例)和验证集(587例)。基于训练集数据,采用Logistic回归构建Stanford A型主动脉夹层术后低氧血症发生风险预测模型并绘制列线图。采用ROC曲线、校准曲线和决策曲线分析(DCA)评估列线图的预测性能和临床价值。结果:训练集发生低氧血症914例,验证集305例。预测模型最终纳入吸烟史、心包积液、使用重组人凝血因子Ⅶa、年龄≥50岁、BMI≥25 kg/m^(2)、体外循环时间≥195 min共6个因素,OR(95%CI)分别为5.421(3.445~8.531)、1.973(1.598~2.435)、4.174(2.900~6.007)、2.730(2.082~3.581)、5.063(3.118~8.221)和7.298(4.244~12.550)。在训练集和验证集中,该模型预测的AUC(95%CI)分别为0.737(0.715~0.759)和0.716(0.676~0.756);校准曲线与理想曲线均有较高的一致性,DCA提示模型具有较高的临床应用价值。结论:构建的Stanford A型主动脉夹层术后低氧血症预测模型具有较高的应用价值。 展开更多
关键词 低氧血症 主动脉夹层术 预测模型
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固本祛瘀解毒方治疗慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征夜间低氧血症的临床观察
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作者 何沂 李紫雨 +3 位作者 张文江 高金柱 樊长征 王蓓蓓 《中国实验方剂学杂志》 北大核心 2025年第6期146-153,共8页
目的:观察固本祛瘀解毒方治疗慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)夜间低氧血症(肺脾肾虚、瘀毒交阻证)的临床疗效及安全性。方法:采用前瞻性、随机双盲、安慰剂对照的设计方法,选择符合COPD合并OSAHS的... 目的:观察固本祛瘀解毒方治疗慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)夜间低氧血症(肺脾肾虚、瘀毒交阻证)的临床疗效及安全性。方法:采用前瞻性、随机双盲、安慰剂对照的设计方法,选择符合COPD合并OSAHS的西医诊断标准且中医辨证为肺脾肾虚、瘀毒交阻证患者96例,随机分为观察组和对照组,各48例。两组均在西医常规治疗基础上,观察组加用固本祛瘀解毒方,对照组加用中药安慰剂治疗,疗程均为90 d。比较治疗前后两组患者夜间最低血氧饱和度(SpO_(2))、呼吸暂停指数(AHI)、OSAHS疗效判定、中医证候疗效评定、中医症状积分的变化。结果:观察组脱落5例、对照组脱落8例,实际完成观察组43例,对照组40例。与治疗前比较,观察组夜间最低SpO_(2)、AHI均显著改善(P<0.01),且显著优于对照组(P<0.01);OSAHS疗效观察组优于对照组(χ^(2)=7.085,P<0.05);中医证候疗效,观察组总有效率81.40%(35/43),对照组总有效率15.00%(6/40),观察组明显高于对照组(χ^(2)=36.78,P<0.01);中医症状积分二组均较治疗前改善,在打鼾、憋醒、嗜睡、咳嗽4项主证上疗效相当,但在头昏头痛、胸闷胸痛、喘息、口干口渴等10项细节上观察组优于对照组(P<0.05)。结论:固本祛瘀解毒方联合常规西医治疗COPD合并OSAHS夜间低氧血症(肺脾肾虚、瘀毒交阻证),可改善患者最低SPO_(2)、提升OSAHS控制水平、提高生活质量、改善临床症状。 展开更多
关键词 慢性阻塞性肺疾病 阻塞性睡眠呼吸暂停低通气综合征 低氧血症 固本祛瘀解毒方 随机双盲 临床观察
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机械通气前焦虑程度对全身麻醉患者氧化应激及低氧血症的影响
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作者 杨晴 汪孟幻 +3 位作者 张抒宇 王嘉宇 向导 信文启 《成都医学院学报》 2025年第2期299-302,307,共5页
目的探究机械通气前焦虑程度对全身麻醉患者氧化应激及低氧血症的影响。方法选取河南大学淮河医院普外科2023年5月至2024年2月收治的200例需行腹腔镜手术治疗的结直肠癌患者作为研究对象,采用焦虑自评量表(SAS)评估患者术前焦虑程度,根... 目的探究机械通气前焦虑程度对全身麻醉患者氧化应激及低氧血症的影响。方法选取河南大学淮河医院普外科2023年5月至2024年2月收治的200例需行腹腔镜手术治疗的结直肠癌患者作为研究对象,采用焦虑自评量表(SAS)评估患者术前焦虑程度,根据评分结果将患者分为重度焦虑组、轻中度焦虑组和正常组。对比不同程度焦虑患者机械通气后氧化应激指标水平及低氧血症发生情况。根据低氧血症发生情况将患者分为低氧血症组和血氧正常组,对比两组患者临床资料,筛选全身麻醉患者机械通气后发生低氧血症的危险因素。结果SAS量表显示,术前存在重度焦虑的患者有90例,轻中度焦虑的患者68例,心理状态良好的患者42例。低氧血症发生率比较,重度焦虑组46.67%>轻中度焦虑组20.59%>正常组4.76%,差异有统计学意义(P<0.05)。氧化应激指标超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平比较,重度焦虑组<轻中度焦虑组<正常组,丙二醛(MDA)水平比较,重度焦虑组>轻中度焦虑组>正常组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,SOD、GSH-Px水平与焦虑程度呈负相关(r=-0.5523、-0.3171,P<0.001),MDA水平与焦虑程度呈正相关(r=0.6010,P<0.001)。Logistic回归分析结果显示,体重指数(BMI)、吸烟史、慢性阻塞性肺疾病(COPD)、术前焦虑程度是全身麻醉患者机械通气后发生低氧血症的影响因素(P<0.05)。结论机械通气前焦虑程度与围术期氧化应激指标水平变化存在相关性,焦虑是围术期发生低氧血症的独立危险因素。 展开更多
关键词 机械通气 焦虑程度 全身麻醉 氧化应激 低氧血症
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基于决策树的老年全身麻醉病人术中低氧血症预测模型构建与验证
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作者 张冬群 陆瑞华 +1 位作者 谭海珍 陈尔英 《全科护理》 2025年第1期86-89,共4页
目的:构建基于决策树的老年全身麻醉病人术中低氧血症预测模型并验证。方法:回顾性选取2022年1月—2023年12月于医院行全身麻醉手术的132例老年病人为建模组,根据是否发生术中低氧血症分为低氧血症组(n=26)和未发生低氧血症组(n=106),... 目的:构建基于决策树的老年全身麻醉病人术中低氧血症预测模型并验证。方法:回顾性选取2022年1月—2023年12月于医院行全身麻醉手术的132例老年病人为建模组,根据是否发生术中低氧血症分为低氧血症组(n=26)和未发生低氧血症组(n=106),收集两组病人的临床资料并进行分析。采用单因素和多因素分析病人术中低氧血症的影响因素,并根据多因素分析结果构建基于决策树的预测模型。使用受试者工作特征(ROC)曲线分析模型的预测价值。另选取2024年1月—3月于医院行全身麻醉手术的58例老年病人为验证组进行验证。结果:多因素分析显示,体质指数(BMI)、合并高血压、吸烟史、术前经皮血氧饱和度(SpO_(2))及手术时间均为老年全身麻醉病人发生术中低氧血症的独立影响因素(均P<0.05)。根据多因素分析结果构建老年全身麻醉病人术中低氧血症决策树预测模型,共3层,12个节点,手术时间是最重要的预测因子。ROC分析结果显示,决策树模型建模组的ROC曲线下面积(AUC)为0.884[95%CI(0.817,0.952),P<0.05],决策树模型验证组的AUC为0.864[95%CI(0.765,0.963),P<0.05]。结论:本研究构建的基于决策树的老年全身麻醉病人术中低氧血症预测模型预测效果较好,可有效识别高风险术中低氧血症的老年全身麻醉病人,临床可据此制订、修改和实施对应的护理措施,以减少术中低氧血症的发生。 展开更多
关键词 决策树模型 老年病人 全身麻醉 术中低氧血症 风险预测
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Preventive and therapeutic effects of magnesium sulfate on nikethamide-induced seizures:Implications for COVID-19 treatment
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作者 Dao-Jian Xu Qiang Zhong +1 位作者 Guo-Tao Wang Xiang Lu 《World Journal of Methodology》 2025年第4期277-286,共10页
BACKGROUND Nikethamide,a respiratory stimulant,is used to treat hypoxemia caused by coronavirus disease 2019(COVID-19),but it carries a risk of convulsions.Magnesium sulfate(MgSO_(4)),a seizure inhibitor,might serve a... BACKGROUND Nikethamide,a respiratory stimulant,is used to treat hypoxemia caused by coronavirus disease 2019(COVID-19),but it carries a risk of convulsions.Magnesium sulfate(MgSO_(4)),a seizure inhibitor,might serve as a rescue agent against nikethamide-induced seizures.AIM To investigate the therapeutic effect of MgSO_(4)on nikethamide-induced seizures in COVID-19 patients through animal experiments,providing experimental support for the clinical application of MgSO_(4)in preventing and treating seizures caused by nikethamide.METHODS Forty mice were randomly divided into four groups:(1)Physiological saline;(2)Low-dose MgSO_(4)(50 mg/kg);(3)Medium-dose MgSO_(4)(100 mg/kg);and(4)High-dose MgSO_(4)(200 mg/kg).After 15 minutes of intraperitoneal injection of different doses of MgSO_(4)or an equal volume of physiological saline,the mice were injected with nikethamide(250 mg/kg).RESULTS Compared to the normal saline group,all doses of MgSO_(4)significantly prolonged the seizure latency and reduced the severity of convulsions.However,they also extended the duration of seizures and correspondingly increased survival time(P<0.05).The incidence of seizures and mortality rate in the MgSO_(4)-treated groups were significantly lower than those in the normal saline group(P<0.05).CONCLUSION MgSO_(4)can prevent and treat seizures caused by nikethamide in mice.This finding has implications for the application of MgSO_(4)in treating and preventing seizures caused by nikethamide in COVID-19 treatment. 展开更多
关键词 COVID-19 Drug discovery hypoxemia Magnesium sulfate NIKETHAMIDE Seizures
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单肺通气患者术后麻醉苏醒期发生低氧血症的影响因素研究
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作者 谢泽 胡召锟 《麻醉安全与质控》 2025年第3期202-207,共6页
目的对全麻下采用单肺通气(OLV)患者麻醉苏醒期发生低氧血症的影响因素研究。方法选取2021年1月至2023年12月在广西医科大学附属肿瘤医院行OLV胸科手术患者214例,年龄>18岁,美国麻醉医师协会(ASA)分级Ⅰ~Ⅲ级,分组标准以患者术后入... 目的对全麻下采用单肺通气(OLV)患者麻醉苏醒期发生低氧血症的影响因素研究。方法选取2021年1月至2023年12月在广西医科大学附属肿瘤医院行OLV胸科手术患者214例,年龄>18岁,美国麻醉医师协会(ASA)分级Ⅰ~Ⅲ级,分组标准以患者术后入麻醉恢复室复苏期间是否发生低氧血症,将患者分为发生组(n=67)和未发生组(n=147)。回顾性收集并分析两组患者的一般资料、术前检查结果资料、术中麻醉及手术情况资料等。采用单因素及多元Logistic回归分析OLV胸科手术患者麻醉苏醒期低氧血症的影响因素。结果纳入的214例OLV患者中,共有67例在麻醉苏醒期发生低氧血症(31.31%);两组患者在年龄、吸烟史、ASA分级、合并基础病、麻醉时间、白细胞介素-6(IL-6)、C反应蛋白(CRP)和第1秒用力呼气容积(FEV_(1))水平比较,差异有统计学意义(P<0.05)。多元Logistic回归分析结果显示,年龄(OR=0.220)、吸烟(OR=0.925)、ASA分级(OR=0.180)、合并基础疾病(OR=2.387)、IL-6(OR=1.873)、CRP(OR=2.980)和FEV_(1)(OR=3.645)是全麻下行OLV手术患者麻醉苏醒期发生低氧血症的危险因素(P<0.05)。结论全麻下行OLV手术患者麻醉苏醒期发生低氧血症与患者的年龄、吸烟史、ASA分级、合并基础疾病、IL-6、CRP和FEV_(1)有关。 展开更多
关键词 单肺通气 低氧血症 麻醉苏醒期 影响因素
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