目的比较加速康复外科(enhanced recovery after surgery,ERAS)模式下妇科良性疾病腹腔镜手术的多模式镇痛方案与传统镇痛方案的效果。方法收集在首都医科大学附属北京积水潭医院(2022年3月至2023年8月)和北京大学国际医院(2020年9月至2...目的比较加速康复外科(enhanced recovery after surgery,ERAS)模式下妇科良性疾病腹腔镜手术的多模式镇痛方案与传统镇痛方案的效果。方法收集在首都医科大学附属北京积水潭医院(2022年3月至2023年8月)和北京大学国际医院(2020年9月至2021年7月)诊治的291例妇科良性疾病患者。通过区组随机法,按手术类型将入组患者分为3组(附件组、子宫体组、子宫全切组),在每个区组内,患者被随机分配至研究组和对照组,比例为1∶1。研究组和对照组均采用相同的麻醉诱导方案和术中非甾体类抗炎药(NSAIDS)预防性镇痛方案,研究组在切皮前、术毕前均给予罗哌卡因切口局部浸润麻醉,术后给予NSAIDS类药物预防性镇痛;对照组未使用切口局部浸润麻醉,术后不给予常规镇痛(如患者要求,则给予自控镇痛泵镇痛)。比较两组患者术后2、6、24、48h疼痛视觉模拟评分(Visual Analogue Scale/Score,VAS)以及恶心、呕吐的发生率。结果研究组在术后6h相同状态下及术后24h静态下的VAS评分均显著低于对照组(P<0.05),且在术后2、6h相同状态及24h静态下的VAS评分显著低于对照组使用镇痛泵的患者(P<0.05);对照组使用镇痛泵者的恶心(35.2%vs.19.6%)和呕吐(27.8%vs.11.2%)发生率高于研究组(P>0.05)。结论在妇科良性疾病腹腔镜手术ERAS模式下的多模式镇痛方案在镇痛效果及舒适度方面优于传统镇痛方案,术后24h内是镇痛的最佳时间窗。展开更多
Field reversed configuration(FRC)is widely considered as an ideal target plasma for magnetoinertial fusion.However,its confinement and stability,both proportional to the radius,will deteriorate inevitably during radia...Field reversed configuration(FRC)is widely considered as an ideal target plasma for magnetoinertial fusion.However,its confinement and stability,both proportional to the radius,will deteriorate inevitably during radial compression.Hence,we propose a new fusion approach based on axial compression of a large-sized FRC.The axial compression can be made by plasma jets or plasmoids converging onto the axial ends of the FRC.The parameter space that can reach the ignition condition while preserving the FRC's overall quality is studied using a numerical model based on different FRC confinement scalings.It is found that ignition is possible for a large FRC that can be achieved with the current FRC formation techniques if compression ratio is greater than 50.A more realistic compression is to combine axial with moderate radial compression,which is also presented and calculated in this work.展开更多
基金supported by National Natural Science Foundation of China(No.12175226)。
文摘Field reversed configuration(FRC)is widely considered as an ideal target plasma for magnetoinertial fusion.However,its confinement and stability,both proportional to the radius,will deteriorate inevitably during radial compression.Hence,we propose a new fusion approach based on axial compression of a large-sized FRC.The axial compression can be made by plasma jets or plasmoids converging onto the axial ends of the FRC.The parameter space that can reach the ignition condition while preserving the FRC's overall quality is studied using a numerical model based on different FRC confinement scalings.It is found that ignition is possible for a large FRC that can be achieved with the current FRC formation techniques if compression ratio is greater than 50.A more realistic compression is to combine axial with moderate radial compression,which is also presented and calculated in this work.
