目的观察耳穴疗法用于全膝关节置换术围手术期镇痛的效果。方法选择ASAⅠ～Ⅲ级行单侧全膝关节置换骨性关节炎患者60例,随机分为耳穴镇痛组和对照组,每组30例,所有患者手术均由同一组医师施行,实施气管插管全身麻醉。耳穴镇痛组患者术...目的观察耳穴疗法用于全膝关节置换术围手术期镇痛的效果。方法选择ASAⅠ～Ⅲ级行单侧全膝关节置换骨性关节炎患者60例,随机分为耳穴镇痛组和对照组,每组30例,所有患者手术均由同一组医师施行,实施气管插管全身麻醉。耳穴镇痛组患者术前用王不留行籽按压耳穴配合术后患肢局部穴位敷贴镇痛,对照组采用常规治疗,两组患者均术前1天口服塞来昔布400 mg,术后口服塞来昔布每日2次,每次200 mg。当视觉模拟评分(visual analogue scales,VAS)>7分时,予盐酸布桂嗪0.1 g补救。术后两组采用相同的锻炼方法。记录静息时的VAS评分,镇静满意度,发生不良反应情况,术后膝关节活动度(range of motion,ROM)及美国特种外科医院膝关节评分(hospital for special surgery scores,HSS)。结果耳穴镇痛组患者术后6、24 h的静息VAS疼痛评分分别为(5.99±0.67)、(4.26±0.59)分,均明显低于对照组患者(7.02±0.85,4.92±0.43,P<0.01);两组患者术后1、48 h VAS评分差异无统计学意义(P>0.05);两组患者镇静满意程度总体相似;与对照组比较,耳穴镇痛组患者并发症发生率减少,但差异无统计学意义(4:11,P>0.05);ROM和HSS评分方面,耳穴镇痛组术前ROM为75.63°±5.74°,对照组术前ROM为75.43°±5.63°,差异无统计学意义(P>0.05);耳穴镇痛组术后2周主动与被动ROM分别为96.50°±3.79°、107.8°±3.37°,对照组分别为93.50°±3.50°、105.27°±3.25°,均有统计学意义(P<0.05);耳穴镇痛组术前HSS评分为(60.23±3.44)分,对照组为(61.70±2.83)分,差异无统计学意义(P>0.05);术后HSS评分分别为(86.97±2.33)、(85.37±2.30)分,差异有统计学意义(P<0.05)。结论膝关节置换术围手术期配合应用耳穴疗法有助于减轻患者的术后疼痛,减少术后总的麻醉剂使用量,有助于患者的早期康复,同时有着费用低、并发症少、操作简单、安全的优点。展开更多
Land use/cover change is an important theme on the impacts of human activities on the earth systems and global environmental change. National land-use changes of China during 2010–2015 were acquired by the digital in...Land use/cover change is an important theme on the impacts of human activities on the earth systems and global environmental change. National land-use changes of China during 2010–2015 were acquired by the digital interpretation method using the high-resolution remotely sensed images, e.g. the Landsat 8 OLI, GF-2 remote sensing images. The spatiotemporal characteristics of land-use changes across China during 2010–2015 were revealed by the indexes of dynamic degree model, annual land-use changes ratio etc. The results indicated that the built-up land increased by 24.6×10~3 km^2 while the cropland decreased by 4.9×10~3 km^2, and the total area of woodland and grassland decreased by 16.4×10~3 km^2. The spatial pattern of land-use changes in China during 2010–2015 was concordant with that of the period 2000–2010. Specially, new characteristics of land-use changes emerged in different regions of China in 2010–2015. The built-up land in eastern China expanded continually, and the total area of cropland decreased, both at decreasing rates. The rates of built-up land expansion and cropland shrinkage were accelerated in central China. The rates of built-up land expansion and cropland growth increased in western China, while the decreasing rate of woodland and grassland accelerated. In northeastern China, built-up land expansion slowed continually, and cropland area increased slightly accompanied by the conversions between paddy land and dry land. Besides, woodland and grassland area decreased in northeastern China. The characteristics of land-use changes in eastern China were essentially consistent with the spatial govern and control requirements of the optimal development zones and key development zones according to the Major Function-oriented Zones Planning implemented during the 12 th Five-Year Plan(2011–2015). It was a serious challenge for the central government of China to effectively protect the reasonable layout of land use types dominated with the key ecological function zones and agricultural pro展开更多
文摘目的观察耳穴疗法用于全膝关节置换术围手术期镇痛的效果。方法选择ASAⅠ～Ⅲ级行单侧全膝关节置换骨性关节炎患者60例,随机分为耳穴镇痛组和对照组,每组30例,所有患者手术均由同一组医师施行,实施气管插管全身麻醉。耳穴镇痛组患者术前用王不留行籽按压耳穴配合术后患肢局部穴位敷贴镇痛,对照组采用常规治疗,两组患者均术前1天口服塞来昔布400 mg,术后口服塞来昔布每日2次,每次200 mg。当视觉模拟评分(visual analogue scales,VAS)>7分时,予盐酸布桂嗪0.1 g补救。术后两组采用相同的锻炼方法。记录静息时的VAS评分,镇静满意度,发生不良反应情况,术后膝关节活动度(range of motion,ROM)及美国特种外科医院膝关节评分(hospital for special surgery scores,HSS)。结果耳穴镇痛组患者术后6、24 h的静息VAS疼痛评分分别为(5.99±0.67)、(4.26±0.59)分,均明显低于对照组患者(7.02±0.85,4.92±0.43,P<0.01);两组患者术后1、48 h VAS评分差异无统计学意义(P>0.05);两组患者镇静满意程度总体相似;与对照组比较,耳穴镇痛组患者并发症发生率减少,但差异无统计学意义(4:11,P>0.05);ROM和HSS评分方面,耳穴镇痛组术前ROM为75.63°±5.74°,对照组术前ROM为75.43°±5.63°,差异无统计学意义(P>0.05);耳穴镇痛组术后2周主动与被动ROM分别为96.50°±3.79°、107.8°±3.37°,对照组分别为93.50°±3.50°、105.27°±3.25°,均有统计学意义(P<0.05);耳穴镇痛组术前HSS评分为(60.23±3.44)分,对照组为(61.70±2.83)分,差异无统计学意义(P>0.05);术后HSS评分分别为(86.97±2.33)、(85.37±2.30)分,差异有统计学意义(P<0.05)。结论膝关节置换术围手术期配合应用耳穴疗法有助于减轻患者的术后疼痛,减少术后总的麻醉剂使用量,有助于患者的早期康复,同时有着费用低、并发症少、操作简单、安全的优点。
基金National Key Research and Development Program,No.2017YFC0506501National Key Basic Research Program of China,No.2014CB954302
文摘Land use/cover change is an important theme on the impacts of human activities on the earth systems and global environmental change. National land-use changes of China during 2010–2015 were acquired by the digital interpretation method using the high-resolution remotely sensed images, e.g. the Landsat 8 OLI, GF-2 remote sensing images. The spatiotemporal characteristics of land-use changes across China during 2010–2015 were revealed by the indexes of dynamic degree model, annual land-use changes ratio etc. The results indicated that the built-up land increased by 24.6×10~3 km^2 while the cropland decreased by 4.9×10~3 km^2, and the total area of woodland and grassland decreased by 16.4×10~3 km^2. The spatial pattern of land-use changes in China during 2010–2015 was concordant with that of the period 2000–2010. Specially, new characteristics of land-use changes emerged in different regions of China in 2010–2015. The built-up land in eastern China expanded continually, and the total area of cropland decreased, both at decreasing rates. The rates of built-up land expansion and cropland shrinkage were accelerated in central China. The rates of built-up land expansion and cropland growth increased in western China, while the decreasing rate of woodland and grassland accelerated. In northeastern China, built-up land expansion slowed continually, and cropland area increased slightly accompanied by the conversions between paddy land and dry land. Besides, woodland and grassland area decreased in northeastern China. The characteristics of land-use changes in eastern China were essentially consistent with the spatial govern and control requirements of the optimal development zones and key development zones according to the Major Function-oriented Zones Planning implemented during the 12 th Five-Year Plan(2011–2015). It was a serious challenge for the central government of China to effectively protect the reasonable layout of land use types dominated with the key ecological function zones and agricultural pro
