Objective： To explore the relationship of postoperative cognitive dysfunction （POCD） in one-lung ventilation （OLV） patients and regional cerebral oxygen saturation （rSO2）. Methods： Twenty-nine male and twenty-...Objective： To explore the relationship of postoperative cognitive dysfunction （POCD） in one-lung ventilation （OLV） patients and regional cerebral oxygen saturation （rSO2）. Methods： Twenty-nine male and twenty-one female cases of OLV received thoracic surgery, with American Standards Association （ASA） physical status being at Grades Ⅰ-Ⅲ. Neuropsychological tests were performed on the day before operation and 7 d after operation, and there was an intraoperative continuous monitoring of rSO2. The values of rSO2 before anesthesia induction （t1）, at the beginning of OLV （t2）, and at the time of OLV 30 min （t3）, OLV 60 min （t4）, the end of OLV （t5）, and the end of surgery （t6） were recorded. The intraoperative average of rSO2 （ rSO2 ）, the intraoperative minimum value of rSO2 （rSO2, rn=n）, and the reduced maximum percentage of rSO2 （rSO2, %max） when compared with the baseline value were calculated. The volume of blood loss, urine output, and the amount of fluid infusion was recorded. Results： A total of 14 patients （28%） in the 50 cases suffered from POCD. The values of mini-mental state examination （MMSE）, the digit span and the digit symbol on the 7th day after the operation for POCD in OLV patients were found to be significantly lower than those before the operation （P〈0.05）. The values of MMSE and vocabulary fluency scores were significantly lower than those in the non-POCD group （P〈0.05）. The values of rSO2 in the POCD group of OLV patients at t2 and t3 and the values of rSO2 in the non-POCD group at t2 were found to be significantly higher than those at tl （P〈0.05）. The values of rSO2, %max in the POCD group were significantly higher than those in the non-POCD group （P〈0.05）. When the value of rSO2, %max is more than 10.1%, it may act as an early warning index for cognitive function changes, Conclusions： POCD after OLV may be associated with a decline in rSO2.展开更多
目的探讨玉屏风颗粒联合硫酸沙丁胺醇治疗小儿支气管哮喘的临床疗效。方法选取2014年8月—2015年8月锦州市中心医院收治的小儿支气管哮喘患者82例,依据不同的治疗方法分成治疗组和对照组,每组各41例。所有患者均给予止咳、化痰及抗感染...目的探讨玉屏风颗粒联合硫酸沙丁胺醇治疗小儿支气管哮喘的临床疗效。方法选取2014年8月—2015年8月锦州市中心医院收治的小儿支气管哮喘患者82例,依据不同的治疗方法分成治疗组和对照组,每组各41例。所有患者均给予止咳、化痰及抗感染等常规治疗。对照组在此基础上雾化吸入吸入用硫酸沙丁胺醇溶液0.5 m L,用0.9%生理盐水稀释到2.5 m L,3~5min/次,3次/d。治疗组在对照组用药基础上口服玉屏风颗粒,1袋/次,3次/d。两组患者均连续治疗2周。比较两组临床疗效、肺功能变化、动脉血气指标、临床症状及体征消失时间以及肿瘤坏死因子α（TNF-α）、白介素-6（IL-6）和免疫球蛋白E（IgE）表达水平。结果治疗后,对照组和治疗组总有效率分别为75.61%和92.68%,两组比较差异有统计学意义（P〈0.05）。治疗后,两组一秒用力呼气容积（FEV1）、最大呼气流量（PEF）均较同组治疗前显著升高,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗后,治疗组这些观察指标显著高于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,两组氧分压（PO_2）、血氧饱和度（SpO_2）和二氧化碳分压（PCO_2）均好于同组治疗前,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗后,治疗组这些观察指标显著高于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,治疗组患儿咳嗽、喘憋和肺部哮鸣音的消失时间少于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,两组TNF-α、IL-6和IgE表达水平均降低,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗后,治疗组这些观察指标显著低于对照组,两组比较差异具有统计学意义（P〈0.05）。结论玉屏风颗粒联合硫酸沙丁胺醇治疗小儿支气管哮喘具有较好的临床疗效,可以明显改善患儿肺功能,抑制炎性因子表达,具有一�展开更多
基金supported by the Foundation of Shandong Science and Technology Project(No.2011YD18070),China
文摘Objective： To explore the relationship of postoperative cognitive dysfunction （POCD） in one-lung ventilation （OLV） patients and regional cerebral oxygen saturation （rSO2）. Methods： Twenty-nine male and twenty-one female cases of OLV received thoracic surgery, with American Standards Association （ASA） physical status being at Grades Ⅰ-Ⅲ. Neuropsychological tests were performed on the day before operation and 7 d after operation, and there was an intraoperative continuous monitoring of rSO2. The values of rSO2 before anesthesia induction （t1）, at the beginning of OLV （t2）, and at the time of OLV 30 min （t3）, OLV 60 min （t4）, the end of OLV （t5）, and the end of surgery （t6） were recorded. The intraoperative average of rSO2 （ rSO2 ）, the intraoperative minimum value of rSO2 （rSO2, rn=n）, and the reduced maximum percentage of rSO2 （rSO2, %max） when compared with the baseline value were calculated. The volume of blood loss, urine output, and the amount of fluid infusion was recorded. Results： A total of 14 patients （28%） in the 50 cases suffered from POCD. The values of mini-mental state examination （MMSE）, the digit span and the digit symbol on the 7th day after the operation for POCD in OLV patients were found to be significantly lower than those before the operation （P〈0.05）. The values of MMSE and vocabulary fluency scores were significantly lower than those in the non-POCD group （P〈0.05）. The values of rSO2 in the POCD group of OLV patients at t2 and t3 and the values of rSO2 in the non-POCD group at t2 were found to be significantly higher than those at tl （P〈0.05）. The values of rSO2, %max in the POCD group were significantly higher than those in the non-POCD group （P〈0.05）. When the value of rSO2, %max is more than 10.1%, it may act as an early warning index for cognitive function changes, Conclusions： POCD after OLV may be associated with a decline in rSO2.
文摘目的探讨玉屏风颗粒联合硫酸沙丁胺醇治疗小儿支气管哮喘的临床疗效。方法选取2014年8月—2015年8月锦州市中心医院收治的小儿支气管哮喘患者82例,依据不同的治疗方法分成治疗组和对照组,每组各41例。所有患者均给予止咳、化痰及抗感染等常规治疗。对照组在此基础上雾化吸入吸入用硫酸沙丁胺醇溶液0.5 m L,用0.9%生理盐水稀释到2.5 m L,3~5min/次,3次/d。治疗组在对照组用药基础上口服玉屏风颗粒,1袋/次,3次/d。两组患者均连续治疗2周。比较两组临床疗效、肺功能变化、动脉血气指标、临床症状及体征消失时间以及肿瘤坏死因子α（TNF-α）、白介素-6（IL-6）和免疫球蛋白E（IgE）表达水平。结果治疗后,对照组和治疗组总有效率分别为75.61%和92.68%,两组比较差异有统计学意义（P〈0.05）。治疗后,两组一秒用力呼气容积（FEV1）、最大呼气流量（PEF）均较同组治疗前显著升高,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗后,治疗组这些观察指标显著高于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,两组氧分压（PO_2）、血氧饱和度（SpO_2）和二氧化碳分压（PCO_2）均好于同组治疗前,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗后,治疗组这些观察指标显著高于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,治疗组患儿咳嗽、喘憋和肺部哮鸣音的消失时间少于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,两组TNF-α、IL-6和IgE表达水平均降低,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗后,治疗组这些观察指标显著低于对照组,两组比较差异具有统计学意义（P〈0.05）。结论玉屏风颗粒联合硫酸沙丁胺醇治疗小儿支气管哮喘具有较好的临床疗效,可以明显改善患儿肺功能,抑制炎性因子表达,具有一�
