目的:探讨成人和儿童术前乳酸林格氏液液体动力学的差别。方法:本研究是随机,双盲前瞻性研究。择期盆腔、肛肠或者下肢小手术患者28例,美国麻醉医师协会(ASA)I级,其中儿童14例,成人14例。所有患者给予镇静药后在20 min内恒速输入10 m L...目的:探讨成人和儿童术前乳酸林格氏液液体动力学的差别。方法:本研究是随机,双盲前瞻性研究。择期盆腔、肛肠或者下肢小手术患者28例,美国麻醉医师协会(ASA)I级,其中儿童14例,成人14例。所有患者给予镇静药后在20 min内恒速输入10 m L/kg的乳酸林格氏液体,通过血红蛋白(Hb)稀释-时间曲线和尿量采用Matlab 4.2软件包计算液体动力学参数。结果:一级动力学模型拟合结果显示,与成人相比,在输入林格氏液体后90 min内儿童的血浆稀释程度明显降低(0.16 vs 0.07,P=0.000),儿童将输入液体的43%通过肾脏排出,显著高于成人(18%)(P=0.011)。按公斤体重计算儿童和成人对乳酸林格氏液的血浆清除率分别是2.2 m L·min-1·kg-1和0.5 m L·min-1·kg-1(P=0.016),而肾脏对乳酸林格氏液体的清除率两组分别是0.76 m L·min-1·kg-1和0.10 m L·min-1·kg-1,(P=0.000)。结论:儿童对乳酸林格氏液体血浆和肾脏清除率分别是成人的4倍和7倍,术前给儿童输液,按照体重计算量可以参照成人的剂量。展开更多
Oenethera biennis oil was administered (6 g per day) in 23 chronic renal insufficiency pa-tients over a 4 week period. Changes of serum creatinine, creatinine clearance, plasma lipid, renin activity,and angiatensin ...Oenethera biennis oil was administered (6 g per day) in 23 chronic renal insufficiency pa-tients over a 4 week period. Changes of serum creatinine, creatinine clearance, plasma lipid, renin activity,and angiatensin , urinary thromboxane B2 and 6-keto-prostaglandin F1 were observed before and after thetreatment. Results showed that after treatment. the creatinine clearance increased, serum total cholesterol,triglyceride and low density lipoprotein decreased, high density lipoprotein increased, plasma renin activity,angiotensin and urinary thromboxane B2 decreased significantly. The conclusion was that Oenethera bien-nis oil could improve the pathological process of renal diseases, and has benoficial effects on plasma lipiddisorder and glomerular hemodynamics .展开更多
BACKGROUND Preoperative evaluation of future remnant liver reserves is important for safe hepatectomy.If the remnant is small,preoperative portal vein embolization(PVE)is useful.Liver volume analysis has been the prim...BACKGROUND Preoperative evaluation of future remnant liver reserves is important for safe hepatectomy.If the remnant is small,preoperative portal vein embolization(PVE)is useful.Liver volume analysis has been the primary method of preoperative evaluation,although functional examination may be more accurate.We have used the functional evaluation liver using the indocyanine green plasma clearance rate(KICG)and 99mTc-galactosyl human serum albumin single-photon emission computed tomography(99mTc-GSA SPECT)for safe hepatectomy.AIM To analyze the safety of our institution’s system for evaluating the remnant liver reserve.METHODS We retrospectively reviewed the records of 23 patients who underwent preoperative PVE.Two types of remnant liver KICG were defined as follows:Anatomical volume remnant KICG(a-rem-KICG),determined as the remnant liver anatomical volume rate×KICG;and functional volume remnant KICG(frem-KICG),determined as the remnant liver functional volume rate based on 99mTc-GSA SPECT×KICG.If either of the remnant liver KICGs were>0.05,a hepatectomy was performed.Perioperative factors were analyzed.We defined the marginal group as patients with a-rem-KICG of<0.05 and a f-rem-KICG of>0.05 and compared the postoperative outcomes between the marginal and not marginal(both a-rem-KICG and f-rem-KICG>0.05)groups.RESULTS All 23 patients underwent planned hepatectomies.Right hepatectomy,right trisectionectomy and left trisectionectomy were in 16,6 and 1 cases,respectively.The mean of blood loss and operative time were 576 mL and 474 min,respectively.The increased amount of frem-KICG was significantly larger than that of a-rem-KICG after PVE(0.034 vs 0.012,P=0.0273).The not marginal and marginal groups had 17(73.9%)and 6(26.1%)patients,respectively.The complications of Clavian-Dindo classification grade II or higher and post-hepatectomy liver failure were observed in six(26.1%)and one(grade A,4.3%)patient,respectively.The 90-d mortality was zero.The marginal group had no significant difference in postoperative outc展开更多
文摘目的:探讨成人和儿童术前乳酸林格氏液液体动力学的差别。方法:本研究是随机,双盲前瞻性研究。择期盆腔、肛肠或者下肢小手术患者28例,美国麻醉医师协会(ASA)I级,其中儿童14例,成人14例。所有患者给予镇静药后在20 min内恒速输入10 m L/kg的乳酸林格氏液体,通过血红蛋白(Hb)稀释-时间曲线和尿量采用Matlab 4.2软件包计算液体动力学参数。结果:一级动力学模型拟合结果显示,与成人相比,在输入林格氏液体后90 min内儿童的血浆稀释程度明显降低(0.16 vs 0.07,P=0.000),儿童将输入液体的43%通过肾脏排出,显著高于成人(18%)(P=0.011)。按公斤体重计算儿童和成人对乳酸林格氏液的血浆清除率分别是2.2 m L·min-1·kg-1和0.5 m L·min-1·kg-1(P=0.016),而肾脏对乳酸林格氏液体的清除率两组分别是0.76 m L·min-1·kg-1和0.10 m L·min-1·kg-1,(P=0.000)。结论:儿童对乳酸林格氏液体血浆和肾脏清除率分别是成人的4倍和7倍,术前给儿童输液,按照体重计算量可以参照成人的剂量。
文摘Oenethera biennis oil was administered (6 g per day) in 23 chronic renal insufficiency pa-tients over a 4 week period. Changes of serum creatinine, creatinine clearance, plasma lipid, renin activity,and angiatensin , urinary thromboxane B2 and 6-keto-prostaglandin F1 were observed before and after thetreatment. Results showed that after treatment. the creatinine clearance increased, serum total cholesterol,triglyceride and low density lipoprotein decreased, high density lipoprotein increased, plasma renin activity,angiotensin and urinary thromboxane B2 decreased significantly. The conclusion was that Oenethera bien-nis oil could improve the pathological process of renal diseases, and has benoficial effects on plasma lipiddisorder and glomerular hemodynamics .
文摘BACKGROUND Preoperative evaluation of future remnant liver reserves is important for safe hepatectomy.If the remnant is small,preoperative portal vein embolization(PVE)is useful.Liver volume analysis has been the primary method of preoperative evaluation,although functional examination may be more accurate.We have used the functional evaluation liver using the indocyanine green plasma clearance rate(KICG)and 99mTc-galactosyl human serum albumin single-photon emission computed tomography(99mTc-GSA SPECT)for safe hepatectomy.AIM To analyze the safety of our institution’s system for evaluating the remnant liver reserve.METHODS We retrospectively reviewed the records of 23 patients who underwent preoperative PVE.Two types of remnant liver KICG were defined as follows:Anatomical volume remnant KICG(a-rem-KICG),determined as the remnant liver anatomical volume rate×KICG;and functional volume remnant KICG(frem-KICG),determined as the remnant liver functional volume rate based on 99mTc-GSA SPECT×KICG.If either of the remnant liver KICGs were>0.05,a hepatectomy was performed.Perioperative factors were analyzed.We defined the marginal group as patients with a-rem-KICG of<0.05 and a f-rem-KICG of>0.05 and compared the postoperative outcomes between the marginal and not marginal(both a-rem-KICG and f-rem-KICG>0.05)groups.RESULTS All 23 patients underwent planned hepatectomies.Right hepatectomy,right trisectionectomy and left trisectionectomy were in 16,6 and 1 cases,respectively.The mean of blood loss and operative time were 576 mL and 474 min,respectively.The increased amount of frem-KICG was significantly larger than that of a-rem-KICG after PVE(0.034 vs 0.012,P=0.0273).The not marginal and marginal groups had 17(73.9%)and 6(26.1%)patients,respectively.The complications of Clavian-Dindo classification grade II or higher and post-hepatectomy liver failure were observed in six(26.1%)and one(grade A,4.3%)patient,respectively.The 90-d mortality was zero.The marginal group had no significant difference in postoperative outc
