目的探讨咪达唑仑联合瑞芬太尼在脊椎骨折手术麻醉过程中的应用效果。方法选择2010年1月~2014年1月我院收治的脊椎骨折患者60例，随机分为对照组和观察组，每组各30例。对照组给予咪达唑仑麻醉，观察组给予咪达唑仑联合瑞芬太尼麻醉。...目的探讨咪达唑仑联合瑞芬太尼在脊椎骨折手术麻醉过程中的应用效果。方法选择2010年1月~2014年1月我院收治的脊椎骨折患者60例，随机分为对照组和观察组，每组各30例。对照组给予咪达唑仑麻醉，观察组给予咪达唑仑联合瑞芬太尼麻醉。对两组给药前后生命体征相关指标、麻醉苏醒时间及麻醉效果进行比较。结果给药后观察组的心率和呼吸频率明显优于给药前和对照组（P〈0.05），而血氧饱和度与对照组无显著差异（P〉0.05）。观察组的呼吸恢复时间、睁眼时间、拔管时间以及定向力恢复时间明显短于对照组，麻醉术后10 min OAAS评分明显高于对照组，麻醉优良率（96.7%）明显高于对照组（73.3%）（P〈0.05）。结论咪达唑仑联合瑞芬太尼用于脊椎骨折手术麻醉，具有麻醉效果满意、苏醒快速等优点，值得临床推广。展开更多
Osteoporosis is a common metabolic skeletal disorder characterized by decreased bone mass and deteriorated bone structure, leading to increased susceptibility to fractures. With aging population, osteoporotic fracture...Osteoporosis is a common metabolic skeletal disorder characterized by decreased bone mass and deteriorated bone structure, leading to increased susceptibility to fractures. With aging population, osteoporotic fractures are of global health and socioeconomic importance. The three-dimensional microstructural information of the common osteoporosis-related fracture sites, including vertebra, femoral neck and distal radius, is a key for fully understanding osteoporosis pathogenesis and predicting the fracture risk. Low vertebral bone mineral density(BMD) is correlated with increased fracture of the spine. Vertebral BMD decreases from cervical to lumbar spine, with the lowest BMD at the third lumbar vertebra. Trabecular bone mass of the vertebrae is much lower than that of the peripheral bone. Cancellous bone of the vertebral body has a complex heterogeneous three-dimensional microstructure, with lower bone volume in the central and anterior superior regions. Trabecular bone quality is a key element to maintain the vertebral strength. The increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Compared with age-matched controls, increased cortical porosity is observed at the femoral neck in osteoporoticfracture patients. Distal radius demonstrates spatial inhomogeneous characteristic in cortical microstructure. The medial region of the distal radius displays the highest cortical porosity compared with the lateral, anterior and posterior regions. Bone strength of the distal radius is mainly determined by cortical porosity, which deteriorates with advancing age.展开更多
Background Cervicogenic headache （CEH） is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticoste...Background Cervicogenic headache （CEH） is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticosteroid injection, and surgery. The objective of this study was to investigate the safety and efficacy of a continuous epidural block of the cervical vertebra. Methods Medical records were retrospectively analyzed for 37 patients diagnosed with CEH treated by a continuous epidural block of the cervical vertebra with lidocaine, dexamethasone, and saline （5 ml/min） for 3-4 weeks and triamcinolone acetonide 5 mg once weekly for 3-4 weeks. Pain was measured via the visual analogue scale （VAS） in combination with quality of life assessment. Outcome measures were patient-reported days with mild or moderate pain, occurrence of severe pain, and the daily oral dosages of non-steroidal anti-inflammatory drug use （NSAID）. Results In the 3 months immediately preceding placement of the epidural catheter, the mean number of days with mild or moderate pain was 22.0±4.3. The mean occurrence of severe pain was （3.20±0.75） times and the mean oral dosage of NSAID was （1267±325） mg. During the first 6 months after epidural administration of lidocaine and corticosteroids, the mean number of days with mild or moderate pain, the mean occurrence of severe pain, and the mean daily oral dosages of NSAIDs were significantly decreased compared to 3-month period immediately preceding treatment （P 〈0.01）. By 12 months post-treatment, no significant difference in these three outcome measures was noted. Conclusions Continuous epidural block of the cervical vertebra for patients with CEH is effective for at least six months. Further research is needed to elucidate mechanisms of action and to prolong this effect.展开更多
文摘目的探讨咪达唑仑联合瑞芬太尼在脊椎骨折手术麻醉过程中的应用效果。方法选择2010年1月~2014年1月我院收治的脊椎骨折患者60例，随机分为对照组和观察组，每组各30例。对照组给予咪达唑仑麻醉，观察组给予咪达唑仑联合瑞芬太尼麻醉。对两组给药前后生命体征相关指标、麻醉苏醒时间及麻醉效果进行比较。结果给药后观察组的心率和呼吸频率明显优于给药前和对照组（P〈0.05），而血氧饱和度与对照组无显著差异（P〉0.05）。观察组的呼吸恢复时间、睁眼时间、拔管时间以及定向力恢复时间明显短于对照组，麻醉术后10 min OAAS评分明显高于对照组，麻醉优良率（96.7%）明显高于对照组（73.3%）（P〈0.05）。结论咪达唑仑联合瑞芬太尼用于脊椎骨折手术麻醉，具有麻醉效果满意、苏醒快速等优点，值得临床推广。
文摘Osteoporosis is a common metabolic skeletal disorder characterized by decreased bone mass and deteriorated bone structure, leading to increased susceptibility to fractures. With aging population, osteoporotic fractures are of global health and socioeconomic importance. The three-dimensional microstructural information of the common osteoporosis-related fracture sites, including vertebra, femoral neck and distal radius, is a key for fully understanding osteoporosis pathogenesis and predicting the fracture risk. Low vertebral bone mineral density(BMD) is correlated with increased fracture of the spine. Vertebral BMD decreases from cervical to lumbar spine, with the lowest BMD at the third lumbar vertebra. Trabecular bone mass of the vertebrae is much lower than that of the peripheral bone. Cancellous bone of the vertebral body has a complex heterogeneous three-dimensional microstructure, with lower bone volume in the central and anterior superior regions. Trabecular bone quality is a key element to maintain the vertebral strength. The increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Compared with age-matched controls, increased cortical porosity is observed at the femoral neck in osteoporoticfracture patients. Distal radius demonstrates spatial inhomogeneous characteristic in cortical microstructure. The medial region of the distal radius displays the highest cortical porosity compared with the lateral, anterior and posterior regions. Bone strength of the distal radius is mainly determined by cortical porosity, which deteriorates with advancing age.
文摘Background Cervicogenic headache （CEH） is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticosteroid injection, and surgery. The objective of this study was to investigate the safety and efficacy of a continuous epidural block of the cervical vertebra. Methods Medical records were retrospectively analyzed for 37 patients diagnosed with CEH treated by a continuous epidural block of the cervical vertebra with lidocaine, dexamethasone, and saline （5 ml/min） for 3-4 weeks and triamcinolone acetonide 5 mg once weekly for 3-4 weeks. Pain was measured via the visual analogue scale （VAS） in combination with quality of life assessment. Outcome measures were patient-reported days with mild or moderate pain, occurrence of severe pain, and the daily oral dosages of non-steroidal anti-inflammatory drug use （NSAID）. Results In the 3 months immediately preceding placement of the epidural catheter, the mean number of days with mild or moderate pain was 22.0±4.3. The mean occurrence of severe pain was （3.20±0.75） times and the mean oral dosage of NSAID was （1267±325） mg. During the first 6 months after epidural administration of lidocaine and corticosteroids, the mean number of days with mild or moderate pain, the mean occurrence of severe pain, and the mean daily oral dosages of NSAIDs were significantly decreased compared to 3-month period immediately preceding treatment （P 〈0.01）. By 12 months post-treatment, no significant difference in these three outcome measures was noted. Conclusions Continuous epidural block of the cervical vertebra for patients with CEH is effective for at least six months. Further research is needed to elucidate mechanisms of action and to prolong this effect.
