目的探讨不同剂量轻比重丁哌卡因蛛网膜下腔麻醉在高龄患者髋关节骨折手术中的应用效果。方法选取60例行髋关节骨折手术的高龄患者,随机分成A组、B组、C组,每组20例。3组患者分别采用1.4 mL 0.25%轻比重丁哌卡因、1.8 mL 0.25%轻比重丁...目的探讨不同剂量轻比重丁哌卡因蛛网膜下腔麻醉在高龄患者髋关节骨折手术中的应用效果。方法选取60例行髋关节骨折手术的高龄患者,随机分成A组、B组、C组,每组20例。3组患者分别采用1.4 mL 0.25%轻比重丁哌卡因、1.8 mL 0.25%轻比重丁哌卡因、2.2 mL 0.25%轻比重丁哌卡因进行蛛网膜下腔麻醉。比较3组患者的感觉神经及运动神经阻滞起效时间、持续时间,以及麻醉后15 min手术侧单侧阻滞发生率、术中追加局麻药的比例及给药后48 h内不良反应发生情况。结果 3组患者感觉神经阻滞起效时间、运动神经阻滞起效时间及麻醉后15 min术侧单侧阻滞发生率差异均无统计学意义(P均>0.05),而3组患者感觉神经阻滞持续时间和运动神经阻滞持续时间均为C组>B组>A组(均P<0.05)。A组术中追加硬膜外麻醉药的比例均高于B组与C组(均P<0.05),而B组与C组之间差异无统计学意义(P>0.05);C组术中低血压发生率高于B组(P<0.05),而A组与B组之间差异无统计学意义(P>0.05);3组患者均无寒战和术后头痛发生,且心动过缓、恶心呕吐及术后腰背痛发生率均无统计学差异(均P>0.05)。结论在高龄患者髋关节骨折手术中采用1.8 mL 0.25%轻比重丁哌卡因腰麻液进行蛛网膜下腔麻醉,可获得满意的麻醉效果,保持血流动力学稳定,且不良反应少。展开更多
AIM: To describe the ages at diagnosis and operation of biliary atresia(BA) and its incidence over a 15-year period in Taiwan.METHODS: This was a population-based cohort study. BA cases were identified from the Taiwan...AIM: To describe the ages at diagnosis and operation of biliary atresia(BA) and its incidence over a 15-year period in Taiwan.METHODS: This was a population-based cohort study. BA cases were identified from the Taiwan National Health Insurance Research Database based on the International Classification of Diseases,Ninth Revision(ICD-9) code of BA 751.61 plus Kasai operation(ICD-9 procedure code 51.37) or liver transplantation(LT,ICD-9 procedure code 50.5). The patients' characteristics including sex,age at diagnosis,age at receiving Kasai operation and age at receiving LT were compared among three birth cohorts:(1) 1997 to 2001;(2) 2002 to 2006; and(3) 2007 to 2011.RESULTS: There were a total of 540 BA cases(275 females) with an incidence of 1.62 per 10000 live births. No seasonality of BA was noted. The mean ages at diagnosis of three cohorts were 57.9,55.6 and 52.6 d.A linear regression model demonstrated a decreasing trend of the mean age at diagnosis(1.27 d per year). The proportion of BA cases that received the Kasai operation within 60 d of age increased from 76% to 81%. A total of 189(35%) BA patients underwent LT. The mean age at LT was reduced from 3-year-old to 1-year-old. The rates of LT were 25.6% and 32.3% in patients who received the Kasai operation within 60 d or after 60 d of age,respectively. All patients who did not undergo a Kasai operation eventually required LT.CONCLUSION: The ages at diagnosis and operation in BA cases have decreased over time. Kasai operation performed at younger age reduces the need for LT. The incidence of BA in Taiwan fluctuates,but without certain trend.展开更多
文摘目的探讨不同剂量轻比重丁哌卡因蛛网膜下腔麻醉在高龄患者髋关节骨折手术中的应用效果。方法选取60例行髋关节骨折手术的高龄患者,随机分成A组、B组、C组,每组20例。3组患者分别采用1.4 mL 0.25%轻比重丁哌卡因、1.8 mL 0.25%轻比重丁哌卡因、2.2 mL 0.25%轻比重丁哌卡因进行蛛网膜下腔麻醉。比较3组患者的感觉神经及运动神经阻滞起效时间、持续时间,以及麻醉后15 min手术侧单侧阻滞发生率、术中追加局麻药的比例及给药后48 h内不良反应发生情况。结果 3组患者感觉神经阻滞起效时间、运动神经阻滞起效时间及麻醉后15 min术侧单侧阻滞发生率差异均无统计学意义(P均>0.05),而3组患者感觉神经阻滞持续时间和运动神经阻滞持续时间均为C组>B组>A组(均P<0.05)。A组术中追加硬膜外麻醉药的比例均高于B组与C组(均P<0.05),而B组与C组之间差异无统计学意义(P>0.05);C组术中低血压发生率高于B组(P<0.05),而A组与B组之间差异无统计学意义(P>0.05);3组患者均无寒战和术后头痛发生,且心动过缓、恶心呕吐及术后腰背痛发生率均无统计学差异(均P>0.05)。结论在高龄患者髋关节骨折手术中采用1.8 mL 0.25%轻比重丁哌卡因腰麻液进行蛛网膜下腔麻醉,可获得满意的麻醉效果,保持血流动力学稳定,且不良反应少。
基金Supported by The Ditmanson Medical Foundation Chia-Yi Christian Hospital Research ProgramNo.R102-11
文摘AIM: To describe the ages at diagnosis and operation of biliary atresia(BA) and its incidence over a 15-year period in Taiwan.METHODS: This was a population-based cohort study. BA cases were identified from the Taiwan National Health Insurance Research Database based on the International Classification of Diseases,Ninth Revision(ICD-9) code of BA 751.61 plus Kasai operation(ICD-9 procedure code 51.37) or liver transplantation(LT,ICD-9 procedure code 50.5). The patients' characteristics including sex,age at diagnosis,age at receiving Kasai operation and age at receiving LT were compared among three birth cohorts:(1) 1997 to 2001;(2) 2002 to 2006; and(3) 2007 to 2011.RESULTS: There were a total of 540 BA cases(275 females) with an incidence of 1.62 per 10000 live births. No seasonality of BA was noted. The mean ages at diagnosis of three cohorts were 57.9,55.6 and 52.6 d.A linear regression model demonstrated a decreasing trend of the mean age at diagnosis(1.27 d per year). The proportion of BA cases that received the Kasai operation within 60 d of age increased from 76% to 81%. A total of 189(35%) BA patients underwent LT. The mean age at LT was reduced from 3-year-old to 1-year-old. The rates of LT were 25.6% and 32.3% in patients who received the Kasai operation within 60 d or after 60 d of age,respectively. All patients who did not undergo a Kasai operation eventually required LT.CONCLUSION: The ages at diagnosis and operation in BA cases have decreased over time. Kasai operation performed at younger age reduces the need for LT. The incidence of BA in Taiwan fluctuates,but without certain trend.
