目的 观察分析右旋美托咪啶对老年全麻患者术后早期认知功能障碍的影响.方法 选择2017年2月至2019年4月在我院接受治疗的100例开腹手术需全麻老年患者进行分析,通过随机方式将其分为对照组(50例)与观察组(50例),给予观察组静脉输注右美托咪啶,给予对照组静脉输注生理盐水,分析两组患者的麻醉效果以及早期认知功能障碍的影响.结果 在术前,两组患者MAP、HR、SpO2指标比较P>0.05,在术后5min、拔管前5min、拔管后30min两组患者SpO2指标比较P>0.05,在术后5min两组患者MAP指标比较P>0.05,在拔管前5min、拔管后30min,观察组患者MAP指标明显低于对照组P<0.05,在术后5min、拔管前5min、拔管后30min观察组患者HR指标明显低于对照组P<0.05;两组患者在手术前MMSE评分比较P>0.05,手术后1d观察组患者MMSE评分明显高于对照组P<0.05;观察组患者早期认知功能障碍3例(6.0％),对照组早期认知功能障碍11例(22.0％),观察组早期认知功能障碍发生率明显低于对照组P<0.05.结论 采取右旋美托咪啶辅助麻醉有助于稳定患者的血流动力学,预防出现早期认知功能障碍,值得临床推广.

目的:探讨和总结上消化道出血的抢救观察和护理.方法:回顾性分析了某院100例急性上消化道出血的抢救,观察和护理体会.结果:明显提高了抢救的成功率,降低死亡率,避免再次出血及减少并发症.结论:通过加强对上消化道出血的抢救、观察和护理,可以及时发现病情变化作出相应的处理措施,使患者的住院时间缩短,康复快,治疗效果好,减轻了患者的经济负担.

目的:观察异丙酚辅用氯胺酮与芬太尼对高原无痛人工流产术患者的不同影响.方法:84例无痛人工流产术患者,分为K组(氯胺酮组)、F组(芬太尼组)两组,各42例.K组,氯胺酮0.5 mg/kg;F组,芬太尼1μg/kg.两组丙泊酚用量为2 mg/kg.观察指标BP、HR、SpO2、ECG/ReSP变化,围手术期内不良反应.结果:两组BP、HR、SpO2、ECG/ReSP与用药前比较有统计学差异(P＜0.05).两组用药后不良反应无统计学差异.结论;异丙酚辅用小剂量氯胺酮芬用于高原无痛人流术,具有对循环呼吸影响小,并发症少的优点.

A 52-year-old woman was scheduled to undergo right partial thyroidectomy for right thyroid occupying lesion.Preoperative electrocardiographic monitoring showed the following records:BP 140/83 mmHg,HR 90 beats/min,ECG normal,pulse oxygen saturation(SpO2)0.96.She received 20 ml of a mixed solution prepared with 0.75% ropivacaine solution and 2% lidocaine solution in a ratio of 1 to 1 for bilateral cervical plexus block.Five minutes after administration,the woman developed palpitation,chest distress,breath holding,mental stress,excitation and logorrhea.His BP was 168/95 mmHg,his HR was 120 beats/min with frequent premature ventricular contraction and occasional bigeming,and his SpO2 was 0.90.And the auscultation revealed wheezes in the lungs and arrhythmia.After receiving midazolam,lidocaine,dexamethasone,and oxygen,she recovered gradually.