目的 比较行腹腔镜胆囊切除术中应用舒芬太尼复合丙泊酚或七氟烷麻醉对减轻老年患者应激反应及改善苏醒质量的作用.方法 抽取我院2015年1月~2017年4月行腹腔镜胆囊切除术治疗的老年患者66例为研究对象,以术中所用麻醉方式分组:对照组33例行舒芬太尼+七氟烷麻醉,研究组33例行舒芬太尼+丙泊酚麻醉,对两组术中应激反应进行观察,评估两组苏醒质量.结果 研究组术后各应激激素水平、术后恢复时间显著低于对照组(P<0.05).结论 在行腹腔镜胆囊切除术时应用舒芬太尼+丙泊酚复合麻醉,可减轻老年患者应激反应,改善苏醒质量,值得借鉴.
Objective To evaluate the effect of fluid therapy on prognosis in lung injury patients to provide basis for clinical application. Methods Randomized controlled trials(RCTs) were identified from The Cochrane Library(Issue 10,2011.11),Ovid Medline(1996-2011.11),Pub Med(1966-2011.11,EM base(1974-2011.11),VIP(1989-2011.11),and CNKI(-2011.11).The quality of included trials was assessed by two reviewers independently.RevMan 5.0 software provided by The Cochrane Collaboration was used for statistical analysis. Results Six RCTs involving a total of 1252 patients were included.Compared with liberal fluid management strategy,there was no beneficial effect of conservative fluid management strategy on the mortality in lung injury patients(P = 0.52).Meta-analysis wasn't applied for time of ventilation and length of ICU,so a descriptive analysis was conducted. Conclusions No beneficial effect of conservative fluid management strategy on the mortality is observed in lung injury patients.But conservative fluid management strategy can improve lung function and shortened the duration of mechanical ventilation and days in the intensive care unit.These conclusions were made from the limited evidence,and more rigorous RCTs are needed.
Objective To evaluate the effect of ulinastatin on oxygen free radical and inflammatory factors during one lung ventilation.Methods According to the Cochrane Handbook,we searched database like Cochrane Library,OVID,Pubmed to collect related randomized controlled trails(RCT).The quality of the included studies was evaluated and was analyzed by meta-analysis with RevMan 5.0.Results Seven RCTs involving 242 participants were included.Meta-analysis results: Ulinastatin decrease the concentration of IL-6,IL-8,TNF-a,MDA and increase the SOD level in patients`blood.Conclusion Ulinastatin shows protection of lung function by decreasing the concentration of inflammatory factory in patients`blood during one lung ventilation.
