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1.
目的 观察氟比洛芬酯复合丁丙诺啡和单用丁丙诺啡对子痫前期患者剖宫产术后静脉自控镇痛(PCIA)的临床效果和 应用价值。方法 选择90例ASAⅠ~Ⅱ级在腰硬联合麻醉下行子痫前期剖宫产术患者,按随机数字表法分为A组(胎儿娩出后氟比洛芬酯+术后丁丙诺啡PCIA)、B 组(术后氟比洛芬酯+丁丙诺啡PCIA)和C 组(术后丁丙诺啡PCIA),每组30例。观察并记录患者术后1、2、4、12、24h 视觉模拟评分(VAS)、Ramassay镇静评分,平均动脉压(MAP)、心率(HR)及术后恶心、呕吐、嗜睡、皮肤瘙痒等不良反应发生情况,分别于麻醉前、术后4、12 和24h抽取静脉血,检测血清肾上腺素、去甲肾上腺素、多巴胺、血浆儿茶酚胺和内皮素的水平。结果 A 组和B组患者术后各时点VAS 评分均明显低于C组(P<0.05),A 组和B 组各时点Ramsay 镇静评分均明显高于C组(P<0.05);A 组和B 组术后各时点MAP 和HR 均明显低于C 组(P<0.05);术后24h 内PCIA 按压次数A 组和B 组明显低于C组(P<0.05);A 组和B 组术后各时点血清肾上腺素、去甲肾上腺素、多巴胺和内皮素水平均明显低于C 组(均P<0.05);A 组术后4h 内皮素水平明显低于B 组(P<0.05);A 组和B 组头晕、嗜睡、恶心、呕吐发生率均低于C 组(均P<0.05)。结论 氟比洛芬酯能有效抑制术后应激,镇痛效果好且不良反应少,在胎儿娩出后应用氟比洛芬酯并结合术后丁丙诺啡进行PCIA更适合用于子痫前期剖宫产术后患者术后镇痛。  相似文献   
2.
金豪杰  陈兰凤  高宝斌 《应用数学》2013,35(19):1748-1751
目的探讨罗哌卡因联合芬太尼行硬膜外分娩镇痛的最佳有效浓度。方法选择120例初产妇接受L2-3硬膜外穿刺置管拟行分娩镇痛.按随机数字表法分为0.15%罗哌卡因联合1ug/ml芬太尼(F1组)、0.12%罗哌卡因联合1ug/ml芬太尼(F2组)、0.10%罗哌卡因联合1ug/ml芬太尼(F3组)及0.08%罗哌卡因联合1ug/ml芬太尼(F4组)。监测镇痛过程中阻滞平面和运动阻滞发生情况、VAS、缩富素使用增加例数等。结果F1、F2组运动神经阻滞发生的例数多于F3、F4组(P〈0.05)。F1组缩宫素使用增加例数多于其它3组(P〈0.05)。不同罗哌卡因浓度比较,F4组起效时间最长,明显长于F1、F2、F3组(P〈0.05)。F4组给药后30、60、90min时的VAS明显高于F1、F2、F3组,停药时的VAS明显高于F1组(P〈0.05)。F4组镇痛后30min内第3次宫缩开始每次宫缩对应的VAS明显高于F1、F2、F3组(P〈0.05)。结论罗哌卡因联合1ug/ml芬太尼用于分娩镇痛时,010%是最佳有效浓度,镇痛效果好,运动阻滞轻,安全性高。  相似文献   
3.
郭小文  陶涛  吕晨  王世萍  马千 《应用数学》2016,38(2):112-116
目的两种不同麻醉和镇痛方法对糖耐量减低的老年患者全膝置换术后糖代谢的影响。方法60例择期行全膝置换术的糖耐量减低患者随机分成腰硬联合麻醉联合术后硬膜外镇痛组(腰硬组)和全身麻醉联合术后静脉镇痛组(全麻组)各30例,分别测定入手术室后,术后30min、1、3、7d的空腹血糖和胰岛素浓度;术后10d空腹和口服糖耐量试验(OGTT)2h的血糖和胰岛素浓度,并计算相应胰岛素抵抗指数,以视觉模糊疼痛评分(VAS)评估术后1h、1、3、7d的疼痛评分,并记录围手术期相关不良事件发生率。结果腰硬组术后30min、1、3d的空腹血糖相比全麻组明显较低(均P<0.05);腰硬组在术后30min、1、3、7d的胰岛素浓度和胰岛素抵抗指数相比全麻组明显较低(均P<0.05)。腰硬组在术后1d和3d的中餐后2h血糖浓度相比全麻组明显较低(均P<0.05)。全麻组术后10d空腹、OGTT2h的胰岛素浓度和胰岛素抵抗指数相比术前均明显升高(均P<0.05),且相比腰硬组明显更高(均P<0.05)。术后1h和术后1d腰硬组VAS评分明显小于全麻组(均P<0.05)。结论腰硬联合麻醉和硬膜外镇痛能减轻糖耐量减低的老年高血压患者的全膝置换术后糖代谢紊乱。  相似文献   
4.
Chitosan‐based molecular imprinted polymer (CS‐MIP) nanogel is prepared in the presence of morphine template, fully characterized and used as a new vehicle to extend duration of morphine analgesic effect in Naval Medical Research Institute mice. The CS‐MIP nanogel with ≈25 nm size range exhibits 98% loading efficiency, and in vitro release studies show an initial burst followed by an extended slow release of morphine. In order to study the feasibility of CS‐MIP nanogel as morphine carrier, 20 mice are divided into two groups randomly and received subcutaneous injection of morphine‐loaded CS‐MIP and morphine (10 mg kg?1) dissolved in physiologic saline. Those received injection of morphine‐loaded CS‐MIP show slower and long lasting release of morphine with 193 min effective time of 50% (ET50) analgesia compared to 120 min ET50 in mice received morphine dissolved in physiologic saline. These results suggest that CS‐MIP nanogel can be a possible strategy as morphine carrier for controlled release and extension of its analgesic efficacy.

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5.
目的探讨硬膜外罗哌卡因复合芬太尼分娩镇痛对分娩方式的影响。方法回顾7136例具备顺产条件初产妇的最终分娩方式,按产妇意愿分为对照组(A组)4168例及分娩镇痛组(B组)2968例。A组产妇未接受分娩镇痛,B组产妇给予L2~3或L3~4硬膜外阻滞,头向置管后1%利多卡因5ml试验量确定阻滞平面后,予以6~15ml/h持续泵注0.15%罗哌卡因和2μg/ml芬太尼的复合液。记录汇总最终分娩方式及剖宫产原因,评定两组新生儿出生后1、5minApgar评分,评定产妇镇痛后的视觉模拟评分(VAS)及改良Bromage评分。结果B组产妇剖宫产率(20.28%)及产钳使用率(4.38%)明显高于A组(7.70%、2.33%,P<0.01);B组第一产程时间延长于A组(P<0.01);B组因第一产程延长而行剖宫产比例(64.62%)明显高于A组(42.81%,P<0.01);B组胎儿宫内窘迫的比例(12.29%)明显低于A组(31.25%,P<0.01);胎头下降停滞及羊水问题、胎位异常比例与A组比较差异均无统计学意义(均P>0.05)。两组新生儿出生后1、5min的Apgar评分差异无统计学意义(P>0.05)。B组产妇宫口6、10cm时的VAS评分明显低于A组(P<0.01),但两组产妇下肢改良Bromage评分差异无统计学意义(P>0.05)。结论0.15%罗哌卡因复合2μg/ml芬太尼的硬膜外分娩镇痛可增加产妇剖宫产率、阴道器械助产率及延长第一产程,但对新生儿Apgar评分及产妇下肢肌力无影响。  相似文献   
6.
本文对超声引导下连续腰交感神经节阻滞联合全麻对膝关节置换术患者镇痛及苏醒质量的影响进行了分析和探讨。选取2017年1月~2019年1月本院膝关节置换术患者100例,依据随机数字表分为滞麻组和单麻组,每组50例,单麻组给予单纯全麻,滞麻组在此基础上给予超声引导下连续腰交感神经节阻滞,比较两组镇痛及苏醒质量、不良反应。结果显示,滞麻组切皮时(T1)、关节置换时(T2)、术毕(T3)的平均动脉压(MAP)、心率(HR)明显低于单麻组,滞麻组镇痛优良率明显高于单麻组,有统计学差异(P<0.05);滞麻组呼之睁眼、呼之握拳、拔管、苏醒时间和苏醒并发症率明显低于单麻组,有统计学差异(P<0.05);滞麻组和单麻组不良反应率比较,无统计学差异(P>0.05)。本文认为,超声引导下连续腰交感神经节阻滞联合全麻可有效改善膝关节置换术患者镇痛及苏醒质量,且安全性好,值得临床推广。  相似文献   
7.
In this study, different injection solutions containing opioid and nonopioid compounds used for patient-controlled analgesia in hospice and palliative care were evaluated in terms of analyte stability. Investigated injection solutions contained different combinations of morphine, hydromorphone, metamizole and esketamine. For the practical implementation, samples from infusion pumps were daily drawn over a period of 7 days at 22 and 37°C. Quantitative measurements were performed on a high-performance liquid chromatography system with ultraviolet detection applying a validated analytical method. All compounds apart from morphine showed no evident changes in concentration. However, a significant loss of morphine was observed for injection mixtures containing both morphine and metamizole at 37°C. After 7 days, only 72% of the initially measured morphine concentration was measured in the binary and 77% in the ternary mixture. Furthermore, an additional compound was detected that could represent the morphine-metamizole-adduct, “metamorphine”. Based on these results, a significantly reduced morphine concentration must be expected after only 3 days if an injection solution mixture containing both morphine and metamizole is administered to a patient at 37°C. Since the analgesic effects of morphine–metamizole adducts have not yet been thoroughly investigated, further clinical studies are necessary before accurate conclusions can be drawn in this regard.  相似文献   
8.
Corydalis yanhusuo extract (YHS) has been used for centuries across Asia for pain relief. The extract is made up of more than 160 compounds and has been identified as alkaloids, organic acids, volatile oils, amino acids, alcohols, and sugars. However, the most crucial biological active constituents of YHS are alkaloids; more than 80 have been isolated and identified. This review paper aims to provide a comprehensive review of the phytochemical and pharmacological effects of these alkaloids that have significant ties to analgesia.  相似文献   
9.
Summary: Commercial Guar Gum, a galactomannan polysaccharide, was purified by the use of two subsequent methods, including precipitation with Fehling solution in order to eliminate protein impurities. The protein content (3.6%) was totally removed. Glutaraldehyde cross-linked gels were prepared with purified (GGP) and unpurified gum (GGU). The viscosity of the gels is similar to that of Hylan G-F 20, a commercial substitute of hyaluronic acid, used in viscosupplementation in human osteoarthritis. Guar Gums (gel and solution) were injected intra-articularly into the knee joints of rats subjected to experimental OA and the effect in hypernociception and cells influx measured. GGU promoted hypernociception and cell influx in naïve rats. GGP was innocuous to naïve rats and inhibited hypernociception, both as a gel or solution, to the same extent as Hylan G-F20. GGP promotes analgesia in OA due to its carbohydrate component.  相似文献   
10.
Sigma receptors modulate nociception, offering a potential therapeutic target to treat pain, but relatively little is known regarding the role of sigma-2 receptors (S2R) in nociception. The purpose of this study was to investigate the in vivo analgesic and anti-allodynic activity and liabilities of a novel S2R selective ligand, 1-[4-(6,7-dimethoxy-1,2,3,4-tetrahydroisoquinolin-2-yl)butyl]-3-methyl-1,3-dihydro-1,3-benzimidazol-2-one (CM-398). The inhibition of thermal, induced chemical, or inflammatory pain as well as the allodynia resulting from chronic nerve constriction injury (CCI) model of neuropathic pain were assessed in male mice. CM-398 dose-dependently (10–45 mg/kg i.p.) reduced mechanical allodynia in the CCI neuropathic pain model, equivalent at the higher dose to the effect of the control analgesic gabapentin (50 mg/kg i.p.). Likewise, pretreatment (i.p.) with CM-398 dose-dependently produced antinociception in the acetic acid writhing test (ED50 (and 95% C.I.) = 14.7 (10.6–20) mg/kg, i.p.) and the formalin assay (ED50 (and 95% C.I.) = 0.86 (0.44–1.81) mg/kg, i.p.) but was without effect in the 55 °C warm-water tail-withdrawal assay. A high dose of CM-398 (45 mg/kg, i.p.) exhibited modest locomotor impairment in a rotarod assay and conditioned place aversion, potentially complicating the interpretation of nociceptive testing. However, in an operant pain model resistant to these confounds, mice experiencing CCI and treated with CM-398 demonstrated robust conditioned place preference. Overall, these results demonstrate the S2R selective antagonist CM-398 produces antinociception and anti-allodynia with fewer liabilities than established therapeutics, adding to emerging data suggesting possible mediation of nociception by S2R, and the development of S2R ligands as potential treatments for chronic pain.  相似文献   
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