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应用血管扩张剂和正性收缩能药物治疗心力衰竭的体会

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中华医学杂志 1983年第11期63卷 705-708页

作者：陈曙霞杜慧君李金禧常佩伦包世宏臧德良张世华陆惠华俞国瑞郑道声上海第二医学院附属第三人民医院内科

近十年来,对联合应用洋地黄和利尿剂治疗无效的难治性心力衰竭病例以及并发于急性心肌梗塞的泵衰竭,较多推荐用血管扩张剂治疗,并已取得一定的疗效,但在无血液动力学监测的条件下应用此方法应

关键词：心力衰竭/药物疗法血管收缩药/治疗应用血管舒张药/治疗应用

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TOX-ACLS: Toxicologic-oriented advanced cardiac life support

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ANNALS OF EMERGENCY MEDICINE 2001年第4期37卷 S78-S90页

作者： Albertson, TE Dawson, A de Latorre, F Hoffman, RS Hollander, JE Jaeger, A Kerns, W Martin, TG Ross, MP Univ Calif Davis Med Ctr Sacramento CA 95817 USA Newcastle Mater Misericordiae Hosp Newcastle NSW Australia Univ Val Hebron Barcelona Spain New York Poison Ctr New York NY USA Univ Penn Philadelphia PA 19104 USA Hop Univ Strasbourg Strasbourg France Carolinas Med Ctr Charlotte NC 28203 USA Univ Washington Med Ctr Seattle WA 98195 USA Univ Louisville Louisville KY 40292 USA

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Postresuscitation management

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ANNALS OF EMERGENCY MEDICINE 2001年第4期37卷 S182-S195页

作者： Schleien, CL Osmond, MH Hickey, R Hutchison, J Buunk, G Douglas, IS Gervais, HW Wenzel, V Columbia Univ New York Presbyterian Hosp New York NY 10032 USA Univ Pittsburgh Childrens Hosp Pittsburgh PA USA Univ Ottawa Childrens Hosp Eastern Ontario Ottawa ON Canada Franciscus Hosp Roosendaal Netherlands Univ Mainz D-6500 Mainz Germany Loeopold Franzens Univ Innsbruck Innsbruck Austria

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Use of pressors in the treatment of cardiac arrest

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ANNALS OF EMERGENCY MEDICINE 2001年第4期37卷 S152-S162页

作者： Babbs, CF Berg, RA Kette, F Kloeck, WGJ Lindner, KH Lurie, KG Morley, PT Nadkarni, VM Otto, CW Paradis, NA Perlman, J Stiell, I Timerman, A Van Reempts, P Wenzel, V Thomas Jefferson Univ Sch Med AI duPont Hosp Children Wilmington DE 19899 USA Univ Innsbruck A-6020 Innsbruck Austria Thomas Jefferson Univ Sch Med Wilmington DE USA Purdue Univ W Lafayette IN 47907 USA Univ Arizona Tucson AZ USA S Maria della Misercordia Hosp Udine Italy Resusicitat Council So Africa Johannesburg South Africa Univ Minnesota Sch Med Minneapolis MN USA Royal Melbourne Hosp Melbourne Vic Australia Univ Colorado Hlth Sci Ctr Denver CO 80202 USA Univ Texas SW Med Sch Dallas TX 75230 USA Loeb Res Inst Ottawa ON Canada Univ Antwerp Hosp Antwerp Belgium Univ Innsbruck A-6020 Innsbruck Austria

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Risk factors for intra-abdominal infection after pancreas transplantation

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AMERICAN JOURNAL OF SURGERY 2000年第2期179卷 99-102页

作者： Knight, RJ Bodian, C Rodriguez-Laiz, G Guy, SR Fishbein, TM Mt Sinai Med Ctr Dept Surg Recanati Miller Transplantat Inst New York NY 10029 USA Mt Sinai Med Ctr Dept Biomath Sci New York NY 10029 USA Temple Univ Sch Med Dept Surg Philadelphia PA 19122 USA

BACKGROUND: This study was designed to determine risk factors for intra-abdominal abscess after pancreas transplantation. METHODS: We performed a single-center retrospective review of all pancreas transplants from 1994 to 1999, Risk factors studied were donor age, body weight, body mass index, peak serum glucose, peak serum amylase, need for presser agents, cause of death, cold ischemic preservation time, recipient age, type of dialysis, surgical technique, and peak recipient amylase. RESULTS: The 1-year graft survival rate was 90%, Of the 34 patients studied, there were 4 cases of peripancreatic abscess formation (12%). Elevated donor body weight (P <0.01), elevated body mass index (P <0.05), and the peak recipient serum amylase in the first postoperative week (P <0.01) were significant risk factors for the development of intra-abdominal infection. CONCLUSIONS: These data suggest that pancreas grafts from obese donors may be more susceptible to ischemia-reperfusion injury resulting in abscess formation, Am J Surg. 2000;179:99-102. (C) 2000 by Excerpta Medica, Inc.

关键词：腹部脓肿/病因学年龄因素淀粉酶类/血液血糖/分析人体质量指数体重死亡原因低温保存疾病易感性移植物存活 Logistic模型肥胖症/并发症胰腺移植/方法腹膜透析肾透析再灌注损伤/病因学回顾性研究危险因素时间因素组织供者血管收缩药/治疗应用青少年成年人儿童人类中年人

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Survival with full neurologic recovery and no cerebral pathology after prolonged cardiopulmonary resuscitation with vasopressin in pigs

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 2000年第2期35卷 527-533页

作者： Wenzel, V Lindner, KH Krismer, AC Voelckel, WG Schocke, MF Hund, W Witkiewicz, M Miller, EA Klima, G Wissel, J Lingnau, W Aichner, FT Univ Innsbruck Dept Anesthesiol & Crit Care Med A-6020 Innsbruck Austria Univ Innsbruck Dept Histol A-6020 Innsbruck Austria Univ Innsbruck Dept Neurol A-6020 Innsbruck Austria Univ Innsbruck Dept Magnet Resonance & Spect A-6020 Innsbruck Austria

OBJECTIVES We sought to determine the effects of vasopressin and saline placebo in comparison with epinephrine on neurologic recovery and possible cerebral pathology in an established porcine model of prolonged cardiopulmonary resuscitation (CPR). BACKGROUND It is unknown whether increased cerebral: blood flow during CPR with vasopressin is beneficial with regard to neurologic recovery or detrimental owing to complications such as cerebral edema after return of spontaneous circulation. METHODS After 4 min of cardiac arrest, followed by 3 min of basic life support CPR, 17 animals were randomly assigned to receive every 5 min either vasopressin (0.4, 0.4 and 0.8 U/kg;n = 6), epinephrine (45, 45 and 200 mu g/kg;n = 6) or saline placebo (n = 5). The mean value +/- SEM of aortic diastolic pressure was significantly (p < 0.05) higher 90 s after each of three vasopressin versus epinephrine versus saline placebo injections (60 +/- 3 vs. 45 +/- 3 vs. 29 +/- 2 mm Hg;49 +/- 5 vs. 27 +/- 3 vs. 23 +/- 1 mm Hg;and 50 +/- 6 vs. 21 +/- 3 vs. 16 +/- 3 mm Hg, respectively). After 22 min of cardiac arrest, including 18 min of CPR, defibrillation was attempted to achieve return of spontaneous circulation. RESULTS All the pigs that received epinephrine and saline placebo died, whereas all pigs on vasopressin survived (p < 0.05). Neurologic evaluation 24 h after successful resuscitation revealed only an unsteady gait in all vasopressin-treated animals;after 96 h, magnetic resonance imaging revealed no cerebral pathology. CONCLUSIONS During prolonged CPR, repeated vasopressin administration, but not epinephrine or saline placebo, ensured long-term survival with full neurologic recovery and no cerebral pathology in this porcine CPR model. (J Am Coll Cardiol 2000;35:527-33) (C) 2000 by the American College of Cardiology.

关键词：心肺复苏术/副作用心肺复苏术/方法脑血管循环/药物作用脑血管障碍/诊断脑血管障碍/病因学脑血管障碍/病理生理学脑血管障碍/预防和控制疾病模型动物电抗休克肾上腺素/治疗应用磁共振成像猪血管收缩药/治疗应用血管升压素类/治疗应用心室颤动/治疗动物

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Hydroxyethylstarch 10% is superior to Ringer's solution for preloading before spinal anesthesia for Cesarean section

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CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE 2000年第7期47卷 616-621页

作者： Siddik, SM Aouad, MT Kai, GE Sfeir, MM Baraka, AS Amer Univ Beirut Dept Anesthesiol Beirut Lebanon

Purpose: To compare the preloading effect of 500 ml hydroxyethylstarch (HES) 10% with IL Lactated Ringer's solution (LR). Methods: In 40 healthy women undergoing elective Cesarean section HES, 500 ml (n = 20), or LR, IL (n = 20), was administered during 10 min before spinal anesthesia. The incidence of hypotension, (systolic blood pressure < 80% of baseline and < 100 mm Hg), and the amount of ephedrine used to treat it were compared. Also, the incidence of nausea and/or vomiting were recorded. Neonatal outcome was assessed using Apgar scores and umbilical venous and arterial blood gases. Results: The incidence of hypotension was higher in the LR than in HES group (80% vs 40%), Mean minimum systolic blood pressure was lower in the LR than in the HES group (86.1 +/- 12.7 mm Hg vs 99.6 +/- 9.7 mm Hg P < 0.05). Systolic blood pressure < 90 mmHg occurred in two of 20 patients (10%) who received HES vs 11 of 20 patients (55%) who received LR (P < 0.05). More doses of ephedrine were required to treat hypotension in the LR than in the HES group (35.3 +/- 18.4 mg vs 10.6 +/- 8.6 mg;P < 0.05), The incidence of nausea and/or vomiting was lower in the HES than in the crystalloid group. Neonatal outcome was good and similar in both groups. Conclusion: Preloading patients undergoing elective Cesarean section with 500 mi HES 10%, decreases the incidence and severity of spinal-induced hypotension more than preloading with IL of LR solution.

关键词：麻醉产科/方法麻醉脊椎/方法血液代用品/治疗应用二氧化碳/血液剖宫产术/方法胶剂/治疗应用麻黄碱/治疗应用胎血/代谢羟乙基淀粉/治疗应用低血压/病因学低血压/预防和控制等渗溶液/治疗应用氧/血液手术后恶心呕吐/病因学手术后恶心呕吐/预防和控制麻醉前用药/方法血管收缩药/治疗应用成年人女(雌)性人类婴儿新生妊娠

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ISOMETHEPTENE - NON-ERGOT DRUG IN TREATMENT OF MIGRAINE

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HEADACHE 1975年第3期15卷 211-213页

作者： DIAMOND, S MEDINA, JL DIAMOND HEADACHE CLIN LTD 5252 N WESTERN AVE CHICAGO IL 60625 USA CHICAGO MED SCH CHICAGO IL USA ST JOSEPH HOSP CHICAGO IL USA VET ADM HOSP DEPT NEUROL HINES IL USA W SIDE MED CTR CHICAGO IL USA MT SINAI HOSP MED CTR CHICAGO IL USA

SYNOPSIS Thirty-six patients participated in a double-blind, two-way crossover study of isometheptene (Octin) and placebo. Seventeen had a better response on isometheptene than on placebo. Placebo was superior to isometheptene in eight cases. Of 72 courses of treatment with each drug, isometheptene produced good or complete relief of pain in 30 courses of treatment (42%) while placebo produced a similar response in 21courses of treatment (29%) (p<0.05). When the severity of pain and the degree of relief were considered, the superiority of isometheptene did not reach statistical significance at the 5% level. Side effects due to isometheptene were few and mild or of moderate severity. Isometheptene may be an alternative treatment when ergotamine is contraindicated.

关键词：药物评价甲胺类/治疗应用偏头痛/药物疗法安慰剂拟交感神经药/治疗应用血管收缩药/治疗应用成年人女(雌)性人类男(雄)性中年人

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The effects of dilute epinephrine saline irrigation on the need for tourniquet use in routine arthroscopic knee surgery

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AMERICAN JOURNAL OF SPORTS MEDICINE 1999年第3期27卷 354-356页

作者： Olszewski, AD Jones, R Farrell, R Kaylor, K Wilford Hall USAF Med Ctr Dept Orthopaed Surg Lackland AFB TX 78236 USA

A prospective, randomized, double-blinded study was performed to determine whether dilute epinephrine saline irrigation (1 mg/l) delivered by gravity flow would significantly reduce the need for tourniquet use during routine arthroscopic surgery. One hundred five patients requiring straightforward arthroscopic knee surgery were randomly assigned to either an epinephrine group that received dilute epinephrine irrigation by gravity flow or to a placebo group that received normal saline irrigation by gravity flow. The need for tourniquet use and the tourniquet time, total operative time, and volume of irrigation fluid used were documented and compared between the two groups. A tourniquet was required 50% less often in the epinephrine group than in the placebo group. This difference was found to be statistically significant using the Student's t-test (P < 0.008, alpha less than or equal to 0.05). If a tourniquet was required, the presence of dilute epinephrine in the irrigation fluid did not affect the overall tourniquet time or the ratio of tourniquet time to total operative time. We believe this study proved that dilute epinephrine irrigation is effective in decreasing the need for tourniquet use during routine arthroscopic knee surgery.

关键词：关节镜检查双盲法内窥镜检查/方法肾上腺素/治疗应用止血手术/方法灌洗膝关节/外科学前瞻性研究氯化钠止血带血管收缩药/治疗应用成年人女(雌)性人类男(雄)性

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Cavernosal spongiosium shunt in the management of priapism in Zaria, Nigeria

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TROPICAL DOCTOR 2000年第1期30卷 31-32页

作者： Dawam, D Kalayi, G Nmadu, PN ABU Teaching Hosp Dept Surg Urol Unit Zaria Nigeria

Between 1982 and 1994 13 patients have needed surgery for priapism persisting after conservative measures using the technique described by Quackel(1).

关键词：引流术/仪器和设备引流术/方法随访研究尼日利亚苯福林/治疗应用阴茎异常勃起/药物疗法阴茎异常勃起/病因学阴茎异常勃起/外科学治疗结果血管收缩药/治疗应用青少年成年人儿童人类男(雄)性中年人

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