目的:比較七氟醚吸入麻醉和丙泊酚、瑞芬太尼靜脈麻醉用于小兒手術的臨床效果。方法:100例1～8歲的患兒隨機分為丙泊酚、瑞芬太尼組(A組)與七氟醚吸入組(B組）。麻醉誘導后,A組持續輸注丙泊酚和瑞芬太尼維持麻醉,B組吸入七氟醚維持麻醉。術中根據生命體征調整丙泊酚、瑞芬太尼的輸注速度及七氟醚的吸入濃度,記錄術中循環變化、術后麻醉恢復情況。結果:與B組相比,A組術中MAP下降明顯(Plt;005)。結論:與A組相比,B組術中生命體征控制平穩;術后清醒迅速、完全、平穩,拔管時間無明顯差異。
ObjectiveTo evaluate the clinical manifestation, radiological, pathological features and treatment of organizing pneumonia (OP) induced by aerosolized recombinant super compound interferon (rSIFN-co). MethodsClinical features and related laboratory examinations of a patient with OP developing after initiation of rSIFN-co for treatment of lung adenocarcinoma were analyzed, and the relevant literature was reviewed. ResultsA 48-year-old man developed cough, fevers, shortness of breath and weight loss, shortly half a month after initiation of therapy with rSIFN-co for lung adenocarcinoma. Chest high resolution computerized tomography (HRCT) showed multiple lung infection diseases. However, the anti-infection treatment was invalid. Lung tissue biopsy by bronchofibroscope was consistent with OP. After discontinuation of rSIFN-co and receiving pulse corticosteroid therapy followed by oral methylprednisolone, the pneumonic symptoms and chest manifestations markedly improved. After eight-month follow-up, the patient's condition was stable. The relative literature screening from Pubmed and Wanfangdata was implemented, but there was no report about OP caused by aerosolized rSIFN-co for lung adenocarcinoma. ConclusionThis report suggests that treatment with aerosolized rSIFN-co for lung adenocarcinoma may induce OP, a rare complication, and clinicians should have vigilance on it.
Objective To investigate the efficacy of low-dose inhaled nitric oxide (iNO) in the treatment of severe hypoxemia after Sun’s operation. Methods The clinical data of patients undergoing Sun’s operation for acute Type A aortic dissection in our hospital from January 2020 to June 2022 were retrospectively analyzed. Patients who received conventional treatment before November 2021 were enrolled as a control group. After November 2021, iNO was used in our hospital, and the patients who received iNO as an iNO group. The preoperative clinical baseline data, perioperative clinical data and oxygenation index were compared between the two groups. Results A total of 54 patients were included in the control group, including 45 males and 9 females, with an average age of 53.0±10.9 years. A total of 27 patients were included in the iNO group, including 21 males and 6 females, with an average age of 52.0±10.6 years. The preoperative body mass index of the two groups was greater than 25 kg/m2, white blood cell count, C-reactive protein were significantly higher than normal level, but there was no statistical difference between the groups (P＞0.05). There were no statistical differences in intraoperative data between the two groups (P＞0.05). The iNO group had significantly shorter duration of mechanical ventilation, postoperative ICU stay, and postoperative hospital stay than the control group (P<0.001). After 12 h of iNO treatment, hypoxic condition improved obviously, oxygenation indices in 12 h, 24 h, 36 h,48 h, 60 h and 72 h in the iNO group were significantly higher than those in the control group (P<0.05). Conclusion The treatment of severe hypoxemia after Sun’s surgery with low-dose of iNO is safe and effective, can significantly improve oxygenation function, and has significant advantages in shortening ventilator use time, postoperative ICU stay and postoperative hospital stay, but it is not significant in changing postoperative mortality.
ObjectiveTo describe the imaging and clinical features of vaccinia virus induced pneumonia by long-term follow-up.MethodsThe clinical data, imaging features and long-term follow-up of 5 patients with vaccinia virus pneumonia admitted to Wuxi People's Hospital Affiliated to Nanjing Medical University were analyzed.ResultsAll the 5 patients were male, aged between 21 and 54 years. The latent period of the disease was 2 to 5 days. All the patients had fever and pneumonia, while 3 of them had herpes. Two patients with severe pneumonia showed extensive patchy and nodular shadows in both lungs. Chest CT findings of the other three patients showed scattered small nodules in both lungs. All patients were followed up by telephone every half a year for 3 years. The prognosis of all patients was good. The patients reported in the English literature were clinically clustered, with fever, vomiting and rash as the main symptoms.ConclusionsVaccinia virus may cause different clinical symptoms through different transmission routes, and its infectivity is strong. Biological protection should be strengthened in laboratory and working environment.