Increasing evidences show that a gradual trend away from deep hypothermia toward moderate hypothermic circulatory arrest, which has been proved to be safe and effective in clinic. By summarizing and analyzing the research progress and applying status of the moderate hypothermia circulatory arrest with selective antegrade cerebral perfusion, the article aims at promoting the application of this tenique as a cerebral protection strategy in aortic arch surgery for adults in China.
【摘要】 目的 評價α2受體激動劑是否可以降低七氟烷引起的小兒術后躁動的發生率。 方法 通過檢索Medline、荷蘭醫學文摘、Cochrane臨床試驗數據庫、中國生物醫學文獻數據庫和中國期刊網全文數據庫等數據庫，收集可樂定或右美托咪啶對七氟烷引起的小兒術后躁動的預防作用的隨機對照試驗（randomized controlled trial，RCT），提取資料和評估方法學質量，采用Cochrane協作網RevMan 5.0軟件進行Meta分析。 結果 最終納入11個RCT，其中104例患兒預防性使用右美托咪啶，268例患兒使用可樂定，365例患兒使用安慰劑。Meta分析顯示，可樂定組小兒術后躁動發生率的比值比（OR）為0.31，95%CI為（0.15，0.61）（P=0.000 8）；右美托咪啶組小兒術后躁動發生率的OR為0.16，95%CI為（0.08，0.31）（Plt;0.000 01）。 結論 α2受體激動劑可以顯著降低七氟烷引起的小兒術后躁動的發生率。【Abstract】 Objective To determine whether alpha2-adrenoceptor agonists can decrease emergence agitation (EA) in pediatric patients after sevoflurane anesthesia. Methods The Medline, Embase, Cochrane Library, CBM and CNKI were searched. All randomized controlled trials comparing clonidine or dexmedetomidine with other interventions in preventing emergence agitation after sevoflurane anesthesia were retrieved. Study selection and assessment, data collection and analyses were undertaken. Meta-analysis was done using the Cochrane Collaboration RevMan 5.0 software. Results Eleven articles reached our inclusion criteria and were included in the Meta-analysis. A total of 104 children treated with dexmedetomidine, 268 children treated with clonidine, and 365 children treated with placebo were evaluated for the incidence of emergence agitation. The pooled odds ratio for the clonidine subgroup was 0.31, with a 95% confidence interval of 0.15-0.61 (P=0.000 8). The pooled odds ratio for the dexmedetomidine subgroup was 0.16, with a 95% confidence interval of 0.08-0.31 (Plt;0.000 01). Conclusion Alpha2-adrenoceptor agonists can significantly decrease the incidence of emergence agitation in pediatric patients after sevoflurane anesthesia.
目的 觀察電壓依賴性鈣通道是否作用于大鼠脊髓背角膠狀質層（SG）神經元大振幅微小興奮性突觸后電流的形成。 方法 選用成年雄性Sprague-Dawley（SD）大鼠，2%～3%異氟烷麻醉后，分離其腰骶部的脊髓，然后切片。采用全細胞電壓鉗技術，玻璃微電極的電阻為4~6 MΩ，鉗制電壓為?70 mV，記錄膠狀質層神經元微小興奮性突觸后電流（mEPSC）電流。將電流信號用Axopatch 200來放大并儲存于電腦。對照組和用藥結束后，持續采樣mEPSC電流30 s。mEPSC電流的頻率和振幅用Clampfit 8.1進行分析。 結果 鉗制電壓為?70 mV時，所有SG神經元均有自發性的EPSC。辣椒素增加mEPSC發生的頻率和波幅。鈷離子抑制辣椒素誘導的大振幅mEPSC。鈷離子抑制辣椒素誘導的mEPSC的平均振幅，而不抑制其發生頻率。 結論 電壓依賴性鈣離子通道參與了辣椒素引起的痛覺形成。
目的：探討在不同年齡SD大鼠右心房注射前列腺素E2（PGE2）對呼吸的影響。方法：7～9 d和21～23 d大鼠在迷走神經完整和迷走神經切斷的情況下從右心房注射PGE-2，觀察呼吸指標的變化。結果：①右心房注射PGE2在7～9 d和21～23 d大鼠中均引起呼吸暫停，呼氣延長時間分別為基礎呼氣時間的9.5和7.5倍（Plt;0.05）；②切斷迷走神經后，右心房注射PGE-2在7～9 d和21～23 d大鼠均不再產生呼吸暫停，僅出現輕微呼吸抑制。結論：右心房注射PGE2在7～9 d和21～23 d大鼠均產生呼吸暫停，且依賴于迷走神經的完整性。
Gastrointestinal complications after cardiac surgery are rare, but they are associated with significant morbidity and mortality. The mechanisms of gastrointestinal complications after cardiac surgery may be unique, as the abdominal cavity is not involved. This review summarizes the current evidence of the pathophysiology, clinical manifestations, risk factors, and management of gastrointestinal complications after cardiac surgery, aiming to improve the recognition of gastrointestinal complications after cardiac surgery.