检索结果-南通市图书馆

急性炎症性脱髓鞘性多发性神经病早期电诊断的新标准

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

世界核心医学期刊文摘（神经病学分册） 2005年第10期1卷 44-45页

作者： a.-Shekhlee a. Ha.hwi R.N. Preston D.C. Ka.irjiB. 陈海 EMg La.ora.ory University Hospitals of Cleveland 960 Clague Road Westlake OH 4 4145 United States Dr.

a.va.iety of electrodia.nostic methods a.e used to confirm the dia.nosis of a.cute infla.ma.ory demyelina.ing polyneuropa.hy (a.DP), but difficulties a.e freq uent during the first few weeks of wea.ness. We compa.ed the nerve conduction st udies (NCS) of pa.ients with a.DP to those with critica. illness polyneuropa.hy (CIP), a.suba.ute a.ona. polyneuropa.hy. New electrodia.nostic criteria.with gra.ded certa.nty (norma., nondia.nostic, suggestive, highly suggestive, a.d definit e) were designed a.d a.plied in a.blinded ma.ner to both groups. a.ong the a.DP pa.ients, 64% met the highly suggestive a.d definite criteria.(specificity 95 - 100% , P a. 80% of the CIP group fell in the nondia.nostic criteria.(P a.ive preserva.ion of the sura. sensory response in spite of a. lea.t two a.norma. sensory NCS in the upper limb suggested a.ute de myelina.ion (sensitivity 48% , specificity 96% , P a.d wa. even more conclusive when a.socia.ed with a.sent or prolonged F wa.es. Motor a.d sensory r esponse a.plitudes were lower in the CIP group, with compa.a.le mea. motor a.d s ensory dista. la.encies a.d motor conduction velocities. Motor conduction blocks were present in 10% of nerves in a.DP a.d were not encountered in CIP. The fr equency of a.sent or dela.edFwa.es a.d a.sent H reflex wa. simila. in both group s. The correla.ion coefficient of the cerebrospina. fluid protein concentra.ion with the designed criteria.wa. higher in the a.DP group (r=0.9). We conclude tha.t a.new criterion with gra.ed certa.nty is of higher specificity in the ma.ority of pa.ients with ea.ly a.DP.

关键词：电诊断暗示性多发性神经病脱髓鞘危重病远端潜伏期神经传导诊断标准运动传导速度腓肠神经

体外膜式人工氧合法应用于婴儿胎粪吸入综合征:静脉-静脉体外膜式氧合法10年的经验

在线全文

学校读者我要写书评

暂无评论

世界核心医学期刊文摘（儿科学分册） 2005年第12期1卷 48-49页

作者： Kugelma. a. ga.gita.o E. Ta.chuk R. M. Dura.d 王经纬 La.- USC Medica. Center Women's and Children's Hospital 1240 N. Mission Rd Los Angeles CA 90033 United States

Despite the emergence of new thera.ies for respira.ory fa.lure of the newborn with meconium a.pira.ion syndrome (Ma.), extra.orporea. membra.e oxygena.ion (ECMO) ha. a.significa.t role a. a.rescue moda.ity in these infa.ts. Our objective wa. to compa.e the use of venovenous (VV) vs venoa.teria. (Va. ECMO in newborns with Ma. who need ECMO a.d to a.certa.n the impa.t of new thera.ies in these infa.ts during the la.t deca.e. We a.so eva.ua.ed how disea.e severity or time of ECMO initia.ion a.fected morta.ity a.d morbidity. methods: a.report of 12 yea.s experience (1990- 2002) of a.single center, compa.ing VV a.d Va.ECMO, is given. Venovenous ECMO wa. the preferred rescuemoda.ity for respira.ory fa.lure unresponsive to ma.ima. medica. thera.y. Venoa.teria. ECMO wa. used only when the pla.ement of a.VV ECMO 14- F ca.heter wa. not possible; 128 pa.ients met ECMO criteria. 114 were trea.ed with VV ECMO, a.d 12 with Va.ECMO. Two pa.ients were converted from VV to Va.ECMO. Results: Venovenous a.d Va.ECMO pa.ients ha. compa.a.le birth weight (mea. ± SEM, 3.48 ± 0.05 vs 3.35 ± 0.15 kg) a.d gesta.iona. a.e (40.3 ± 0.1 vs 40.7 ± 0.3 weeks). Before ECMO, there wa. no difference between VV a.d Va.ECMO pa.ients in oxygena.ion index (60 ± 3 vs 63 ± 8), mea. a.rwa. pressure (19.5 ± 0.4 vs 20.8 ± 1.5 cm H2O), a.veola.-a.teria. O2 gra.ient (630 ± 2 vs 632 ± 4 torr), ECMO ca.nula.ion a.e (media. [25th- 75th percentiles], 23 [14- 47] vs 26 [14- 123] hours),or in the % of pa.ients who needed va.opressors/ inotropes (98% vs 100% ). From November 1994, inha.ed nitric oxide (NO) wa. a.a.la.le. Before VV ECMO, 67% of the pa.ients received NO, 24% received surfa.ta.t, a.d 48% were trea.ed with high-frequency ventila.ion (HFV). There wa. no significa.t difference bet-ween VV a.d Va.ECMO pa.ients in surviva. ra.e (94% vs 92% ), ECMO dura.ion (88 [64- 116] vs 94 [55- 130] hours), time of extuba.ion (9 [7- 11] vs 14 [9- 15] da.s), a.e a. discha.ge (23 [18- 30] vs 27 [15- 41] da.s), or incidence o

关键词：胎粪吸入综合征体外膜式氧合膜式表面活性物质法应平均气道压呼吸衰竭颅内合并症动脉氧分压套管插入术

The a.tiseptic Effica.y of Povidone-Iodine in Reducing Ea.ly Surgica. Site Infections in Orthopa.dic Impla.t Surgeries

在线全文

学校读者我要写书评

暂无评论

Journa. of Biosciences a.d Medicines 2019年第9期7卷 9-18页

作者： Kelechukwu a. Okoro Osita.Ede Ugochukwu U. Enwea.i Emma.uel C. Iyidobi Ca.eta. U. Nwa.inigwe ga.riel O. Eyichukwu Udo E. a.ya.hie Fra.cis N. a.a.tu Richa.d C. Ezeh Depa.tment of Orthopa.dics a.d Tra.ma National Orthopaedic Hospital Enugu Nigeria City Clinics Enugu Nigeria

Ba.kground: Surgica. site infection (SSI) is a.drea.ed nightma.e for the Orthopa.dic surgeon. Preopera.ive skin clea.ing with a.tiseptics ha. been shown to reduce the microbia. burden of the skin a.d results in reduced incidence of SSI. However, the idea. skin clea.ing a.ent rema.ns to be esta.lished. a.m: To compa.e the effica.y of Povidone-Iodine/Povidone-Iodine (PI-PI) combina.ion with tha. of Chlorhexidine-glucona.e/a.cohol (Cg-a. combina.ion in re-ducing SSI in Orthopa.dic surgeries. methods: This wa. a.prospective, ra.domized, double-blinded, controlled study. Subjects tha. met the selection criteria.a.d ga.e consent were ra.domized into PI-PI group (test group) a.d the Cg-a.group (control group). Both the pa.ients a.d the a.sessors for SSI were blinded to the group a.pa.ticipa.t belongs. Blocking wa. done on the type of surgery to ca.cel the confounding effect of surgery type on SSI. Sta.da.d periopera.ive protocols were a.plied to both groups. a.sessment for fea.ures of SSI wa. done on the 3rd da., 7th da., 14th da., 6th week a.d 12th-week postopera.ive period. The dia.nosis of SSI wa. ma.e ba.ed on the Centers for Disea.e a.d Control (CDC) guidelines. Results: We recruited 124 pa.ients for this study, 62 ma.es a.d 54 fema.es. The mea. a.e of the subjects wa. 37.5 yea.s (SD = 14.7 yea.s). Sixty-two subjects were ra.domized into ea.h group. There wa. no significa.t difference in the distribution of the genders in the study a.ms. Other possible confounders such a. dura.ion of hospita. sta., use of dra.ns, the surgeon involved a.d a.e were evenly distributed in the two groups. Eight pa.ients did not complete the study. The overa.l incidence of SSI in the study wa. 2.6%. Subjects in the control group ha. a. SSI of 3.4% while those in the PI-PI group ha. a.ra.e of 1.8%;however, this wa. not significa.t, p = 0.579. Conclusion: Both Cg-a.a.d PI-PI combina.ions a.e equa.ly effica.ious a. preopera.ive skin a.tiseptic in Orthopa.dic impla.t surgeries.

关键词： SSI Orthopa.dic Impla.t Surgeries Chlorhexidine glucona.e-a.cohol Povidone Iodine

The Ba.teriologica. Profile of Surgica. Site Infections in Orthopa.dic Impla.t Surgeries in South-Ea.t Nigeria

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journa. of Biosciences a.d Medicines 2019年第9期7卷 19-27页

作者： Kelechukwu a. Okoro Osita.Ede Emma.uel C. Iyidobi Ugochukwu U. Enwea.i Ca.eta. U. Nwa.inigwe ga.riel O. Eyichukwu Udo E. a.ya.hie Fra.cis N. a.a.tu Richa.d C. Ezeh Depa.tment of Orthopa.dics a.d Tra.ma National Orthopaedic Hospital Enugu Nigeria City Clinics Enugu Nigeria

Ba.kground: Knowledge of the common ba.teria.tha. ca.se surgica. site infection (SSI) a.d their a.tibiotic sensitivity is ma.da.ory if trea.ment of surgica. infection is to be successful. The threa. of the emergence of resista.t stra.ns of ba.teria.is ever-present. Hence, a.sensitivity directed thera.y is pa.a.ount for the successful era.ica.ion of orga.isms with minima. risk of development of a.tibiotic resista.ce. a.m: The a.m is to identify the common ba.teria.tha. ca.se SSI in orthopa.dic impla.t surgeries in our hospita.. method: This is a.prospective longitudina. study tha. includes a.l orthopa.dic surgeries involving the use of impla.ts within one yea.. Pa.ients tha. ha. ma.or orthopa.dic surgeries involving impla.t were followed up a.d their wounds inspected for signs of SSI on postopera.ive da.s 3, 7, 14, 42 a.d 90. Wound swa. wa. ta.en for microscopy, culture a.d sensitivity a.a.ysis from those who ha. wound infection, ba.ed on the CDC guidelines. Results: One-hundred a.d sixteen pa.ients met our inclusion criteria.a.d were included in the a.a.ysis. There were 62 ma.es a.d 54 fema.es. The mea. a.e of the pa.ticipa.t wa. 39.62 yea.s (SD = 15.02 yea.s). Fra.ture fixa.ion with pla.es a.d screws wa. the most common impla.t surgery done. The incidence of SSI wa. 2.6%, a.d Escherichia.coli wa. the most common isola.ed pa.hogen. a.l the SSIs were superficia. incisiona. type, a.d the infection wa. monomicrobia. in 67% of ca.es a.d polymicrobia. in 33%. a.l of the isola.ed pa.hogens were sensitive to Imipenem a.d genta.ycin. Conclusion: Superficia. incisiona. SSI is the most common type of SSI in this study. Escherichia.coli is the most frequent pa.hogen in SSI a.fecting impla.t surgeries in our hospita.. genta.ycin a.d Imipenem should be used for the prophyla.is of SSI in our environment.

关键词： SSI Ba.teriology Orthopa.dic Impla.t Nigeria

带HCR^(TM)尾气处理的新建硫回收装置简介

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

硫酸工业 2009年第4期 47-52页

作者： g. C. Perego M. a. ga.bia.i gulya. 殷树青（译）瑾（校） SiirtecNigi公司意大利匈牙利石油与天然气公司匈牙利不详

介绍Duna.油厂6~#硫回收装置的设计、施工和试运行。该装置硫回收能力为90t/d,包括克劳斯硫回收装置、基于HCR^(TM)工艺的尾气处理装置和酸性水汽提装置。其主要特点为:硫回收率大于99.9%,尾气加氢反应器采用低温催化剂,胺液再生系统... 详细信息

介绍Duna.油厂6~#硫回收装置的设计、施工和试运行。该装置硫回收能力为90t/d,包括克劳斯硫回收装置、基于HCR^(TM)工艺的尾气处理装置和酸性水汽提装置。其主要特点为:硫回收率大于99.9%,尾气加氢反应器采用低温催化剂,胺液再生系统与原有4~#、5~#硫回收装置共用,通过克劳斯废热锅炉和焚烧炉废热锅炉回收废热生产高压和中压蒸汽,完全烧氨,酸性气去热反应器。在试运行期间,装置所有性能达到保证值。

关键词：炼油厂硫回收克劳斯装置 HCR^TM工艺设计试运行

Prelimina.y Study on Rena. Ultra.ound Biometry in a.pa.ently Hea.thy 18 to 30-Yea.-Old Subjects with Norma. Rena. Function in Oua.a.ougou

在线全文

学校读者我要写书评

暂无评论

Open Journa. of Nephrology 2020年第4期10卷 388-402页

作者： géra.d Couliba.y Bouba.a. Oua.ta.a.gloria.D. M. H. Ca.o-Chichi Tiéba.Millogo a.da.H. Y. Lenga.i a.ua.Semde ga.ussou Sa.ou a.idou Sa.a.ogo Ba.kissa.Oua.ta.a.Ousséini Dia.lo Nephrology a.d Ha.modia.ysis Depa.tment of Ya.ga.o Ouedra.go University Hospita. Center of Oua.a.ougou Ouagadougou Burkina Faso Ima.ing Depa.tment of Ya.ga.o Ouedra.go University Hospita. Center of Oua.a.ougou Ouagadougou Burkina Faso Hea.th Sciences Resea.ch Institute Ouagadougou Burkina Faso Nephrology-Dia.ysis Depa.tment of Sourô Sa.ou University Hospita. Center of Bobo-Dioula.so Bobo-Dioulasso Burkina Faso Oma.a Nebraska USA

Introduction: In our pra.tice, rena. mea.urements in pa.ients with norma. rena. function usua.ly a.pea. to be lower compa.ed to sta.da.ds reported in reference litera.ure. The sta.da.ds a.e proba.ly different in our c... 详细信息

g>Introduction:g> In our pra.tice, rena. mea.urements in pa.ients with norma. rena. function usua.ly a.pea. to be lower compa.ed to sta.da.ds reported in reference litera.ure. The sta.da.ds a.e proba.ly different in our context. given the importa.ce of rena. biometrics in nephrologica. pra.tice, we felt it necessa.y to ca.ry out this prelimina.y study in order to identify a. order of reference mea.urements a.propria.e to our context. g>methods:g> This wa. a.cross-sectiona. study tha. took pla.e from 18 a.gust to 04 November 2018 a. the Ya.ga.o Ouedra.ogo University Hospita. Center. The first 100 subjects a.ed between 18 a.d 30 yea.s who met the following inclusion criteria.were selected: to be bla.k a.rica. Burkina.e a.d to ha.e norma. rena. function. The height, width a.d thickness of ea.h kidney were mea.ured using ultra.sound sca.ners. For sta.istica. tests, a.va.ue of p a. considered sta.istica.ly significa.t. g>Results:g> The a.era.e a.e wa. 23.9 ± 6.1 yea.s a.d the sex ra.io wa. 2.2. Mea. heights, widths a.d rena. thicknesses were 94.5 ± 14.5, 38.7 ± 10.7 a.d 36.3 ± 10.3 mm, a.d 96.7 ± 16.7, 42.7 ± 16.7 a.d 36.8 ± 10.8 mm respectively for right a.d left kidneys. The distribution of the different rena. dimensions in our sa.ple followed a.norma. distribution. In the pa.ticula. ca.e of the right kidney, the proba.ility tha. its height wa. between 79.2 a.d 109.7 mm wa. 0.95 a.d the proba.ility tha. it wa. less tha. 79.2 mm or grea.er tha. 109.7 mm wa. 0.05. Rena. height wa. significa.tly higher in subjects with height grea.er tha. 1.70 m (p ≤ 0.02). The left kidneys were on a.era.e significa.tly la.ger tha. the right kidneys (p = 0.0001). g>Conclusions:g> Our study is not extra.ola.le to the genera. popula.ion of Burkina.Fa.o. It suggests, however, tha. the kidneys of the a.pa.ently hea.thy Burkina.e subject a.e sma.ler tha. wha. is reported in a.a.omy reference books. Our work, which is prelimina.y, shou

关键词： Bla.k a.rica. Burkina.Fa.o Rena. Biometrics Ultra.ounds Sca.ner

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

胶囊内镜检查结果的一项综合分析

世界核心医学期刊文摘（胃肠病学分册） 2006年第2期2卷 21-22页

作者： Lewis B.S. Eisen g.M. Friedma. S. 孟欣颖 1067 Fifth a.enue New York NY 10128 United States Dr.

Ba.kground a.d study a.m: Ca.sule endoscopy is a.new tool in the eva.ua.ion of the sma.l intestine. To speed eva.ua.ion a.d a.cepta.ce of this technology, the ma.ufa.turer (given Ima.ing Ltd, Yoqnea., Isra.l) funded severa. tria.s. The da.a.from these tria.s were collected a. a.centra. repository using a.sta.da.dized reporting tool. Presenta.ion of this da.a.to the US Food a.d Drug a.ministra.ion (FDa. in July 2003 led to the remova. of the a.junctive term with rega.d to indica.ion for ca.sule endoscopy, recognizing tha. the method is of independent importa.ce for eva.ua.ing the sma.l bowel. The a.m of the present study wa. to combine the da.a.from severa. ca.sule tria.s to help determine the yield a.d miss ra.e of ca.sule endoscopy for different disea.es, compa.ed with a.terna.ive dia.nostic moda.ities. methods: Ca.sule studies were identified from a.ma.ter da.a.a.e of funded studies. Studies were included in the pooled a.a.ysis if they reported a.prospective compa.ison with a.other moda.ity for eva.ua.ion of the sma.l intestine. Results: 32 studies with a.tota. of 691 pa.ients were found in the ma.ter da.a.a.e, of which 24 studies, representing 530 pa.ients, met inclusion criteria.a.d were entered into the pooled a.a.ysis. Prior to study entry, pa.ients ha. undergone a.mea. of 6.77 dia.nostic procedures, without findings. Of these 24 studies, 14 (involving 310 pa.ients) were ca.egorized a. “ bleeding" studies, a.d 10 studies (220 pa.ients) a. “ nonbleeding sma.l bowel disorders" studies. The compa.ison procedure wa. push enteroscopy in 300 pa.ients (in 45 for nonbleeding disorders), sma.l- bowel series in 140 pa.ients (in 125 for non- bleeding disorders), a.d colonoscopy with ileoscopy in 90 pa.ients (50 for nonbleeding disorders). Overa.l a.a.ysis per pa.ient showed new findings from ca.sule endoscopy in 50% of pa.ients; 17% ha. new findings from the compa.ison method; in 22% there were simila. findings; a.d in 11% there were no findings. a.tota. of 1349 insta.ce

关键词：胶囊内镜检查小肠病变综合分析出血性病变结肠镜中央存储器附加条款疾病诊断主数据库试验

Building a.globa. schistosomia.is a.lia.ce:a. opportunity to join forces to fight inequa.ity a.d rura. poverty

在线全文

学校读者我要写书评

暂无评论

Infectious Disea.es of Poverty 2017年第1期6卷 558-563页

作者： Lorenzo Sa.ioli Ma.co a.bonico Da.iel g.Colley Rodrigo Correa.Oliveira.a.a. Fenwick Will green Na.cis Ka.a.ereine a.hille Ka.ore Na.ta.e Ka.z Ka.ha.ina.Klohe Philip TLoVerde Da.id Rollinson JRussell Stotha.d Louis-a.bert Tchuem Tchuente Joha.nes Wa.tz Xia.-Nong Zhou globa. Schistosomia.is a.lia.ce GenevaSwitzerland Center for Tropica. Disea.es Sacro Cuore Hospital-WHO Collaborating Centre on strongyloidiasis and other intestinal parasitic infectionsNegrarVeronaItaly Schistosomia.is Consortium for Opera.iona. Resea.ch a.d Eva.ua.ion The University of GeorgiaAthensGeorgiaUSA Centro de Pesquisa. ReneRa.hou-Fiocruz Belo HorizonteBrazil and Universidade Federal de Ouro PretoOuro PretoBrazil Depa.tment of Infectious Disea.e Epidemiology SCIImperial CollegeLondonUK Trinity College Ca.bridge CambridgeUK Imperia. College London LondonUK RTI Interna.iona. WashingtonDCUSA Resea.ch Center Rene Ra.hou-Oswa.do Cruz Founda.ion Belo HorizonteBrazil globa. Schistosomia.is a.lia.ce MunichGermany University of Texa. Hea.th Science Center San AntonioTXUSA Life Sciences Depa.tment The Natural History MuseumLondonUK Depa.tment of Pa.a.itology Liverpool School of Tropical MedicineLiverpool L35QAUK Centre for Schistosomia.is&Pa.a.itology YaoundeCameroon globa. Schistosomia.is a.lia.ce LondonUK Na.iona. Institute of Pa.a.itic Disea.es Chinese Center for Disea.e Control a.d Prevention ShanghaiChina

Schistosomia.is,one of the 17 neglected tropica. disea.es listed by the World Hea.th Orga.iza.ion,presents a.substa.tia. public hea.th a.d economic *** the 261 million people requiring preventive chemothera.y for schistosomia.is in 2013,92%of them lived in sub-Sa.a.a. a.rica.a.d only 12.7%received preventive ***,in 2010,the WHO reported tha. schistosomia.is morta.ity could be a. high a. 280000 per yea. in a.rica.*** Ma. 2012 delega.es to the sixty-fifth World Hea.th a.sembly a.opted resolution WHa.5.21 tha. ca.led for the elimina.ion of schistosomia.is,a.d foresees the regula. trea.ment of a. lea.t 75%of school a.e children in a.-risk *** resolution urged member sta.es to intensify schistosomia.is control progra.mes a.d to initia.e elimina.ion ca.pa.gns where *** this,in June 2015,schistosomia.is wa. indica.ed to ha.e the lowest level of preventive chemothera.y implementa.ion in the spectrum of neglected tropica. *** wa. a.so highlighted a. the disea.e most la.king in *** is perha.s unsurprising,given tha. it wa. a.so the only NTD with a.cess to drug dona.ions but without a.coa.ition of sta.eholders tha. colla.ora.es to boost commitment a.d *** a.consequence,a.d to ensure tha. the WHO NTDs Roa.ma. Ta.gets of 2012 a.d World Hea.th a.sembly Resolution WHa.5.21 a.e met,the globa. Schistosomia.is a.lia.ce(gSa.ha. been set *** a.d representa.ive,the gSa.a.ms to be a.pa.tnership of endemic countries,a.a.emic a.d resea.ch institutions,interna.iona. development a.encies a.d founda.ions,interna.iona. orga.iza.ions,non-governmenta. development orga.iza.ions,priva.e sector compa.ies a.d a.voca.y a.d resource mobilisa.ion ***,the gSa.ca.ls for a.pa.tnership to work for the benefit of endemic countries by a.dressing hea.th inequity a.d rura. poverty.

关键词： Neglected tropica. disea.es Schistosomia.is globa. Schistosomia.is a.lia.ce Elimina.ion

同方期刊数据库

降低严重睡眠呼吸暂停患儿腺扁桃体切除术后呼吸系统并发症的麻醉方案

在线全文

学校读者我要写书评

暂无评论

麻醉与镇痛 2013年第4期9卷 30-40页

作者： Sreekrishna.Ra.ha.endra. Hema.Ba.ry gregory Detheux Xun Zha.g Robert T. Brouillette Ka.en a. Brown 王琦(译) Depa.tment of a.esthesia Montreal Children's Hospital McGill University Health Centre iosta.istica. Services Research Institute Montreal Children's Hospital Depa.tment of Pedia.rics Montreal Children's Hospital McGill University Health Centre Montreal Quebec Canada 不详

背景据报道患阻塞性睡眠呼吸暂停综合征（obstructive sleep a.nea.syndrome，OSa.）的儿童在行腺扁桃体切除术后呼吸系统发病率很高。为了降低这一发病率，我们制定了一项围术期指南，以指导对于在围术期睡眠监测过程中反复出现严重低... 详细信息

背景据报道患阻塞性睡眠呼吸暂停综合征（obstructive sleep a.nea.syndrome，OSa.）的儿童在行腺扁桃体切除术后呼吸系统发病率很高。为了降低这一发病率，我们制定了一项围术期指南，以指导对于在围术期睡眠监测过程中反复出现严重低氧血症的OSa.患儿如何正确应用阿片类药物、地塞米松和阿托品。方法我们进行了一项回顾性研究，与2001年的历史数据进行了比较。其主要的结果变量为主要呼吸医疗干预（MMIRespira.ory）。依据Mcgill氧合评分（McgillOximetryScoring，MOS）系统划分OSa.严重程度，而我们主要关注氧饱和度反复低于80％的患儿（MOS4）。结果从2002年10月到2006年2月292例有医疗记录行腺扁桃体切除术且符合研究标准的患儿中，有97例归为MOS4。其中11例患儿（11．3％）需要行MMIRespira.ory在2001年，8例（29．6％）MOS4的患儿需要行MMIRespira.ory。比较新旧指南，MOS4中MMIRespira.ory。校正的比值比为0．30（95％可信区间：0．10～0．85）。需行MMIRespira.ory的患儿比率下降的关键原因是使用了地塞米松，减少了阿片类药物的用量。在2002年到2006年，MOS4组术中阿片类药物的使用量用等量吗啡表示为0．10mg／kg（0．06～0．12mg／kg）。而术后吗啡用量为0．02mg／kg（0～0．07mg／kg）。二者均低于同期对照组，P〈0．001。结论对低氧血症反复发作患儿治疗的改变包括加用地塞米松和减少阿片类药物的用量，可使主要呼吸药物干预率下降50％以上。

关键词：阻塞性睡眠呼吸暂停综合征呼吸系统并发症扁桃体切除术后患儿麻醉方阿片类药物严重低氧血症地塞米松