检索结果-南通市图书馆

超声检查测定胃动力指导心脏手术后机械通气患儿肠内营养应用的临床研究

在线全文

学校读者我要写书评

暂无评论

中华小儿外科杂志 2013年第6期34卷 420-423页

作者：袁媛马小静柳梅王静静何亚峰吴洋夏娟武汉亚洲心脏病医院超声中心 430022 武汉市第一医院icu

目的探讨超声检查测定胃动力指数的方法在指导心脏术后机械通气患儿肠内营养应用中的作用。方法对2011年5月至2012年5月间心脏术后机械通气超过48h且需行肠内营养治疗的92例患儿进行研究，将其分成两组，其中回抽胃液组（46例）每4h使... 详细信息

目的探讨超声检查测定胃动力指数的方法在指导心脏术后机械通气患儿肠内营养应用中的作用。方法对2011年5月至2012年5月间心脏术后机械通气超过48h且需行肠内营养治疗的92例患儿进行研究，将其分成两组，其中回抽胃液组（46例）每4h使用回抽胃液法评估胃残余量进而调整肠内营养制定方案；超声测定组（46例）每4h使用超声测定胃排空和胃动力指数的方法指导肠内营养的制定方案。实时监测和追踪术后患儿肠内营养达标时间、肠内营养并发症（如感染、反流、腹泻）、实验室营养指标（前白蛋白、白蛋白）及预后（脱机时间、icu时间、住院时间、病死率）等指标。比较两组患儿的肠内营养治疗效果。结果超声测定组肠内营养达标所需时间（30．4±10．3）h较回抽胃液组（36．6±9．5）h明显缩短，平均每天热卡值（60．3±13．9）kcal／kg较回抽胃液组（42．7±10．8）kcal／kg明显升高，两组间两项指标差异均有统计学意义（P〈0．05）。术后第3天超声测定组与回抽胃液组前白蛋白[（247．5±65．3）mg／LVS（215．6±45．8）mg／L]和白蛋白[（34．7±6．2）g／LVS（30．4±4．9）g／L]水平比较，差异有统计学意义（P〈（）．05）。超声测定组和回抽胃液组的感染发生率分别为6．5％（3／46）和26．1％（12／46），反流发生率分别为10．9％（5／46）和32．6％（15／46），组间比较，差异有统计学意义（P〈O．05）；两组脱机时间[（6（1．7±12．4）hvs（78．5±10．2）hl、icu时间[（4．4±1．6）dVS（5．4±1．2）d]、住院时间[（11．6±3．2）dVS（13．2±4．2）d]比较，差异有统计学意义（P〈0．05）。结论超声测定胃动力法可以有效指导心脏术后机械通气患儿肠内营养应用，显著提高心脏术后机械通气患儿肠内营养治疗效果和减少相关并发症。

关键词：超声检查心脏外科手术通气机机械胃排空肠道营养

Surgical Repair of Encephaloceles in Gabriel TouréHospital: Review of 17 Cases

在线全文

学校读者我要写书评

暂无评论

Open Journal of Modern Neurosurgery 2018年第4期8卷 375-382页

作者： Youssouf Sogoba Drissa Kanikomo Boubacar Sogoba Djenè Kourouma Oumar Coulibaly Issa Amadou Seybou Hassane Diallo Moustapha Mangané Hamidou Almeimoune Maiga Madani Thierno Diop Belco Maiga Leonie Diakité Fousseyni Traoré Youssoufa Maiga Yacaria Coulibaly Broulaye Samaké Djibo M. Diango Department of Neurosurgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurosurgery H&#244 pital du Mali Bamako Mali Department of pediatric Surgery H&#244 pital Gabriel Touré Bamako Mali Department of Neurology H&#244 pital Gabriel Touré Bamako Mali Department of Anesthesiology and icu H&#244 pital Gabriel Touré Bamako Mali Department of pediatrics H&#244 pital Gabriel Touré Bamako Mali

Background: Encephaloceles are congenital neural tube defects characterized by the protrusion of meninges and/or brain tissue from a defect in the skull. The incidence of the disease is about 0.8 - 5.6/10,000 live births. They are classified based on the location and type of skull defect as occipital encephalocele, encephalocele of the cranial vault, frontoethmoidal encephalocele, and basal encephaloceles. Surgical reduction being the first line treatment and resection of herniated structures may be necessary when the encephalocele is large. In the present study, the authors present their experience in treating 17 patients with encephaloceles. Methods: This study is a retrospective analysis of 17 patients from January 2013 to December 2016 in Gabriel Touré Hospital, Bamako, Mali. A history was obtained from the family at presentation. Medical information before and during the pregnancy was compiled. All patients underwent CT scan as a routine preoperative imaging study, to evaluate the encephalocele and to plan the surgical procedure. The following data were recorded for analysis: age, sex, location of encephalocele, neurological status, operative method, postoperative complications and surgical results. Results: There were 10 (58.8%) female and 7 (41.2%) male patients. The patients ranged in age from 3 days to 36 months. The most common site of encephalocele sac was the occipital region in 14 (82.4%) cases followed by the frontal region in 2 (11.8%) cases and the vertex in 1 (5.9%) case. The sac size was less than 3 cm in 5 (17.6%) cases, 3 - 5 cm in 8 (47.1%) cases and more than 5 cm in 4 (23.5%) cases. Three (17.6%) children presented with CSF leakage. Hydrocephalus was present in the preoperative period in 6 (35.3%) cases;all of them required VP shunt procedure. None of the cases had a preoperative neurologic deficit. Surgical excision was performed in all cases. In the postoperative period, meningitis developed in 2 cases (11.8%), wound infection in 1 case (5.9

关键词： Encephalocele Neural Tube Defect Hydrocephalus Congenital Malformation

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

伴喘鸣的婴儿肺炎其TFV环变化及临床意义

小儿急救医学 1999年第1期6卷 17-19页

作者：吴冀川樊寻梅刘玺成北京儿童医院icu

目的了解伴喘鸣的肺炎婴儿其潮气流速容量（ＴＦＶ）环形态及相关参数的变化，为临床判断此类患儿病情及观察疗效寻找敏感的指标。方法５０例肺炎婴儿，其中伴喘鸣者２７例，应用森迪２６００儿童肺功能仪测定患儿安静睡眠状态下的ＴＦ... 详细信息

目的了解伴喘鸣的肺炎婴儿其潮气流速容量（ＴＦＶ）环形态及相关参数的变化，为临床判断此类患儿病情及观察疗效寻找敏感的指标。方法５０例肺炎婴儿，其中伴喘鸣者２７例，应用森迪２６００儿童肺功能仪测定患儿安静睡眠状态下的ＴＦＶ环及相关参数。１３例喘鸣阳性患儿在喘鸣消失后复查，比较喘鸣阳性与阴性、喘鸣发作期与恢复期ＴＦＶ环及相关参数的变化。结果喘鸣阳性患儿，ＴＦＶ环呼气高峰前移，呼气曲线降枝呈“波谷”样凹向容量轴，喘鸣消失后，降枝呈弓背向上的抬高。喘鸣阴性患儿ＴＦＶ环呈“梭形”％ＶＰＦ、Ｔｐ／Ｔｅ、２５／ＰＦ及５０／ＰＦ在喘鸣阳性与阴性两组间差异显著。结论ＴＦＶ环形态及％ＶＰＦ、Ｔｐ／Ｔｅ、２５／ＰＦ及５０／ＰＦ可做为反映婴儿下气道阻塞性疾患的可靠指标。

关键词：婴儿肺炎喘鸣潮气流速容量环

1例血型不合非活体肝移植患儿术后急性抗体介导排斥反应的护理

在线全文

学校读者我要写书评

暂无评论

中华护理杂志 2021年第7期56卷 1062-1065页

作者：梁江淑渊曾妃浙江大学医学院附属第二医院综合icu 杭州市310000

总结1例ABO血型不合非活体肝移植患儿术后急性抗体介导排斥反应的护理经验。护理要点包括:严密监测病情变化,及时启动应急预案,全程监测移植肝功能;免疫抑制药物精准化管理;血浆置换期间做好各项监测,包括不良反应、滤器抗凝和凝血功能... 详细信息

总结1例ABO血型不合非活体肝移植患儿术后急性抗体介导排斥反应的护理经验。护理要点包括:严密监测病情变化,及时启动应急预案,全程监测移植肝功能;免疫抑制药物精准化管理;血浆置换期间做好各项监测,包括不良反应、滤器抗凝和凝血功能的监测,进行滴定式浅镇静管理和管路安全管理;消化道出血期间,提供合理的营养支持;严格执行医院感染防控措施。经过积极治疗,患儿安全度过急性排斥反应,最终康复出院。

关键词：肝移植血型不合急性抗体介导排斥反应儿科护理学

Comorbidities,clinical characteristics and outcomes of COVID‑19 in pediatric patients in a tertiary medical center in the Netherlands

在线全文

学校读者我要写书评

暂无评论

World Journal of pediatrics 2022年第8期18卷 558-563页

作者： Amrita Biharie Maya WKeuning Katja CWolthers Dasja Pajkrt Department of pediatric Infectious Diseases Rheumatology and ImmunologyAmsterdam University Medical Centers Location Academic Medical CenterUniversity of AmsterdamMeibergdreef 91105 AZ AmsterdamNetherlands Department of Medical Microbiology Amsterdam University Medical Centers Location Academic Medical CenterUniversity of AmsterdamAmsterdamNetherlands

Having pre-existing comorbidities is described as a risk factor for more severe disease in adult corona virus disease 2019(COVID-19)and in infections with SARS-CoV-1 and MERS-CoV[1].In adult SARS-CoV-2 infections,patients with pre-existing underlying comorbidities,such as chronic obstructive pulmonary disease,cardiovascular disease,diabetes and obesity,are more likely to have severe disease compared to healthy adults[2].An inconsistency is seen in current fndings on the association with comorbidities and pediatric COVID-19 *** important limitation in currently available studies is limited data:severe disease is rare in children compared to adults,and most studies describe COVID-19 severity merely by reporting intensive care unit(icu)admission or mortality rates instead of detailed data on clinical presentation and outcomes.

关键词： morbid pediatric patients

小儿终末期肝病肝移植术式选择(附15例报告)

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

中国实用儿科杂志 2009年第6期24卷 471-473页

作者：刘蕾刘懿禾沈中阳王兴强于立新王峪天津市第一中心医院移植外科icu 天津300192

目的探讨小儿终末期肝病的临床特点及肝移植术式选择。方法天津市第一中心医院于2000年8月至2007年11月对15例年龄≤12岁终末期肝病患儿施行18次肝移植手术。2000—2004年前的7例10次手术均为减体积肝移植,2006年后实施的8例肝移植中4... 详细信息

目的探讨小儿终末期肝病的临床特点及肝移植术式选择。方法天津市第一中心医院于2000年8月至2007年11月对15例年龄≤12岁终末期肝病患儿施行18次肝移植手术。2000—2004年前的7例10次手术均为减体积肝移植,2006年后实施的8例肝移植中4例为劈离式、4例为活体部分肝移植。术后均给予抗排斥、抗感染、抗凝等治疗,密切监测移植肝血流及肝功能变化。结果术后各种并发症的发生率分别为急性排斥反应20.0%、感染73.3%、胆管并发症33.3%、肝动脉栓塞20.0%、腹腔出血13.3%。4例(26.7%)患儿因腹腔感染、出血、血栓形成再次手术,其中2例血栓形成患儿分别行二次、三次肝移植,再移植率为13.3%。死亡4例(26.7%),其余11例患儿随访1年1个月至8年4个月(至2008年12月),健康存活。结论肝移植是治疗小儿终末期肝病的有效方法,积极防治术后并发症是其成功的关键。

关键词：肝移植儿童

Early results and factors affecting arterial switch operation in provincial medical center

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2021年第22期134卷 2741-2743页

作者： Hui-Jun Mou Mei Zhu An-Biao Wang Bo Han Chun-Yang Xu Department of Ultrasound Shandong Provincial HospitalCheeloo College of MedicineShandong UniversityJinanShandong 250021China Department of Cardiac Surgery Intensive Care Unit(ICU)Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandong 250021China Department of pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandong 250021China Department of Critical Care Medicine Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandong 250021China.

Transposition of the great arteries(TGA)is a serious and complicated congenital heart disease,accounting for 5%to 7%of all congenital heart *** fetuses with TGA can survive stably to *** birth,their survival depends on the associated ventricular septal defect(VSD),atrial septal defect(ASD)or patent ductus arteriosus(PDA).Without treatment,approximately 30%of these infants die in the first week after birth and 90%die within the first year.[1]Arterial switch operation is now recognized worldwide as an effective treatment for TGA and good results have been achieved with this *** was performed late at our center,with a few patients and high mortality rates in the early *** recent years,both the number of patients and the survival rate have increased with the gradual improvement of the skills of the surgical *** patients have been diagnosed prenatally with the development and promotion of fetal *** pregnancy to delivery to surgery,children with TGA require monitoring with close cooperation among medical staff from multiple *** this study,the data of 87 patients who underwent ASO from January 2014 to December 2019 at our center were retrospectively summarized to analyze the major nonsur-gical factors affecting patient prognosis[Table 1].The study was approved by the Ethics Committee of Shandong Provincial Hospital.

关键词： operation summarized promotion

早产儿动脉导管未闭发生与液体入量的关系探讨

在线全文

学校读者我要写书评

暂无评论

小儿急救医学 2003年第3期10卷 163-164页

作者：宋振江李克华刘红北京儿童医院icu 北京100045

动脉导管未闭(PDA)是早产儿常见并发症,也是导致早产儿充血性心力衰竭、呼吸衰竭的常见原因之一.目前有关PDA发病机制、病理生理等方面学术研究较多[1-2],而临床针对动脉导管未闭发生与早产儿生后早期(<1周)液体治疗二者关系报道较少.... 详细信息

动脉导管未闭(PDA)是早产儿常见并发症,也是导致早产儿充血性心力衰竭、呼吸衰竭的常见原因之一.目前有关PDA发病机制、病理生理等方面学术研究较多[1-2],而临床针对动脉导管未闭发生与早产儿生后早期(<1周)液体治疗二者关系报道较少.本文旨在探讨早产儿生后早期每日液体入量与PDA发生之间的关系,为临床液体治疗提供一定参考.

关键词：早产儿动脉导管未闭液体入量并发症发病机制病理生理

麻疹并发吉兰巴雷综合征、急性呼吸窘迫综合征、心跳呼吸骤停一例(附3年随访)

在线全文

学校读者我要写书评

暂无评论

中国小儿急救医学 2010年第1期17卷 93-94页

作者：李梅董力杰周东元刘国慧哈尔滨市儿童医院icu

患儿,男,12个月,因"发热3 d,皮疹及双下肢运动障碍1 d"来院,门诊以"吉兰巴雷综合征"收入。既往健康,入院前4 d接种过麻疹疫苗。入院时神志清,呼吸促(40次/min),体温36.4℃,脉搏120次/min,血压160/90 mm Hg(1 mm Hg=0.133 kPa)。双眼结... 详细信息

患儿,男,12个月,因"发热3 d,皮疹及双下肢运动障碍1 d"来院,门诊以"吉兰巴雷综合征"收入。既往健康,入院前4 d接种过麻疹疫苗。入院时神志清,呼吸促(40次/min),体温36.4℃,脉搏120次/min,血压160/90 mm Hg(1 mm Hg=0.133 kPa)。双眼结膜充血,吞咽困难,可见轻度吸气性凹陷,双肺散在痰鸣。肝肋下3.0 cm。颈部、头面部、躯干可见较密充血疹。双上肢肌力Ⅳ～Ⅴ级,双下肢Ⅲ级,双膝腱

关键词：麻疹疫苗吉兰巴雷综合急性呼吸窘迫心跳呼吸骤停下肢运动障碍入院前血压体温收入神志皮疹门诊脉搏接种健康患儿发热 min