中国作者重要发表 - 新生猪进展性气胸的血液动力学与血气的连续性改变研究



新生猪进展性气胸的血液动力学与血气的连续性改变研究





Sequential changes of hemodynamics and blood gases in newborn piglets with developing pneumothorax





Liu J., Joynt C., Tymafichuk C., Cheung P.-Y. 2009/5/29 18:39:31

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Pediatric Pulmonology, 2009, Volume 44, Issue 1




Introduction: Little information is available regarding the temporal changes in hemodynamics and blood gases during the development of a moderate pneumothorax in a neonate. In this study, we aim to investigate the temporal changes of hemodynamics and arterial blood gases in a neonatal swine model of unilateral pneumothorax. Study Design: Prospective observational controlled animal research. Methods: Experimental pneumothorax (n = 9) was created by intermittent progressive introduction of 10 ml/kg of room-air every 5 min to a total 40 ml/ kg, via a 20G Insyte® angiocatheter placed in the fourth intercostal space in line with the right frontal limb. Changes in heart rate, mean arterial pressure, central venous pressure (CVP), common carotid arterial flow (CCAF) and arterial blood gases were measured and compared with the normoxic baseline and a control group (n = 7) (ANOVA). Results: As the pneumothorax developed, SaO2 and PaO2 deteriorated after injecting 20 ml/kg of room-air (P < 0.001 vs. baseline and control), whereas the pH and PaCO2 remained unchanged. CVP increased after injecting 30 ml/kg of room-air (P< 0.001), with no significant changes in heart rate and mean arterial pressure. Meanwhile, CCAF increased and carotid oxygen delivery declined after 30 ml/kg (P < 0.05). Conclusions: Deterioration in oxygenation was noted early in the development of pneumothorax in newborn piglets followed by metabolic acidosis. CVP progressively increased despite the lack of significant changes in systemic hemodynamics when moderate pneumothorax developed. Although CCAF increased during a moderate pneumothorax, carotid oxygen delivery decreased. © 2008 Wiley-Liss, Inc.



Correspondence Address: Cheung, P.-Y.; NICU, Royal Alexandra Hospital, 10240 Kingsway Avenue, Edmonton, AB T5H 3V9, Canada; email: poyin@ualberta.ca



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高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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