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[Circulating anticoagulant and open heart surgery (author's transl)]. [循环抗凝血和心脏直视手术(作者简介)]。
Pub Date : 1981-01-01
C Dufay, J P Devulder, A Watel, H Warembourg, A Pol, R Krivosic-Horber

Two patients presenting an unsettled mitral cardiopathy had to receive a valve replacement under cardiopulmonary by-pass in spite of a circulating anticoagulant with antiprothrombinase activity. A higher risk of thromboembolic trouble required an increase of heparin administration, under a strict biological control. Nevertheless both patients died: the first of coronary thrombosis, the second of cataclysmic bleeding, associated to severe and diffused thrombosis. Thus it is essential to insist upon the risk occurred by those patients and the difficulty of adaptation and control of heparin administration.

两例出现不稳定二尖瓣心脏病的患者在心肺旁路下接受瓣膜置换术,尽管使用了具有抗凝血酶原活性的循环抗凝剂。在严格的生物控制下,血栓栓塞性疾病的高风险需要增加肝素的施用。然而,两名患者均死亡:第一名患者死于冠状动脉血栓形成,第二名患者死于剧烈出血,并伴有严重的弥漫性血栓形成。因此,有必要强调这些患者发生的风险以及肝素给药的适应和控制的困难。
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引用次数: 0
[Advantage of nicergoline after cardiac surgery in an adult (author's transl)]. [成人心脏手术后使用尼麦角林的优势[作者简介]]。
Pub Date : 1981-01-01
C Zerr, G Fauchon, P Lebreton, A Khayat, D Maiza, J Quesnel

Hemodynamic effects of nicergoline injected by intravenous route were studied in 43 patients early after open-heart operations. A serial witnesses has been compared with 5 other groups for which the posologies were increased. Catheterisms of radial artery and pulmonary artery allows the measuring of systolic arterial pressure (SP), right atrial pressure (RAP), pulmonary capillary wedge pressure (PCWP) and cardiac index (CI). The heart rate (HR) was noticed. The systemic vascular resistance (SVR), the stroke index (SI) and the left ventricular stroke work index (SWI) were calculated. The results were statistically analysed by the Student test. After injection of a bolus of 0,3 mg kg-1 by intravenous route, stable effects are obtained with a maintenance posology of 0,8 mg.kg-1.h-1. The SP diminishes by 20 p. cent (123 to 104 mm Hg; p less than 0,01). There is a loose of 16 p. cent from the RAP (9,5 to 8 mm Hg; p less than 0,05) and of 18 p. cent from the PCWP (16,5 to 13,5 mm Hg; NS). The HR decreases by 13 p. cent (97 to 81 syst. min.-1; p less than 0,05). The CI increases by 25 p. cent (2,2 to 2,75 1.min.-1m-2; p less than 0,01); the SI by 40 p. cent (35 to 35 ml beat-1m-2; p less than 0,01) and the SWI by 32 p. cent (27,5 to 36 g.m.m-2; p less than 0,05). We conclude from this investigation that nicergoline injected through intravenous route with an output of 0,8 mg.kg-1.h-1 mainly leads to afterload reduction. Thanks to its effect on the CI and on the HR as well as to its mild to moderate action, it is a clinical useful agent for primary or adjunctive therapy of postoperative low cardiac output.

对43例心内直视术后早期静脉注射尼麦角林对血流动力学的影响进行了研究。将一系列证人与其他5组证人进行了比较,这些证人的死亡人数有所增加。桡动脉和肺动脉导管可测量收缩压(SP)、右心房压(RAP)、肺毛细血管楔压(PCWP)和心脏指数(CI)。观察心率(HR)。计算全身血管阻力(SVR)、卒中指数(SI)和左室卒中工作指数(SWI)。结果通过学生测试进行统计分析。经静脉注射0.3 mg kg-1后,效果稳定,维持剂量为0.8 mg.kg-1.h-1。SP降低20% (123 ~ 104 mmhg);P < 0.01)。RAP(9.5至8毫米汞柱)有16%的松动;p < 0.05), 18%来自PCWP(16.5至13.5 mm Hg;NS)。人力资源减少13%(97至81)。min.-1;P < 0.05)。CI增加25% (2,2 ~ 2,75.1 min.-1m-2);P < 0.01);SI降低40% (35 ~ 35 ml -1m-2);p < 0.01), SWI下降32%(27.5至36 g.m -2;P < 0.05)。本研究得出结论:经静脉注射的尼麦角林,其输出量为0.8 mg.kg-1.h-1,主要导致后负荷减少。由于其对CI和HR的影响,以及其轻至中度的作用,它是一种临床有用的药物,可用于术后低心输出量的主要或辅助治疗。
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引用次数: 0
[Total thoracic compliance. Determination by calculator and comparison with values obtained with the syringe method (author's transl)]. [全胸廓顺应性。用计算器测定并与注射器法比较[作者简介]。
Pub Date : 1981-01-01
C Martin, P Rignault, A Chevalier, J P Auffray, F Gouin

The performance of a calculator was studied on 19 patients requiring therapy with mechanical ventilation. Values of total compliance displayed by this calculator device were compared with values obtained with the syringe method. The determination of compliance were made at a series of values for Tidal volume (T. V.): 3, 4, 5, 6, 8, 10, 12, 15, 18, 20, 23 and 26 ml.kg-1. Measurements were performed while patients were paralysed by pancuronium bromide. In each patient the calculator device displayed values that correlate closely with the value obtained by the syringe method. Compliance increased between 3 and 26 ml.kg-1 of T. D. Between 4 and 15 ml.kg-1 of TD the changes of compliance were nearly identical whatever the method of measurement used. The calculator can be used for reliable monitoring or recordings of total compliance.

在19例需要机械通气治疗的患者中研究了计算器的性能。将该计算器装置显示的总顺应性值与注射器法获得的值进行比较。在潮汐容积(t.v.) 3、4、5、6、8、10、12、15、18、20、23和26 ml.kg-1的一系列值下测定顺应性。测量是在病人被泮库溴铵麻痹时进行的。在每个患者中,计算器装置显示的值与注射器法获得的值密切相关。服药量在3 ~ 26 ml.kg-1之间增加,服药量在4 ~ 15 ml.kg-1之间,无论采用何种测量方法,服药量的变化几乎相同。该计算器可用于可靠的监测或记录总的遵守情况。
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引用次数: 0
[Use of new internal jugular vein catheterization modified by using of a "catheter around the needle" (author's transl)]. [使用“针周围导管”改良的新型颈内静脉置管术[作者简介]]。
Pub Date : 1981-01-01
G Coulombe, J Arrignon, G Oksenhendler, C Winckler

Although widely used, subclavian catheterization has lost popularity to the benefit of internal jugular vein judged more secure. Numerous technics have been described. Since two years we use internal jugular vein catheterization according to the description of Boulanger et al. modified by using a "Catheter around the needle" type device 13 cm long and 1.65 mm wide. 122 patients have experienced 125 catheterizations which were performed on the right side in 96.8 p. cent of the cases. More than 50 p. cent of the patients was conscious at the time of venepuncture. 118 attempts were successful. In 7 cases failure was due either to impossibility of puncture (4 times) or catheterization (3 times). The sole complication was accidental arterial puncture (5 times, 4 p. cent). 4 of them at the time of failure of venepuncture. Training has an important role in the occurrence of failures and complications. They were much more frequent during the twenty first attempts. According to us this technic can reduce incidence of accidental arterial puncture. The risk of pneumothorax is low in spite of the length of the needle. But because of the length and relative stiffness of the catheter the tip is always located in the superior vena cava when the right side has been chosen.

锁骨下置管虽被广泛应用,但由于颈内静脉置管被认为更安全而失去了知名度。已经描述了许多工艺。两年来,我们根据Boulanger等人的描述使用颈静脉内置管,并使用长13cm,宽1.65 mm的“针周围导管”型装置进行修改。122例患者经历了125次置管,其中96.8%的病例在右侧进行。超过50%的患者在静脉穿刺时是有意识的。118次尝试成功。7例因穿刺失败(4次)或置管失败(3次)。唯一的并发症是意外动脉穿刺(5次,4%)。其中4人在静脉穿刺失败时死亡。培训在失败和并发症的发生中起着重要作用。在第21次尝试中,它们更加频繁。我们认为该技术可以降低意外动脉穿刺的发生率。尽管针的长度不同,气胸的风险很低。但由于导管的长度和相对硬度,当选择右侧时,尖端总是位于上腔静脉。
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引用次数: 0
[Intervention among patients with right bundle branch block and left anterior hemiblock. Operatory risk (author's transl)]. 右束支阻滞和左前半部分阻滞患者的干预。手术风险(作者陈述)。
Pub Date : 1981-01-01
P Coriat, A Harari, J P Tarot, A Ducardonnet, P Viars

In order to assess the risk of advanced heart block during anesthesia in patients with right bundle branch block and left anterior hemiblock, 35 consecutive patients were monitored throughout the pre-, intra- and postoperative period. As conventional ECG monitoring may only detect advanced atrioventricular block, patients were monitored according to the Holter method which can easily detect even minor changes of atrioventricular conduction namely slight increased PR interval or dropped P wave. All patients were asymptomatic, in normal sinus rhythm without second degree AV block. Surgical procedures were performed under general anesthesia (n = 15) and epidural anesthesia using lidocaine (n = 20). No episode of second or third degree atrioventricular block occurred. The only modifications observed were rare and transient increase of PR, occurring during surgical procedures in 5 patients, always associated with a sinus bradycardia. They immediately regressed at the termination of the sinus bradycardia either spontaneously or following atropine injection, strongly suggesting the responsability of increased vagal tone. Thus general or epidural anesthesia did not compromise infranodal conduction in any of the observed patients. These data indicate that anesthesia can be safely used without prophylactic preoperative insertion of pacemakers in patients with asymptomatic chronic right bundle branch block and left anterior hemi-block.

为了评估右束支阻滞和左前半部阻滞患者麻醉期间发生晚期心脏传导阻滞的风险,我们连续监测了35例患者的术前、术中和术后情况。由于常规心电监测只能检测到晚期房室传导阻滞,因此采用Holter法监测患者,可以很容易地检测到房室传导的微小变化,即PR间期的轻微增加或P波的下降。所有患者无症状,窦性心律正常,无二度房室传导阻滞。手术在全麻(n = 15)和利多卡因硬膜外麻醉(n = 20)下进行。未发生二度或三度房室传导阻滞。唯一观察到的变化是罕见的和短暂的PR增加,发生在5例患者的手术过程中,总是与窦性心动过缓有关。它们在窦性心动过缓终止时立即消退,无论是自发的还是注射阿托品后,强烈提示迷走神经张力增加的原因。因此,在任何观察到的患者中,全身麻醉或硬膜外麻醉都不会损害肠内传导。这些数据表明,对于无症状的慢性右束支阻滞和左前半阻滞患者,麻醉可以安全使用,无需预防性的术前植入起搏器。
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引用次数: 0
[Complications of loco-regional anaesthesia in obstetrical practice (author's transl)]. 产科手术中局部区域麻醉的并发症(作者简介)。
Pub Date : 1981-01-01
L Lecron

Complications of loco-regional anaesthesia in obstetrics are usually due to several factors: 1. choice of drugs: this must be judicious, taking into account duration of effect, potency and eventual maternal and foetal toxicity. This rule includes also morphinic drugs; 2. choice of technique: taking into consideration the stage of labour and also the eventual surgical procedure. Paracervical block must be avoided because of the numerous side-effects, chiefly foetal distress. Spinal anaesthesia is indicated only for instrumental procedures or caesarian section, with the usual reserves about headaches, severe hypotension. Peridural anaesthesia may present some complications, like extensive peridural anaesthesia, hypotension. In eclampsia and gemellarity, loco-regional, anaesthesia must be induced with the utmost caution. Moreover, an unrecognized uterine rupture may happen during labour under medullary anaesthesia if the patient had previously a caesarian section.

产科局部区域麻醉的并发症通常是由以下几个因素引起的:1。药物的选择:这必须是明智的,考虑到作用的持续时间,效力和最终的母婴毒性。这条规则也包括吗啡类药物;2. 技术选择:考虑到分娩阶段和最终的手术程序。必须避免宫颈旁阻滞,因为有许多副作用,主要是胎儿窘迫。脊髓麻醉仅适用于器械手术或剖宫产,通常用于头痛、严重低血压。硬膜外麻醉可能出现一些并发症,如广泛的硬膜外麻醉、低血压。在子痫和子痫中,局部局部麻醉必须非常谨慎。此外,如果病人以前做过剖腹产手术,在髓质麻醉下分娩时可能会发生未被识别的子宫破裂。
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引用次数: 0
[Uptake of oxygen in the lung: a program for the microcomputer]. [肺中氧气的吸收:微型计算机程序]。
Pub Date : 1981-01-01
M Duvelleroy

Written for pedagogic purpose, this paper describes a Basic program of the alveolar diffusion and shunt effect, for personal computer. Equations and algorythms are described first. Then the program is explained in great detail in order to be easily implemented. Nine typical situations are stimulated and discussed.

本文是为教学目的编写的,描述了一个用于个人计算机的肺泡扩散和分流效应的基本程序。首先描述了方程和算法。然后对程序进行了详细的说明,以便于实现。模拟并讨论了九种典型情况。
{"title":"[Uptake of oxygen in the lung: a program for the microcomputer].","authors":"M Duvelleroy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Written for pedagogic purpose, this paper describes a Basic program of the alveolar diffusion and shunt effect, for personal computer. Equations and algorythms are described first. Then the program is explained in great detail in order to be easily implemented. Nine typical situations are stimulated and discussed.</p>","PeriodicalId":7785,"journal":{"name":"Anesthesie, analgesie, reanimation","volume":"38 3-4","pages":"155-9"},"PeriodicalIF":0.0,"publicationDate":"1981-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18271540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Pheochromocytoma and pregnancy. Report of two cases (author's transl)]. 嗜铬细胞瘤与妊娠。两例报告[作者简介]。
Pub Date : 1981-01-01
F Artru, J F Doussin, M Sassard, J M Grozel, V Banssillon

We found in the literature 119 cases of pheochromocytoma manifested during pregnancy and observed 2 personal cases. Pheochromocytoma and pregnancy show reciprocal influences. Unsuspected diagnosis is frequent and followed by a high maternal mortality. The tumor was surgically removed in 42 cases. There are two different attitudes: when diagnosed in early pregnancy, the tumor can be excised without delay although the foetal risk is high; when the diagnosis is made in the last trimester, foetal maturity has to be awaited to perform a combined caesarean section and excision of the tumor.

我们在文献中发现119例妊娠期出现嗜铬细胞瘤,其中2例为个例。嗜铬细胞瘤与妊娠相互影响。未经怀疑的诊断是常见的,随之而来的是高产妇死亡率。42例手术切除肿瘤。有两种不同的态度:当在妊娠早期诊断出肿瘤时,尽管胎儿风险高,但可以立即切除;当诊断是在最后三个月时,必须等待胎儿成熟,进行联合剖腹产和肿瘤切除。
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引用次数: 0
[Variations of blood flow during epidural analgesia measured by a non-invasive method, i.e. transcutaneous pulsed ultrasonic Doppler velocimetry (author's transl)]. [采用无创方法,即经皮脉冲超声多普勒测速法测量硬膜外镇痛过程中的血流变化[作者的transl]。
Pub Date : 1981-01-01
A Landais, J P Morin, C Saint-Maurice

The present study aimed at appreciating the variations of femoral blood flow caused by epidural analgesia in women during delivery. In all cases the women lay supine, the cutaneous analgesia was below T 9. Bupivacaine at the average dose of 25 mg was used. Three preparations (bupivacaine 0.25 p. cent, bupivacaine 0.25 p. cent + adrenaline 1/200,000) were used. No significant variation in femoral blood flow was observed whether the solution injected contained adrenaline or not.

本研究旨在了解妇女分娩时硬膜外镇痛引起的股骨血流变化。在所有病例中,女性仰卧,皮肤镇痛低于t9。布比卡因平均剂量为25mg。使用三种制剂(0.25%布比卡因、0.25%布比卡因+肾上腺素1/200,000)。无论注射的溶液中是否含有肾上腺素,股骨血流量均无明显变化。
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引用次数: 0
[Interest of spontaneous ventilation oxygenation in emergency. About rupture of the stomach following a therapeutic oxygenation (author's transl)]. 紧急情况下自发通气氧合的研究。关于治疗性氧合后胃破裂[作者译]。
Pub Date : 1981-01-01
P Daversin, A Fichaux, M Germain, C Hennequin, P Symphorien
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引用次数: 0
期刊
Anesthesie, analgesie, reanimation
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