目的探讨喉罩全麻与蛛网膜下腔阻滞（腰麻）在宫腔镜手术中的应用效果。方法选取2015年8-12月于郑州大学第三附属医院行宫腔镜手术的100例患者为研究对象,采用随机数字表法将患者分为两组：喉罩组（LMA组）和蛛网膜下腔阻滞组/腰麻组（S...目的探讨喉罩全麻与蛛网膜下腔阻滞（腰麻）在宫腔镜手术中的应用效果。方法选取2015年8-12月于郑州大学第三附属医院行宫腔镜手术的100例患者为研究对象,采用随机数字表法将患者分为两组：喉罩组（LMA组）和蛛网膜下腔阻滞组/腰麻组（SA组）,每组各50例。LMA组予以长托宁0.5 mg,地塞米松10 mg,咪达唑仑2 mg,舒芬太尼0.3μg/kg,丙泊酚2-2.5μg/kg静脉诱导后置入喉罩,吸入七氟烷1.5%-2%维持麻醉,手术结束后停止七氟烷的吸入,高流量吸氧将患者肺内七氟烷排出体外,待患者自主呼吸恢复、潮气量适宜后叫醒患者,拔出喉罩。SA组患者于左侧卧位L3-4间隙通过针内针技术穿刺,于蛛网膜下腔注入0.5%罗哌卡因2.5 m L,调整麻醉平面T8-T6。观察记录麻醉实施前、麻醉后5 min、手术开始即刻两组患者的平均动脉压（MAP）及心率（HR）,记录患者从麻醉开始到手术开始的时间（T值）,随访观察两组患者的肛门排气时间、下床活动时间、恶心呕吐,及相关麻醉并发症的发生情况。结果麻醉实施前两组患者MAP、HR值比较差异无统计学意义（P〉0.05）;与麻醉实施前比较,麻醉后5 min SA组患者MAP明显降低,HR明显升高,差异均有统计学意义（P〈0.05）;与麻醉实施前比较,麻醉后5 min LMA组患者HR值明显下降（P〈0.05）,而MAP下降不明显（P〉0.05）。麻醉后5 min和手术开始即刻,SA组患者MAP明显低于LMA组,HR明显高于LMA组,差异均有统计学意义（P〈0.05）。LMA组患者T值[（5.2±0.8）min]较SA组[（12.2±0.7）min]明显缩短（P〈0.05）。LMA组患者术后肛门排气时间及下床活动时间明显少于SA组,术后恶心、呕吐发生率明显低于SA组,差异均有统计学意义（P〈0.05）。结论喉罩全麻用于宫腔镜手术麻醉患者血流动力学更稳定、舒适,术后恢复更快。展开更多
Transition metal dichalcogenides(TMDs), exhibit a range of crystal structures and topological quantum states. The1T phase, in particular, shows promise for superconductivity driven by electron–phonon coupling(EPC), s...Transition metal dichalcogenides(TMDs), exhibit a range of crystal structures and topological quantum states. The1T phase, in particular, shows promise for superconductivity driven by electron–phonon coupling(EPC), strain, pressure,and chemical doping. In this theoretical investigation, we explore 1T-Rh Se Te as a novel type of TMD superconductor with topological electronic states. The optimal doping structure and atomic arrangement of 1T-Rh Se Te are constructed.Phonon spectrum calculations validate the integrity of the constructed doping structure. The analysis of the electron–phonon coupling using the electron–phonon Wannier(EPW) method has confirmed the existence of a robust electron–phonon interaction in 1T-Rh Se Te, resulting in total EPC constant λ = 2.02, the logarithmic average frequency ω_(log)= 3.15 me V and T_c = 4.61 K, consistent with experimental measurements and indicative of its classification as a BCS superconductor.The band structure analysis revealed the presence of Dirac-like band crossing points. The topological non-trivial electronic structures of the 1T-Rh Se Te are confirmed via the evolution of Wannier charge centers(WCCs) and time-reversal symmetryprotected topological surface states(TSSs). These distinctive properties underscore 1T-Rh Se Te as a possible candidate for a topological superconductor, warranting further investigation into its potential implications and applications.展开更多
文摘目的探讨喉罩全麻与蛛网膜下腔阻滞（腰麻）在宫腔镜手术中的应用效果。方法选取2015年8-12月于郑州大学第三附属医院行宫腔镜手术的100例患者为研究对象,采用随机数字表法将患者分为两组：喉罩组（LMA组）和蛛网膜下腔阻滞组/腰麻组（SA组）,每组各50例。LMA组予以长托宁0.5 mg,地塞米松10 mg,咪达唑仑2 mg,舒芬太尼0.3μg/kg,丙泊酚2-2.5μg/kg静脉诱导后置入喉罩,吸入七氟烷1.5%-2%维持麻醉,手术结束后停止七氟烷的吸入,高流量吸氧将患者肺内七氟烷排出体外,待患者自主呼吸恢复、潮气量适宜后叫醒患者,拔出喉罩。SA组患者于左侧卧位L3-4间隙通过针内针技术穿刺,于蛛网膜下腔注入0.5%罗哌卡因2.5 m L,调整麻醉平面T8-T6。观察记录麻醉实施前、麻醉后5 min、手术开始即刻两组患者的平均动脉压（MAP）及心率（HR）,记录患者从麻醉开始到手术开始的时间（T值）,随访观察两组患者的肛门排气时间、下床活动时间、恶心呕吐,及相关麻醉并发症的发生情况。结果麻醉实施前两组患者MAP、HR值比较差异无统计学意义（P〉0.05）;与麻醉实施前比较,麻醉后5 min SA组患者MAP明显降低,HR明显升高,差异均有统计学意义（P〈0.05）;与麻醉实施前比较,麻醉后5 min LMA组患者HR值明显下降（P〈0.05）,而MAP下降不明显（P〉0.05）。麻醉后5 min和手术开始即刻,SA组患者MAP明显低于LMA组,HR明显高于LMA组,差异均有统计学意义（P〈0.05）。LMA组患者T值[（5.2±0.8）min]较SA组[（12.2±0.7）min]明显缩短（P〈0.05）。LMA组患者术后肛门排气时间及下床活动时间明显少于SA组,术后恶心、呕吐发生率明显低于SA组,差异均有统计学意义（P〈0.05）。结论喉罩全麻用于宫腔镜手术麻醉患者血流动力学更稳定、舒适,术后恢复更快。
基金Project supported by the National Natural Science Foundation of China (Grant No. 12204400)Science Research Project of Hebei Education Department (Grant No. QN2022169)+1 种基金the Natural Science Foundation of Hebei Province (Grant Nos. A2022203010 and A2024203011)Innovation Capability Improvement Project of Hebei Province (Grant No. 22567605H)。
文摘Transition metal dichalcogenides(TMDs), exhibit a range of crystal structures and topological quantum states. The1T phase, in particular, shows promise for superconductivity driven by electron–phonon coupling(EPC), strain, pressure,and chemical doping. In this theoretical investigation, we explore 1T-Rh Se Te as a novel type of TMD superconductor with topological electronic states. The optimal doping structure and atomic arrangement of 1T-Rh Se Te are constructed.Phonon spectrum calculations validate the integrity of the constructed doping structure. The analysis of the electron–phonon coupling using the electron–phonon Wannier(EPW) method has confirmed the existence of a robust electron–phonon interaction in 1T-Rh Se Te, resulting in total EPC constant λ = 2.02, the logarithmic average frequency ω_(log)= 3.15 me V and T_c = 4.61 K, consistent with experimental measurements and indicative of its classification as a BCS superconductor.The band structure analysis revealed the presence of Dirac-like band crossing points. The topological non-trivial electronic structures of the 1T-Rh Se Te are confirmed via the evolution of Wannier charge centers(WCCs) and time-reversal symmetryprotected topological surface states(TSSs). These distinctive properties underscore 1T-Rh Se Te as a possible candidate for a topological superconductor, warranting further investigation into its potential implications and applications.
