目的 观察和比较收肌管阻滞与股神经阻滞对全麻下老年患者全膝关节置换术(TKA)后恢复质量的影响。方法 选择2023年5—12月行单侧TKA患者100例,男24例,女76例,年龄65~80岁,BMI 18.5~35.0 kg/m^(2),ASAⅡ或Ⅲ级。采用随机数字表法将患者...目的 观察和比较收肌管阻滞与股神经阻滞对全麻下老年患者全膝关节置换术(TKA)后恢复质量的影响。方法 选择2023年5—12月行单侧TKA患者100例,男24例,女76例,年龄65~80岁,BMI 18.5~35.0 kg/m^(2),ASAⅡ或Ⅲ级。采用随机数字表法将患者分为两组:收肌管神经阻滞组(A组)与股神经阻滞组(F组),每组50例。术前30 min A组于收肌管注射0.375%罗哌卡因10 ml行收肌管神经阻滞,F组于腹股沟注射0.375%罗哌卡因10 ml行股神经阻滞。术后24、48 h记录QoR-15量表并采用徒手肌力法(MMT)评估手术侧下肢肌力情况,记录术后自主呼吸恢复时间、拔管时间、首次下床活动时间、术后48 h静脉血C-反应蛋白(CRP)浓度、术后24、48 h静息、活动时NRS疼痛评分、术后24 h内患者镇痛满意度、镇痛泵有效按压次数、镇痛泵总按压次数、补救镇痛情况、反弹性疼痛发生情况、不良反应发生情况。结果 与F组比较,A组术后48 h QoR-15评分和术后24 h MMT评分明显升高,首次下床活动时间明显缩短,术后48 h CRP浓度明显降低(P<0.05)。两组术后自主呼吸恢复时间、拔管时间、术后24 h QoR-15评分、24、48 h MMT评分和NRS疼痛评分、镇痛满意率、镇痛泵有效按压次数、镇痛泵总按压次数、补救镇痛率差异均无统计学意义。两组反弹性疼痛、术后24 h内恶心呕吐、心律失常、头晕发生率差异均无统计学意义。结论 与股神经阻滞比较,收肌管阻滞更好地保留老年患者TKA手术侧下肢肌力,缩短术后首次下床活动时间,提高患者术后恢复质量。展开更多
The magnetic fields and dynamical processes in the solar polar regions play a crucial role in the solar magnetic cycle and in supplying mass and energy to the fast solar wind,ultimately being vital in controlling sola...The magnetic fields and dynamical processes in the solar polar regions play a crucial role in the solar magnetic cycle and in supplying mass and energy to the fast solar wind,ultimately being vital in controlling solar activities and driving space weather.Despite numerous efforts to explore these regions,to date no imaging observations of the Sun's poles have been achieved from vantage points out of the ecliptic plane,leaving their behavior and evolution poorly understood.This observation gap has left three top-level scientific questions unanswered:How does the solar dynamo work and drive the solar magnetic cycle?What drives the fast solar wind?How do space weather processes globally originate from the Sun and propagate throughout the solar system?The Solar Polarorbit Observatory(SPO)mission,a solar polar exploration spacecraft,is proposed to address these three unanswered scientific questions by imaging the Sun's poles from high heliolatitudes.In order to achieve its scientific goals,SPO will carry six remote-sensing and four in-situ instruments to measure the vector magnetic fields and Doppler velocity fields in the photosphere,to observe the Sun in the extreme ultraviolet,X-ray,and radio wavelengths,to image the corona and the heliosphere up to 45 R_(s),and to perform in-situ detection of magnetic fields,and low-and high-energy particles in the solar wind.The SPO mission is capable of providing critical vector magnetic fields and Doppler velocities of the polar regions to advance our understanding of the origin of the solar magnetic cycle,providing unprecedented imaging observations of the solar poles alongside in-situ measurements of charged particles and magnetic fields from high heliolatitudes to unveil the mass and energy supply that drive the fast solar wind,and providing observational constraints for improving our ability to model and predict the three-dimensional(3D)structures and propagation of space weather events.展开更多
文摘目的 观察和比较收肌管阻滞与股神经阻滞对全麻下老年患者全膝关节置换术(TKA)后恢复质量的影响。方法 选择2023年5—12月行单侧TKA患者100例,男24例,女76例,年龄65~80岁,BMI 18.5~35.0 kg/m^(2),ASAⅡ或Ⅲ级。采用随机数字表法将患者分为两组:收肌管神经阻滞组(A组)与股神经阻滞组(F组),每组50例。术前30 min A组于收肌管注射0.375%罗哌卡因10 ml行收肌管神经阻滞,F组于腹股沟注射0.375%罗哌卡因10 ml行股神经阻滞。术后24、48 h记录QoR-15量表并采用徒手肌力法(MMT)评估手术侧下肢肌力情况,记录术后自主呼吸恢复时间、拔管时间、首次下床活动时间、术后48 h静脉血C-反应蛋白(CRP)浓度、术后24、48 h静息、活动时NRS疼痛评分、术后24 h内患者镇痛满意度、镇痛泵有效按压次数、镇痛泵总按压次数、补救镇痛情况、反弹性疼痛发生情况、不良反应发生情况。结果 与F组比较,A组术后48 h QoR-15评分和术后24 h MMT评分明显升高,首次下床活动时间明显缩短,术后48 h CRP浓度明显降低(P<0.05)。两组术后自主呼吸恢复时间、拔管时间、术后24 h QoR-15评分、24、48 h MMT评分和NRS疼痛评分、镇痛满意率、镇痛泵有效按压次数、镇痛泵总按压次数、补救镇痛率差异均无统计学意义。两组反弹性疼痛、术后24 h内恶心呕吐、心律失常、头晕发生率差异均无统计学意义。结论 与股神经阻滞比较,收肌管阻滞更好地保留老年患者TKA手术侧下肢肌力,缩短术后首次下床活动时间,提高患者术后恢复质量。
文摘The magnetic fields and dynamical processes in the solar polar regions play a crucial role in the solar magnetic cycle and in supplying mass and energy to the fast solar wind,ultimately being vital in controlling solar activities and driving space weather.Despite numerous efforts to explore these regions,to date no imaging observations of the Sun's poles have been achieved from vantage points out of the ecliptic plane,leaving their behavior and evolution poorly understood.This observation gap has left three top-level scientific questions unanswered:How does the solar dynamo work and drive the solar magnetic cycle?What drives the fast solar wind?How do space weather processes globally originate from the Sun and propagate throughout the solar system?The Solar Polarorbit Observatory(SPO)mission,a solar polar exploration spacecraft,is proposed to address these three unanswered scientific questions by imaging the Sun's poles from high heliolatitudes.In order to achieve its scientific goals,SPO will carry six remote-sensing and four in-situ instruments to measure the vector magnetic fields and Doppler velocity fields in the photosphere,to observe the Sun in the extreme ultraviolet,X-ray,and radio wavelengths,to image the corona and the heliosphere up to 45 R_(s),and to perform in-situ detection of magnetic fields,and low-and high-energy particles in the solar wind.The SPO mission is capable of providing critical vector magnetic fields and Doppler velocities of the polar regions to advance our understanding of the origin of the solar magnetic cycle,providing unprecedented imaging observations of the solar poles alongside in-situ measurements of charged particles and magnetic fields from high heliolatitudes to unveil the mass and energy supply that drive the fast solar wind,and providing observational constraints for improving our ability to model and predict the three-dimensional(3D)structures and propagation of space weather events.
