目的评价多联数字评分量表在开胸手术术后患者自控静脉镇痛方案中的应用价值。方法择期行开胸手术患者74例,采用随机数字表法分为多联数字评分量表组(M组)和对照组2组(n=37)。M组:患者离开手术室转送到监护病房前及术后每2小时根据多联...目的评价多联数字评分量表在开胸手术术后患者自控静脉镇痛方案中的应用价值。方法择期行开胸手术患者74例,采用随机数字表法分为多联数字评分量表组(M组)和对照组2组(n=37)。M组:患者离开手术室转送到监护病房前及术后每2小时根据多联视觉模拟评分(visual analogue scale,VAS)、Ramsay镇静评分、BCS(bruggrmann comfort scale)舒适评分、恶心及呕吐评分量表、呼吸抑制程度对患者进行综合评分,根据评分结果调整患者自控镇痛(patient controlled analgesia,PCA)的持续剂量和单次加强剂量;对照组:按照预设的持续给药剂量和单次PCA剂量实施术后患者自控静脉镇痛(patient controlled intravenous analgesia,PCIA),剂量不予调整。两组PCIA的预设镇痛方案为:舒芬太尼300μg+氟比洛芬酯200 mg+托烷司琼15 mg,用0.9%生理盐水稀释至300 m L持续泵注,持续给药剂量3 m L/h,单次PCA剂量2 m L,锁定时间15 min。观察并记录患者术后2、4、8、24 h和48 h的静息和运动VAS评分、Ramsay镇静评分、BCS舒适评分和不良反应发生率,术后48 h PCA的总共消耗量、PCA的有效按压次数、患者总体满意度评分。结果与对照组比较,术后各个观察时间点M组的静息VAS评分差异无统计学意义(P>0.05),M组的PCA有效按压次数显著降低(P<0.05);M组术后2 h和4 h运动VAS评分明显降低,术后2、4 h和8 h BCS舒适评分明显升高(P<0.05);M组术后2 h Ramsay镇静评分明显升高,术后48 h Ramsay镇静评分明显降低(P<0.05);M组术后2 h PCA消耗量明显增加(P<0.05),术后4、8、24、48 h消耗量明显降低(P<0.05),M组总体满意度明显升高(P<0.05)。术后48 h两组患者不良反应发生率差异无统计学意义(P>0.05),对照组发生2例呼吸抑制,2例眩晕和3例恶心、呕吐,M组发生3例眩晕和2例恶心、呕吐。两组均无患者出现皮肤瘙痒。结论与单纯PCIA相比,多联数字评分量表指导实施的PCIA能够更加安全有效地应用于开胸手术患者的术后镇痛,提高了术后镇痛的质量和患者的总体满意度。展开更多
目的:探索慢性腰痛病人利兹神经病理性症状和体征疼痛评分(leeds assessment of neuropathic symptoms and sign,LANSS)与疼痛强度的关系。方法:(1)三家研究中心(北京大学人民医院、中日友好医院和南京军区南京总医院)入选的慢性腰痛病...目的:探索慢性腰痛病人利兹神经病理性症状和体征疼痛评分(leeds assessment of neuropathic symptoms and sign,LANSS)与疼痛强度的关系。方法:(1)三家研究中心(北京大学人民医院、中日友好医院和南京军区南京总医院)入选的慢性腰痛病人填写LANSS量表及疼痛数字评分量表(numerical rating scale,NRS)。(2)使用spearman相关分析评价LANSS量表评分与疼痛强度的关系。结果:入组2115例慢性腰痛病人,总合格率为90.0%,调查对象平均年龄为50.1±15.6年,合格病人中男778例,女1125例。LANSS评分中值随疼痛强度的增加有一定的增长,但是两者的spearman秩相关系数小于0.4,且LANSS量表各项评分与疼痛强度的spearman秩相关系数均小于0.4。结论:中文版LANSS评分随疼痛强度的增加有一定的上升趋势,但是两者并无相关性。展开更多
The model of heat source(MHS) which reflects the thermal interaction between materials and laser during processing determines the accuracy of simulation results. To acquire desirable simulations results, although vari...The model of heat source(MHS) which reflects the thermal interaction between materials and laser during processing determines the accuracy of simulation results. To acquire desirable simulations results, although various modifications of heat sources in the aspect of absorption process of laser by materials have been purposed, the distribution of laser power density(DLPD) in MHS is still modeled theoretically. However, in the actual situations of laser processing, the DLPD is definitely different from the ideal models. So, it is indispensable to build MHS using actual DLPD to improve the accuracy of simulation results. Besides, an automatic modeling method will be benefit to simplify the tedious pre-processing of simulations. This paper presents a modeling method and corresponding algorithm to model heat source using measured DLPD. This algorithm automatically processes original data to get modeling parameters and provides a step MHS combining with absorption models. Simulations and experiments of heat transfer in steel plates irradiated by laser prove the mothed and the step MHS. Moreover, the investigations of laser induced thermal-crack propagation in glass highlight the signification of modeling heat source based on actual DLPD and demonstrate the enormous application of this method in the simulation of laser processing.展开更多
文摘目的评价多联数字评分量表在开胸手术术后患者自控静脉镇痛方案中的应用价值。方法择期行开胸手术患者74例,采用随机数字表法分为多联数字评分量表组(M组)和对照组2组(n=37)。M组:患者离开手术室转送到监护病房前及术后每2小时根据多联视觉模拟评分(visual analogue scale,VAS)、Ramsay镇静评分、BCS(bruggrmann comfort scale)舒适评分、恶心及呕吐评分量表、呼吸抑制程度对患者进行综合评分,根据评分结果调整患者自控镇痛(patient controlled analgesia,PCA)的持续剂量和单次加强剂量;对照组:按照预设的持续给药剂量和单次PCA剂量实施术后患者自控静脉镇痛(patient controlled intravenous analgesia,PCIA),剂量不予调整。两组PCIA的预设镇痛方案为:舒芬太尼300μg+氟比洛芬酯200 mg+托烷司琼15 mg,用0.9%生理盐水稀释至300 m L持续泵注,持续给药剂量3 m L/h,单次PCA剂量2 m L,锁定时间15 min。观察并记录患者术后2、4、8、24 h和48 h的静息和运动VAS评分、Ramsay镇静评分、BCS舒适评分和不良反应发生率,术后48 h PCA的总共消耗量、PCA的有效按压次数、患者总体满意度评分。结果与对照组比较,术后各个观察时间点M组的静息VAS评分差异无统计学意义(P>0.05),M组的PCA有效按压次数显著降低(P<0.05);M组术后2 h和4 h运动VAS评分明显降低,术后2、4 h和8 h BCS舒适评分明显升高(P<0.05);M组术后2 h Ramsay镇静评分明显升高,术后48 h Ramsay镇静评分明显降低(P<0.05);M组术后2 h PCA消耗量明显增加(P<0.05),术后4、8、24、48 h消耗量明显降低(P<0.05),M组总体满意度明显升高(P<0.05)。术后48 h两组患者不良反应发生率差异无统计学意义(P>0.05),对照组发生2例呼吸抑制,2例眩晕和3例恶心、呕吐,M组发生3例眩晕和2例恶心、呕吐。两组均无患者出现皮肤瘙痒。结论与单纯PCIA相比,多联数字评分量表指导实施的PCIA能够更加安全有效地应用于开胸手术患者的术后镇痛,提高了术后镇痛的质量和患者的总体满意度。
文摘目的:探索慢性腰痛病人利兹神经病理性症状和体征疼痛评分(leeds assessment of neuropathic symptoms and sign,LANSS)与疼痛强度的关系。方法:(1)三家研究中心(北京大学人民医院、中日友好医院和南京军区南京总医院)入选的慢性腰痛病人填写LANSS量表及疼痛数字评分量表(numerical rating scale,NRS)。(2)使用spearman相关分析评价LANSS量表评分与疼痛强度的关系。结果:入组2115例慢性腰痛病人,总合格率为90.0%,调查对象平均年龄为50.1±15.6年,合格病人中男778例,女1125例。LANSS评分中值随疼痛强度的增加有一定的增长,但是两者的spearman秩相关系数小于0.4,且LANSS量表各项评分与疼痛强度的spearman秩相关系数均小于0.4。结论:中文版LANSS评分随疼痛强度的增加有一定的上升趋势,但是两者并无相关性。
基金Project(2021YFF0500200) supported by the National Key R&D Program of ChinaProject(52105437) supported by the National Natural Science Foundation of China+1 种基金Project(202006120184) supported by the Heilongjiang Provincial Postdoctoral Science Foundation,ChinaProject(LBH-Z20054) supported by the China Scholarship Council。
文摘The model of heat source(MHS) which reflects the thermal interaction between materials and laser during processing determines the accuracy of simulation results. To acquire desirable simulations results, although various modifications of heat sources in the aspect of absorption process of laser by materials have been purposed, the distribution of laser power density(DLPD) in MHS is still modeled theoretically. However, in the actual situations of laser processing, the DLPD is definitely different from the ideal models. So, it is indispensable to build MHS using actual DLPD to improve the accuracy of simulation results. Besides, an automatic modeling method will be benefit to simplify the tedious pre-processing of simulations. This paper presents a modeling method and corresponding algorithm to model heat source using measured DLPD. This algorithm automatically processes original data to get modeling parameters and provides a step MHS combining with absorption models. Simulations and experiments of heat transfer in steel plates irradiated by laser prove the mothed and the step MHS. Moreover, the investigations of laser induced thermal-crack propagation in glass highlight the signification of modeling heat source based on actual DLPD and demonstrate the enormous application of this method in the simulation of laser processing.
