目的比较B超测量环状软骨水平气道横径(minimal transverse diameter of the subglottic airway,MTDSA)法、年龄公式法和身高公式法对加强型带套囊气管导管型号选择的预判价值。方法选取睢宁县人民医院外科2021年1月—2021年12月择期手术行全麻气管插管患儿120例(排除失访及资料不全样本7例,删失率5.83%),按照分层随机区组的方式将研究样本分为年龄公式组(36例)、身高公式组(39例)和MTDSA组(38例)。气管导管选择加强型带套囊气管导管,3组分别以年龄公式法、身高公式法和B超测量MTDSA法行气管导管型号预评估,以插管成功最适气管导管型号为标准,判定3种方法的预评估准确率;比较组间换管率,插管后即刻MAP、心率,并发症情况。结果B超测量MTDSA法对首次气管导管型号评估的准确率为86.84%,高于年龄公式法的55.56%、身高公式法的46.15%(P<0.05)。MTDSA组换管率为5.26%、换管例次率为10.53%,均低于年龄公式组的33.33%、44.44%和身高公式组的43.59%、58.97%(P<0.05)。MTDSA组并发症中声音嘶哑(2.63%)、喉头水肿(0)发生率低于身高公式组(28.21%,20.51%)(P<0.05);年龄公式组与MTDSA组并发症发生率差异均无统计学意义(P>0.05)。结论B超测量MTDSA法指导加强型带套囊气管导管型号的选择具有较高的导管型号预测准确率和较低的并发症发生率。
Objective To evaluate the effect of neuropathic pain on the expression of GABAB receptor subtypes in spinal cord of rats with chronic constriction injury.Methods 36 rats were divided into Sham group and CCI group respectively.In CCI group,the left common sciatic nerve of anesthetized rats was exposed,four silk ligatures（30） were tied loosely proximal to the sciatica’s trifurcation.In Sham group,Sham surgery was undergone by exposing the left sciatic nerve without ligation.Hind paw thermal withdrawl latency（TWL） to thermal stimulus and mechanical withdrawl threshold（MWT） of mechanical stimulus were recorded before ligation or on 1 d,3 d,5 d,7 d,10 d,14 d,21 d,28 d after ligation respectively（n=8）.Expression of GABAB receptor subtypes were detected before ligation and 1 d,3 d,7 d,14 d,28 d after ligation respectively using bothe immunohistochemical assay（n=6） and Western blot technique（n=4）.Results There were no significant differences on the values of MWT and TWL before ligation between Sham group and CCI group.Compared with Sham group,the MWT and TWL of rats in CCI group significantly decreased after ligation（P<0.01,P<0.05） and continued to be decreased until 28 d after ligation.Both immunoreactive neurons and protein content of GABAB1a or GABAB2 subtypes increased on the 3rd day after ligation,then both decreased on the 7th day after ligation,and lasted for 28 dafter ligation.（P<0.01,P<0.05）.There were no changes of GABAB1b after ligation（P>0.05）.Conclusion There existed differences among expression of spinal GABAB receptor subtypes on rats with chronic constriction injury induced neuropathic pain.The expression of spinal GABAB1a and GABAB2 decreased while there were no changes of GABAB1b on neuropathic rats.
