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[支气管痉挛病例中麻醉医生面临的诊断、病因及治疗问题。附4例报告]

[Diagnostic, etiologic and therapeutic problems confronting the anesthesiologist in cases of bronchial spasm. Apropos of 4 cases].

作者信息

Fogliani J, Orehek J, Bergier M A

出版信息

Ann Anesthesiol Fr. 1977;18(7-8):611-8.

PMID:74221
Abstract

The authors recall the symptoms of peroperative and early postoperative bronchospasm. They emphasise the etiology and the treatment. In fact, bronchospasm may be induced by several causes:--mechanical or chemical vagal stimulation;--direct or allergic-induced histamine liberation, induced by certain drugs (mainly curare);--taking beta-blockaders before operation, favoured by the use of morphine during operation;--finally, any irritation of the bronchi (inhalation of gastric juice, pulmonary embolism, pulmonary oedemal). The treatment is etiological but also symptomatic:--enrich the inspired air with oxygen;--inject I.V. 1/2 to 1mg of atropine;--in case of failure, one should use Salbutamol I.V. which is very effective during contraction of the bronchial muscles;--massive corticosteroid therapy will be effective in mucosal oedema.

摘要

作者回顾了手术中和术后早期支气管痉挛的症状。他们强调了其病因和治疗方法。事实上,支气管痉挛可能由多种原因引起:——机械性或化学性迷走神经刺激;——某些药物(主要是箭毒)引起的直接或过敏性组胺释放;——术前服用β受体阻滞剂,术中使用吗啡会加重;——最后,任何对支气管的刺激(吸入胃液、肺栓塞、肺水肿)。治疗方法既要针对病因,也要对症治疗:——吸入空气中增加氧气;——静脉注射0.5至1毫克阿托品;——如果无效,应使用静脉注射沙丁胺醇,其在支气管肌肉收缩时非常有效;——大剂量皮质类固醇疗法对黏膜水肿有效。

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