麻醉學精品ppt課件】麻醉新進展-文庫吧
2025-01-03 20:49 本頁面
【正文】 ? NMDA 氯氨酮，笑氣， xenon ? GABAA 吸入麻醉藥，異丙芬，咪唑安定 ? 麻醉藥敏感基因定位于第九號染色體 – 疼痛機制的研究： ? 與疼痛有關(guān)的基因和蛋白，許多與疼痛有關(guān)遞質(zhì) 麻醉學基礎(chǔ)研究的進展 ? Fig. 1. Annual citations in PubMed listed in response to the search terms pharmacogeics or pharmacogenomics 麻醉學基礎(chǔ)研究的進展 ? Sir William Osler, in 1892, said, If it were not for the great variability among individuals, medicine might as well be a science and not an art. ? The past few years (we39。re now a decade into the postgenome era) have witnessed explosive growth in technological capabilities, genome mapping, molecular and human geics, putational biology, etc. 麻醉學基礎(chǔ)研究的進展 ? Pharmacogeics to anesthesia, with a focus on how geic variability affects patients39。 response to drugs. ? Pharmacogeic variability may influence drug metabolism, drug transport, receptor structure and function, cell signaling, and the myriad of downstream responses we perceive in daily practice. 麻醉學基礎(chǔ)研究的進展 ? Clinical impact of pharmacogeics Clinical problems of 1960s – Prolonged apnea after succinylcholine – Thiopentalinduced acute porphyria – Halothane hepatitis – Malignant hyperthermia 麻醉學基礎(chǔ)研究的進展 ? Clinical impact of pharmacogeics Clinical problems of recent – Geic predisposition to latex allergy – Genotyping the Butyrylcholinesterase in Patients with Prolonged Neuromuscular Block – Impact of Pharmacogenomics on Postoperative Nausea and Vomiting – Pharmacogeic Determinants of Human Liver Microsomal Metabolism 麻醉學基礎(chǔ)研究的進展 ? In future might able to – Predict who would develop bleeding and who would develop graft thrombosis after coronary artery bypass grafting. – Transcriptional profiling with goal of silencing or induction of certain genes before anesthesia and surgery, ., we may be able to alter gene expression in elderly to prevent postanesthesia cognitive deficits and confusion. 麻醉學基礎(chǔ)研究的進展 ? In future might able to – Before surgery that would result in an ischemic injury, we may be able to induce genes responsible for defense mechanisms (., genes responsible for antiinflammation and resolution, genes responsible for superoxide dismutase, catalase, or both). 局麻輔助鎮(zhèn)靜技術(shù) ? 在歐美由于醫(yī)療消費的改革以及手術(shù)技術(shù)的進步 ，使局麻手術(shù)量有了大幅度增長 。 ? 通過術(shù)中鎮(zhèn)靜方法消除局麻患者的焦慮與恐懼 ，或使其在睡眠中安度手術(shù) ， 對于提高醫(yī)療質(zhì)量和患者的滿意度十分必要 。 ? 局麻輔助靜脈鎮(zhèn)靜藥可避免麻醉常見不良反應 ，
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