目的:探讨胸腔镜直视下椎旁阻滞在胸腔镜下肺叶切除术术后镇痛的效果。方法:选取2019年5月至12月我院收治的行胸腔镜下肺叶切除术患者80例,美国麻醉协会(American Society of Anesthesiologists,ASA)分级Ⅱ-Ⅲ级,采用随机数字表法分为...目的:探讨胸腔镜直视下椎旁阻滞在胸腔镜下肺叶切除术术后镇痛的效果。方法:选取2019年5月至12月我院收治的行胸腔镜下肺叶切除术患者80例,美国麻醉协会(American Society of Anesthesiologists,ASA)分级Ⅱ-Ⅲ级,采用随机数字表法分为对照组和椎旁阻滞组,每组40例。对照组术毕采用静脉自控镇痛(patient-controlled intravenous analgesia,PCIA);椎旁阻滞组手术结束前行胸腔镜直视下多点椎旁神经阻滞(T 4-5和T 8-9间隙),术毕联合PCIA。记录术后动态VAS评分,镇痛泵按压次数、镇痛满意例数、镇痛补救例数以及术后恶心呕吐、头晕和术后谵妄等不良反应情况。结果:与对照组比较,椎旁阻滞组患者动态VAS评分明显降低;PCIA按压次数明显减少;需要镇痛补救的例数降低;患者术后满意例数增多。而且,椎旁阻滞组患者术后恶心呕吐和头晕的发生率明显低于对照组。结论:胸腔镜直视下椎旁阻滞联合术后PCIA可有效缓解胸腔镜肺叶切除术患者术后疼痛,减少术后镇痛药的应用,降低术后不良反应的发生率。展开更多
Chinese Reminder Theorem(CRT)for integers has been widely used to construct secret sharing schemes for different scenarios,but these schemes have lower information rates than that of Lagrange interpolation-based schem...Chinese Reminder Theorem(CRT)for integers has been widely used to construct secret sharing schemes for different scenarios,but these schemes have lower information rates than that of Lagrange interpolation-based schemes.In ASIACRYPT 2018,Ning,et al.constructed a perfect(r,n)-threshold scheme based on CRT for polynomial ring over finite field,and the corresponding information rate is one which is the greatest case for a(r,n)-threshold scheme.However,for many practical purposes,the information rate of Ning,et al.scheme is low and perfect security is too much security.In this work,the authors generalize the Ning,et al.(r,n)-threshold scheme to a(t,r,n)-ramp scheme based on CRT for polynomial ring over finite field,which attains the greatest information rate(r−t)for a(t,r,n)-ramp scheme.Moreover,for any given 2≤r_(1)<r_(2)≤n,the ramp scheme can be used to construct a(r_(1),n)-threshold scheme that is threshold changeable to(r′,n)-threshold scheme for all r′∈{r_(1)+1,r_(1)+2,···,r_(2)}.The threshold changeable secret sharing(TCSS)scheme has a greater information rate than other existing TCSS schemes of this type.展开更多
文摘目的:探讨胸腔镜直视下椎旁阻滞在胸腔镜下肺叶切除术术后镇痛的效果。方法:选取2019年5月至12月我院收治的行胸腔镜下肺叶切除术患者80例,美国麻醉协会(American Society of Anesthesiologists,ASA)分级Ⅱ-Ⅲ级,采用随机数字表法分为对照组和椎旁阻滞组,每组40例。对照组术毕采用静脉自控镇痛(patient-controlled intravenous analgesia,PCIA);椎旁阻滞组手术结束前行胸腔镜直视下多点椎旁神经阻滞(T 4-5和T 8-9间隙),术毕联合PCIA。记录术后动态VAS评分,镇痛泵按压次数、镇痛满意例数、镇痛补救例数以及术后恶心呕吐、头晕和术后谵妄等不良反应情况。结果:与对照组比较,椎旁阻滞组患者动态VAS评分明显降低;PCIA按压次数明显减少;需要镇痛补救的例数降低;患者术后满意例数增多。而且,椎旁阻滞组患者术后恶心呕吐和头晕的发生率明显低于对照组。结论:胸腔镜直视下椎旁阻滞联合术后PCIA可有效缓解胸腔镜肺叶切除术患者术后疼痛,减少术后镇痛药的应用,降低术后不良反应的发生率。
基金supported by the National Natural Science Foundation of China under Grant Nos.U1705264,61572132,61772292 and 61772476the Natural Science Foundation of Fujian Province under Grant No.2019J01275+1 种基金University Natural Science Research Project of Anhui Province under Grant No.KJ2020A0779the Singapore Ministry of Education under Grant Nos.RG12/19 and RG21/18(S).
文摘Chinese Reminder Theorem(CRT)for integers has been widely used to construct secret sharing schemes for different scenarios,but these schemes have lower information rates than that of Lagrange interpolation-based schemes.In ASIACRYPT 2018,Ning,et al.constructed a perfect(r,n)-threshold scheme based on CRT for polynomial ring over finite field,and the corresponding information rate is one which is the greatest case for a(r,n)-threshold scheme.However,for many practical purposes,the information rate of Ning,et al.scheme is low and perfect security is too much security.In this work,the authors generalize the Ning,et al.(r,n)-threshold scheme to a(t,r,n)-ramp scheme based on CRT for polynomial ring over finite field,which attains the greatest information rate(r−t)for a(t,r,n)-ramp scheme.Moreover,for any given 2≤r_(1)<r_(2)≤n,the ramp scheme can be used to construct a(r_(1),n)-threshold scheme that is threshold changeable to(r′,n)-threshold scheme for all r′∈{r_(1)+1,r_(1)+2,···,r_(2)}.The threshold changeable secret sharing(TCSS)scheme has a greater information rate than other existing TCSS schemes of this type.
