共查询到20条相似文献,搜索用时 140 毫秒
1.
2.
3.
目的 探讨动静脉内瘘手术方法及其临床效果.方法 分别行前臂动静脉内瘘,鼻烟窝部内瘘及上臂动静脉内瘘手术治疗100例慢性肾功能衰竭患者.结果 100例病人手术均1次成功,术后2周以上使用动静脉内瘘均能达到血液透析要求血流量.结论 动静脉内瘘首选非惯用手鼻烟窝处桡动脉和头静脉吻合,其近期并发症最常见是血栓形成,远期常见为吻合口狭窄或闭塞致二次手术. 相似文献
4.
5.
目的通过对慢性血液透析患者鼻烟窝动静脉内瘘的彩超监测,并与常规前臂动静脉内瘘比较,以评价鼻烟窝动静脉内瘘的应用价值。方法51例慢性血液透析患者按内瘘术式不同分为二组,其中鼻烟窝动静脉内瘘组30例、前臂动静脉内痿组21例,应用彩色多普勒超声监测比较二者手术1年后通畅率、吻合口内径、吻合口平均血流量及并发症发生率。结果鼻烟窝动静脉内瘘组与前臂动静脉内瘘组手术1年后通畅率分别为90.0%(27/30)和90.5%(19/21);吻合口内径分别为(3.10±0.11)mm和(3.40±0.12)mm;吻合口平均血流量分别为(368.4±6.2)ml/min和(381.2±6.0)mJ/min;并发症发生率分别为10.0%(3/30)和23.8%(5/21)。二者比较在手术1年后通畅率、吻合口内径、吻合17平均血流量及并发症发生率上差异无统计学意义(P〉0.05)。结论鼻烟窝动静脉内瘘与前臂动静脉内瘩比较,在手术1年后通畅率、吻合口内径、吻合口平均血流量及并发症发生率上无明显差异,可做为慢性血液透析患者首选的内瘘术式之一。 相似文献
6.
目的:研究鼻烟窝动静脉内瘘在长期血液透析患者中的临床应用价值。方法对51例尿毒症患者实施显微镜下鼻烟窝桡动脉远心端与头静脉近心端血管吻合术制作动静脉内瘘。结果49例内瘘手术一次性成功,手术成功率为96.08%,内瘘4周、1年、2年、3年、5年通畅率分别为93.88%、78.57%、75%、50%及23.08%。内瘘初次使用时吻合口平均血流量为(612±104)ml/min,透析平均血流量253 ml/min。结论鼻烟窝动静脉内瘘可作为血管条件较好的长期血液透析患者最优先选择的血管通路。 相似文献
7.
目的 研究扩张头静脉建立鼻烟窝动静脉内瘘在长期血液透析患者中的临床应用价值.方法 137例尿毒症患者分两组分别实施鼻烟窝(72例)与腕部(65例)桡动脉远心端与头静脉近心端血管吻合术制作动静脉内瘘,观察比较两种内瘘手术的吻合口内径、内瘘成熟时间和初次透析的血流量及2年随访观察透析使用时间、通畅度及并发症情况.结果 137例内瘘手术均一次成功,鼻烟窝内瘘的患者头静脉扩张后口径明显增大(P<o.05),扩张前口径小于腕部内瘘的患者,差异具有统计学意义(P<o.05).两种方法的透析使用时间、畅通率差异均无统计学意义(P>0.05).由于肝素生理盐水的冲扩,鼻烟窝内瘘路径术后血栓形成的发生率更小(P<0.05).结论 鼻烟窝动静脉内瘘可作为长期血液透析患者较佳的血管通路选择. 相似文献
8.
目的探讨侧侧吻合术建立的鼻烟窝动静脉内瘘的临床效果。方法回顾性分析因终末期肾病行首次动静脉内瘘手术的患者67例,将行侧侧吻合术建立鼻烟窝动静脉内瘘的33例患者设为观察组,行端侧吻合术建立腕部桡动脉-头静脉内瘘的34例患者设为对照组。比较两组患者手术成功率(术后6周动静脉内瘘可使用率)、2年通畅率、2年后吻合口流量及并发症发生率。结果两组患者手术成功率、2年通畅率、2年后吻合口流量比较均无统计学差异(均P>0.05),观察组患者并发症发生率低于对照组,两组比较有统计学差异(6.06%vs.23.53%,P<0.05)。结论侧侧吻合术建立的鼻烟窝动静脉内瘘具有端侧吻合术建立的腕部桡动脉-头静脉内瘘相同的功效及较低的并发症发生率,推荐作为血液透析患者首次动静脉内瘘手术的首选。 相似文献
9.
目的 血液透析动静脉内瘘是维持性血液透析患者的主要血管通路,它是患者的"生命线",探讨延长动静脉内瘘使用"寿命"的管理,防止动静脉内瘘闭塞,减少病人痛苦;减少医疗护理费用;提高血液透析病人的生存质量;让病人回归社会.方法 分析29例终末期肾功能衰竭患者,33次采用头静脉与桡动脉用钛轮钉做端端吻合内瘘,做好术前指导、术后管理、做好内瘘穿刺与护理、对工作人员和病人进行有关动静脉内瘘的重要性及其护理的教育、防止内瘘感染、建立延长动静脉内瘘使用时间的方法.结果 因护理人员按压不当造成内瘘闭塞1例;术后病人睡眠压迫患侧肢体、造成内瘘闭塞1例;病人自身血管条件差、内瘘使用过早、造成内瘘闭塞1例;1例与透析过程脱水、长期低血压闭塞1例,行第2次动静脉内瘘吻合术4例.除病人死亡、转院治疗、肾移植、经济困难停止透析6例外.内瘘使用1~2年4例,内瘘使用"寿命">3年16例.其余均通畅,目前使用良好.结论 提高患者自我保护意识、强化提高护理人员内瘘穿刺技术与护理,无菌操作,是延长动静脉内瘘使用"寿命"的关键. 相似文献
10.
目的 探讨维持性血液透析患者首选的内瘘手术方式.方法 100例慢性肾功能衰竭患者随机分为鼻咽窝组、前臂腕部(前臂组)各50例,采用显微外科技术分别行直接动静脉内瘘术,比较两组内瘘成熟时间、手术1年后吻合口血流量、血透时血流量、近远期通畅率及并发症等.结果 两组在内瘘成熟时间、手术1年后吻合口血流量、血透时平均血流量、4周后通畅率、1年后通畅率上无统计学意义(P>0.05),但在2、3年后通畅率鼻烟窝组高于前臂组,差异有统计学意义(P<0.05).鼻烟窝组在术后并发症方面少于前臂组.结论 鼻烟窝动静脉内瘘保留了近端血管以备重建内瘘,能满足常规血透的血流量,远期通畅率高,并发症少,是血液透析首选的永久性血管通路. 相似文献
11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD. 相似文献
12.
Jiageng Zhu Jun Li Ruipeng Ji Jianghao Su Mingshun Shen Zhigang Cao 《南京医科大学学报(自然科学版)》2007,21(2):125-128
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment. 相似文献
13.
APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES 总被引:13,自引:0,他引:13
Hong Zhao Tie-hu Ye* Zhi-yi Gong Yang Xue Zhang-gang Xue and Wen-qi HuangDepartment of Anesthesiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing Department of Anesthesiology Zhongshan Hospital Fudan University Shanghai Department of Anesthesiology the First Affiliated Hospital Zhongshan University Guangzhou 《中国医学科学杂志(英文版)》2005,20(1):59-62
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle… 相似文献
14.
Tao Ye * Zhi-quan Liu Jian-jun Mu Xi-han Fu Jun Yang Bao-lin Gao and Xiao-hong Zhang Department of Cardiology First Hospital of Xi'an Jiaotong University Xi'an Hanzhong Cardiovascular Institute Hanzhong 《中国医学科学杂志(英文版)》2004,19(4):248-251
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure. 相似文献
15.
Xi-zhao Sun Zhi-wei Zhang 《中国医学科学杂志(英文版)》2005,20(3):221-221
Shock wave lithotripsy (SWL) is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it's difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath. 相似文献
16.
Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction. 相似文献
17.
INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5 相似文献
18.
People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia its metabolic origin in Tibetan population.…… 《中国医学科学杂志(英文版)》2007,22(2):F0003-F0003
People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population. 相似文献
19.
Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea. 相似文献
20.
In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects. 相似文献