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320排CT头颈联合扫描评价颈动脉血运重建术前后脑血流动力学变化 总被引:1,自引:1,他引:0
目的:采用320排CT头颈联合多参数扫描模式,对拟行颈动脉血运重建术的患者进行扫描,探讨颈动脉狭窄解除与脑灌注参数改善间的关系,并进一步探讨脑血流动力学改变,对血运重建术前不同类型患者选择的意义。方法:30例经超声证实颈动脉狭窄并拟行颈动脉血运重建术的患者,分别于术前及术后2w内进行320排CT头颈联合多参数扫描,对颈动脉狭窄程度及脑灌注各参数相对值进行分析。参数包括相对脑血流量(rCBF)、相对脑血容量(rCBV)、相对平均通过时间(rMTT)、相对达峰时间(rTTP)及相对延迟时间(rDelay)。由2名有经验的放射科医生分别根据脑灌注成像结果,将患者定性分为双侧大脑半球灌注对称组12例、双侧大脑半球灌注不对称组18例。结果:颈动脉血运重建术后患侧rTTP及rDelay较术前改善,其余灌注参数手术前后的差异无统计学意义。根据术前脑灌注状态不同,对术前患者进一步分层研究,术前灌注对称组,术后患侧脑灌注各参数数值改善不明显;术前灌注不对称组,术后rCBV、rMTT、rTTP及rDelay较前改善。结论:320排CT头颈联合多参数扫描模式,可以全面地显示颈动脉血运重建术前后,颈动脉狭窄的形态学改变,及其所导致的患侧供血区血流动力学的改变,为患者术前评价、治疗方案的选择及术后疗效的观察提供依据。 相似文献
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Objective To evaluate the effect on ultrasound-guided locsl comprression and surgical to treat iatrogenic fem- oral artery pseudoanerurysms. Methods 197 patients were diagnosed as iatrogenic femoral artery pseudoaneurysms from Apri 1199 to April 2008.There were 122 male and 75 female, aged 59.7 years (rimed 40- 81 years). One. Hundrel and severty-one stahle cases were managed by ultrasound-guided local compression initially and 26 patients were directly treated with surgical repair because d the rupture of femoral artery pesudoaneurysms or the pseudoaneurysms≥40mm in diameter. Results 171 patients received llocal com- pression therapy, 137 cases were cured directly (the effective rate was 80%), but the last failed 34 cases were required conversion to surgical reparr. The nymber of the surgical repaired patients was 60 (incluing 26 cases with direct operation and 34 cases with required conversion to surgical repair). Forty-seven patients received direct excision of femoral artery pseudoaneurysm, six patients underwent angioplasty with autogenously saphenous vein patch, and seven patients got bypass operation with artificial vascular graft. During the perioperative period, no serious complications including bleeding, neuralgia, and lymphatic fistula even arterio venous fis- tula and so on, no death occurred. All patients were followed up for 1 month to5 years after the procedures, no local FAP recurred, no limb ischemia developed and no deaths occurred. Conclusion Uitrasound-guided compression, surgical repair, and ultrasound- guided percutaneous thrombin injection are the three main modalities of treating iatrogenic FAP, while ultrasound-guided compresson and magical therapy get popularized domestically. Ultrasound-guided comperession seems a safe, inexpensive, and effective method for the managerment of iatrogenic femoral artery pseudoaneurysms. It may be used as a lust-line therapetic modality for mint of the un-complicated patients. However, surgical repair can be reserved for those who failed comperssion therapy or unsuitable as mentioned above. 相似文献
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【目的】探讨内皮素受体(ETR)亚型基因表达在门静脉高压症胃病(PHG)中的变化及作用。【方法】采用逆转录聚合酶链式反应(RT-PCR)分析42例肝硬化门静脉高压症患者PHG病变部位ETA受体和ETB受体mRNA的变化。【结果】轻度PHG胃黏膜ETAR mRNA、ETBR mRNA表达明显升高,与无PHG组及对照组比较差异均有显著意义(P〈0.001),重度PHG的ETAR mRNA、ETBR mRNA表达进一步增强,与轻度PHG者比较差异亦有显著意义(P〈0.001);【结论】PHG患者ETR基因过度表达可能是加重胃黏膜损害的重要因素之一。 相似文献
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结缔组织病(CTD)是一组累及全身多系统、多脏器的自身免疫性疾病,肺脏受累以间质性肺疾病最多见。间质性肺疾病(ILD)是主要累及肺间质、肺泡和(或) 细支气管的一组肺部弥漫性疾病,以进行性呼吸困难,X线胸片弥漫性阴影,限制性通气功能障碍,弥散功能降低及低氧血症为临床表现的疾病群。ILD并不是一种独立的疾病,ILD 中有一部分继发于结缔组织病,是一类通过自身免疫反应导致机体损伤的全身性疾病累及肺泡,导致肺间质和支气管周围组织不同程度的炎症反应及纤维组织增生,称为结缔组织病相关间质性肺病(CTD-ILD)。本文旨在总结CTD-ILD的临床特点,从而提高对CTD-ILD的认识,做到早期诊断,早期治疗。 相似文献
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Objective To evaluate the effect on ultrasound-guided locsl comprression and surgical to treat iatrogenic fem- oral artery pseudoanerurysms. Methods 197 patients were diagnosed as iatrogenic femoral artery pseudoaneurysms from Apri 1199 to April 2008.There were 122 male and 75 female, aged 59.7 years (rimed 40- 81 years). One. Hundrel and severty-one stahle cases were managed by ultrasound-guided local compression initially and 26 patients were directly treated with surgical repair because d the rupture of femoral artery pesudoaneurysms or the pseudoaneurysms≥40mm in diameter. Results 171 patients received llocal com- pression therapy, 137 cases were cured directly (the effective rate was 80%), but the last failed 34 cases were required conversion to surgical reparr. The nymber of the surgical repaired patients was 60 (incluing 26 cases with direct operation and 34 cases with required conversion to surgical repair). Forty-seven patients received direct excision of femoral artery pseudoaneurysm, six patients underwent angioplasty with autogenously saphenous vein patch, and seven patients got bypass operation with artificial vascular graft. During the perioperative period, no serious complications including bleeding, neuralgia, and lymphatic fistula even arterio venous fis- tula and so on, no death occurred. All patients were followed up for 1 month to5 years after the procedures, no local FAP recurred, no limb ischemia developed and no deaths occurred. Conclusion Uitrasound-guided compression, surgical repair, and ultrasound- guided percutaneous thrombin injection are the three main modalities of treating iatrogenic FAP, while ultrasound-guided compresson and magical therapy get popularized domestically. Ultrasound-guided comperession seems a safe, inexpensive, and effective method for the managerment of iatrogenic femoral artery pseudoaneurysms. It may be used as a lust-line therapetic modality for mint of the un-complicated patients. However, surgical repair can be reserved for those who failed comperssion therapy or unsuitable as mentioned above. 相似文献
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目的:探讨直肠癌前切除手术术后吻合口漏的发生率和危险因素.方法:回顾性分析1998-02/2007-05我院行直肠癌前切除手术患者518例的病例资料,探讨直肠癌前切除手术术后吻合口漏发生率的危险因素.结果:518例直肠癌前切除术后共发生吻合口漏48例,发生率9.2%(48/518).患者年龄>65岁、术前血清白蛋白<35 g/L、术前有糖尿病病史、术中没有行保护性近端肠造瘘、肿瘤病灶直径>30 mm是患者术后发生吻合口漏的危险因素.结论:对于存在上述吻合口漏风险因素的患者,行保护性近端肠造瘘能够减低了吻合口漏的发生率. 相似文献
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目的:评价应用"医护一体化"集成信息系统的效果。方法:对照"军字一号"信息系统,抽查10名护士工作质量,选取78例患者进行满意测评。结果:"医护一体化"集成信息系统与"军字一号"系统相比,护士处理文书、收集资料的时间明显减少,具有统计学差异,且降低护理缺陷发生率;患者对护理服务的满意度较前系统提高。结论:应用升级的集成信息系统,可提高护理工作效率和质量,达到提高患者满意度的效果。 相似文献