west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "介入" 251 results
  • Evidence-Based Clinical Treatment for a First-Diagnosed Patient with Coronary Artery-Pulmonary Artery Fistula

    Objective To formulate an individualized evidence-based treatment for a first-diagnosed patient with coronary artery-pulmonary artery fistula. Methods Aiming at the issue of whether interventional operation was necessary for first-diagnosed coronary artery-pulmonary artery fistula or not, the computer retrieval was conducted in the US National Guideline Clearinghouse, The Cochrane Library, PubMed and MEDLINE from 1990 to 2011, to collect and assess the best evidence of relevant systematic reviews, randomized controlled trials, controlled clinical trials and treatment guidelines, in order to be applied in clinical treatment. Results There were 1 clinical guideline for treating coronary artery fistula and 3 different high-quality evidence studies were retrieved. The results showed percutaneous coronary intervention was the best treatment currently. According to the obtained evidence and patient’s willingness, the relevant examinations were taken, and the preoperative preparation for percutaneous coronary intervention was done actively after the patient was admitted. Three days after hospitalization, the selective coronary angiography showed right coronary artery-pulmonary artery fistula and left coronary circumflexus artery-left atrial multiple fistulae, then the percutaneous coronary intervention spring coil embolization was successfully conducted for right coronary artery-pulmonary artery fistula. After operation, bayasprin enteric-coated tablets 0.1 g/d was taken for anti-platelet aggregation and preventing thrombotic diseases. The observation during operation and postoperative 5-day hospitalization showed no relevant complications. Conclusion Percutaneous coronary intervention is safe and effective for the symptomatic patients with coronary artery-pulmonary artery fistula.

    Release date: Export PDF Favorites Scan
  • Status Quo of Global Interventional Therapy for Tumors: A Systematic Review

    Objective To evaluate the trends, dominant diseases and clinical outcomes of the global interventional therapy for tumors based on evidence, so as to provide references for standard access of interventional technology. Methods Such databases as PubMed, EMbase, Web of Science, The Cochrane Library, CBM, CNKI and VIP were electronically and comprehensively searched for relevant clinical or fundamental studies about interventional therapy for tumors from inception to September, 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria and extracted data. Then, descriptive analysis was performed using SPSS 13.0 and Microsoft Excel 2003 software. Results Totally, 4 544 studies were included, consisting of 4 136 (91.0%) clinical studies and 408 (9.0%) fundamental studies. These clinical studies including 155 systematic reviews (SRs), 338 randomized controlled trials (RCTs), 1 191 clinical controlled trials (CCTs), and 2 451 case series or case reports (CSs/CRs). Transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) were the most clinically frequenly-used interventional technologies for tumors, accounting for 32.6% and 17.1% of the total, respectively. Hepatocellular carcinoma (HCC) was the dominant tumor, which was mentioned in 99 SRs (57.6%), 198 RCTs (58.6%), 824 CCTs (69.1%) and 1 191 CSs/CRs (48.6%), following by colorectal liver metastases (CLM). Radiofrequency ablation (RFA) treating HCC resulted in a higher rate of 3-year survival (12 SRs/Meta-analyses) and lower recurrence (10 SRs/Meta-analyses) compared with percutaneous ethanol injection (PEI). Compared with hepatic resection (HR), RFA treating HCC resulted in lower rates of 3-year (11 SRs/Meta-analyses) and 5-year survival (9 SRs/Meta-analyses), and no significant difference was found in 1-year survival between the two groups (17 SRs/Meta-analyses). Preoperative TACE before HR or liver transplantation could not improve the survival for patients with advanced HCC (6 SRs/Meta-analyses), but postoperative TACE might prolong the 1-and 3-year survival (3 SRs/Meta-analyses). TACE combined with other interventional therapy (i.e., RFA, PEI) could also prolong the survival of HCC patients. For the treatment of uterine leiomyoma, uterine artery embolization (UAE) resulted in less hospital duration or operative time, and it caused a higher re-intervention rate, compared with surgery, but it lacked long-term outcomes. Conclusion Interventional therapy is an optional and promising technology for patients with tumors. We should well-consider currently available best clinical evidence as well as local medical facilities or skill level when applying them to clinical practice, so as to perform relevant interventional techniques with scientific, rational and standardized methods.

    Release date: Export PDF Favorites Scan
  • Intracoronary Glycoprotein IIb/IIIa Inhibitor for Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Meta-Analysis

    Objective To systematically review the effectiveness and safety of intracoronary glycoprotein IIb/IIIa inhibitors (GPIs) undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) compared with intravenous administration. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 9, 2012), Ovid, CBM, CNKI and VIP were electronically searched for randomized controlled trials (RCTs) about intracoronary GPIs administration versus intravenous administration undergoing PCI for ACS from inception to September 30th, 2012. Meanwhile, domestic relevant papers published in recent 1 year were also retrieved manually. References of the included studies were retrieved, too. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed the methodologically quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results 10 RCTs involving 3 553 ACS patients were finally included. The results of meta-analysis showed that: compared with intravenous administration, intracoronary GPIs administration decreased the major adverse cardiovascular event (MACE) (OR=0.54, 95%CI 0.34 to 0.85, P=0.008). The incidences of re-infarction (MI), revascularization (TVR) and heart failure were (OR=0.62, 95%CI 0.39 to 0.97, P=0.04), (OR=0.59, 95%CI 0.36 to 0.97, P=0.04), (OR=0.52, 95%CI 0.32 to 0.84, P=0.008), respectively. But for the mortality, there were no significant differences between the two groups (OR=0.81, 95%CI 0.58 to 1.14, P=0.23). Intravenous administration and intracoronary administration were alike in the incidences of mild/serious bleeding (mild: OR=0.94, 95%CI 0.75 to 1.19, P=0.63; serious: OR=1.18, 95%CI 0.76, 1.84, P=0.47). Conclusion Compared with routine GPIs regimen of intravenous bolus, intracoronary administration with initial dosage showed significant benefits in clinical outcomes in ACS patients undergoing PCI, which could not increase the incidence of bleeding.

    Release date: Export PDF Favorites Scan
  • 全身麻醉下介入治疗低级别颅内动脉瘤术前不留置尿管的可行性研究

    目的 探讨颅内低级别(Hunt-Hess分级为0~Ⅲ级)动脉瘤患者在介入治疗围手术期不留置导尿管的可行性,为临床实践提供指导。 方法 2010年6月-2011年6月,对符合纳入标准的132 例颅内动脉瘤患者,术前经患者及家属知情同意并根据自愿原则,按是否留置导尿管分为两组。观察组(n=67)术前不安置尿管,对照组(n=65)则在全身麻醉下留置尿管,观察两组术中躁动对手术的影响及术后排尿情况。 结果 两组术中均未发生因尿急引起的躁动。术后观察组2 h内自行排尿58 例,2~4 h内排尿6例,需放置尿管3例(4%);对照组 24 h内拔出尿管52 例,其余24 h后拔出,最长留置12 d,3例出现肉眼血尿(4%),12例出现尿路感染(12%)。 结论 颅内低级别动脉瘤患者介入围手术期可不留置导尿,既可提高患者舒适度,又能较好降低泌尿道感染率。

    Release date:2021-06-23 07:35 Export PDF Favorites Scan
  • Selective Interventional Therapy for Liver Cancer Related Portal Hypertension

    目的 评价选择性介入治疗在原发性肝癌(HCC)门脉高压症中的应用价值。 方法 2008年11月-2011年3月,收治65例临床明确诊断的HCC伴门脉高压症患者,选择性使用肝动脉化学疗法(化疗)栓塞术、脾栓塞术、门静脉化疗栓塞术、门静脉支架、胃冠状静脉栓塞术等介入术式,术后通过观察临床指标、定期复查影像检查等了解病变转归,随访生存期并评价疗效。 结果 65例HCC患者均合并不同程度门静脉高压,其中门静脉癌栓46例中有37例显示肝动脉-门静脉分流,通过肝动脉及门静脉化疗栓塞术进行主瘤体及癌栓治疗。11例行门静脉支架置入术,支架置入后门静脉压较术前明显下降(P<0.01),支架中位通畅时间为5.8个月。39例行胃冠状静脉和(或)胃短静脉栓塞术,术后有4例再次发生门脉高压性出血,再出血率10.26%。18例行脾动脉栓塞术,术后3个月血小板较术前显著升高(P<0.01)。随访术后3、6、12及24个月的生存率分别为90.77%、69.23%、35.38%及13.85%。 结论 选择性联合使用各种介入术式是治疗HCC及其相关性门脉高压症的一种有效方法,可有效预防高危风险,延长患者生存期。

    Release date:2021-06-23 07:35 Export PDF Favorites Scan
  • 医学教育中跨专业教育的发展概况

    全球人口老龄化和慢性病例数的增加,患者及其需求的加剧,医学知识和技术的日新月异,要求当今的卫生人才不仅要具备全面的专业知识和技能,更需要有跨专业的团队合作能力。跨专业教育(IPE)作为一种促进专业沟通,改善团队合作的途径被提出。现就医学教育中的IPE全球开展情况、基础理论、介入时间、评价工具、发展制约因素等方面的现状及进展进行综述。

    Release date:2016-08-26 02:09 Export PDF Favorites Scan
  • 急诊经皮冠状动脉介入治疗术中再灌注心律失常的分析与急救护理

    目的 总结急性心肌梗死急诊经皮冠状动脉介入治疗术中再灌注心律失常的特点及急救护理。 方法 2007年1月-2012年4月对179例急性心肌梗死急诊经皮冠状动脉介入治疗术中再灌注心律失常进行分析。 结果 心肌梗死血管为左前降支、左回旋支发生快速型心律失常的比例较高,右冠状动脉梗死发生缓慢型心律失常的比例高,具有统计学意义(P<0.01)。发病至血管再通时间<6 h易发生心律失常,具有统计学意义(P<0.01)。 结论 护士应掌握心律失常的特点,做好充分护理评估和急救准备,可确保急诊经皮冠状动脉介入治疗手术得以顺利进行。

    Release date: Export PDF Favorites Scan
  • 弹力绷带“8”字包扎法对经皮穿刺股动脉行心脏介入诊疗后伤口出血或血肿发生率的影响

    【摘要】 目的 研究弹力绷带“8”字包扎法对经皮穿刺股动脉行心脏介入诊疗后伤口出血或血肿发生率的影响。 方法 2010年 1-6月收治的600例经皮穿刺股动脉行心脏介入诊疗后患者,随机分为对照组(300例)和试验组(300例),两组在年龄、性别、病理、心功能、有无高血压、器质性心脏病、术中肝素使用量、术后人工压迫止血时间、下床活动时间等差异均无统计学意义(Pgt;0.05),术后72 h观察出血或血肿发生情况。 结果 对照组出血或血肿发生率9/300(3%),试验组出血/血肿发生率2/300(0.67%),两组差异有统计学意义(P=0.033)。 结论 对经皮穿刺股动脉行心脏介入诊疗后,用弹力绷带“8”字包扎法包扎伤口能降低血肿的发生率。

    Release date:2016-08-26 02:18 Export PDF Favorites Scan
  • Interventional Treatment for the Patients with Type 2 Diabetes Combined with Vascular Lesions of Lower Extremities

    【摘要】 目的 探讨2型糖尿病合并下肢血管病变血管内介入治疗的临床意义。 方法 2009年1-5月对4例2型糖尿病合并下肢血管病变患者,根据血管狭窄情况选择不同介入治疗方式,行下肢动脉造影及动脉球囊扩张或支架成形术。 结果 4例患者均有表现静息痛及间歇性跛行,下肢血管超声显示糖尿病下肢动脉有不同程度的斑块、狭窄与血栓形成,病变累及下肢股动脉、髂动脉及胫前、足背动脉。介入治疗后患者下肢血管灌注得到明显改善,静息痛及间歇性跛行明显改善,皮温改善,需要截肢患者截肢平面显著降低。 结论 通过下肢血管DSA造影检查,准确了解糖尿病患者下肢血管的阻塞部位及程度,在保守治疗基础上选择不同方式的介入治疗,有助于下肢血管病变的明显改善。【Abstract】 Objective To investigate the clinical significance of intervention therapy for patients with type 2 diabetes combined with vascular lesions of lower extremities. Methods From January to May, 2009, four diabetic patients with vascular lesions of lower extremities were examined by Doppler ultrasonography and digital subtration angiography (DSA). All patients were treated by percutaneous transluminal angioplasty (PTA) or stenting therapy. Results Stenoses and obstruction of lower extremity blood vessels were observed in all patients. After intervention therapy, vascular perfusion of lower extremities was improved and signs of rest pain and intermittent claudication were relieved; the skin temperature was improved, and the amputation level was apparently decreased. Conclusion It suggests that DSA is effective in judging extend and location of blood vessel stenosis,and the interventional treatment could lead to a satisfying prognosis.

    Release date: Export PDF Favorites Scan
  • 原发性肝癌破裂出血的治疗选择

    【摘要】 目的 总结原发性肝癌破裂出血治疗的选择原则。 方法 回顾分析2006年1月-2010年2月收治的 37例原发性肝癌破裂出血患者临床资料。 结果 内科加介入止血效果好,肝叶切除术组术后彻底止血,无手术死亡病例。肝叶切除术9例中生存1年者7例,2年者5例,3年者3例;内科保守治疗19例中生存1年者7例,最长生存16个月;介入治疗组10例中生存1年者4例,2年者1例,无3年以上生存者。 结论 充分评估病情及选择适当的治疗方法对原发性肝癌破裂出血治疗有重要意义。肝叶切除是治疗原发性肝癌破裂出血的有效方法,可明显延长生存期。介入治疗并发症少,急诊肝动脉栓塞止血效果好,可通过血管造影判断有无行根治性手术的可能,以减少不必要的急诊手术探查。

    Release date: Export PDF Favorites Scan
26 pages Previous 1 2 3 ... 26 Next

Format

Content