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find Author "张玮" 17 results
  • 结扎术后输卵管二次吻合术六例临床分析

    目的 总结分析结扎术后输卵管二次吻合术注意事项。 方法 1997年3月~2004年3月,对6例患者行结扎术后输卵管二次吻合术。年龄31~38岁。首次吻合术距二次吻合术时间为1~6年。术后随访输卵管复通及复孕情况。 结果 患者获随访1~7年。术后1个月,输卵管通液检查5例通畅;术后6个月,输卵管通液检查3例通畅, 1例已宫内妊娠;术后1年,宫内妊娠2例,足月分娩;术后2年输卵管妊娠1例。结论 结扎术后输卵管二次吻合术成功率尚不高,术中应用显微外科技术和保留足够长度输卵管是手术成功的关键。

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • Nursing Experience for the Patients with Hyperthyroidism Treated by Radioactive 131I

    【摘要】 目的 总结甲状腺功能亢症(甲亢)患者131I治疗中的护理特点及经验。 方法 2008年1-8月对收治的184例行131I治疗的甲亢患者,依据131I治疗特点采取针对性的护理措施:心理上帮助其消除紧张焦虑的情绪,饮食方面指导禁食碘物,并密切观察病情及预防甲亢危象,对服药中出现的一些不适症状及时对症处理。 结果 184例经131I治疗的甲亢患者3~6个月病情痊愈和缓解153例(83.15%),甲亢复发22例(11.96%),甲状腺功能减退症发生9例(4.89%)。 结论 有效对症的护理措施是甲亢患者积极配合治疗,早日获得康复的重要因素。【Abstract】 Objective To summarize the nursing characteristics and experience for the patients with hyperthyroidism treated by 131I. Methods A total of 184 patients with hyperthyroidism underwent 131I treatment between January and August 2008 were included. We took care of the patients according to the therapeutic features of 131I treatment: helped them calm down, advised not eating iodine-containing food, observed the disease condition and dealt with the discomfort after medicated. Results In 184 patients with hyperthyroidism treated by 131I treatment for three to six months, 153 (83.15 %) were cured, 22 (11.96 %) recurred, and 9 (4.89 %) had hypothyroidism. Conclusion Comprehensive nursing is a key point to make the patients with hyperthyroidism cooperate and recover.

    Release date:2016-09-08 09:24 Export PDF Favorites Scan
  • 腺苷负荷核素心肌灌注显像护理

    【摘要】 目的 总结腺苷负荷心肌灌注显像MPI护理方法及特点。 方法 2009年6月—2010年1月,对148例临床疑似冠心病患者行腺苷负荷MPI以确诊。腺苷注射前做好患者心理护理,腺苷注射中持续心电监护,并及时处理不适症状,注射后予以相关健康指导。 结果 148例患者顺利完成腺苷负荷MPI,患者出现面色潮红、呼吸急促、气短、胸闷、胸部压迫感、心悸及头胀等不良反应共114例,124例患者发生血压改变,34例无不良反应。 结论 腺苷负荷MPI无创安全,简便可行,重复性好,不良反应轻微,在心血管疾病的诊疗中具有明显优势。

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
  • 分化型甲状腺癌患者术后碘131治疗的不良反应护理

    目的 总结核医学科分化型甲状腺癌术后患者口服碘131(131I)治疗的常见不良反应及处理。 方法 收集2013年7月-2014年6月经131I治疗的分化型甲状腺癌术后患者970例,总结131I治疗过程中出现的不良反应,以及针对各种不良反应给予的相应处理措施。 结果 970例分化型甲状腺癌术后患者均顺利出院,502例出现不良反应,不良反应发生率为5 1.75%。其中头颈部反应258例,消化道反应398例,造血系统反应2例,生殖系统反应1例。在发生不良反应的502例患者中,401例患者出现的不良反应在其出院时均得到有效缓解,53例患者在出院1个月后电话随访中告知不良反应已消失,48例诉症状已逐渐减轻。 结论 131I治疗分化型甲状腺癌可出现一过性的不良反应。对症处理后均可恢复正常。

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  • 主动脉弓右降畸形压迫食管误诊为食管平滑肌瘤一例

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  • Ictal eye movement in posterior epileptic seizure

    ObjectiveTo identify the clinical significance of epileptic eye movement for localization of posterior epileptic seizures. MethodsThere were 12 posterior epileptic patients, who were undertaken the detailed presurgical evaluation and ictal SEEG recording, and the epileptogenic zone of whom was confirmed restricted within posterior cortex through the boarder of epileptic cortical resection and the result of epileptic surgery, included in the research. ResultsThe cluster analysis of posterior cortical area of interest showed that parieto-occipital sulcus (POS) with the adjacent cortical areas belonged to the Medial Group; intraparietal sulcus (IPS) with the adjacent areas belonged to the Intermediate Group; and the Lateral Group included anterior occipital sulcus (AOS) and posterior temporal cortex. Eyes forced stare had the significant correlation with IPS, POS and related cortical group. Contraversive eye deviation had no significant correlation with cortical eye field with the related cortical areas. ConclusionsForced eye stare was significant eye movement in posterior epilepsy, and had significant correlation with IPS and POS. Ipsiversive eye deviation and convergence binocular movement were rare semiology in posterior epilepsy, and AOS had significant correlation with the two type of epileptic eyes movement.

    Release date:2016-10-02 06:51 Export PDF Favorites Scan
  • The Lateralization of Ictal Scalp EEG in Focal Epilepsy

    ObjectiveTo investigate the lateralization of ictal scalp EEG in different times in focal epilepsy.Methods356 surface ictal EEG of 41 patients were reviewed retrospectively in focal epilepsy arising from the mesial frontal, lateralfrontal, mesialtemporal, neocorticaltemporal, insular lobes and posterior cortex from July, 2010 to at, 2016. Each ictal scalp EEG was subdivided into ten epoches (E1-E10), then the lateralization of every epoch was analyzed. Ten epochs EEG were merged into three timesas E1-E3, E4-E6 and E7-E10. The ratio of lateralization, mislateralization and non-lateralization of each timeEEG were studied. Ictal onset zone (IOZ) were precise localized by intracranial EEG. The results of epileptogenic zone corresponded with surgical outcomes as seizure free or decreased.Results62% seizures were lateralized by surface ictal EEG in all epilepsies. Lateralized ictal scalp EEG were seen in nearly 80% of seizures in all times in temporal lobe epilepsy (TLE). The highest lateralization of 89% occurred inE4-E6 andfalse lateralization up to 30% in E1-E3 in mesial temporal lobe epilepsy (MTLE), whereas 95% lateralized seizures emerged in E1-E3 in neocortical temporal lobe epilepsy (NTLE). Apparent non-lateralization in all times were higher than lateralization in frontal lobe epilepsy (FLE), especially in mesial frontal lobe epilepsy (MFLE). Lateralization in E1-E3 was only 24% higher than other times. In addition, False lateralization never occurred in all times in lateral frontal lobe epilepsy (LFLE). There were maximum of 83%lateralized seizures in E1-E3 in LFLE and 93% in E1-E3 in posterior cortex epilepsy (PCE). Seizures arising from insular lobe epilepsy (ILE) tendedto predict less lateralization in all times.ConclusionsIctal scalp EEG of E1-E3 are valuable in the lateralization in all epilepsies particularly in LFLE, NTLE and PCE. Lateralized E4-E6 and E7-10 are very useful in MTLE.

    Release date:2020-01-09 08:49 Export PDF Favorites Scan
  • ASSEMBLING AND CLINICAL APPLICATION OF VIDEO OUTPUT SYSTEM UTILIZING TEACHING SIGHT GLASS OF SURGICAL MICROSCOPE

    Objective To investigate the assembl ing and cl inical appl ication of the video output system util izing teaching sight glass of surgical microscope. Methods Between June 2009 and April 2010, 10 patients with craniocervical junction malformation were treated by the method of transoral-transpharyngeal approach with the microscope and videooutput system under the direct vision. There were 6 males and 4 females with an average age of 32 years (range, 13-52 years). Three cases had the history of injury and 7 cases had no history of definite injury. The disease duration was from 10 months to 12 years (median, 5 years). The main cl inical symptoms were brevicoll is or torticoll is; 2 patients had malformation appearance and 4 patients had occi put-cervical pain. The physical examination showed that all patients had the symptoms that upper cervical cord was damaged; the imaging examination showed that all patients had basilar invagination, atlantoaxial dislocation, and ossification. Before and after operations, the functions of nerve were evaluated by Japanese Orthopaedic Association (JOA) scoring, the improvement rate was calculated to evaluate the efficacy. Results By the video output system assembly, 15.1 mill ion pixels high-definition images could be collected and reached 1 920 × 1 080 pixels video camera, so assistants or medical students could watch the cl inical operation directly. All patients had no neural injury or cerebrospinal fluid leakage during operation. Basilar invagination and atlantoaxial dislocation were corrected. Infection at incision occurred in 1 patient; other incisions healed by first intention without early compl ication. All patients were followed up 6-16 months (mean, 13.5 months). The average JOA score was increased from 10.2 preoperatively to 15.5 at 6 months postoperatively with an improvement rate of 77.9%. At 12 months after operation, bony fusions were achieved. Conclusion The miscroscope and video output system can improve the effectiveness of the original surgical microscope. It makes visual fields much clearer and operations more accuratewith a few compl ications.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • Characteristics of motor semiology of epileptic seizure originated from dorsolateral frontal lobe:an analysis based on stereoelectroencephalography

    ObjectiveTo investigate characteristics of motor semiology of epileptic seizure originated from dorsolateral frontal lobe. MethodsRetrospectively analysis the clinical profiles of patients who were diagnosed dorsolateral frontal lobe epilepsy (FLE) based on stereoelectroencephalography (SEEG) and underwent respective surgeries subsequently. Component of motor semiology in a seizure can be divided into elementary motor (EM, include tonic, versive, clonic, and myoclonic seizures) and complex motor (CM, include automotor, hypermotor, and so on). A Talairach coordinate system was constructed in the sagittal series of MRI images in each case. From the cross point of VAC and the Sylvian Fissure, a line was drawn antero-superiorly, which made an angle of 60° with the AC-PC line, then the frontal lobe could be divided into anterior and posterior portion. The epileptogenic zone, which was defined as ictal onset and early spreading zone in SEEG, was classified into three types, according to the positional relationship of the responding electrodes contacts and the "60° line": the anterior, posterior, and intermediate FLE. The correlation of the components of motor semiology in seizures and the location of the epileptogenic zone was analyzed. ResultsFive cases (26.3%) were verified as anterior FLE, among which there were 2 of EM, one of CM, and 2 of EM+CM. In 7 cases (36.8%) of intermediate FLE, there were one of EM, none of CM, and 6 of EM+CM. In the rest 7 cases of posterior FLE, there were 6 of EM, none of CM, and one of EM+CM. Compared with the cases that the epileptogenic zone involved anterior portion, the posterior FLE is more likely to present EM seizures (85.7%), and less likely to show CM components (P < 0.05). And Compared with the anterior FLE and posterior FLE, the intermediate FLE is more likely to present EM+CM seizures (85.7%)(P < 0.05). ConclusionThe motor seizure semiology of dorsolateral FLE has significant correlation with the localization of the epileptogenic zone. Posterior FLE mainly present a pure elementary motor seizure, and once the epileptogenic zone involved anteriorly beyond the "60° line", the component of complex motor seizure would be seen. Intermediate FLE, as its specialty of transboundary, is more likely to show "comprised semiology" of EM and CM. Construction of the "60° line" with AC-PC coordinate system in the MRI images may play an useful role in semiology analysis in presurgical evaluation of FLE.

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  • The Impact of Analysis of Age for Pancreaticoduodenectomy

    ObjectiveTo investigate the age of patients can be the independence factor to affect the feasibility of pancreaticoduodenectomy. MethodsThe cases in the First Affiliated Hospital, Xinjiang Medical University from Feb. 2011 to Feb. 2015 were retrospectively analyzed, and divided into six groups according to age < 50, 50≤age < 60, 60≤age < 70, 70≤age < 75, 70≤age < 80, and≥80 years old. The complications, hospitalization days, and mortality rates for six groups were analyzed. ResultsThe differences in ASA classification (P < 0.001), hypertension (P < 0.001), coronary heart disease (P=0.001), diabetes mellitus (P < 0.001), heart failure (P=0.001), respiratory failure (P=0.037), postoperative hospitalization days (P=0.014), and delayed gastric emptying grade C (P=0.006) had statistical significance, and pancreatic fistula (P=0.058), postoperative bleeding (P=0.786), and mortality (P=0.125) of the different age groups had no significant difference. ConclusionAge is not the independent risk factor to affect the feasibility of pancreaticoduodenectomy, but the strictly preoperative comorbidities assessment is necessary.

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