ObjectiveTo compare the functioning time, duration, cervical vascular blood flow and adverse effects of different concentrations of ropivacaine mesylate in performing stellate ganglion block (SGB) under Doppler ultrasound. MethodsA total of 240 patients (grade Ⅰ or Ⅱ classified by American Society of Anesthesiologists) aged between 23 and 62 years old ready to undergo SGB between January and April 2013 were chosen for our research. They were randomly divided into two groups with 120 patients in each. Group A and B received unilateral SGB with 7 mL of 0.239% and 0.596% ropivacaine mesylate respectively. Successful SGB was verified by Horner syndrome. The functioning time, duration, hemodynamic changes, cervical vascular blood flow and adverse effects were recorded and compared. ResultsHorner syndrome was observed in all patients. There was no significant difference in functioning time between the two groups (P>0.05). The duration of functioning was significantly longer in group B than that in group A (P<0.05). No significant difference was found in hemodynamic changes after SGB (P>0.05). No adverse effects were found in both groups. The blood flow of the vertebral artery and the internal carotid artery before the injection and 10 minutes after the injection were not significantly diferent (P>0.05). ConclusionSGB can be induced with 0.239% and 0.596% ropivacaine mesylate. We suggest using 0.596% ropivacaine mesylate by ultrasound-guiding because of the significantly longer functioning duration.
ObjectiveTo explore the relation between ultrasound images of endometriosis and its clinical symptoms. MethodsChoosing clinical data of 300 patients with endometriosis pathologically diagnosed between January 2009 and January 2014, we retrospectively analyzed ultrasound images and clinical symptoms, using Chisquare test for statistical analysis, and the index P<0.05 was statistically significant. ResultsIn patients with big endometriosis' nidus, the menstrual quantity increased, menstrual cycle prolonged, the incidence of abnormally vaginal bleeding was high (χ2=11.749, P=0.001; χ2=4.847, P=0.028; χ2=5.686, P=0.017). In patients whose endometriosis were located in posterior uterine wall, the menstrual quantity increased, and the incidence of abnormally vaginal bleeding was high (χ2=5.188, P=0.023; χ2=49.691, P<0.001). The size of endometriosis' nidus had nothing to do with dysmenorrhea, constipation and frequent micturition (P>0.05). The position of endometriosis' nidus had nothing to do with menostaxis, dysmenorrhea, constipation and frequent micturition (P>0.05). ConclusionThe size of endometriosis' nidus has a connection with the clinical symptoms of menorrhea, menostaxis and abnormally vaginal bleeding; the position of endometriosis' nidus has a connection with the clinical symptoms of menorrhea and abnormally vaginal bleeding. The results of ultrasonography should be combined with clinical symptoms in diagnosing endometriosis, avoiding missed-diagnosis and misdiagnosis.
ObjectiveTo comparatively analyze the image features of tumorous acute pancreatitis (T-AP) and non-tumorous acute pancreatitis (NT-AP). MethodsSixteen cases of histopathologically proven pancreatic tumors inducing acute pancreatitis and 30 cases of non-tumorous acute pancreatitis were collected, and studied their CT and MRI features. ResultsThere were 16 cases (100%) with focal nodules or masses in T-AP group and none in NT-AP group. The average innerdiameter of main pancreatic ducts in T-AP group was (9.6±6.8) mm, in which 14 cases (87.5%) were dilated. And the average innerdiameter of main pancreatic ducts in NT-AP group was (2.9±0.9) mm, in which 7 cases (23.3%) were dilated. The cases of sinistral portal hypertension (SPH), accompanying cholelithiasis and lymphadenosis between the two groups were 10 (62.5%), 3 (18.8%), 14 (87.5%), and 1 (3.4%), 25 (83.3%), 30 (100%), respectively. The occurrence of manifestation of focal nodules or masses, dilated main pancreatic ducts, SPH, and accompanying cholelithiasis were significantly different (P=0.000) between T-AP and NT-AP groups. While, the differences in enhancement pattern and the occurrence of lymphadenosis between the two groups were not significant (P > 0.05). ConclusionThe image features of T-AP are various. The application of CT and MRI could provide effective diagnostic guidelines for patients with T-AP.
The injuries caused by earthquake were characterized as complicated injuries, multiple injuries, crush injury, commonly accompanied by the impairment of the organs, open wound with susceptibility to contamination, difficulties in the implementation of in-time treatment, and resource-limited settings. Considering the specialty of early treatment of earthquake victims and existing misconduct, we propose recommendations according to general principles of early rationale use of antibiotics, in order to treat the earthquake victims safely, effectively and feasibly, and to decrease wound infection rates after surgery.
摘要:目的:探讨改良De Vega环缩术与经典De Vega环缩术相比对于治疗重度三尖瓣返流是否具有更好的成形效果。方法: 2007年12月至2009年3月对29例重度三尖瓣返流的患者行De Vega环缩术。其中16例行改良De Vega环缩术,13例行经典De Vega环缩术,随访比较两组患者三尖瓣返流程度,右心室舒张期末内径,EF值及心功能分级。以秩和检验分析研究两组患者三尖瓣返流程度和心功能分级的差异,以t检验研究两组患者右心室舒张末期内径及EF值变化。结果:术前两组患者一般指标无显著差异。两组患者随访时间无显著差异。随访经典De Vega组重度返流1例,中度返流5例,轻度返流5例,微量及无返流2例;改良De Vega组无中、重度返流,轻度返流8例,微量及无返流8例。经分析显示两组患者三尖瓣返流程度结果差异有统计学意义(Plt;0.05)。经典De Vega组心功能分级I级5例,II级7例,III级1例;改良De Vega组I级7例,II级8例,III级1例,两组患者心功能差异无统计学意义(Pgt;0.05)。两组患者右室舒张期末内径及EF值组内比较随访与术前差异均有统计学意义(Plt;0.05),随访时组间比较差异有统计学意义(Plt;0.05), 改良De Vega环缩术随访时右室舒张期末内径缩小更显著,射血分数改善更明显。结论:改良De Vega环缩术治疗重度三尖瓣返流效果优于经典De Vega环缩术。Abstract: Objective: To compare the efficacy of one kind of modified De Vega technique and traditional De Vega technique for the correction of severe tricuspid regurgitation. Methods: From December 2007 to March 2009, 29 patients were treated with tricuspid valve annuloplasty. These were 16 patients in modified De Vega annuloplasty group and the others (13 patients) in traditional De Vega annuloplasty group. The grade of tricuspid regurgitation、New York Heart Association (NYHA) functional class、ejection fraction (EF) and the right ventricular enddiastolic dimension of two groups were followed and reviewed. Results: There was no statistically difference between two groups about preoperative characteristics and followup time. There was 1 patient with severe TR, 5 patients with moderate TR, 5 patients with mild TR and 2 patients without TR in traditional De Vega annuloplasty group after the operations. In modified De Vega annuloplasty group, no patient was observed with severe or moderate TR, 8 patients with mild TR, and 8 patients without TR. At interval time, there was significant difference in the grade of tricuspid regurgitation between two groups (Plt;0. 05). Both tricuspid valve plasty techniques could reduce the right ventricular enddiastolic dimension and improve ejection fraction significantly (Plt; 0. 05), and there was significant difference in the right ventricular enddiastolic dimension and ejection fraction at interval time between two groups (Plt;0.05). Conclusions: The outcome of modified tricuspid De Vega technique is superior to that of traditional De Vega technique in correcting severe tricuspid regurgitation.