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find Author "金峰" 6 results
  • 肝素涂层与非肝素涂层动脉过滤器的临床对比观察

    目的 对肝素涂层和非肝素涂层动脉过滤器在体外循环术中的应用结果进行对比观察。方法 80例体外循环心脏直视手术患者随机分为两组,每组40例。A组:用肝素涂层动脉过滤器,B组:用非肝素涂层动脉过滤器;并于不同的时间点观察血小板计数、血红蛋白、红细胞压积、激活凝血时间和过滤器内网在电子显微镜下的改变。结果 转流60分钟和结束时血小板计数,A组高于B组(P〈0.05)。电子显微镜示A组网眼清晰,边缘清楚,偶见有块状过滤物,B组滤网有絮状物,散在分布于网眼边缘,模糊不清,堵塞网眼,表明有纤维蛋白聚集,血小板粘附,脱落形成血小板碎片。结论 肝素涂层动脉过滤器能改善其生物相容性。

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • Application of Membrane Covered SelfExpanding Metallic Stent for 49 Patients with the Malignant Stricture of Advanced Esophagus and Cardia under Endoscope

    【摘要】目的探索内镜直视下应用带膜记忆合金支架对晚期食管、贲门恶性狭窄的介入治疗方法。方法2005年1月2009年11月对49例失去手术机会或拒绝手术的晚期食管癌或贲门癌致食管或贲门狭窄患者,行电子胃镜引导下放置镍钛合金支架;对狭窄程度重、胃镜不能通过者,先行Savary探条扩张再放置支架。结果49例均成功置入支架,解除狭窄有效率达100%。结论内镜直视下带膜支架置入操作方法简便、安全,可改善患者的生存质量,延长生存时间。

    Release date:2016-09-08 09:31 Export PDF Favorites Scan
  • Combined Therapy of Mosapride and Compound Digestive Enzymes for Functional Dyspepsia

    【摘要】 目的 观察莫沙必利联合复方消化酶胶囊治疗功 能性消化不良的临床疗效和安全性。方法 2008年1月—2009年7月对62例功能 性消化不良患者随机分为两组,每组31例,两组均口服莫沙必利片,三餐饭前30 min服用5 mg;试验组加服复方消化酶胶囊,进餐后30 min服用1粒。4周后观察疗 效。结果 试验组治疗总有效率明显优于对照组,分别为87.1%和61.3%(Plt;0 05)。对上腹痛、餐后饱胀、早饱、上腹烧灼感症状改善情况进行比较,试验 组治疗前后的症状总积分及症状改善有效率与对照组比较差异有统计学意义( Plt;005),而且起效时间明显缩短。两组患者均未发现严重不良反应。结论 莫沙必利联合复方消化酶胶囊治疗功能性消化不良安全有效,其疗效明显优于 单用促动力药莫沙必利。

    Release date:2016-09-08 09:37 Export PDF Favorites Scan
  • Analysis of clinical efficacy and safety of suturesuspension single hole laparoscopic cholecystectomy and traditional laparoscopic cholecystectomy in the treatment of gallbladder disease

    Objective To compare the clinical efficacy and safety of suturesuspension single hole laparoscopic cholecystectomy and traditional laparoscopic cholecystectomy (LC) in the treatment of gallbladder disease. Methods A total of 86 cases who got treatment in our hospital from February 2014 to July 2015 were collected prospectively, and then 86 cases were divided into 2 groups: 43 cases of control group underwent LC and 43 cases of experimental group underwent suturesuspension single hole laparoscopic cholecystectomy. Clinical efficacy and safety of the two groups were compared. Results ① Complication. No one suffered from bile duct injury, bile leakage, bile duct stricture, and umbilical hernia; but there were 2 cases suffered from complications in control group, including 1 case of abdominal pain and 1 case of bloating, and the morbidity was 4.65% (2/43). The morbidity of experimental group was 0, there was no significant difference between the 2 groups in the morbidity (P>0.05). During the follow-up period, 1 case suffered from long-term compilation in experimental group, and 2 cases in normal group, there was no significant difference in the long-term complication between the 2 groups (P>0.05). ② Operation and hospitalization. The blood loss and operation time in the experimental group were lower than those of the control group (P<0.05), but there was no significant difference in the hospital stay and hospitalization cost between the 2 groups (P>0.05). ③ Postoperative electrolytes, liver and kidney function. The levels of Na+ and K+ in the experimental group were higher than those of the control group (P<0.05), and the levels of alanine aminotransferase and aspartate aminotransferase were lower than those of control group (P<0.01), but there was no significant difference in the blood urea nitrogen and serum creatinine between the 2 groups (P>0.05). ④ The recovery of gastrointestinal function after surgery. The anal exhaust time and bowel sounds recovery time in experimental group were shorter than those of the control group (P<0.01). Conclusion Suturesus-pension single hole laparoscopic cholecystectomy in the treatment of gallbladder disease is safe, effective, and minimally invasive, and it has little disturbance on gastrointestinal function and liver function, which is worthy of clinical application.

    Release date:2017-04-01 08:56 Export PDF Favorites Scan
  • 3例原发性乳腺恶性淋巴瘤的诊断和治疗

      病例1 女,48岁,因发现右乳腺无痛性肿物1个月入院。查体: 双乳腺大小形态对称,右乳腺内上象限扪及1个2.5 cm×2.5 cm大小的肿物,圆形,表面光滑,与皮肤无粘连,质中等,活动好,无压痛,双腋下淋巴结未及。彩超: 右乳腺内上象限实质性占位,无完整包膜,内有少许血流信号; 钼靶检查: 右乳腺内上象限边缘光滑的等密度肿物,无明显钙化影。X线和B超未见异常。行右乳腺肿物切除术,术中冰冻切片: 可见增生的淋巴样细胞,无上皮样结构,恶性不除外。术后病理报告: 黏膜相关淋巴组织型边缘区B细胞淋巴瘤。免疫组化CK(-)、EMA(-)及CD20(+)。行CHOP方案化疗,共6个疗程,并直线加速器放疗1个疗程,随访7年,无复发。  病例2 女,69岁,因右乳腺无痛性肿物3个月入院。查体: 双乳腺形态大小对称,右乳腺外上象限扪及1个1.5 cm×1.5 cm分叶状肿物,质中等,偏硬,边界清楚,与皮肤无粘连,活动好,无压痛,双腋窝淋巴结未及。彩超: 右乳腺外上象限实质性占位,有少许血流信号; 钼靶检查: 右乳腺外上象限中等密度分叶状肿物,边缘清,内部分布均匀,无钙化。X线和B超未见异常。行右乳腺肿物切除,术中冰冻切片: 淋巴细胞密集增生,无上皮样结构。术后病理报告: 黏膜相关淋巴组织型边缘区B细胞淋巴瘤。免疫组化LCA(+)、CD20(+)、CD40(-)及EMA(-),分期为Ⅱa期,行二期右乳腺癌改良根治术,腋窝淋巴结转移4/19。行CHOP方案化疗,共6个疗程,并直线加速器放疗1个疗程,随访第5年复发,全身器官淋巴瘤浸润,全身衰竭死亡。  病例3 女,52岁,发现右乳腺无痛性肿物1个月,肿物破溃1周入院。查体: 右乳腺外上象限扪及1个4.5 cm×4.5 cm大小的肿物,圆形,表面光滑,与皮肤粘连,中央破溃,有少许脓性分泌物,边界清,压痛阳性,左乳腺正常。右腋下扪及有3枚肿大淋巴结,质硬,活动好。彩超: 右乳实质性占位,内有少许血流信号; 钼靶检查: 右乳腺圆形巨大包块,边界清,无钙化,右腋下可见肿大淋巴结。X线和B超未见异常。行右乳腺肿物切除术,术中快速切片提示: 右乳腺淋巴癌可能。术后病理提示: 黏膜相关淋巴组织型边缘区B细胞淋巴瘤。免疫组化CK(-)、EMA(-)及CD20(+)。术后行CHOP方案化疗6个疗程和放疗1个疗程,2年后复发,全身器官淋巴瘤浸润,全身衰竭死亡。  讨论  本病临床诊断有一定难度,临床表现、查体、B超、X线特征与乳腺癌、乳腺纤维瘤均难鉴别。大部分病例术中冰冻切片检查也不能确诊,只能看到乳腺腺体内有增生的淋巴样细胞,必须依靠常规病理及免疫组化才能确诊及分型。病理中非霍奇金淋巴瘤占绝大多数,多为B细胞来源。组织学上淋巴样细胞可排列成串状,类似经典浸润性小叶癌,非霍奇金淋巴瘤镜下所见易与乳腺未分化癌及髓样癌相混淆,必须常规免疫组化检查,而CD20等阳性,临床上主要为弥漫大B细胞淋巴瘤和黏膜相关淋巴组织型边缘区B细胞淋巴瘤两种类型。原发性乳腺恶性淋巴瘤的治疗方案目前仍有争议,但也遵循恶性肿瘤综合治疗的原则,只不过是联合化疗为主,加手术、放疗的综合治疗,对于四期可进行术前化疗,手术以乳腺肿物局部切除为主,肿物较大者行单乳切除。关于化疗方案,我们还是首选CHOP方案,一般4~6个疗程,最少坚持6个疗程,同时或化疗后行1个疗程放疗。

    Release date:2016-09-08 11:49 Export PDF Favorites Scan
  • Treatment of ventricular septal defect with pulmonary hypertension with entricular septal defect repair and lung allograft: a case report

    Objective To explore the clinical effect of ventricular septal defect repair and lung allograft (simply as "heart repair and lung transplant") in the treatment of ventricular septal defect complicated with severe pulmonary hypertension. Methods A 21-year-old female patient with ventricular septal defect and severe pulmonary hypertension was treated with cardiopulmonary bypass (CPB) under general anesthesia, and then right lung transplantation was performed, and then left lung transplantation was performed after changing body position. Results The operation was conducted successively. The intraoperative CPB support time was 90 minutes, and the blood loss was 2000 mL. Extracorporeal membrane oxygenation was removed on the second day after operation, the ventilator was evacuated on the third day, and the patient recovered and discharged on the 38th day. Postoperative echocardiography showed significant improvement in pulmonary artery pressure. Conclusion For patients with simple congenital heart disease complicated with severe pulmonary hypertension, "heart repair and lung transplant" can improve their quality of life.

    Release date: Export PDF Favorites Scan
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