局部动脉内溶栓治疗视网膜中央动脉阻塞26例报告

目的观察局部动脉内溶栓治疗视网膜中央动脉阻塞的疗效,探讨如何提高其治疗效果。方法将微导管插入眼动脉或置于颈动脉内行眼动脉造影,将10万～25万U尿激酶用100ml生理盐水稀释溶解,间断手控推人眼动脉或颈内动脉一眼动脉起始部,行溶栓治疗。结果本组26例患者中,8例术后视力由术前光感或眼前数指恢复至0．1以上,10例有中度增进,8例无明显好转。视力有所恢复的18例中,发病至溶栓时间均在8天以内,视力明显恢复的3例中,2例是在发病3天内溶栓。结论局部动脉内溶栓治疗视网膜中央动脉阻塞有明显疗效,溶栓效果与溶栓时间密切相关,溶栓治疗应尽早开始。     

超选择眼动脉插管局部溶栓治疗视网膜中央动脉阻塞

目的　观察超选择眼动脉插管灌注尿激酶溶栓治疗视网膜中央动脉阻塞的疗效。方法　经股动脉或颈动脉插管 ,应用微导管技术将导管插入眼动脉局部溶栓治疗 12例中央动脉血栓形成致视力障碍患者。结果　治疗后 ,患者视力有不同程度提高 ,获得了比较满意的效果。结论　正确诊断 ,早期应用超选择局部溶栓、扩血管并尽可能应用较大剂量溶栓药物 ,可能比其他治疗方法更为有效     

脑梗死的超早期动脉接触性溶栓不同时间窗的疗效对比

脑梗死有较高的致死率和致残率,其治疗的关键是早期溶栓治疗,因此超早期经动脉接触性溶栓已被大力提倡。本文收集2000-04—2004-07共收治的18例急性脑梗死病人,均采取超早期经动脉接触性溶栓,获得了满意疗效,现报道如下。1材料与方法18例超早期(从发病到溶栓<6 h)脑梗死患者,男12例,女6例,年龄53~68岁,均有肢体偏瘫,舌面瘫,失语及意识障碍。采用Seld inger法股动脉穿刺插管,先行全脑血管造影,发现梗塞血管后用微导管做超选择性插管,经微导管推注尿激酶进行溶栓,尿激酶用法和用量:50万u溶于150 m l生理盐水15 m in推完,20 m in后造影复查,若…     

动脉内联合灌注尿激酶,丹参及肝素的溶栓效果观察

目的：评估经导管动脉内联用尿激酶、丹参及肝素溶栓的临床效果。材料和方法：经股动脉穿刺，将５Ｆ导管插入至血栓近心端，经导管注入尿激酶、丹参、术中术后配合肝素抗凝，然后行血管造影，评估治疗效果，结果：血管通畅者１０例，通而不畅者１例，无效得１例，总有效率为９２％。结论：经导管动脉内联有尿激酶、丹参、配合肝素抗凝治疗外周动脉栓塞是一种有效、安全的治疗方法。     

动脉内溶栓治疗急性脑梗塞

目的：探讨急性动脉闭塞性脑梗塞经动脉内溶栓治疗的安全性和疗效。材料和方法：36例患者均采用经皮股动脉穿刺插管行全脑血管造影后将导管选择性插管至患侧颈内动脉内，后经造影导管送入微导管至梗塞部位注入尿激酶溶栓。结果：36例患者DSA造影33例（92％），梗塞部位明确其溶栓后1小时及24小时再通28例（75％），症状和体征完全恢复34例（94％），明显好转1例，无明显变化1例（3％）。结论：动脉内溶栓治疗急性缺血灶脑梗塞是一种安全有效的治疗方法，具有重要的临床应用价值和意义。其最佳治疗时间应控制在梗塞发生后6小时以内。     

下肢深静脉血栓的经动脉溶栓治疗

目的：探讨经动脉保留导管溶栓治疗下肢深静脉血栓的应用价值。方法：40例下肢深静脉血栓患者经健侧股动脉穿刺插管至患侧髂股动脉内，并保留导管3－7d，经导管注入肝素3000－5000IU及尿激酶25万－100万IU稀释液50－200ml，每日1次。另40例经足背静脉注入同样的药物。共植入下腔静脉滤器31例，髂股静脉支架植入术10例。结果：80例患肢肿胀、疼痛均于溶栓治疗后1－3d内开始消退、减轻。31例滤器均未发生移位变形，下腔静脉通畅，10例支架无阻塞。结论：经动脉保留导管溶栓治疗下肢深静脉血栓形成，安全有效。     

尿激酶溶栓治疗内瘘血栓形成

目的 探讨外周和经皮穿刺股动脉导管注入尿激酶对动静脉内瘘血栓形成的治疗效果。方法 对16内瘘血栓形成的病人分别进行了外周溶栓和股动脉插管溶栓治疗。方法是12例病人于内瘘的动脉端穿刺后输注尿激酶，4例病人在DSA下经动脉插管至血栓部位，灌注尿激酶，尿激酶用量为75～100万U，外周溶栓输注时间为3～4h，导管溶栓时间为45～60min。结果 12例外周溶栓病人再通6例，外周溶栓成功率为50％，6例失败，其中4例进行了插管溶栓，3例成功，1例失败，成功率为75％，再通后的内瘘次日可行血液透析，并随访了6～44月，情况良好。结论尿激酶局部输注治疗内瘘血栓形成是安全有效的，可以作为首选的治疗措施。     

慢性周围动脉闭塞的选择性动脉内溶栓治疗

目的 :探讨慢性周围动脉闭塞的选择性动脉内溶栓治疗价值。方法 :36例慢性周围动脉闭塞中 ,男 19例 ,女17例。年龄 38～ 6 9岁 ,平均 4 8.5± 6 .8岁。右下肢 11例 ,左下肢 16例 ,左上肢 6例 ,右上肢 3例。按治疗方式分为 3组 ,常规动脉内导管药物溶栓者 16例 (A组 ) ,改良动脉内导管药物溶栓者 12例 (B组 ) ,超声溶栓结合导管内药物溶栓者 8例(C组 )。溶栓后球囊成形者 13例 ,同时行内支架植入者 4例。结果 :36例慢性周围动脉闭塞均溶栓成功 ,无 1例产生并发症。A、B、C三组的平均溶栓时间分别为 18.4± 5 .8h ,9.6± 3.2h和 8.5± 2 .8h ,C组的溶栓时间明显短于A、B组 (P <0 .0 5 )。A、B、C三组的平均尿激酶量分别为 10 6 .8± 38.5万u ,112 .5± 2 5 .6万u和 4 5 .6± 12 .5万u ,C组的平均尿激酶用量明显少于A、B组 (P <0 .0 5 )。结论 :选择性动脉内溶栓治疗是慢性周围动脉闭塞的安全有效的治疗方法。     

超选择性动脉溶栓治疗急性脑梗塞

目的：探讨急诊超选择性动脉溶栓治疗急性脑梗塞的价值和安全性。方法：对12例急性脑梗塞患者经股动脉插管，超选择至闭塞血管后，注入尿激酶行溶栓治疗。结果：颈内动脉闭塞4例，大脑中动脉闭塞8例。完全开通10例，2例部分开通。术后一周复查CT均未见大面积梗塞灶。1例发生术后脑出血。结论：早期超选择动脉溶栓是治疗急性脑梗塞最有效的方法之一。     

实时磁共振成像引导下猪脑动脉溶栓治疗的实验研究

目的 探讨实时MR成像引导下治疗猪脑动脉栓塞的可行性.方法 选用10只美国产的雌性小型猪作为实验对象.经皮穿刺股动脉,在实时MR成像的引导下,将3 F主动追踪微导管分别插至双侧咽升动脉内.经3 F微导管注入血栓堵塞咽升动脉,30～60 min后,经3 F微导管注射50万～75万u尿激酶溶栓.动脉增强MRA和冠状位压脂的MR冠状位T1成像评估溶栓治疗效果.结果 MRA证实,猪主要由双侧咽升动脉在颅底形成微血管网供应脑的血供.在实时MR成像引导下,10只猪的双侧咽升动脉经股动脉插管均获得成功,并完全被血栓堵塞.经动脉溶栓治疗后,血管内的血栓被溶解,堵塞的咽升动脉完全再通.结论 在实时MR成像的引导下,进行猪的动脉溶栓治疗可行.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].