快速性心律失常患者射频消融术后发生假性动脉瘤的影响因素分析

目的 探讨快速性心律失常患者射频消融术后发生假性动脉瘤的影响因素.方法 回顾性分析2017年1月至2020年1月于本院接受射频消融术治疗的90例快速性心律失常患者的临床资料,根据术后是否发生假性动脉瘤分为发生组(n=31)与未发生组(n=59).采用单因素与多因素分析快速性心律失常患者射频消融术后发生假性动脉瘤的影响因素.结果 两组快速性心律失常类型、高血压、年龄及INR值延长比较差异有统计学意义(P<0.05);Logistic回归分析结果显示,快速性心律失常类型为房颤、高血压、年龄>60岁及INR值延长均为导致快速性心律失常患者射频消融术后发生假性动脉瘤的危险因素(OR>1,P<0.05).结论 快速性心律失常患者射频消融术后发生假性动脉瘤可能与年龄、快速性心律失常类型为房颤、高血压、INR值延长等因素有关,临床上应重视上述风险因素的早期评估,以降低患者射频消融术后假性动脉瘤的发生风险.     

腹腔镜下肾脏肿瘤射频消融术的护理特点分析

目的：探讨腹腔镜下肾脏肿瘤射频消融术的护理特点。方法选取该院自2011年12月-2012年12月收治的42例腹腔镜下肾脏肿瘤射频消融术患者,对其临床资料进行回顾性分析。结果该组42例患者通过相应的治疗及护理,手术均获得成功,且患者均未发生护理并发症。结论给予腹腔镜下肾脏肿瘤射频消融术患者系统的护理干预,可有效的提高手术效果,促进患者康复,临床效果显著,值得推广和应用。     

胸膜腔穿刺胸膜反应的相关因素分析及护理对策

目的.探讨胸膜腔穿刺中患者发生胸膜反应的因素。方法 :对 14例胸膜反应相关因素进行回顾分析。结果 :胸膜反应原因与患者紧张恐惧、饥饿、体弱、反复穿刺等因素有关。结论 :针对诱因进行预防性护理是减少和避免胸膜反应发生的重要措施。     

射频消融术治疗肝肿瘤64例护理分析

目的:探讨射频消融术治疗肝肿瘤的临床护理方法及效果。方法:选择64例肝肿瘤患者为研究对象,给予射频消融术治疗后,采用综合护理,观察治疗及护理效果。结果:64例患者均顺利完成射频消融术治疗,57例患者治疗效果明显。患者对护理服务满意度为100%。结论:射频消融术治疗肝肿瘤后给予科学、精密的围手术期综合护理措施,利于患者康复,减少术后并发症的发生率,值得临床推广应用。     

CT导向下射频消融对不能手术切除肺癌的治疗效果分析

目的探讨CT导向下射频消融对不能手术切除肺癌的治疗效果。方法选取肺部肿瘤患者64例,共75个肿瘤病灶,采用CT导向下射频消融术对其进行治疗,分别于术后3个月和6个月行胸部CT扫描复查,并与治疗前进行对比,评价病灶变化情况及不良反应。结果 64例患者75个肿瘤病灶共进行了81次射频消融治疗(其中6个病灶进行了2次重复射频消融),治疗后3个月复查,75个肿瘤病灶体积均有不同程度的缩小,有效率100%。治疗6个月后再次复查总有效率为86.67%。所有患者均未发生大出血、支气管胸膜瘘等严重并发症。结论 CT导向下射频消融治疗肺癌具有定位准确、疗效确切、创伤小、不良反应少的优点,可作为不能手术肺癌患者的主要治疗手段之一。     

围术期护理对肝脏肿瘤射频消融术患者术后并发症的影响

目的探析围术期护理对肝脏肿瘤射频消融术患者术后并发症的影响。方法选取我院2016年2月至2017年6月收治的肝脏肿瘤患者140例,所有患者施行射频消融手术治疗,均采用围术期护理,观察和分析患者术后并发症的发生情况。结果所有患者并发症发生率低,治疗及时,并未复发。结论对肝脏肿瘤射频消融术患者采用围术期护理,术后并发症发生率低,效果显著。     

射频消融术心律失常患者焦虑抑郁状况及其影响因素

目的 调查射频消融术患者的焦虑抑郁状况,并分析其影响因素.方法 选择拟行射频消融手术的心律失常患者50例作为射频组及同期拟行药物治疗的心律失常患者50例作为对照组,对两组焦虑抑郁状况及生活质量的评分进行分析.结果 射频组的焦虑抑郁评分均明显高于对照组(P＜0.05).射频组的躯体化、强迫、人际关系敏感、敌对、恐怖、偏执、精神病性评分也均明显高于对照组(P＜0.05).二分类logistic逐步回归分析结果显示年龄、受教育年限、强迫评分、躯体化评分与饮酒为焦虑抑郁发生的主要影响因素(P＜0.05).结论 射频消融术患者多存在焦虑抑郁状况,可导致患者生活质量下降,要积极针对影响因素进行疏导干预.     

经皮经肝穿刺射频消融术(PRFA)治疗肝脏肿瘤的疗效分析

目的探讨经皮经肝穿刺射频消融术治疗肝脏肿瘤的临床疗效。方法将该院收治的142例肝脏肿瘤患者随机分为观察组与对照组,每组71例,其中观察组行经皮经肝穿刺射频消融术,对照组行肝脏肿瘤切除术,比较两组患者的临床疗效及不良反应发生情况。结果两组患者治疗后QOL评分差异显著,观察组明显优于对照组(P<0.05);治疗1年后观察组复发率为11.27%,3年生存率为53.52%,与对照组比较差异无统计学意义(P>0.05);观察组发生感染6例,疼痛10例,发热4例,无漏胆汁与胆汁性腹膜炎及肝功能衰竭发生,不良反应发生率明显低于对照组(P<0.05)。结论经皮经肝穿刺射频消融术治疗肝脏肿瘤疗效显著,且不良反应少,值得临床推广应用。     

两种射频消融方法治疗原发性肝癌的疗效分析

目的:对照比较开腹手术中射频消融与经皮射频消融术治疗原发性肝癌的疗效。方法:将79例原发性肝癌患者分为开腹射频消融与经皮射频消融治疗,并对所有患者进行24月的术后随访,比较两组患者的生存率。结果:本组经皮射频消融治疗的41患者,术前AFP升高者36例,术后33例降至正常,2年内14例(34.2%)肿瘤复发,外科手术中经肝包膜进针射频消融治疗的38例患者,36例术前AFP升高,术后35例降至正常,2年内7例(18.4%)患者肿瘤复发(P0.05);经皮射频消融治疗后感染和出血的发生率分别为4.9%和2.4%,开腹射频消融治疗后感染和出血发生率分别为5.3%和7.9%;经皮射频消融治疗组1年和2年生存率分别为78.1%和65.9%,开腹射频消融治疗组则分别为92.1%和81.2%(P0.05)。结论:射频消融术治疗肝癌后患者肝功能有不同程度的受损,应注意保护。开腹经肝包膜射频消融术后肿瘤复发率低,术后无瘤生存时间延长。     

氢溴酸西酞普兰对心律失常射频消融术后抑郁障碍的疗效研究

目的 探讨心律失常（室上性心动过速）患者行射频消融术后抑郁障碍的发生情况,并观察氢溴酸西酞普兰治疗对患者抑郁障碍的疗效.方法 采用抑郁自评量表（SDS）、汉密尔顿抑郁量表（HAMD-24）评定心律失常（室上性心动过速）患者行射频消融术术前、术后1个月患者的抑郁障碍发生情况.观察被评定为抑郁障碍的患者,氢溴酸西酞普兰治疗组与谷维素对照组的临床疗效.结果射频消融术术前合并抑郁障碍为40.2%,射频消融术术后1个月抑郁障碍为47.2%;抑郁评分差异有统计学意义（P〈0.01）;治疗组SDS、HAMD-24抑郁评分较干预前明显降低（P〈0.05）,并且明显低于对照组（P〈0.01）.结论心律失常患者射频消融术术后患者发生抑郁障碍的比例明显增加,氢溴酸西酞普兰治疗能有效治疗患者的抑郁障碍程度.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.