骶骨肿瘤的术前血管栓塞

目的：评估骶骨肿瘤的术前动脉栓塞的应用价值。方法：7例骶骨肿瘤患者在术前2－4天采用明胶海绵结合弹簧及丝线栓塞。结果：所有病灶均完全切除,术中出血量明显降低,平均随访11个月,未见严重并发症和局部复发。结论：骶骨肿瘤的术前动脉栓塞能有效降低术中出血、减少并发症。     

肝动脉栓塞化疗后肝切除治疗中晚期肝癌

目前原发性肝癌首选的治疗方法仍然是肿瘤切除。临床上常遇到的病人大部分为中晚期肝癌,癌肿体积大,常侵犯或紧靠第一、二肝门及下腔静脉,多合并肝硬化,而不能手术切除。对这部分病人进行肝动脉栓塞化疗,被认为是一种有效的姑息治疗方法之一,可延长病人寿命。另外,部分病人栓塞化疗肿瘤缩小后再行肝切除术,以达到根治性治疗的效果。我院1991年5月以来行肝动脉栓塞化疗500多例,其中行肝切除43例,现就其治疗情况分析讨论。临床资料1　一般资料:本组43例,男39例,女4例,年龄29～67岁,平均50.4岁。合并肝硬化39例,乙肝表面抗原阳性者37例。全部病…     

Balloon occlusion test and therapeutic occlusion on traumatic carotid cavernous fistulas

Ｉ　ＤｅｐａｒｔｍｅｎｔｏｆＮｅｕｒｏｓｕｒｇｅｒｙ,ＦｉｒｓｔＡｆｆｉｌｉａｔｅｄＨｏｓｐｉｔａｌ,ＧｕｉｙａｎｇＭｅｄｉｃａｌＣｏｌｌｅｇｅ,Ｇｕｉｙａｎｇ５５０００４,Ｃｈｉｎａ（ＹａｎｇＨ）ＲｅｓｅａｒｃｈＣｅｎｔｅｒｏｆＩｎｔｅｒｖｅｎｔｉｏｎａｌＮｅｕｒｏｒａｄｉｏｌｏｇｙｏｆＢｅｉｊｉｎｇＨｏｓｐｉｔａｌ,Ｂｅｉｊｉｎｇ１００７３０,Ｃｈｉｎａ（ＬｉｎｇＦ,ＷａｎｇＤＭ,ＬｉＭ,ＺｈａｎｇＨＱ,ＭｉａｏＺＲ,ＺｈａｎｇＰ,ＭａＤＨａｎｄＳｏｎｇＱＢ）ｎｔｒａｖａｓｃｕｌａｒｔｅｃｈ…     

Application of super—selective renal artery embkolization in renal injuries

Objective:To use super-selective renal artery embolization in treatment of patients with renal injuries.Methods:From 1991 to 1998,11 cases of renal injuries due to different causes underwent super-selective renal artery embolization.In these patients,91% of injury sites were segmental arteries and their branches.All the patients were treated with steel coil for embolization.Results:Nine patients showed prompt cessation of hematuria,and in 2 patients hematuria stopped 2-4 days after embolization.Conclusions:Super-selective renal artery embolization (SSRAE) is suitable for severe hematuria,limited size of kidney injuries,stable hemodynamic parameters after conservative treatment and low reserve of renal function.Steel coil is an effective embolic material,Rapid hemostasis can be fulfilled and renal function can be reserved.super-selective renal artery embolization has low incidence of comkplications and can shorten hospitalization time.     

胆道大出血的导管治疗

目的 探讨运用选择性动脉造影和栓塞术对胆道大出血的诊断和治疗价值。方法 运用Seldinger技术对11例胆道大出血患者进行急诊选择性肝动脉及其分支造影和栓塞术,栓塞材料运用明胶海绵粒或明胶海绵粒加方纱线段。结果 7例胆道术后、1例腹腔镜胆囊摘除术后,1例肝脏外伤后及2例巨块型肝癌破裂后大出血的患者,行选择性肝动脉及其分支造影有9例发现异常,表现为造影剂外溢征（9例）,肿瘤血管和肿瘤染色征（2例）和假性动脉瘤形成（4例）。经导管栓塞术后,11例患者出血均停止,2例导管治疗48小时后复发大出血。结论 胆道大出血的急诊导管治疗是一种快速、安全、有效的方法;导管治疗后保持胆道引流的通畅也很重要。     

中晚期肝癌的导管治疗

中晚期肝癌的导管治疗巩照华赵文英郝春志周轶廖博贤肝癌的化疗栓塞术，在目前肝癌治疗中有其重要的价值，其方法优于其他方法。近几年已被广泛应用，本院自１９９５年元月至１９９７年元月共收治中晚期肝癌４７例，现就其方法及疗效报告如下：材料和方法１一般资料：本组...     

栓塞疗法治疗中晚期肝癌

栓塞疗法治疗中晚期肝癌于海文综述潘承恩审校（西安医科大学第一临床医学院肝胆外科西安７１００６１）以栓塞疗法为主要手段的综合治疗，已成为肝癌非手术疗法中的首选方案。近些年来，栓塞疗法取得了较大进展，本文就此作一综述。１栓塞疗法的理论基础１．１正常肝组织...     

原发性肝癌栓塞化疗术

原发性肝癌是我国常见的恶性肿瘤，一经发现多属中晚期，８０％～９０％已失去手术时机。１９７６年Ｇｏｌｄｓｔｅｉｎ首先用肝动脉栓塞（ｈｅｐａｔｉｃａｒｔｅｒｙｅｍｂｏｌｉｚａｔｉｏｎ，ＨＡＥ）治疗肝癌以来〔１〕，随着介入放射学的迅速发展，ＨＡＥ已被广泛用...     

介入栓塞治疗上消化道大出血术后再出血的疗效评估

目的 观察分析介入栓塞治疗上消化道大出血术后再出血的临床价值。方法 选择１１例上消化道大出血术后再出血的患,应用超选择性腹腔动脉造影确定出血部位,指导注入栓塞剂达到止血目的。结果 １１例患工行１３次选择怀腹腔动脉造影及栓塞,１０例获得满意止血效果。结论 选择性腹腔动脉造脉影响结合介入栓塞入止血,能够使消化道大出血术后再出血患得到及时的定位诊断和迅速、有效的治疗,是处惠消化道大出血术后再出血的     

Continuous renal replacement therapy improves renal recovery from acute renal failure

BACKGROUND: Acute renal failure (ARF) occurs in up to 10% of critically ill patients, with significant associated morbidity and mortality. The optimal mode of renal replacement therapy (RRT) remains controversial. This retrospective study compared continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) for RRT in terms of intensive care unit (ICU) and hospital mortality, and renal recovery. METHODS: We reviewed the records of all patients undergoing RRT for the treatment of ARF over a 12-month period. Patients were compared according to mode of RRT, demographics, physiologic characteristics, and outcomes of ICU and hospital mortality and renal recovery using the Chi square, Student's t test, and multiple logistic regression as appropriate. RESULTS: 116 patients with renal insufficiency underwent RRT during the study period. Of these, 93 had ARF. The severity of illness of CRRT patients was similar to that of IHD patients using APACHE II (25.1 vs 23.5, P = 0.37), but they required significantly more intensive nursing (therapeutic intervention scale 47.8 vs 37.6, P = 0.0001). Mortality was associated with lower pH at presentation (P = 0.003) and increasing age (P = 0.03). Renal recovery was significantly more frequent among patients initially treated with CRRT (21/24 vs 5/14, P = 0.0003). Further investigation to define optimal timing, dose, and duration of RRT may be beneficial. CONCLUSIONS: Although further study is needed, this study suggests that renal recovery may be better after CRRT than IHD for ARF. Mortality was not affected significantly by RRT mode.     

Influences of renal stone surgeries on renal function--evaluation of renal function with 99mTc-DMSA renal scintigraphy]

From 1984 to 1990, 99mTc-DMSA renal scintigraphy was performed before and after nephrolithotomy (15 cases), pyelolithotomy (15 cases), percutaneous nephrolithotripsy (PNL: 15 cases) and extracorporeal shock wave lithotripsy (ESWL: 16 cases, 17 kidneys) in order to evaluate of influences of renal stone surgeries on split renal function. DMSA renal uptake change ratio of treated kidneys of nephrolithotomy (-24.94 +/- 5.60%) was significantly lower than that of PNL (-0.06 +/- 3.92%), pyelolithotomy (-4.08 +/- 4.79%) (p less than 0.01) and ESWL (-7.72 +/- 3.87%) (p less than 0.05). The average change ratios of contralateral kidneys were as follows: PNL 4.80 +/- 4.21% nephrolithotomy 4.67 +/- 4.73%, pyelolithotomy -1.46 +/- 5.39% and ESWL -2.02 +/- 4.44%. One to 3 weeks after PNL, the cold area on the renal image was found in 10 (66.7%) of 15 cases. In cases of ESWL, DMSA renal uptake decreased even 4-10 weeks (mean 7 weeks) after treatment. In conclusion, possivility of deterioration of renal function after ESWL was suggested.     

Abnormal renal arteriography after renal trauma.

Angiograms following renal trauma in a ten-year-old girl were highly suggestive of renal neoplasm, especially Wilms' tumor. There are striking similarities between arteriograms after renal trauma and those showing neovascularity.     

Extensive renal involvement by renal cell carcinoma

Experience with the management of 3 cases of bilateral renal adenocarcinoma and 1 case of unilateral carcinoma in the solitary kidney is presented. Two patients died of metastases six and thirteen months postoperatively, while one is alive with metastases at fourteen months and another is alive without metastases at four months. The literature is reviewed, and the various treatments are discussed.     

Reversible renal hypertension due to renal hygroma

A hygroma of the left kidney was found at surgery in a thirty-five-year-old woman, who presented with anemia, hypertension, and a left abdominal mass. There was a very high sedimentation rate and fine needle aspiration yielded bizarre cells which raised the possibility of malignancy. Compression of the kidney by the cystic structure probably interfered with renal blood flow and was responsible for the elevated blood pressure which receded to normal after removal of the cyst and the left kidney.