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1.
目的::分析和评价胰腺假性囊肿的治疗方法及其疗效. 方法:回顾性分析2009年1月~2014年1月我科收治的47例胰腺假性囊肿患者,根据其治疗方式的不同分为3组:保守治疗组、穿刺引流组、外科手术组,评估其疗效. 结果:保守治疗组13例,其中11例在随访期间囊肿自行吸收,1例慢性胰腺炎反复发作合并多发假性囊肿,因囊肿多发并且囊壁较薄(壁厚<1cm) ,好转出院后失访;1例由慢性胰腺炎并胰管多发结石所引起的胰腺假性囊肿,患者及家属拒绝手术治疗;穿刺引流组9例,治愈率66.7%;外科手术组25例,总治愈率76%,其中行假性囊肿空肠Roux-en-Y吻合术患者的治愈率为82.4%. 以上病例随访到32例,随访率68%,随访时间3个月~4年(平均31个月). 结论:(1)急性胰腺炎后并发胰腺假性囊肿,病程<6周,囊肿最大径<6cm,无重症感染的患者首选保守治疗. (2) CT引导下经皮穿刺置管引流创伤小、操作简单,可作为囊肿壁未成熟、合并感染的PPC的主要治疗方式. (3)外科手术尤其是囊肿空肠Roux-en-Y吻合术疗效确切、并发症低,是成熟胰腺假性囊肿简单合理的内引流术式.  相似文献   

2.
目的探讨CT导向下经皮穿刺外引流治疗胰腺假性囊肿的价值。方法搜集直径5~20mm胰腺假性囊肿32例,行CT导向下经皮穿刺外引流术,随访1~12月,观察治疗效果。结果32例囊肿消失23例,有效率71.87%。结论CT引导向下经皮穿刺外引流治疗胰腺假性囊肿是一种安全有效、成功率高的方法。  相似文献   

3.
陈敏  王维  罗蓉  李罗红  张铭光 《西部医学》2012,24(9):1811-1813
目的探讨胰腺假性囊肿经胰管支架或鼻胰管引流的护理价值。方法采用回顾性调查对31例行内镜下经十二指肠乳头胰管内外引流术的胰腺假性囊肿患者进行分析,探讨内镜下经十二指肠乳头胰管内引流及有效的护理对胰腺假性囊肿的治疗作用。结果 31例胰腺假性囊肿经内镜引流(ERCPO)32例(次),其中鼻胰管引流(ENPD)8例;胰管支架(ERPD)10例;ENPD+ERPD13例。术后出现囊肿感染4例,感染率13%;2例转外科手术治疗,其中1例因胰腺假性囊肿多分隔,另外1例因引流液中查到异型细胞,转手术切除;囊肿复发1例,再次给予ERPD引流后治愈;胰腺假性囊肿残腔形成1例。无出血、穿孔、死亡等并发症发生。胰管支架放置至囊肿消失时间平均3mon,平均住院40.6d。结论内镜经乳头引流治疗交通性胰腺假性囊肿是一种确切有效的治疗方法,而术前、术中、术后护理措施是保证手术顺利进行及手术疗效的必备条件。  相似文献   

4.
目的:总结胰腺假性囊肿的诊治体会。方法回顾性分析我院2007年3月至2014年3月收治的29例胰腺假性囊肿患者的治疗经过。结果胰肠内引流19例,均行囊肿空肠Roux_en_Y吻合;穿刺引流5例,穿刺成功率100%;胰腺体、尾部切除术并囊肿切除3例;穿刺外引流者5例囊肿消失后拔管,1例复发后行囊肿内引流治愈。保守治疗2例得以治愈。25例得到随访,随访率86.2%,平均随访期2.5年。随访病例除1例外引流患者复发后行内引流治愈外,无一例复发。结论胰腺假性囊肿应根据病程长短及病情等采用个体化的治疗原则,胰腺假性囊肿治疗成功的关键是选择正确的治疗方法和恰当的手术时机。  相似文献   

5.
目的:探讨B超引导下经皮穿刺引流在胰腺假性囊肿治疗中的应用。方法选取胰腺假性囊肿患者188例,随机分为观察组和对照组,每组94例,对照组给予常规手术治疗,观察组给予B超引导下经皮穿刺引流治疗。对2组临床疗效及不良反应发生情况以及胰腺假性囊肿复发情况进行观察。结果观察组治疗有效率为93.62%,略低于对照组的95.74%(P>0.05);观察组并发症发生率为4.26%,显著低于对照组的21.28%(P<0.05);治疗后1年内观察组胰腺假性囊肿复发率为3.19%,与对照组的4.25%比较无明显差异(P>0.05)。结论 B超引导下经皮穿刺引流治疗胰腺假性囊肿安全有效,可作为外引流术的替代方法,值得推广应用。  相似文献   

6.
目的 探讨外伤性胰腺假性囊肿的处理方式.方法 回顾性分析18例外伤性胰腺假性囊肿的临床资料.结果 18例患者中2例合并胰管断裂者先行外引流后,再行内引流治疗,4例行内引流治疗,余12例未行手术治疗,所有患者均治疗成功.结论 外伤性胰腺假性囊肿手术可行.  相似文献   

7.
目的:内镜下经十二指肠乳头引流治疗与主胰管相通的胰腺假性囊肿,探讨交通性胰腺假性囊肿的内镜治疗效果。方法:回顾分析22例交通性胰腺假性囊肿经十二指肠乳头引流,观察术后囊肿消退及临床症状改善情况。结果:治疗后20例患者囊肿消退及症状明显改善,1例囊肿3个月后复发,再行引流,1例引流3天后囊肿消退,但5天后引流管堵塞,原有囊肿复发,且新的部位(胰尾部)亦出现囊肿,转外科手术。结论:经十二指肠乳头引流治疗与主胰管相通的胰腺假性囊肿,安全有效,可作为首选的治疗方法。  相似文献   

8.
目的探讨胃癌根治术后并发胰腺假性囊肿的诊断和治疗方法。方法对近11年来治疗的21例胃癌根治术后并发胰腺假性囊肿的病例进行回顾性分析。结果保守治疗3例(14.3%),B超下经皮穿刺6例(28.6%),手术外引流5例(23.8%),内引流7例(33.3%),21例患者均痊愈出院。结论胃癌根治术后并发胰腺假性囊肿的治疗应采用个体化治疗的原则,早期可采用保守治疗、穿刺和外引流,内引流可作为治疗的最后的选择。  相似文献   

9.
陈莉  徐春霞 《当代医学》2009,15(29):616-617
目的探讨CT引导下胰腺假性囊肿引流的治疗与术中护理。方法52例胰腺假性囊肿患者实行CT引导下经皮引流治疗,并规范护理。结果本组患者经过CT引导下经皮引流治疗和护理均取得较满意的临床效果。结论CT引导下胰腺假性囊肿引流是一种有效而可靠的非手术治疗方法。  相似文献   

10.
目的通过对早期较大胰腺假性囊肿行经皮穿刺引流和保守观察治疗的对照研究,了解经皮穿刺引流治疗较大假性囊肿的有效性和安全性。方法选择早期胰腺假性囊肿患者中囊肿直径>6cm者为研究对象,分两组分别行经皮穿刺引流和保守观察治疗,随访2年比较两组的并发症,痊愈、好转和失败率。结果经皮穿刺引流组平均引流(19.8±4.9)d,并发症发生率46.8%(15/32)。囊肿完全消失37.6%(12/32),好转31.2%(10/32),失败31.2%(10/32);保守观察组并发症发生率12.1%(4/33),囊肿完全消失12.1%(4/33),好转33.4%(11/33),失败54.5%(18/33)。结论早期较大胰腺假性囊肿经皮穿刺引流是安全和有效的。  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
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.  相似文献   

13.
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.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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