脾切断流术后预防门静脉系血栓行抗凝治疗时机选择的临床研究

目的探索脾切断流术后行抗凝治疗预防门脉系血栓形成的最佳时机及安全性。方法选取择期行脾切断流术的肝硬化门脉高压症患者90例,随机分成三组。A组：行祛聚治疗基础上,术后第2天开始加用低分子肝素钠。B组：行祛聚治疗基础上,血小板计数〉300×10-9／L时加用低分子肝素钠行抗凝治疗。c组：仅行祛聚治疗。比较三组间血栓发生率、术后再出血等不良反应情况。结果A组术后门静脉系统血栓发生率（3．39％）明显低于B组（25．93％,P〈0．05）和C组（35．71％,P〈0．05）。B组和C组间血栓发生率比较差异无统计学意义（X2=0.6167,P〉0．05）。三组患者治疗期间均无明显出血等不良反应。结论术后尽早（术后第2天）行抗凝治疗预防断流术后门静脉系血栓形成效果佳,且安全、方便。     

门静脉高压症术后再出血外科治疗的探讨--附65例临床分析

目的 探讨门脉高压症术后再出血外科治疗手术方式的选择。方法 本文总结了６５例门脉高压症术后再出血的治疗情况。结果 ４７例采用了不同术式的外科治疗,其中行肠腔侧侧分注术２９例,肠系膜下静脉腔静脉分流术６例,肠系膜上静脉属支腔静脉分流术４例,肠系膜上静脉属支左肾静脉分流术２例,断流术６例,手术死亡５例。结论 外科治疗目前仍是治疗门脉高压术后再出血的主要手段,且以择期手术为宜,其中肠腔侧侧分流术是断流术     

加压素和硝普钠对兔血吸虫病肝硬变门静脉血流的影响

采用 Diasonic-spectra 彩超仪,观察先后应用加压素和硝普钠对血吸虫病兔门脉血流量的影响。先用加压素(2 U/kg,iv),门脉即刻缩小,血流量锐减,20 min 后用硝普钠(2 mg/kg,iv),门脉即刻扩张,门脉血流量恢复至用药前水平。故二者联合应用时应采用先后用药,二者均可发挥治疗作用,又可相互协同和抵消副作用。     

CT guided 125iodine seed implantation for portal vein tumor thrombus in primary hepatocellular carcinoma

Background This study evaluated the clinical application of CT guided ^125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma.
Methods The ten patients （9 males and 1 female, aged from 36 to 72 years） with portal vein tumor thrombus accompanying hepatocellular carcinoma had been treated with comprehensive therapy including surgery, transcatheter arterial chemoembolization, radiotherapy ablation, microwave ablation or percutaneous ethanol injection. The average diameter of each tumor thrombus was 21.5 mm × 30.5 mm. Seeds of 30 MBq ^125I were implanted 5 mm apart within the portal vein tumor thrombus. The follow-up after 4 months included enhanced spiral CT.
Results CT screening of the tumours indicated that 4 out of 10 patients showed complete response to the therapy, 5 partial response and 1 stable disease. Adverse effects included aggravated abdominal dropsy and temporarily increased transaminase, which were controlled by medical management. Severe complications such as haemorrhage, biliary fistula hepatic abscess, pancreatic fistula and hepatic function failure were not observed. Implanted seeds migrated to lung and left hepatic lobe in 1 case.
Conclusion CT guided implantation of ^125iodine seeds, can effectively treat portal vein tumor thrombus accompanying hepatocellular carcinoma with minimal damage and few complications.     

The effects of the combination of phentolamine and vasopressin on hepatic and systemic hemodynamics in girrhotic portal hypertensive dog model

Summary The experimental study was aimed at elucidating the effects of phentolamine and vasopressin used separately or in combination on hepatic and systemic hemodynamics in cirrhotic portal hypertensive dogs. The results showed that either of the two drugs used separately could lead to reduction in portal venous pressure and could also influence systemic hemodynamics or lower hepatic blood flow. When phentolamine in combination with vasopressin was administered, no side-effect could be found on hepatic and systemic hemodynamics, suggesting that the drugs used in combination could efficaciously decrease portal hypertension and counteract their respective side-effect. This combination therapy will be useful in treating bleeding from esophageal variceal rupture in cirrhotic patients with portal hypertension.     

耐多药肺结核患者心理支持与药物治疗同步进行临床观察

目的探讨心理支持治疗对耐多药肺结核患者治疗效果及抗结核药物副作用发生情况的影响。方法把住院治疗的76例耐多药肺结核患者按住院顺序和临床分型随机分为两组,即心理支持治疗组和单纯化疗组,两组患者均根据药敏和既往用药情况给予合理化疗,同时心理支持组给予心理支持治疗,评价两组患者的治疗效果及药物不良反应发生情况。结果心理支持治疗组患者的治疗效果明显好于单纯化疗组,差异有统计学意义（P〈0．05）,药物不良反应发生率明显降低。结论心理支持治疗对耐多药肺结核患者的治疗效果有明显的促进作用,可增加患者对治疗的耐受性。     

国产帕罗西汀与针灸理疗治疗躯体化障碍的对照研究

目的:探讨帕罗西汀与针灸理疗治疗躯体化障碍的疗效和副反应。方法:184例患者按就诊先后随机分为治疗组和对照组,分别进行帕罗西汀与针灸理疗治疗4周,于治疗前及治疗后分别进行汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、四级临床疗效评定标准、副反应量表(TESS)及实验室检查评估疗效及安全性。结果:对照组总有效率分别为92.39%、55.43%,两组间疗效差异有显著性。对照组未见明显不良反应。治疗组不良反应发生率为11.01%。主要为轻度恶心、多汗和性欲改变。结论:帕罗西汀治疗躯体化障碍疗效较好,副作用少。     

六君子汤加味在原发性肝癌介入治疗中的应用

目的：探讨六君子汤对减轻原发性肝癌介入治疗后毒副反应的作用。方法将６０例原发性肝癌病人随机分为治疗组和对照组,同时接受介入化疗加栓塞治疗,术后治疗组服中药六君子汤,对照组按常规处理。结果：在减轻因介入化疗和栓塞引起的毒副反应方面六君子汤优于常规治疗。结论;六君子汤味减轻介入治疗后毒副反应有一定缓解作用,为再次介入治疗奠定基础。     

分流联合断流术治疗门静脉高压疗效分析

目的: 观察分流联合断流术治疗门静脉高压的临床疗效。方法: 对112例门静脉高压者分别采用分流断流联合术31例和断流术81例,观察手术前后门静脉压力(FPP)变化以及近远期疗效。结果: 分流断流联合术组FPP下降优于断流术组(P < 0.01);2组术后病死、近期再出血及肝性脑病发生率差异无统计学意义(P > 0.05);分流断流联合术组远期再出血和腹水发生率均低于断流术组(P < 0.05),远期肝性脑病的发生率差异无统计学意义(P > 0.05)。结论: 分流断流联合手术治疗门静脉高压,既明显降低出血率又不增加脑病发生,应成为治疗门静脉高压的首选术式。     

阿立哌唑与利培酮治疗老年期精神分裂症对照研究

目的比较阿立哌唑与利培酮治疗老年期精神分裂症的疗效及不良反应。方法将对病程<4年的160例老年期精神分裂症的住院患者,按入院顺序随机分为服用阿立哌唑组(A组)与服用利培酮组(B组),每组80例。阿立哌唑剂量为10￣30mg/d,利培酮剂量为2￣6mg/d。疗程8周,采用阳性与阴性症状量表(PANSS)评定疗效,采用副反应量表(TESS)评定不良反应。结果A组退出2例,B组退出3例。两药对老年期精神分裂症的疗效相当,两组无显著性差异。阿立哌唑的不良反应较利培酮轻微,其中震颤、静坐不能、肌强直等发生率少于利培酮组。结论阿立哌唑与利培酮治疗老年期精神分裂症的疗效相当,不良反应较利培酮少。