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1.
老年冠心病患者行冠状动脉内支架置入术的近期临床评估   总被引:3,自引:0,他引:3  
目的 评估老年冠心病患者的冠状动脉内支架置入术 (支架术 )的安全性和有效性。方法 对 5 6例年龄≥ 6 0岁 (老年组 )和 4 3例年龄 <6 0岁 (非老年组 )已行支架术的冠心病患者的临床病灶特点 ,手术成功率、手术并发症及近、远期临床随访结果进行对照分析。结果 老年组在经皮冠状动脉腔内成形术 (PTCA)的基础上行支架术总成功率与非老年组比较无显著差异性 (96 .3%与 97.6 % ,P >0 .0 5 ) ;两组间冠状动脉血管 ,外周血管并发症无明显差异 ;老年组因冠状动脉扩张后发生急性血管闭塞或严重内膜撕裂而置入支架比例明显高于非老年组 (P <0 .0 0 1) ;老年组左主干病变化比例明显高于非老年组 (P <0 .0 0 1)。随访 6 - 18个月 ,两组患者恶性心脏事件发生率无明显差异 ,但老年组患者再次血运重建率明显高于非老年组 (P <0 .0 5 )。结论 对 6 0岁以上冠心病患者行PTCA治疗是安全有效的 ,成功率较高 ,并发症少 ,但应严格掌握手术适应症。  相似文献   

2.
目的 探讨经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗术后外周血管并发症,分析好发因素及处理效果,为今后实施PCI手术提供参考.方法 将行PCI治疗的患者234例根据性别、年龄、基础疾病、治疗情况进行分组,记录患者基础疾病及各类并发症的发生情况,从整体水平分析各类并发症的比例比较各类患者发生并发症的差异.结果 12.39%(29/234)患者PCI术后发生外周血管并发症,发生最多的是穿刺部位出血和血肿65.52%(19/29),其后依次为动脉栓塞17.24%(5/29),假性动脉瘤6.90%(2/29),动静脉瘘6.90%(2/29)和腹膜后血肿3.45%(1/29).其并发症发生率除性别与压迫方式差异无统计学意义(P>0.05)外,高龄、高血压、糖尿病以及实施强化抗凝的患者术后较无此基础疾病及未强化抗凝者更易发生外周血管并发症,差异均有统计学意义(P<0.05).结论 严格把握手术适应证,规范PCI手术操作,及时发现并处理术中外周血管并发症可有效预防外周血管并发症.  相似文献   

3.
目的 观察冠心病患者经皮冠状动脉介入术(PCI)治疗的有效性和安全性.方法 选择进行PCI治疗的532例冠心病患者,其中急性心肌梗死患者188例、不稳定型心绞痛患者252例、稳定型心绞痛患者58例、陈旧性心肌梗死患者34例.分析所有患者冠状动脉的靶血管特点、手术成功率、并发症及术后随访情况.结果 经皮冠状动脉成形术(PTCA)成功率98.1%,治疗病变成功率95.4%,冠状动脉内支架植入术(CASI)成功率96.9%.其中A、B、c型病变成功率分别为100%、100%、88.7%.完全闭塞病变血管168支,成功率达67.9%.严重并发症2.5%.结论 PTCA和CASI的成功率均达95%以上,因此PTCA及CASI治疗冠心病是安全有效的.  相似文献   

4.
王红  吕桂芬  谢剑  李娟 《广西医学》2002,24(8):1175-1177
目的 :回顾分析 88例次经皮腔内冠状动脉成形术 (PTCA)及支架置入术 (支架术 )治疗冠心病的临床疗效。方法 :对 82例冠心病患者共行 88例次 PTCA或加支架术 ,其中心绞痛患者 5 0例 ,心肌梗死 3 1例 ,无症状性心肌缺血 1例 ;临床心功能 (2 .8± 0 .6)级 (除外急性心肌梗死急诊手术者 ) ;处理病变血管 10 8处 ,共置入支架 95枚 ,其中 L M2枚 ,L AD42枚 ,LCX2 0枚 ,RCA3 1枚。结果 :PTCA成功率 93 .5 % ,PTCA成功后 ,拟行支架术者均能完成支架术 ,心绞痛缓解率 98% ,临床心功能 (1.5± 0 .5 )级 ,较术前明显改善 (P <0 .0 5 ) ;支架术并发症小于 4.5 % ,多为穿刺局部并发症。结论 :PTCA加支架术治疗严重心肌缺血患者疗效确切 ,并发症少 ,值得临床进一步推广应用  相似文献   

5.
冠状动脉内支架安置术已经成为治疗经皮冠状动脉腔内成形术 (PTCA)后冠状动脉急性闭塞和减少PTCA术后再狭窄的有效方法。我科自 1999年 11月~ 2 0 0 2年 12月实施冠状动脉腔内支架安置术 2 6 4例 ,效果满意 ,现将术后观察及护理报告如下。1 临床资料本组冠心病病人 2 6 4例 ,男 16 6例 ,女 98例 ;年龄 32~77岁 ,平均 (5 2 .0± 6 .8)岁。冠心病心绞痛 174例 ,急性心肌梗死 2 8例 ,陈旧性心肌梗死 6 2例 ,其中急性心肌梗死急诊手术 18例。出现并发症 11例 ,其中穿刺部位血肿 4例 ,低血压 5例 ,急性心肌梗死行急诊PTCA后冠状动脉急性…  相似文献   

6.
目的探讨冠状动脉造影与经皮冠状动脉介入术后外周血管并发症的发生率、原因和处理方法。方法分析经皮冠脉介入术后出现外周血管并发症患者的临床资料。结果5763例患者中118例(2.1%)发生外周血管并发症,其中穿刺部位单纯血肿84例(1.5%),假性动脉瘤28例(0.5%),动静脉瘘6例(0.1%)。经皮冠状动脉介入术后外周血管并发症的发生率显著高于冠状动脉造影术后(2.9%与0.8%,P〈0.05)。弹力绷带加压包扎结合超声指导下压迫修复的成功率为100%。结论经皮冠状动脉介入术后外周血管并发症并不少见,主要与穿刺方法不当、术者经验不足、女性、高龄及抗凝治疗有关。超声指导下压迫修复成功率较高。  相似文献   

7.
目的 :了解 3 5例急性心肌梗死 (AMI)患者经皮腔内冠状动脉介入治疗 (PCI)的疗效、适应证及并发症。方法:对 3 5例 AMI患者行 PCI治疗 ,其中男性 3 4例 ,女性 1例 ,年龄 3 9~ 72 (5 4.8± 8.6)岁。其中 2 1例患者为急诊 PTCA,均在发病后平均 (7.4± 6.6) h内直接进行 PTCA;3例为溶栓失败后补救性 PTCA;11例为延迟PTCA。 结果 :PCI成功率为 10 0 % ,术前梗塞相关血管平均狭窄 (93 .2± 5 .9) % ,术后残余狭窄为 (10 .6± 6.3 ) %。结论:AMI时行急诊 PTCA成功率高 ,残余狭窄少 ,对溶栓失败或并发心源性休克者应积极行 PTCA,可获得较高的梗塞相关血管再通率和较低的心梗复发率和死亡率 ,同时可减少梗塞面积 ,保护心功能  相似文献   

8.
经皮冠状动脉腔内成型和支架置入(PTCA STENT)术中并发冠状动脉穿孔,是冠状动脉介入治疗(PCI)过程中发生率较低的一种并发症,据报道其发生率为0.1%~2.7%[1].虽然并不常见,但有时会引起心包填塞和急性心肌梗塞,甚至死亡[2].如果抢救不及时,将会给患者造成极严重的后果,而果断有效的护理配合是抢救成功的关健.我院曾成功抢救一例冠状动脉破裂患者,现报告如下:  相似文献   

9.
目的 :探讨经桡动脉途径行冠状动脉支架植入治疗的可行性和安全性。方法 :选择我院 2 0 0 1年12月~ 2 0 0 4年 10月住院、Allen’s试验阳性病人 190例 ,使用 6F桡动脉鞘行经皮冠状动脉球囊扩张成形术(PTCA)、支架植入。结果 :对 190例病人中 2 18处病变进行了治疗 ,单纯PTCA 9处 ,2 0 9处病变植入支架 2 75枚。经统计学处理 ,提示术前狭窄 88 6 %± 7 .9% ,术后无残余狭窄。平均桡动脉穿刺时间为2 6± 1 7min ,一次桡动脉穿刺成功率 96. 9% ,术前和术后 2 4hAllen’s试验时间无显著性差异 ,并发症少。结论 :本研究提示 ,经桡动脉途径植入冠状动脉支架安全可行、手术成功率高、血管并发症少、无需限制体位 ,可作为冠状动脉支架植入术的首选血管途径。  相似文献   

10.
266例冠心病患者经皮冠状动脉介入治疗的临床分析   总被引:7,自引:1,他引:6  
目的 观察冠心病患者经皮冠状动脉介入术(PCI)治疗的有效性和安全性.方法 选择2008年6月至2009年6月进行PCI治疗的266例冠心病患者,其中急性心肌梗死患者94例、不稳定型心绞痛患者126例、稳定型心绞痛患者29例、陈旧性心肌梗死患者17例.分析所有患者冠状动脉的靶血管特点、手术成功率、并发症及术后随访情况.结果 经皮冠状动脉成形术(PTCA)成功率98.1%,治疗病变成功率95.4%,冠状动脉内支架植入术(CASI)成功率96.9%.其中A、B、C型病变成功率分别为100%、100%、88.7%.完全闭塞病变血管84支,成功率达67.9%.严重并发症2.3%.结论 PTCA和CASI的成功率均达95%以上,因此PTCA及CASI治疗冠心病是安全有效的.  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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