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1.
《JACC: Cardiovascular Interventions》2022,15(12):1205-1215
BackgroundDistal radial access (DRA) has been proposed to improve procedure ergonomics and favor radial artery patency. Although promising data, nothing is known on evolving hand function after DRA.ObjectivesThis study sought to comprehensively evaluate hand function in patients undergoing DRA.MethodsReal-world patients undergoing DRA undertook a thorough multimodality assessment of hand function implementing multidomain questionnaires (Disabilities of the Arm, Shoulder and Hand and Levine-Katz), and motor (pinch grip test) and sensory (Semmes-Weinstein monofilaments test) examinations of both hands. All assessments were performed at preprocedural baseline and planned at 1-, 6-, and 12-month follow-up (FU). Adverse clinical and procedural events were documented too.ResultsData of 313 patients (220 men, age 66 ± 10 years) from 9 international centers were analyzed. The Disabilities of the Arm, Shoulder and Hand and the Levine-Katz scores slightly improved from baseline to FU (P = 0.008 and P = 0.029, respectively). Pinch strength mildly improved from baseline to FU (P < 0.001 for both the left and right hands). Similarly, touch pressure threshold appeared to faintly improve in both the left and right hands (P < 0.012 for all the sites). For both motor and sensory function tests, comparable findings were found for the DRA hand and the contralateral one, with no significant differences between them. Repeated assessment of all tests over all FU time points similarly showed lack of worsening hand function. Access-related adverse events included 19 harmless bleedings and 3 forearm radial artery and 3 distal radial artery occlusions. None affected hand function at FU.ConclusionsIn a systematic multidimensional assessment, DRA was not associated with hand function impairment. Moreover, DRA emerges as a safe alternative vascular access. 相似文献
2.
目的研究云南白药在围术期对全髋关节置换术术中出血量及术后引流量的影响。方法2006至2008年我科收治的股骨颈骨折行全髋关节置换术60例,随机分成两组,分别服用云南白药胶囊和空胶囊;术前术后测定凝血酶原时间(PT),记录全部病人术中出血量及术后24 h引流量。结果实验组和对照组病人的凝血酶原时间(PT)差异有统计学意义(P<0.01);试验组的术中出血量、术后24 h引流量分别为(380±78)ml(、336±77)ml,较对照组(481±77)ml(、418±68)ml明显减少,差异具有统计学意义(P<0.01)。结论云南白药胶囊能够明显减少全髋关节置换术围术期出血量。 相似文献
3.
内镜下套扎与硬化夹心联合法治疗食管静脉曲张出血的研究 总被引:8,自引:0,他引:8
目的 了解套扎与硬化夹心联合法 (套扎 硬化 套扎 )能否获得优于单纯内镜下食管静脉曲张结扎 (EVL)的疗效。方法 对 98例肝硬化食管静脉曲张伴活动性出血或近期出血的患者随机采用单纯EVL或夹心法治疗 (EVL组 5 0例 ,夹心法组 4 8例 )。EVL组每条曲张静脉结扎皮圈不超过 3个 ,夹心法组每条曲张静脉结扎 2个皮圈 ,并在两个结扎点之间的曲张静脉内注射 1~ 3ml硬化剂。夹心法组 7例在首次内镜治疗时接受食管静脉造影检查。 7~ 10d重复 1次内镜治疗 ,直至静脉曲张消除。结果 7例行静脉造影检查 ,其中 6例硬化剂在曲张静脉内滞留时间超过 4 5min。两种方法控制活动性食管静脉曲张出血 (EVB)的止血成功率相同 (10 0 .0 % ) ;两组间静脉曲张消除率相似 (夹心法组 93.8% ,EVL组 90 .2 % ,P >0 .0 5 ) ,但夹心法组一次治疗后静脉曲张消除率明显高于EVL组 (6 6 .7%比10 .0 % ,P <0 .0 0 1) ,达到消除的平均治疗次数明显减少 (1.2± 0 .4比 3.8± 1.5 ,P <0 .0 1) ,所需时间显著缩短 [(13.1± 4 .3)d比 (42 .5± 16 .7)d ,P <0 .0 1];与EVL组相比 ,夹心法组再出血率较低 (8.3%比2 8.0 % ,P <0 .0 5 ) ,随访期内静脉曲张复发率明显下降 (8.3%比 4 4 .0 % ,P <0 .0 0 5 ) ;两组间并发症发生率相似 (夹心法组 1 相似文献
4.
S. Kitano H. Kawanaka M. Tomikawa H. Hirabayashi M. Hashizume K. Sugimachi 《Surgical endoscopy》1994,8(5):405-407
In a 48-year-old Japanese man there was an uncontrollable and recurrent bleeding from a gastric ulcer and laparoscopic surgery was done. Two cannulae were placed in the gastric cavity through the abdominal wall and suture ligation of the bleeding vessel at the posterior wall of the stomach was done under videovisual control with endoscopic guidance. The bleeding ceased, complications were nil, and he remains well.This article reports on surgery done to repair uncontrollable, recurrent bleeding from a gastric ulcer. Two cannulae were placed in the gastric cavity through the abdominal wall and suture of the vessel at the posterior wall of the stomach was done with videovisual control and endoscopic guidance. This approach is concluded to have supplied minimal-access surgery, cost effectiveness, early discharge, less pain, and doctor-patient satisfaction. 相似文献
5.
目的 探索一种无创性的牙龈出血检测方法--龈沟液隐血试验(GCFobt),并分析牙龈出血与微生物之间的内在联系。方法 用隐血试纸进行102例唾液标本的唾液隐血(Sobt)检查,1600个位点的GCFobt、牙龈出血指数(SBI)、探诊深度(PD)检测,分别对79、32个龈下细菌标本作涂片检查和厌氧培养,分析临床指数与龈下细菌的关系。结果 GCFobt具较高灵敏度(68.05)和特异度(80.5%),较Sobt更能说明局部牙周炎症状况,与SBI有非常显著相关关系(P<0.001);GCFobt阳性与阴性部位螺旋体、杆菌、球菌百分含量有非常显著差异(P<0.001);在0与3之间黑色菌检出率有非常显著差异(P<0.01),在0与2、3之间梭杆菌检出率有显著差异(P<0.05)。结论 GCFobt是一种快速、简便、无创伤的检测牙龈出血新方法,可以作为牙周病临床检查的一项客观指标。 相似文献
6.
Brian C. Reuben Greg Stoddard Robert Glasgow Leigh A. Neumayer 《Journal of gastrointestinal surgery》2007,11(1):22-28
Background In the era of Helicobacter pylori treatment, the role of vagotomy in bleeding duodenal ulcers is debatable. National outcomes were evaluated to determine the
current surgical treatment and use of vagotomy for bleeding duodenal ulcers.
Methods Data from the Nationwide Inpatient Sample (NIS) were used from years 1999 to 2003. Patients were selected using diagnostic
codes for acute duodenal ulcer bleed and procedure codes for simple oversew of a bleeding ulcer and vagotomy. Data were analyzed
using multiple linear and logistic regression.
Results Between 1999 and 2003, 100,931 patients with an acute bleeding duodenal ulcer were identified. Over time, there was a decrease
in the number of acute bleeding ulcers (p = 0.027) and a decrease in the number of vagotomies (p = 0.027). A high co-morbidity index [odds ratio (OR), 0.60, p = 0.017], operation in the Midwest (OR 0.50, p < 0.001) and operation in the West (OR 0.68, p = 0.034) were predictive of no vagotomy during surgery for a bleeding duodenal ulcer.
Conclusions A vagotomy is not commonly performed during surgical treatment of an acute bleeding duodenal ulcer. This variation in practice
was not fully explained by patient characteristics. We must seek new evidence to determine the safety of combined medical
and surgical management of this clinical problem.
Presented at DDW/SSAT May 20–24, Los Angeles, California. 相似文献
7.
益气止血药对脾不统血证模型动物前列腺素的作用 总被引:2,自引:1,他引:1
采用复合因素的脾不统血证大鼠模型 ,以 6 酮 前列腺素F1α(6 酮 PGF1α)和血栓素B2(TXB2 )作为观测指标 ,对益气止血药对脾不统血证模型大鼠血浆和子宫前列腺素的影响进行了研究。结果 :大剂量组益气止血药能降低脾不统血证模型血浆和子宫的 6 酮 PGF1α及子宫 6 酮 PGF1α/TXB2 比值。说明 6 酮 PGF1α及 6 酮 PGF1α/TXB2 比值升高可能是脾不统血证的重要机理之一。 相似文献
8.
9.
探讨小儿消化性溃疡并出血66例。方法:纤维内窥镜检查证实36例,胃肠钡餐造影确诊30例。结果:内科保守治疗64例,外科手术治疗2例。并对小儿消化性溃疡并出血的高危因素进行分析,发现与年龄、环境、长期误诊误治及血型均有一定关系。 相似文献
10.
目的:米索前列醇预防产后出血的效果。方法:选择1998年8月至1999年7月在我院住院分娩的300例单胎头位孕妇,随机分为米索前列醇组,催产素组,每组150例,米索组在胎儿娩出前,胎头着冠时给产妇直肠内置米前列醇600ug。催产素组在胎儿娩出后产妇臂部肌注催产素20Iu。观察两组产后2h内出血量。结果:产后2h平均出血量米索前列醇组明显低于催产素组,差异有极显性。产后出血发生率米索前列醇组为3. 相似文献