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951.
目的总结金属覆膜支架联合鼻胆管治疗内镜逆行胰胆管造影术(ERCP)Ⅲ型Stapfer穿孔的疗效及安全性。方法对ERCPⅢ型Stapfer穿孔患者放置金属覆膜胆道支架,支架内再放置鼻胆引流管,术后2~4周行支架取出术。结果 6例患者均好转出院,无开腹手术患者,有效率100.00%,无支架相关并发症发生。1例住院期间出现腹腔感染症状,发生率为16.67%。结论金属覆膜支架联合鼻胆管治疗ERCPⅢ型Stapfer穿孔的方法是安全有效的,值得临床推广应用。  相似文献   
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It is not clear that how long the affected fetuses can tolerate fetomaternal hemorrhage (FMH). Incidental serial measurements of the fetal peak systolic velocity of the middle cerebral artery and the retrospective analysis of stocked blood available incidentally indicated that our patient had suffered from FMH for at least 2 weeks prior to delivery.  相似文献   
955.
目的观察中药灌肠治疗胃肠术后腹胀的临床疗效。方法 90例胃肠术后腹胀患者随机两组。治疗组采用中药灌肠治疗,对照组口服西沙比利,连续治疗5d后评定疗效。结果治疗组总有效率明显优于对照组(P0.01)。结论中药灌肠治疗胃肠术后腹胀疗效可靠。  相似文献   
956.
我国是胃癌大国,胃癌早期诊断率低( < 10%),在胃癌高危人群中进行筛查和内镜早期诊断、早期治疗是改变我国胃癌诊治现状的高效可行途径。为此,中华医学会消化内镜学分会等制定了《中国早期胃癌筛查及内镜诊治共识意见》。本文对该共识意见中我国胃癌诊治现状、病因、高危人群以及如何提高早期胃癌诊断率做了解读,并综述了近几年血清学检查和内镜技术在早期胃癌诊断中的应用进展。该共识认为,采用非侵入性诊断方法筛选出胃癌高风险人群,继而进行有目的的内镜下精查是较为可行且高效的诊断策略。  相似文献   
957.
目的研究小骨窗入路显微外科治疗高血压基底核区脑出血的临床效果,为临床高血压基底脑出血的治疗提供依据。方法对入院治疗的102例患者进行研究,随机分为二组,对照组采用常规骨瓣开颅手术,观察组采用小骨窗入路显微外科治疗,比较二组患者GCS评分、溃疡及癫的发生率,二组患者手术时间、血肿清除率以及术后再出血率,比较二组患者脑梗死、脑积液等并发症的发生率,并对二组患者日常生活能力进行评分比较。结果观察组患者术后24h GCS评分明显高于对照组,癫及溃疡的发生率明显低于对照组,差异有统计学意义(P<0.05);观察组患者手术时间明显低于对照组,血肿清除率以及术后再出血率明显低于对照组,差异有统计学意义(P<0.05);观察组患者脑梗死、脑积液、肺部感染等并发症的发生率明显低于对照组,差异有统计学意义(P<0.05);观察组患者生活能力良好率为80.4%,明显高于对照组54.9%,二组比较差异有统计学意义(P<0.05)。结论小骨窗入路显微外科治疗高血压基底核区脑出血临床效果显著,手术操作时间更短,患者并发症更少,患者恢复生活能力的良好率更高,值得临床推广应用。  相似文献   
958.
Colovesical fistulae typically present with pneumaturia and/or fecaluria. Diverticulitis, inflammatory bowel disease, and malignancies of the colon are the commonest causes. The fistulous tract and adjacent organs are best demonstrated by contrast‐enhanced CT scan with rectal contrast or MRI. Biopsy at cystoscopy/colonoscopy is necessary for complete evaluation and treatment planning.  相似文献   
959.

Objective

To analyze trends in mortality rates, functional outcomes, and treatment in patients with aneurysmal subarachnoid hemorrhage (aSAH) over the past 3 decades.

Patients and Methods

We conducted a retrospective review of consecutive patients with aSAH treated at Mayo Clinic in Rochester, Minnesota, between January 1, 1985, and December 31, 2014.

Results

A total of 1173 patients identified were grouped by decade of treatment: 1985 to 1994, n=274; 1995 to 2004, n=461; and 2005 to 2014, n=438. Overall, the use of endovascular techniques increased progressively from 5.1% (14) in 1985 to 1994 to 65.5% (287) in 2005 to 2014. This corresponded to a progressive decrease in the rate of clipping from 78.8% (216) in 1985 to 2004 to 21.5% (94) in 2005 to 2014 (P<.001). The percentage of patients admitted with poor clinical grade also increased from 22.3% (61) in 1985 to 1994 to 24.1% (111) in 1995 to 2004 and 29.5% (129) in 2005 to 2014 (P=.06). The in-hospital mortality rate decreased from 22.6% (62) in 1985 to 1994 to 16.3% (75) in 1995 to 2004 and remained relatively constant at 16.7% (73) in 2005 to 2014. Good functional outcome at 3- to 6-month follow-up improved significantly from 64.8% (173) in 1985 to 1994 to 72% (332) in 1995 to 2004 and 78.8% (345) in 2005 to 2014 (P<.001).

Conclusion

Outcomes in patients with aSAH have markedly improved over the past 3 decades, in terms of both in-hospital survival and functional recovery of survivors. Higher rates of endovascular coiling over time paralleled these improvements in clinical outcomes. More detailed investigation is necessary to determine whether this or other factors may directly explain the favorable trends in survival and functional recovery over time.  相似文献   
960.
Over-the-counter (OTC) analgesics are routinely used worldwide for self-management of various painful conditions. Despite this, there has been little in-depth review of the safety of non-aspirin analgesics at OTC doses. This paper reviews the available literature on the gastrointestinal (GI) and hepatic safety of non-aspirin OTC analgesics, including nonsteroidal anti-inflammatory drugs (NSAIDs; ibuprofen, ketoprofen, diclofenac, and naproxen) and acetaminophen; safety in overdose is also reviewed. Each non-aspirin OTC analgesic has a distinct adverse event (AE) profile, with GI AE rates for OTC dosing in one study ranging from 37% for diclofenac to 7.2% for ibuprofen and 7.6% for acetaminophen; GI effects accounted for 75% of total AEs in the study. Across all studies reviewed here, the risk of serious GI toxicity, including upper GI bleeding and peptic ulcers, was low at OTC doses. By contrast, while both NSAIDs and acetaminophen may be associated with hepatotoxicity and acute liver failure (ALF), the risks associated with acetaminophen are somewhat higher and better documented. Reports of NSAID-associated hepatotoxicity rarely make distinctions by dose, making the risk at OTC doses difficult to assess. Liver injury due to acetaminophen, however, can occur at doses < 4000 mg. Case reports of NSAID-associated overdose are rare, while acetaminophen-containing drugs are a leading cause of overdose and are implicated in up to 97% of ALFs leading to transplant involving overdose. OTC analgesics are effective for self-management of pain; however, they are associated with a low but important rate of GI and hepatic events, as well as a risk of intentional and non-intentional overdose. Given the widespread use of this class of drugs, it is important for healthcare professionals to be mindful of their patients’ use of OTC analgesics.  相似文献   
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