等离子射频辅助双侧声带后端切断术治疗双侧声带麻痹导致的上气道梗阻患者13例

目的 评估内镜下等离子射频辅助双侧声带后端切断术治疗双侧声带麻痹导致上气道梗阻患者的疗效。 方法 回顾性分析13例双侧声带麻痹导致的上气道梗阻患者的病例资料,其中男6例、女7例,27~73岁,所有患者均接受等离子射频辅助双侧声带后端切断术。总结评估该手术的临床疗效。 结果 13例随访时间1年1个月~2年11个月,所有患者无严重并发症发生。一次拔管率为84.44%(10/13),二次手术拔管率为88.89%(11/13),拔管时间1~3个月,中位数1个月,上气道梗阻均未复发。 结论 内镜下等离子射频辅助双侧声带切断术操作简单、手术风险小,同时治疗双侧声带麻痹效果可靠,是双侧声带麻痹导致上气道梗阻的有效治疗方法之一,也可作为其他治疗失败的补救治疗措施。     

Treatment of two newborns with esophageal atresia and distal tracheoesophageal fistula complicated by gastric perforation: choosing the simple way

Abstract

Objective: Gastric distention and perforation are possible results in a preterm newborn with esophageal atresia and distal tracheoesophageal fistula, especially when there is a need for mechanical ventilatory support. The results of the reported cases treated with emergency thoracotomy and fistula ligation after gastrostomy are not very satisfactory. Sometimes simple temporary solutions can be useful for stabilization and allow safety for required surgical treatment for later.

Patient and methods: Two preterm newborns with esophageal atresia and distal tracheoesophageal fistula complicated by gastric perforation were reported.

Results: Both of the patients were initially treated with a simple peritoneal drainage and, then the definitive operations were performed without any problem in stabilized patients.

Conclusion: Performing fistula ligation or occlusion as an initial treatment in patients with impaired cardiac and respiratory functions may worsen the status of the patient. In such cases, it could be better to perform simple interventions first to facilitate subsequent treatments.     

Paclitaxel drug-coated balloon angioplasty for the treatment of failing arteriovenous fistulas: a single-center experience

Abstract

Objectives: To report our experience of angioplasty with Lutonix (Bard Peripheral Vascular, Inc., Tempe, AZ) drug-coated balloon (DCB) for the treatment of failing arteriovenous fistulas (AVF).

Materials and methods: Retrospective, single-center analysis consisting of 14 patients treated with Lutonix paclitaxel DCBs in the period from July 2015 through April 2017. We analyzed technical success, clinical success, primary patency of the target lesion, primary patency of the dialysis circuit, and the rate of complications. Regular follow-up of AVF patency was realized by clinical examination and duplex ultrasonography. The Kaplan–Meier survival method was applied to determine the cumulative primary patency of the target lesion and the dialysis circuit.

Results: Technical success was 100% and clinical success 92.9%. There were no major or minor complications. Cumulative target lesion primary patency after DCB was 69.2% at 6 months and 31.6% at 12 months. Cumulative vascular circuit primary patency was 61.5% at 6 months and 31.6% at 12 months.

Conclusion: Compared to results reported in literature with plain old balloon angioplasty (POBA), Lutonix paclitaxel DCB angioplasty proved a short-term patency benefit in treatment of dialysis AVF stenosis.     

化毒清湿汤对复杂性肛瘘新型探查术后患者手术创面恢复功效研究

目的:研究化毒清湿汤对于复杂性高位肛瘘新型探查术后患者手术创面恢复及相关细胞因子水平的改善功效。方法: 从接受复杂性肛瘘新型探查术治疗的患者中选取104例纳入本次研究,入选患者随机均分为对照组与治疗组,对照组给予术后常规治疗,治疗组在对照组疗法的同时加用化毒清湿汤治疗,于术后2 d、15 d分别对比两组患者的创面面积、疼痛程度,观察创面愈合时间; 术后28 d评估两组疗效,同时观察两组患者术后2 d、28 d时血清细胞生长因子与炎性因子水平的变化。结果:治疗组总有效率98.08%高于对照组的86.54%(P<0.05); 术后15 d两组创面面积、疼痛VAS评分均有所降低且两组比较治疗组更低; 治疗组创面愈合时间为(23.71±5.57)d,对照组为(30.46±7.92)d,两组比较治疗组更低(P<0.05); 术后28 d两组各项细胞生长因子均有上升,组间比较治疗组更高,差异具有统计学意义(P<0.05); 术后28 d两组各项炎性因子均有好转,组间比较治疗组更优,差异具有统计学意义(P<0.05)。结论:化毒清湿汤可提高复杂性肛瘘新型探查术临床疗效,加快患者术后后创口愈合速度,进一步改善患者细胞生长因子与炎性因子的表达水平。     

An unusual case of prenatal diagnosis of right coronary artery to right ventricle fistula with HD-flow render mode and spatiotemporal image correlation (STIC)

Coronary artery fistula is rare in prenatal diagnosis. We have reported a case diagnosis of coronary artery fistula by using high-definition flow (HD-flow) render mode and spatiotemporal image correlation (STIC), and then evaluated the postnatal outcomes in our hospital.