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Objectives: To determine the incidence of sonographic hepatic portal venous gas (HPVG) and to clarify the relationship between the presence of HPVG and clinical outcomes in patients with out-of-hospital cardiac arrest (OHCA). Methods: From April 2002 to January 2003, patients with non-traumatic OHCA were prospectively enrolled in a tertiary medical centre in Taipei, Taiwan. Emergency abdominal sonography during resuscitation was performed to detect the presence of HPVG within the first 10 min on arrival of the emergency department (ED). Results: HPVG was detected in 16 (36%) of the 44 patients enrolled in this study. The patients with HPVG were older (P=0.039), their cardiac arrest was witnessed less frequently (P=0.01), they received more prolonged resuscitation (P=0.008), and needed more accumulated doses of adrenaline (epinephrine) (P=0.002). These patients had a considerably lower incidence of return of spontaneous circulation (ROSC) (P<0.001), less survival to hospital admission (P<0.001), less 24 h survival (P<0.001) and less survival to discharge (P=0.036). In a multiple regression analysis, HPVG was noted as an independent factor negatively associated with ROSC. Conclusion: HPVG is not uncommon in patients receiving resuscitation for OHCA and is associated with poor outcome in these patients.  相似文献
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This report describes a case of hepatic portal venous gas (HPVG) in a patient with intestinal ischaemia and necrosis resulting from an obstructing lesion in the sigmoid colon. CT images demonstrating a large amount of HPVG are presented.  相似文献
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患者男,50岁,因“腹痛、腹胀进行性加重1天,伴高热”入院。查体:全腹膨隆,张力较高,上腹部散在压痛、轻度反跳痛及肌紧张,扣诊呈鼓音,震水音阳性,肠鸣音减弱。实验室检查:白细胞18.44×109/L,血小板803.0×109/L,CRP173.86 mg/L,凝血酶原时间延长。腹部CT平扫提示肝外周、包膜下2cm内枯树枝样积气,肠系膜上静脉积气(图1A、1B所示);小肠肠腔扩张、积气、积液并散在液气平征象,肠壁间多发气体密度影(图1B、1C);诊断:急性缺血坏死性小肠炎并肝-门静脉系统多发积气。临床急诊行剖腹探查术,术中见腹腔大量淡黄色脓性腹水约500ml,小肠明显扩张,部分浆肌层裂开,距屈氏韧带20cm-220cm该段小肠缺血坏死,肠壁呈“花斑”样改变,水肿明显,全段小肠系膜未见坏死及血栓样改变,结肠扩张,未见明显缺血坏死,遂行小肠切除吻合、肠外减压,术后患者恢复良好。  相似文献
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