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1.
《Indian heart journal》2022,74(3):258-259
Ultra-low contrast percutaneous coronary intervention (ULCPCI) can be performed electively in advanced chronic kidney disease. Engage guide catheter and advance guidewire into the coronary artery without using contrast. IVUS-guided PCI can reduce the contrast load. Perform co-registration of distal and proximal radio-opaque marker bands of intravascular ultrasound (IVUS) catheter. Deploy the stent at the target lesion under fluoroscopic guidance of these co-registered position of the IVUS-marking images. Complete the ULCPCI procedure with a final angiography using minimal contrast. Newer contrast sparing techniques and intravascular imaging technologies provide opportunities to perform ULCPCI efficiently with good results and the least complications.  相似文献   
2.
BackgroundWe aimed to assess the decrease in contrast media volume (CMV) with ultra-low contrast delivery technique (ULCD) developed at our institution versus the usual automated contrast injector system (ACIS) contrast delivery in coronary procedures.MethodsWe analyzed the amount of contrast given in the consecutive 204 patients of the operators who use ULCD technique versus consecutive 200 patients of the other operators who use ACIS without ULCD technique for coronary angiograms and/or percutaneous coronary interventions (PCIs) from May 2017 to July 2018 at our center. We calculated the mean CMV between these groups.ResultsWe observed a significant reduction in mean CMV with ULCD technique versus standard ACIS, respectively: angiogram 24.8 ± 15.8 mL (n = 194) vs 42.3 ± 25.1 mL (n = 200) (p < 0.0001); PCI 23.5 ± 19.7 mL (n = 52) vs 48.2 ± 30.8 mL (n = 16) (p < 0.0070); angiogram with ad hoc PCI 53.4 ± 32.1 mL (n = 23) vs 89.7 ± 35.6 mL (n = 16) (p < 0.0024); and overall angiogram and PCI 27.4 ± 20.5 mL (n = 204) vs 44.9 ± 28.0 mL (n = 181) (p < 0.0001).ConclusionOur study showed a highly significant reduction in CMV using ULCD technique compared to standard ACIS contrast delivery in coronary invasive procedures. Even in the standard ACIS arm, CMV was significantly lower than values reported in literature, possibly due to operators' bias toward contrast preservation.  相似文献   
3.
目的:分析临床超低位直肠癌保肛手术(SSO)中实施腹腔镜下经肛门括约肌间切除术(ISR)的临床效果。方法:选取本院收治的超低位SSO患者80例作为研究对象,随机分为两组,每组40例。对照组实施开腹处理,而研究组实施腹腔镜下ISR处理,观察记录两组患者手术时间、术中出血量、住院时间、并发症发生率,并对比分析。结果:研究组手术时间、术中出血量、住院时间、并发症发生率均明显优于对照组,前后比较差异具有统计学意义(P<0.05)。结论:超低位直肠癌保肛手术患者实施腹腔镜下ISR治疗可取得良好的效果,所需手术时间短、出血少、住院时间短以及并发症发生率低,值得临床推广应用。  相似文献   
4.
近年来,直肠癌的新辅助治疗和辅助治疗改善了直肠癌病人的治疗效果.但外科手术仍然是治疗直肠癌的最有效手段。随着功能外科时代的出现,低位超低位吻合保肛手术的比例越来越高.亟待建立和完善手术标准。  相似文献   
5.

Purpose

To investigate the value of 4 different protocols for prospectively triggered 256-slice coronary computed tomography angiography (coronary CTA).

Methods

Two hundred and ten patients underwent prospectively triggered coronary CTA for suspected or known coronary artery disease (CAD). Patients with heart rate >75 bps before the scan despite ß-blocker administration and with arrhythmia were excluded. From January to September 2010, 60 patients underwent coronary CTA using a non-tailored protocol (120 kV; 200 mAs) and served as our ‘control’ group. From September 2010 to April 2012, based on the body mass index (BMI) of the examined patients (BMI subgroups of < 25; 25–28; 28–30, and ≥ 30 kg/m2) current tube voltage and tube current were: (1) slightly, (2) moderately or (3) strongly reduced, resulting into the 3 following BMI-adapted acquisition groups: (1) a ‘standard’ (100/120 kV; 100–200 mAs; n = 50), 2) a ‘low dose’ (100/120 kV; 75–150 mAs; n = 50), and 3) an ‘ultra-low dose’ (100/120 kV; 50–100 mAs; n = 50) protocol.

Results

Patients examined using the non-tailored protocol exhibited the highest radiation exposure (3.2 ± 0.4 mSv), followed by the standard (1.6 ± 0.7 mSv), low-dose (1.2 ± 0.6 mSv) and ultra-low dose protocol (0.7 ± 0.3 mSv) (radiation savings of 50%, 63% and 78% respectively). Overall image quality was similar with standard dose (1.9 ± 0.6) and low-dose (2.0 ± 0.5) compared to the non-tailored group (1.9 ± 0.5) (p = NS for all). In the ultra-low dose group however, image quality was significant reduced (2.7 ± 0.6), p < 0.05 versus all other groups).

Conclusion

Using BMI-adapted low dose acquisitions image quality can be maintained with simultaneous radiation savings of ∼65% (dose of ∼1 mSv). This appears to be the lower limit for diagnostic coronary CTA, whereas ultra-low dose acquisitions result in significant image degradation.  相似文献   
6.
目的分析改良式经内外括约肌间切除术治疗超低位直肠癌的临床效果。方法96例超低位直肠癌患者按手术方式不同分为两组,各48例。对照组采用传统经内外括约肌间切除术,观察组采用改良式经内外括约肌间切除术,观察对比两组患者术后并发症发生率,术后3个月、6个月及12个月肛门功能满意率及肛门失禁评分情况。结果两组患者术后并发症发生率无显著差异(P〉0.05);观察组术后3个月肛门功能满意率高于对照组(P〈0.05),术后6个月和12个月肛门功能满意率两组均无显著差异(P〉0.05);观察组术后3个月和6个月肛门失禁评分均低于对照组(P〈0.01),两组术后12个月肛门失禁评分无显著差异(P〉0.05)。结论改良式经内外括约肌间切除术治疗超低位直肠癌,能提高术后3个月的肛门功能满意率,降低术后3个月和6个月肛门失禁评分,且不增加并发症发生率,值得临床推广应用。  相似文献   
7.
The ability of contrast-enhanced CT to detect “late enhancement” in a fashion similar to magnetic resonance imaging has been previously reported. We report a case of acute myocarditis with coronary CT angiography as well as “late enhancement” imaging with ultra-low effective radiation dose.  相似文献   
8.
李邓松  刘金炎  庄丹 《吉林医学》2013,34(14):2639-2640
目的:探讨经肛门内外括约肌间径路行内括约肌切除术在超低位直肠癌保肛的可行性和安全性,并评估肿瘤根治效果和术后控便功能。方法:回顾性分析78例成功完成保肛手术的肿瘤下缘距肛缘<5 cm的超低位直肠癌患者的临床资料,其中通过采用经肛门内外括约肌间径路切除超低位直肠癌(A组)36例,通过双吻合器行直肠癌超低位前切除42例(B组),对比两组患者的术后复发率及术后控便功能情况。结果:采用经肛门内外括约肌间径路切除超低位直肠癌(A组)的术后复发率比通过双吻合器行直肠癌超低位前切除前,差异有统计学意义(P<0.05),而术后近期(1年内)和远期(>1年)的控便功能比较,差异无统计学意义(P>0.05)。结论:采用经肛门内外括约肌间径路行内括约肌切除术完成超低位直肠癌切除是一种可选择的保肛术式,具有安全性高、根治效果好的特点,值得推广。  相似文献   
9.
《中国现代医生》2021,59(25):152-154+159
报道1 例胎龄27 周超低体重儿心包积液/填塞、动脉导管开胸闭合术的临床表现、辅助检查、原因分析和治疗转归,并复习相关文献。本例超低体重儿在生后第1 天行脐静脉置管,第9 天出现心率增快、肝脏增大、呼吸机参数明显上调,胸X 线片示心胸比值0.8,心脏彩超示:心包腔内大量积液、动脉导管未闭(3.2 mm),立即拔除脐静脉导管,B 超定位下心包穿刺抽液,心包积液消失。经内科治疗,动脉导管未缩小,心力衰竭难以纠正、多次撤机失败,出生后第36 天手术结扎动脉导管,术后心力衰竭纠正,顺利撤机,体重增长良好,正常出院。脐静脉置管后新生儿临床上突然病情恶化,出现呼吸困难、发绀、心率增快、肝脏增大,应考虑心包积液/填塞可能,及时予B 超确诊并拔出脐静脉导管、心包穿刺抽液减压,降低死亡风险。内科治疗失败的超低体重儿动脉导管未闭,因血管细,从血管介入手术难度极大,可行开胸结扎动脉导管,有利于心力衰竭的纠正及顺利撤机、体重增长、尽早出院。  相似文献   
10.
经会阴平面超低位直肠前切除术治疗低位直肠癌39例   总被引:1,自引:0,他引:1  
目的:总结经会阴平面超低位直肠前切除术治疗低位直肠癌的手术经验.方法:回顾性分析我院2008-01/2011-10行经会阴平面超低位直肠前切除术的39例患者临床资料.结果:全组无手术死亡病例,吻合口漏2例,吻合口狭窄1例,随访4mo-3年,局部复发2例,术后排便频率2-7次/d,平均为3次/d,远期效果仍在跟踪随访.结论:经会阴平面超低位直肠前切除术是低位直肠癌行保肛手术治疗的一种有效方法.  相似文献   
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