空气灌肠诊治小儿肠套叠的临床应用

目的 探讨透视下空气灌肠诊断小儿肠套叠及气压灌肠复位的临床应用价值.方法 对病程＜48h的150例急性肠套叠空气灌肠的诊断、治疗进行回顾性分析.结果 空气灌肠对肠套叠诊断率100％,合理应用气压灌肠使138例成功复位,成功率约92％.结论 空气灌肠为诊治小儿肠套叠起到了重要的作用,具有疗程短、创伤小、成功率高等方面的优势.     

Successful reduction of recalcitrant ileocolic intussusception with a double-balloon-tipped catheter that prevents air leaks and catheter expulsion

Noninvasive reduction of ileocolic intussusception requires increasing intracolonic pressure via gas or liquid administered through a rectal catheter. A tight seal around the catheter is required to maintain intracolonic pressures and this tight seal is difficult to maintain with existing techniques. I describe the safe and effective use of a catheter with 2 balloons near the tip that surround the anus internally and externally to prevent leakage of air during an enema on a toddler after failure with a single-balloon tipped catheter.     

小儿肠套叠空气灌肠复位影响因素探讨

目的 分析空气灌肠治疗小儿肠套叠的各种影响因素。方法 对117例确诊肠套叠的患儿，采用双腔气囊外接压力计或不接压力计，在X线透视下行空气灌肠。结果 117例中，完全复位92例(78％)，复位失败17例(14．5％)，不完全复位8例(6％)。结论 空气灌肠是治疗小儿肠套叠的重要方法，其影响复位成功与否的因素，主要有套入时间、类型、复位方法等。     

Malpositioned biliary endoprosthesis: retrieval using a vascular balloon catheter

Successful function of an indwelling biliary endoprosthesis requires precise initial positioning relative to the stricture site. Delayed failures may occur as a result of migration either proximally or distally. The authors describe a method for retrieval of a distally displaced endoprosthesis using a vascular balloon-dilatation catheter.     

Selective hepatic angiography using a balloon catheter guide

A 3-F balloon catheter guide was successfully used instead of a conventional guide wire for selective hepatic angiography in 30 patients. The technique provides an easy way to advance the catheter without complications.     

Dilatation technic in esophageal stenoses using a balloon catheter

In dilating oesophageal stenoses by balloon catheters it becomes necessary to adapt the technique of the intervention to the type and degree of stenosis and condition of the patient. The dilatation may be successfully performed even in very narrow postinflammation, postoperation and postcorrosion stenoses. The dilatation is usually performed for the period of 30 minutes, the shortest period between interventions being twice in a week, being followed by weekly or several weeks intervals. In a careful application of the balloon catheters transnasally or transorally it becomes possible to decrease the unpleasant feelings of the patient and possible complications to a minimum.     

Dilatation of benign urethral stenosis using a balloon catheter

The authors report their experience of benign urethral stricture dilatation by balloon catheter in 11 male patients. Ten posterior and 2 anterior urethral strictures were treated; in 1 patient several narrowings coexisted at various levels. Etiology was inflammatory in 4 cases, iatrogen in 3, post-traumatic in 2, and equivocal in 2. The patients were studied both before and soon after dilatation by means of retrograde and voiding cystourethrogram and uroflowgraphy; the follow-up (2-14 months) was performed by urodynamics alone. In all cases, dilatation was followed by the restoration of urethral gauge, together with prompt functional improvement of urodynamic parameters. The latter result subsisted in time in 9 patients. In 2 cases recurrences were observed, demonstrated at once by clinics and urodynamics. Both lesions were successfully re-treated. Neither early nor late complications occurred. In spite of the limited material, the valuable results obtained, together with the absence of complications, the peculiar morphology of recurrences, and the chance of repeating it make the procedure advisible as a valid alternative to conventional techniques for these pathologies.     

Dilatation of malignant esophageal stenoses using a balloon catheter

The paper summarizes the experience with the dilatation of malignant oesophageal stenosis by a balloon catheter. In a patient after gastrectomy with a relapse of the tumorous process the author performed 10 dilatation interventions by a balloon 22 mm wide. After a short interval of renewed normal passage, marked swallowing difficulties always rapidly returned. The patient died 24 hours after a subsequent surgical revision and an attempt to remove the tumour.     

Pancreatic angiography using balloon catheter occlusion and a vasoconstrictor.

When a vasoconstrictor (noradrenaline) was injected during occlusion of the common hepatic artery with a balloon catheter, the vasoconstrictor flowed only into the proper hepatic artery and constricted it. The balloon was immediately deflated and contrast medium injected into the common hepatic artery. The flow of the contrast medium into the gastroduodenal artery was then increased, clearly visualizing the entire pancreatic-duodenal arcade.     

Inhibition of pseudointimal hyperplasia in swine TIPS models: the efficacy of local delivery of paclitaxel using a perforated balloon catheter

The aim of this study was to investigate the efficacy and feasibility of local delivery of paclitaxel to inhibit pseudointimal hyperplasia/intimal hyperplasia in swine transjugular intrahepatic portosystemic shunt (TIPS) models TIPS were created in seven healthy domestic swine (15-20 kg). Before TIPS stent insertion, we performed a short-term infusion of paclitaxel (treatment group: n = 4) and saline (control group: n = 3) into the TIPS tract using a balloon catheter in which two 0.010 inch holes were created on opposite sides of the balloon. Paclitaxel or saline was given to all animals via the hepatic parenchymal and venous outflow tract. The animals were followed for up to two weeks and then killed. Gross and histological evaluations of the shunts were performed, and the maximum pseudointimal/intimal hyperplasia thicknesses were calculated for each animal The average infusion time of paclitaxel or saline was 7.6 min (6-9 min). At gross and histological evaluation, considerable pseudointimal hyperplasia had formed in the control group and statistically significant differences were found upon microscopic evaluation in the maximum pseudointimal hyperplasia thickness between the control (2.41 mm, range 1.7-3.16 mm) and animals receiving paclitaxel (0.63 mm, range 0.42-0.98 mm, p<0.05) Local delivery of paclitaxel at the time of TIPS creation may have been effective in reducing pseudointimal/intimal hyperplasia in swine TIPS models.     

Experience with dilatation of tight esophageal stenoses using a balloon catheter

The dilatation of oesophageal stenoses with balloon catheters was made in 38 patients with 44 stenoses of different origin. The most frequent stenosis was localized in oesophagogastric or oesophagocolic anastomosis after oesophagectomy, postcorrosive stenoses an those after reflux oesophagitis. The stenoses were mostly of filiform type, the diameter being 1-3 mm (79%) less frequently 4-7 mm (21%). It became possible to dilate 37 stenoses up to 10 to 20 mm, four stenoses to 22 mm. In only three cases the stenosis was dilated to less than 10 mm. In six patients it proved necessary to repeat the dilatation within one to six-month intervals. The dilatation failed to give positive in one case.     

CT retrograde pancreatography using an indwelling balloon catheter

We report a new technique for computed tomography (CT) of the pancreas during retrograde injection of contrast material into the pancreatic duct via an in situ balloon catheter placed by duodenoscopy (CT-RP). The method resulted in more stable ductgrams at CT than were obtained with other methods. Our data suggest that CT-RP provides useful information in evaluating pancreatic lesions that produce subtle or insignificant abnormalities of the outline of the pancreas and the ductal system on conventional CT and ERP.     

脉冲式空气灌肠治疗小儿肠套叠(附86例分析)

目的:探讨脉冲式空气灌肠治疗小儿急性肠套叠的临床价值和疗效。方法:经肛门插入Foley气囊导管,连接脉冲灌肠整复仪,先行诊断性空气灌肠,确诊为肠套叠后行脉冲空气整复,难复型结合手法按摩,本组病例气压选择在8~16KPa之间。结果:86例患者中,回—结肠型72例(83.7%),回—回—结肠型14例(16.3%),套头位于回盲部25例,升结肠17例,结肠肝曲14例,横结肠8例,结肠脾曲9例,降结肠5例。81例患者复位成功,成功率约94.2%。结论:脉冲式空气灌肠能减轻套叠部位的痉挛与水肿,提高肠套叠的整复成功率。