共查询到20条相似文献,搜索用时 31 毫秒
1.
术中判断肠活力三种方法的比较 总被引:1,自引:0,他引:1
术中准确地评价肠活力是外科医师面临的一个普遍问题。应用兔肠缺血模型,比较静脉荧光素、表面血氧测定和激光多普勒三种技术判断肠活力的精确性。结果:诊断效率静脉荧光素法为78%,表面血氧测定为68%,激光多普勒为95%。后者精确度显著优于前二者,且操作简便、迅速,具有临床应用前景。 相似文献
2.
研究早产儿视网膜病(retinopathy of prematurity,ROP)的发生率、高危因素、治疗与随访情况。方法对2005年7月-2007年12月温州医学院附属第一医院NICU收治的符合ROP筛查标准的早产儿,于生后2周开始由资深眼科医师开始行间接眼底镜检查眼底,并进行随访。结果434例早产儿中ROP的发生率为5.5%(24/434例),24例ROP中Ⅰ期19例,Ⅱ期3例,Ⅲ期2例。Ⅲ期阈值病变者行激光光凝治疗,全部患儿均恢复正常。对434例早产儿行单因素分析得出,胎龄、出生体重、住院时间、吸氧、吸氧浓度、吸氧时间、呼吸暂停、新生儿肺透明膜病(RDS)、肺表面活性剂(PS)的应用、机械通气、输血、光疗时间、感染与ROP的发生有相关性(P<0.05)。Logistic回归分析显示胎龄、出生体重、胎数、吸氧时间、光疗时间、代谢性酸中毒、母亲妊高症、颅内出血是影响ROP发生的主要因素。结论早产是ROP的根本原因,防治各种并发症、合理的氧疗是预防ROP的关键。建立完善有效的ROP筛查制度,早期发现、早期治疗ROP,可改善ROP的预后。 相似文献
3.
The use of specific dietary restrictions, cofactor administration, mobilisation of insoluble substances, environmental modifications, product replacement and selective enzyme inhibition are now established for the treatment of some inborn errors of metabolism. There is no generally accepted application for enzyme administration, cytopharmacology (manipulation of the cytoskeleton) or for cell transplantation except for bone marrow transplantation in disorders where the bone marrow is primarily at fault. The other uses of bone marrow transplantation which have been proposed require further evaluation. Results of recent research suggest that the scope of this approach is gradually being widened. There is also scope for development in the field of organ transplantation taking advantage of recent technical1 and immunological progress. The treatment of inborn errors of metabolism by genetic modification is not yet on a practical clinical level; more laboratory and animal studies are needed before this can be attempted in man. Adenosine deaminase deficiency appears to be the disease in which this will be first attempted using a retroviral vector to insert the gene into the genome of pluripotential bone marrow cells. 相似文献
4.
目的 探讨影响婴幼儿法乐四联症手术治疗近期疗效的各相关因素.方法 将2003年8月至2011年2月经作者一期手术纠治的117例年龄≤3岁的法乐四联症患儿分为疗效良好、疗效较差两组.分析手术时患儿年龄、体重、术前HCT值、McGoon指数、EDVI、主动脉阻断时间、转流时间、室间隔缺损大小、升主动脉与肺动脉干直径比、... 相似文献
5.
主动脉缩窄(coarctation of aorta,CoA)是主动脉的局限性狭窄,狭窄最常见于峡部,是一种常见的先天性心血管畸形,占所有先天性心脏病的5% ~8%.缩窄导致上肢血压升高,下肢血压降低,并可引起心功能下降,未经治疗的CoA预后不佳.治疗方式包括外科治疗及经皮介入治疗,不同治疗方式的并发症发生率不同,术后长期监测其并发症、心功能是评估预后的重要指标.该文对主动脉缩窄的治疗方式及术后并发症、心功能情况的研究进展作一综述. 相似文献
6.
Sasidharan CK Anoop P Vijayakumar M Jayakrishnan MP Reetha G Sindhu TG 《Indian journal of pediatrics》2004,71(5):459-463
Aneurysm of the vein of Galen is a rare intracranial vascular malformation. It is known to have diverse manifestations and
varying severity. Four cases with different modes of presentation and outcome are reported. A mortality of 50 per cent was
encountered. Among the survivors, one had neurologic sequelae whereas the other had attained age-appropriate developmental
milestones. The former was a rare case of spontaneous thrombosis of the aneurysm while the latter was a boy who underwent
therapeutic embolization. 相似文献
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目的探讨小儿法洛四联症根治术的特点,以提高手术疗效。方法对1998-02—2005-07在河南省郑州市第七人民医院接受法洛四联症根治术的106例患儿的临床资料进行回顾性分析。结果治愈103例,死亡3例,病死率为2.9%。术后随访率100%,随访3~93个月,无晚期死亡。全部病例心功能皆恢复至Ⅰ或Ⅱ级(NYHA)。结论绝大部分法洛四联症患儿可施行一期根治术,提高手术成功率的关键在于合理的体外循环灌注、严密修补室间隔缺损和恰当疏通右室流出道。 相似文献
10.
Retinopathy of prematurity is a potentially blinding disorder of premature infants. Retinal ablation of the avascular retina originally described using cryotherapy but now most commonly undertaken with laser photocoagulation, reduces the unfavourable structural outcomes and improves the functional visual acuity outcome. The CRYO-ROP study showed the long-term benefit of treatment of threshold disease compared with no treatment, however even with cryoablation 44.4% of treated eyes had a visual acuity of 6/60 or worse at 10 year follow-up. The ETROP study of earlier treatment for high-risk pre-threshold disease, rather than treatment at threshold, has shown that pre-threshold treatment of type 1 disease produces a significantly improved outcome. Despite treatment some infants develop retinal detachment for which various surgical treatments have been described, although not always with a good functional outcome. Future treatment modalities may include the use of anti-VEGF therapies. 相似文献
11.
R Rogers T Reybrouck M Weymans M Dumoulin L Van der Hauwaert M Gewillig 《Acta paediatrica (Oslo, Norway : 1992)》1994,83(8):866-869
Sixty-nine patients (age 10 × 3.5 years, median 9.7 years) operated on for tetralogy of Fallot, underwent excercise testing 5.1 × 2.5 years after total correction. Aerobic capacity was assessed by the ventilatory threshold method. After the exercise test, parents completed a validated standardized questionnaire to evaluate the habitual level of physical activity of their child. They were then asked to place their child into one of three groups, describing their child's activity level, compared to normals (below average, average and above average). In the average and above-average groups, 73% and 65% of the patients were misclassified when compared to objective exercise testing. However, in the below-average group, no misclassifications were found. Subjective estimates of activity level, and consequently exercise tolerance, were poorly associated with objective measurements of exercise performance in these patient groups. Our results question the reliability of self-reported estimates of physical activity level and consequently exercise capacity in children after surgical correction of tetralogy of Fallot. 相似文献
12.
��־���������� 《中国实用儿科杂志》2016,31(12):887-890
??Inhaled corticosteroids??ICS?? are the most effective medicine for chronic airway inflammation nowdays. Atomization inhalation has been widely applied in clinics because of its efficacy??fewer side-effects and convenience. Here??we focused on some points which should be paid attention to??including how to choose appropriate patients??how to ensure the effectiveness of inhaled steroids and how to reduce possible side-effects. 相似文献
13.
哮喘是威胁儿童健康最常见的慢性气道炎症性疾病之一.毛细支气管炎显著增加了儿童哮 喘的发病风险,研究毛细支气管炎向哮喘发展的相关因素是近年研究热点,它有助于深入认识哮喘发生、发展的机制,为哮喘提供新的防治措施.目前研究认为,毛细支气管炎在遗传学、免疫学、环境因素(如病毒感染)等方面影响着哮喘的发展,而毛细支气管炎是否直接导致儿童哮喘的发展,通过预防毛细支气管炎能否降低儿童哮喘的发病率仍有待进一步研究. 相似文献
14.
Evaluation of the Efficacy of Treatment of Kawasaki Disease before Day 5 of Illness 总被引:15,自引:0,他引:15
We evaluated the efficacy of treating Kawasaki disease earlier than Day 5 of illness with a standard dose of immunoglobulin and aspirin. We performed a case–control study of patients with Kawasaki disease admitted to Princess Margaret Hospital from 1994 to 1999. Patients with pretreatment coronary aneurysm or those treated after day 10 of illness were excluded. All patients received immunoglobulin (2 g/kg) and aspirin (80–100 mg/kg/day) until fever subsided for 48 hours. Immunoglobulin retreatment was given for persistent fever 48 hours after the first dose of immunoglobulin or recrudescent fever. The case group consisted of 15 patients who received treatment earlier than day 5 of illness, and the control group consisted of 66 patients who were treated on or after day 5. Patients sex, age, duration of posttreatment fever, need for additional immunoglobulin, and coronary artery status were noted. Treatment efficacy was assessed by the duration of posttreatment fever and the prevalence of coronary artery aneurysms. Eighty-one patients were included in this study. There were 15 patients in the case group and 66 in the control group. No significant difference was noted in age and sex between the case and control groups. Thirty-three percent (5/15) and 8% (5/66) of the case and control groups, respectively, had persistent/ recrudescent fever 48 hours after the first dose of immunoglobulin that required retreatment (p = 0.017). Thirteen percent (2/15) and 5% (3/66) of the case and control groups, respectively, had coronary aneurysms (p = 0.158). Treatment of Kawasaki disease before day 5 of illness was associated with persistent/recrudescent fever that required retreatment. However, there was no significant increase in the prevalence of coronary aneurysm if retreatment was given.
Poster presented at the third World Congress of Pediatric Cardiology and Cardiac Surgery, Toronto, Ontario, Canada, 2001 相似文献
15.
LEH Smith 《Acta paediatrica (Oslo, Norway : 1992)》2002,91(S437):26-28
Retinopathy of prematurity (ROP) is a blinding disease, initiated by delayed retinal vascular growth after premature birth. There are both oxygen-regulated and non-oxygen-regulated factors, which contribute to both normal vascular development and retinal neovascularization. One important oxygen-regulated factor, critical to both phases of ROP, is vascular endothelial growth factor (VEGF). A critical non oxygen-regulated growth factor is insulin-like growth factor (IGF-1). In knockout mice, lack of IGF-1 prevents normal retinal vascular growth, despite the presence of VEGF, important to vessel development. In vitro , low IGF-1 prevents vascular endothelial growth factor-induced activation of Akt, a kinase critical for vascular endothelial cell survival. Premature infants who develop ROP have lower levels of serum IGF-1 than age-matched infants without disease.
Conclusion : IGF-1 is critical to normal vascular development. Low IGF-1 predicts ROP and restoration of IGF-1 to normal levels may prevent ROP. 相似文献
Conclusion : IGF-1 is critical to normal vascular development. Low IGF-1 predicts ROP and restoration of IGF-1 to normal levels may prevent ROP. 相似文献
16.
目的构建应用于遗传性疾病诊断的基因组二代测序数据分析流程,为候选变异筛选提供参考流程。方法复旦大学附属儿科医院(我院)新生儿出生缺陷生物样本库中的87例多发畸形样本,以美国贝勒外显子组测序分析流程(贝勒流程)为参考标准进行候选变异筛选,同一批样本以我院建立的全外显子组测序分析流程(复旦流程)也行候选变异筛选,以染色体的位置和突变的碱基作为突变位点的标识符对贝勒和复旦流程检出变异逐行比较。结果 87例新生儿多发畸形样本共检出变异7 820 777个,复旦流程经质量控制、公共数据库的变异频率筛选、内部数据库的变异频率筛选、变异类型的筛选和关注与孟德尔遗传病相关的变异数筛选,平均单个病例180~210个变异作为最终候选变异行临床诊断分析;贝勒流程检出候选变异15 242个,复旦流程检出候选变异15 660个,2个流程均检出候选变异15 137个,复旦流程比贝勒流程多检出的候选变异523个,105个候选变异贝勒流程检出复旦流程未检出,复旦流程敏感度、特异度、阳性预测值和阴性预测值均高于96.66%。结论虽然复旦流程候选变异筛选能真实有效地模拟贝勒流程对WES数据进行筛选,并寻找候选变异的过程;复旦流程所展现的注释和筛选只是粗略的框架,但提供了WES应用于临床时不可或缺的筛选程序。 相似文献
17.
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目的探讨脑性瘫痪的诊断以利防治。方法对南京市儿童医院早期干预门诊确诊的640例脑患儿[早产儿258例(早产儿组),足月儿382例(足月儿组)]分析其病因、早期临床表现及头颅CT征象,进行体格神经系统检查并智测。结果(1)高危因素,两组在颅内出血、肺部疾病早产儿组明显高于足月儿组,缺氧缺血性脑病组足月儿明显高于早产儿组,P均<0·05外余P均>0·05。(2)6个月以内确诊早产儿、足月儿两组各为28、90例的临床表现,反应差、嗜睡、少吃、少哭、少动,肌张力低下,早产儿组明显高于足月儿组,而不停啼哭,护理困难,肌张力增高,足月儿组明显高于早产儿组,P均<0·01及0·05余P均>0·05。(3)早产儿、足月儿两组的身长、体重、头围、MDI和PDI各为73·24±9·82、73·58±11·64(cm),9·12±2·31、9·23±2·80(kg),44·15±3·47、42·99±4·23(cm),44·42±6·09、41·99±7·28(分),43·81±4·95、40·80±4·51(分)。(4)头颅CT表现。早产儿、足月儿两组CT异常率各为95·4%及89·8%,P<0·05。(5)发育落后早产儿组言语落后明显高于足月儿组外,足月儿组身长<2SD明显高于早产儿组P均<0·05,余P均>0·05。结论当患儿具有高危因素、异常临床表现与神经症状、发育明显落后,应结合头颅CT密切随访可早期诊断脑性瘫痪及早干预。 相似文献
18.
神经病理性疼痛是由躯体感觉神经系统的损伤或疾病所直接引起的疼痛.疼痛症状包括自发性疼痛、痛觉过敏、痛觉超敏等.单纯的镇痛药物很难满意控制疼痛,如何有效控制疼痛是临床治疗的难点,针对神经病理性疼痛的机制来对患者进行治疗是目前研究热点.该文就该病发病机制的研究进展进行综述. 相似文献
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小儿孟氏骨折脱位扣眼畸形的病理认识以及环状韧带重建术的探讨 总被引:11,自引:1,他引:10
目的 对小儿盂氏骨折脱位及陈旧性盂氏骨折的传统治疗方法、创伤病理解剖、治疗结果及发生漏、误诊、误治的病例进行研究,以找到解决问题的方法,提高疗效。方法 对170例盂氏骨折脱位患儿的致病原因、治疗方法、术中所见、手术方式以及治疗效果等进行研究、分析。结果 83例中,优59例,良15例,一般9例,差5例,结论 (1)盂氏骨折脱位的定义应为:尺骨干骨折合并桡-肱及桡-尺脱位,合并/或不合并桡骨上1/3骨折、桡骨颈骨折、桡骨头骨折脱位;(2)尺骨鹰嘴骨折合并肘关节脱位不应诊断为盂氏骨折;(3)提出“超伸直型”盂氏骨折的概念;(4)尺骨骨折的稳妥治疗及坚强内固定是治疗盂氏骨折的关键;(5)桡骨颈骨折既要对位好,更要对线好,以免以后发生旋转障碍;(6)急诊患儿可行环状带修补术及关节囊紧缩术,晚期患儿应行关节囊紧缩术,不主张行环状韧带重建术。 相似文献
20.
儿童孤独症是广泛性发育障碍中的代表性疾病.该文综述近年来孤独症患儿神经影像学及神经病理学方面的异常.脑结构的研究显示孤独症患儿的脑体积的增大,额叶、颞叶等处发育异常;脑功能的研究显示孤独症患儿在颞上回、额下回、梭状回等处存在异常活动;脑代谢物的研究显示孤独症患儿存在谷氨酸及γ-氨基丁酸以及5-羟色胺代谢异常;免疫学研究发现孤独症患儿促炎症因子及脑蛋白抗体的出现等. 相似文献