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21.
目的明确Angiomemor(美国Simbionix公司生产)血管介入仿真模拟器是否有助于冠状动脉造影技术的掌握和提高。方法选取16名无血管放射介入经验的心血管医生,接受相同课时的冠状动脉介入造影理论培训后,按随机表编码随机分为模拟器培训组与非培训组各8名,模拟器培训组8名医生接受Angiomemor血管介入仿真模拟器培训,模拟冠状动脉造影操作,非培训组8名心血管医生未接受仿真模拟器培训。在随后的真实临床环境中操作冠状动脉造影时,评价2组医生冠状动脉造影操作过程中错误的频数、平均造影时间、造影剂使用量及术中放射线剂量。结果相对于非培训组,模拟器培训组医生在冠状动脉造影操作中错误频数减少62.5%、平均造影时间减少44.0%、造影剂使用量减少44.0%,术中平均放射线曝光时间减少了57.7%,平均X线累计曝光剂量减少51.6%,单位面积X线累计曝光剂量减少了52.4%。结论Angiomemor血管介入仿真模拟器有助于医生较快地熟练掌握冠状动脉造影技术,是冠状动脉介入规范化培训的重要辅助手段之一。 相似文献
22.
Patrick N Smith Jeffrey R Balzer Mustafa H Khan Rick A Davis Donald Crammond William C Welch Peter Gerszten Robert J Sclabassi James D Kang William F Donaldson 《The spine journal》2007,7(1):83-87
BACKGROUND CONTEXT: Intraoperative somatosensory evoked potential (SSEP) monitoring has been shown to reduce the incidence of new postoperative neurological deficits in scoliosis surgery. However, its usefulness during cervical spine surgery remains a subject of debate. PURPOSE: To determine the utility of intraoperative SSEP monitoring in a specific patient population (those with cervical radiculopathy in the absence of myelopathy) who underwent anterior cervical discectomy and fusion (ACDF) surgery. STUDY DESIGN: Retrospective review. PATIENT SAMPLE: A total of 1,039 nonmyelopathic patients who underwent single or multilevel ACDF surgery. The control group (462 patients) did not have intraoperative SSEP monitoring, whereas the monitored group (577 patients) had continuous intraoperative SSEP monitoring performed. OUTCOME MEASURE: A new postoperative neurological deficit. METHODS: SSEP tracings were reviewed for all 577 patients in the monitored group and all significant signal changes were noted. Medical records were reviewed for all 1,039 patients to determine if any new neurological deficits developed in the immediate postoperative period. RESULTS: None of the patients in the control group had any new postoperative neurological deficits. In the monitored group there were six instances of transient SSEP changes (1 due to suspected carotid artery compression; 5 thought to be due to transient hypotension) which resolved with the appropriate intraoperative intervention (repositioning of retractors; raising the arterial blood pressure). Upon waking up from anesthesia, one patient in the monitored group had a new neurological deficit (partial central cord syndrome) despite normal intraoperative SSEP signals. CONCLUSIONS: ACDF appears to be a safe surgical procedure with a low incidence of iatrogenic neurological injury. Transient SSEP signal changes, which improved with intraoperative interventions, were not associated with new postoperative neurological deficits. An intraoperative neurological deficit is possible despite normal SSEP signals. 相似文献
23.
Hyo-Chang Kim Seok-Gu Kang Pil-Woo Huh Do Sung Yoo Kyoung Suok Cho Dal Soo Kim 《Journal of clinical neuroscience》2007,14(11):1135-1139
Pituitary abscess is a rare and potentially lethal condition. Pituitary abscess in a pregnant woman has not been previously described. A 38-year-old pregnant woman (34 weeks gestation) with a pituitary mass complained of a progressive headache and sudden visual impairment. She was afebrile and had no inflammatory symptoms on admission. On MRI, the preoperative diagnosis was pituitary adenoma with sphenoid sinusitis. She underwent an uncomplicated transsphenoidal procedure for removal of the pituitary mass. The next day, labor commenced and a healthy preterm baby was delivered. Pathologic examination of the intrasellar mass showed polymorphonuclear cells, debris and no tumor cells. The sellar contents were cultured and Streptococcus viridans was grown. To our knowledge this is the first case of pituitary abscess reported during pregnancy. Although the patient was pregnant, the transsphenoidal approach was safe for the mother and the fetus. Surgical drainage and antibiotic therapy are required for the definitive treatment of this condition. 相似文献
24.
作者用免疫组化ABC法对41例胆囊癌标本核苷二磷酸激酶(NDPK,下同)/nm23表达进行了测定,结果发现:nm23在恶性肿瘤中的表达率明显高于良性病变(P<0.05)。NDPK/nm23表达与胆囊癌组织的分化、局部浸润及淋巴转移密切相关(P<0.01)。NDPK/nm23阳性患者生存中位数12.25个月,阴性患者6.5个月,两者存在显著差异(P<0.01),提示nm23检测对预后有重要价值。 相似文献
25.
In a period of 2 years 7 months, we performed heat probe (HP) thermocoagulation in 153 cases of massive peptic ulcer hemorrhage. The male/female sex ratio was 125/28. The average age was 57.6 +/- 1.3 years (mean +/- SEM; range, 17 to 88). There were 69 cases (45.1%) of spurting hemorrhage, 50 cases (32.7%) of oozing hemorrhage, and 34 cases (22.2%) of nonbleeding visible vessels. Seventy-seven patients (50.3%) were in shock before therapy. After therapy we obtained initial success in 147 cases (96.1%). Rebleeding episodes occurred in 23 patients (15.6%) within 1 month after therapy. Nineteen patients received a second therapy, and treatment in 15 of these cases (78.9%) was ultimately successful. Finally, treatment in 142 cases (92.8%) was ultimately successful. The duration of hospitalization was 6.3 +/- 0.4 days (mean +/- SEM). After discharge all patients were followed at the outpatient department for at least 1 month. Sixty-seven patients were followed endoscopically for at least 2 to 3 months after therapy. Fifty-six patients (83.6%) had a healed scar at the previous bleeding site 2 months after therapy, and 62 patients (92.5%) had a healed scar 3 months after therapy. We conclude that HP thermocoagulation is an ideal and reliable modality of therapeutic endoscopy in arrest of massive peptic ulcer hemorrhage. HP thermocoagulation may become the first choice of therapy for massive peptic ulcer bleeding in the near future. 相似文献
26.
目的总结分析1%联苯苄唑凝胶治疗婴儿花斑癣的临床疗效及不良反应。方法对22例婴儿花斑癣患者采用外用1%联苯苄唑凝胶治疗2周,总结分析其临床资料。结果外用1%联苯苄唑凝胶2周后,总有效率达到90.91%,真菌清除率达到86.36%。结论联苯苄唑凝胶治疗婴儿花斑癣安全、有效,不良反应少。 相似文献
27.
28.
石刻雕塑作业劳动卫生学调查及实验研究 总被引:1,自引:0,他引:1
测定了石雕作业粉尘浓度,几何平均浓度为82.35~3.67mg/m3。工人职业性健康检查结果,接尘工人的咽部充血、咳嗽、咯痰检出率高于对照组;肺功能低下的检出率也高于对照组。该厂自1972年以来发生尘肺患者17例,其病情发展和晋期缓慢,发病工龄长。动物实验研究表明,石雕粉尘有轻微的致纤维化作用。 相似文献
29.
30.
Hong Kwan Kim Young Tae Kim Sook Whan Sung June Dong Park Chang Hyun Kang Joo Hyun Kim Yong Jin Kim 《European journal of cardio-thoracic surgery》2004,25(6):1065-1071
Objectives: Congenital tracheal stenosis is a rare disease. Various methods for treatment exist but there is still much debate as to the appropriate surgical procedure. We present our surgical experiences of patch tracheoplasty and slide tracheoplasty as viable methods for the treatment of congenital tracheal stenosis. Methods: From 1994 to 2002, 13 patients were diagnosed with congenital tracheal stenosis. Eight patients (7 symptomatic and 1 asymptomatic) had their stenosis corrected, three by means of pericardial patch tracheoplasty, four by slide tracheoplasty, and one by resection and anastomosis. Concomitant operations were performed on six patients to treat congenital cardiovascular disease. Five patients showing no significant symptoms did not undergo tracheal surgery and received only cardiac procedures. A retrospective review of the hospital course, complications, and long-term results was conducted. Results: Among the patch tracheoplasty group, every patient suffered from granulation tissue formation. One patient died of respiratory acidosis and one was hospitalized due to recurrent granulation tissue, which required frequent bronchoscopy. The third patient from this group is free of all symptoms. Among the slide tracheoplasty group, one patient died of anastomosis disruption. The three remaining patients are alive and well. The one patient who received resection and anastomosis is alive without symptoms. Conclusions: Surgical repair of long-segment congenital tracheal stenosis exhibited high mortality and morbidity rates. Every patient that underwent pericardial patch tracheoplasty suffered from troublesome granulation tissue. As slide tracheoplasty provided relatively good results in the short and mid-term follow-up periods, it seems to be a preferred method for the treatment of long-segment congenital tracheal stenosis. 相似文献