腹主动脉球囊阻断技术在骶骨肿瘤切除中的临床评价

[目的]探讨应用腹主动脉球囊阻断技术在行骶骨肿瘤切除术中的临床应用价值。[方法]对36例骶骨肿瘤患者切除过程中应用腹主动脉球囊阻断技术(腹主动脉球囊阻断组),复习既往32例骶骨肿瘤应用传统的术前血管栓塞技术切除肿瘤患者(对照组)的临床资料,比较2组手术时间、出血量、并发症发生率、平均住院时间、术后恢复时间及复发率。[结果]腹主动脉球囊阻断组手术时间为(149.19±73.81)min,术中出血量为(826.67±509.11)ml,有2例骶神经损伤,平均住院时间(26.05±7.08)d,术后恢复时间(34.61±8,22)d,半年复发率5.5%,1年复发率11%,2年复发率16%;对照组手术时间为(221.33±45.19)min,出血量为(1652±706.99)ml,有3例骶神经损伤,4例出现局部皮肤缺血性疼痛,1例出现性功能障碍。平均住院时间(37.93±7.63)d,术后恢复时间(46.03±9.67)d,半年复发率18%,1年复发率31%,2年复发率40.6%。两者比较有显著性差异(P<0.05)。[结论]在骶骨肿瘤过程中,采用腹主动脉球囊阻断技术,可以缩短手术时间,减少出血量及并发症,缩短住院天数,术后恢复快,降低了复发率。是一项具有实用价值的临床技术。     

A clinical procedure to predict the value of temporary occlusion therapy in keratoconjunctivitis sicca

PURPOSE: To evaluate the effects of dissolvable collagen punctal plugs on the symptoms, tear stability and volume in aqueous deficient dry eyes. METHODS: Sixty-two aqueous deficient dry eye patients of mixed aetiology underwent lacrimal punctal occlusion with dissolvable collagen plugs. The subjects were randomly allocated to one of two treatment groups: group I (n = 36) had their lower puncta occluded and group II (n = 26) had both their upper and lower puncta occluded. The effectiveness of this treatment was clinically assessed by (1). scoring subject symptoms and (2). measuring the tear parameters of tear thinning time (TTT) and tear meniscus height (TMH) as indicators of tear stability and volume, respectively. Following baseline measurements, patients were reviewed at time intervals of 5 and 12 days post-occlusion. A group of age- and gender-matched normals (n = 45) was recruited for comparison (group III). RESULTS: Tear volume and stability were significantly higher in group III compared with I and II at baseline. In the treated groups on both days 5 and 12: (1). symptom score reduced significantly from a median value of 7 to 3 (p = <0.001); (2). tear stability increased significantly from a median value of 3 to 5 s by day 5 (p 相似文献   

Revascularization of the Posterior Circulation

The primary objective of revascularization procedures in the posterior circulation is the prevention of vertebrobasilar ischemic stroke. Specific anatomical and neurophysiologic characteristics such as posterior communicating artery size affect the susceptibility to ischemia. Current indications for revascularization include symptomatic vertebrobasilar ischemia refractory to medical therapy and ischemia caused by parent vessel occlusion as treatment for complex aneurysms. Treatment options include endovascular angioplasty and stenting, surgical endarterectomy, arterial reimplantation, extracranial-to-intracranial anastomosis, and indirect bypasses. Pretreatment studies including cerebral blood flow measurements with assessment of hemodynamic reserve can affect treatment decisions. Careful blood pressure regulation, neurophysiologic monitoring, and neuroprotective measures such as mild brain hypothermia can help minimize the risks of intervention. Microscope, microinstruments and intraoperative Doppler are routinely used. The superficial temporal artery, occipital artery, and external carotid artery can be used to augment blood flow to the superior cerebellar artery, posterior cerebral artery, posterior inferior cerebellar artery, or anterior inferior cerebellar artery. Interposition venous or arterial grafts can be used to increase length. Several published series report improvement or relief of symptoms in 60 to 100% of patients with a reduction of risk of future stroke and low complication rates.     

通脉灵对心肌缺血再灌注犬心功能的保护作用

本实验复制２４只杂种犬心肌缺血再灌注损伤病理模型，应用与生理盐水、丹参对比的方法观察通脉灵对血液动力学及心功能的影响。结果表明，通脉灵小剂量组（ＴＭ１Ｇ）、通脉灵大剂量组（ＴＭ２Ｇ）和丹参对照组（ＤＳＧ）的心输出量（ＣＯ），心脏指数（ＣＩ），心搏指数（ＳＩ）、左室内压峰值（ＬＶＳＰ）及左室内压最大变化速率（±ｄｐ／ｄｔｍｓｘ）均明显高于生理盐水对照组（ＮＳＧ）。本实验证明，通脉灵主要是通过保护心肌舒缩功能改善血液动力学指标进而防止缺血再灌注时心功能不全的发生。     

Pattern-reversal electroretinograms and visual evoked potentials in branch retinal vein occlusion

We recorded pattern electroretinograms and visual evoked potentials in a group of selected patients with unilateral uncomplicated branch retinal vein occlusion. To document the effects of preexisting risk factors, patients were divided into three groups: diabetes mellitus, hypertension with hyperlipidemia and no systemic disease. The transient and steady-state pattern electroretinogram and visual evoked potential amplitudes were significantly reduced and visual evoked potential peak times were delayed relative to the fellow eyes and agematched normal subjects. There was a second amplitude reduction relative to the other patient groups in both the affected and fellow eyes of the diabetes mellitus group, which was indicative of an additive effect of diabetes mellitus.Abbreviations BRVO branch retinal vein occlusion     

选择性髂内动脉结扎与栓塞对盆腔血供的影响

目的：旨在探讨选择性髂内动脉结扎与栓塞两种方法对盆腔血供的影响。方法：将两组犬在膀胱上动脉分支以下之髂内动脉分别行结扎与栓塞，对比观察两组膀胱创面出血、盆腔动脉造影及盆腔脏器组织学变化，以确定其盆腔脏器的血供情况。结果：①结扎组膀胱创面出血明显大于栓塞组；②结扎组髂内动脉侧支循环建立时间明显早于且数目多于栓塞组；③两组盆腔脏器均未见缺血坏死。结论：栓塞组阻断髂内动脉侧支循环的数目多于结扎组，故对盆腔血供的影响大于结扎组。避免髂内动脉阻断范围过广可减少盆腔脏器缺血坏死的机会。     

踝/肱指数对下肢动脉硬化性闭塞症缺血程度的评价

目的：利用检测下肢动脉硬化性闭塞症患的踝/肱指数对其下肢缺血程度进行评估。方法：采用以色列Flo-link 500T血管多普勒诊断仪对我院50例确诊为下肢动脉硬化性闭塞症患进行了分组踝/肱指数的检测。结果：踝/肱指数在0．5—0．9之间，常提示下肢动脉或近端有单水平阻塞；踝/肱指数在0．45以下常提示患下肢缺血程度严重，为坏疽前期静息痛表现；踝/肱指数在0．30以下多伴有缺血性溃癌或坏死。结论：踝/肱指数的检测可以反映下肢缺血程度，指导临床选择治疗方法，判断愈后及疗效，其无创性、可重复性、价格低康，更易被患接受。     

胎儿耳廓弹性软骨及其组织的发生

用９周－３９周引产胎儿标本７２例，取右耳廓石蜡切片，ＨＥ和Ｗｅｉｔｅｒｔ弹性纤维染色，光镜观察其弹性软骨、弹性纤维、耳廓肌和结缔组织的发生。