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11.
我们自制了16个不同形状和大小的金属支架模型,置入人造血管腔中,并采用高体正常血管8条(犬腹主动脉4条,人冠状动脉4条)进行经血管腔内超声显像(IVUS)的体元模型三维重建(3DR)研究。结果显示,该技术能真实地再现支架在管腔内的形态、支架与管壁之间的间隙及离体正常血管的管腔及管壁形态,经提取后重建的支架模型与实物非常相似。经3DR测得的支架及血管腔内径与实测值均高度相关(r分别为0.96和0.99,p<0.001)。支架与管壁之间空隙的3DR测值与实测值也高度相关(r=0.97,p<r.0.01)。 相似文献
12.
Use of suture-mediated vascular closure devices for the management of femoral vein access after transcatheter procedures. 总被引:1,自引:0,他引:1
James A Shaw Elizabeth Dewire Alan Nugent Andrew C Eisenhauer 《Catheterization and cardiovascular interventions》2004,63(4):439-443
Groin complications remain the most common complication of cardiac catheterization procedures. While the use of closure devices is increasing for arterial sheaths, venous sheaths tend to be removed and hemostasis achieved with manual compression. We report our experience using Perclose suture-mediated vascular closure device to achieve hemostasis and early mobility in patients who have had venous access as part of their procedure. There were a total of 42 patients (21 males; average age, 63.5 years) studied. The majority of the patients had 7 Fr sheaths (24), with access sites of sheaths up to 14 Fr being closed with this technique. Two patients developed complications at the access site: one patient requiring rehospitalization for intravenous antibiotics because of late access site infection, and one patient with deep venous thrombosis and pulmonary emboli. We conclude that the use of the Perclose suture-mediated closure device for closure of femoral venous access sites is feasible and should be considered especially in patients with larger venous sheaths and those at increased risk of groin complications. 相似文献
13.
目的探讨国产前列腺内支架治疗前列腺增生引起排尿困难的疗效及并发症.方法42例前列腺增生引起的排尿困难的患者,置入46枚前列腺内支架.支架均为国产镍钛记忆合金编织而成.结果42例患者中,36例置入支架后立即自行排尿,5例因前列腺增生过大前列腺尿道部过长或支架位置不理想,置入一个支架,排尿仍有困难,再次置入第二个支架后,立即自行排尿,但2例出现长期的尿失禁;1例伴有糖尿病的患者,置入支架1周后排尿困难未改善,而进行外科手术治疗.36例生活质量积分0~3分,29例术后随访6~21个月,国际前列腺症状评分(I-PSS)术前27.49±4.21,术后6.89±3.76(P<0.001),最大尿流率术前(1.78±3.89)ml/s,术后(13.91±3.56)ml/s(P<0.001).结论国产前列腺支架治疗前列腺增生引起的排尿困难虽然会出现一些并发症,但仍是一种安全、可靠的方法. 相似文献
14.
Anterior Cruciate Ligament Reconstruction:
State of the Art 总被引:2,自引:0,他引:2
Abstract The rupture of the Anterior cruciate ligament (ACL)
belongs to the most common ligament injuries of the
human knee joint. ACL rupture results in an increased
anterior translation and internal rotation of the tibia.
Untreated knee instability causes a disintegration of
the roll and sliding movement and a high incidence of
secondary meniscus and chondral damages with consecutive
or advanced arthritic changes.
For deciding on a conservative or operative therapy, it is
necessary to develop a high-risk profile. Elderly, inactive
patients without instability symptoms can be treated
conservatively; younger, active people and complex
ligament injuries should receive an ACL replacement.
The goal is to eliminate instability by maintaining the
physiological kinematics of the knee.
Anterior cruciate ligament may be reconstructed
arthroscopically assisted by autologous tendons. Predominantly,
hamstring- and bone-patellar-tendon
grafts are used. No significant differences in knee laxity,
clinically and functionally, were observed between
both grafts. Various reconstruction techniques, single-
or double-bundle techniques, were described. Successful
replacement depends on a correct tunnel placement
and reconstruction of the physiological band
tension, a sufficient mechanical stability of fixation, an
impingement-free range of motion and an adequate
rehabilitation.
A high degree of patient satisfaction in clinical and
functional outcome could be evaluated. 相似文献
15.
目的探讨镍钛记忆合金带膜内支架在治疗食管癌术后胸内吻合口瘘中的应用价值。方法在X线电视透视下对22例食管癌术后胸内吻合口瘘患者进行镍钛记忆合金带膜内支架植入治疗。结果19例一次植入成功,成功率86%,恢复正常饮食;不完全封堵瘘口3例(14%);16例术后出现轻度的胸骨后疼痛不适或胃液反流的症状;1例出现上消化道大出血。22例病人均治愈出院,治愈率100%。结论镍钛记忆合金带膜内支架植入治疗食管癌术后胸内吻合口瘘成功率高,治愈率高,操作简单,安全,见效快,并发症少,有效解除患者痛苦,宜在临床上推广使用。 相似文献
16.
目的探讨覆膜支架治疗Ⅲ型主动脉夹层的方法和疗效。方法对14例Ⅲ型主动脉患者行爱膜支架治疗。术前强化CT检查明确诊断。术中先行主动脉造影,明确内膜破口位置,分辨真假腔,然后根据病变血管近端正常血管直径加上其直径的15%~20%选择支架型号。沿腹股沟下方约2cm处横行切开,游离股动脉并切开,插入支架输送器,硝普钠降收缩压至70~90mmHg,于破口位置缓慢释放支架,封闭主动脉内膜破口,重新造影,观察支架位置,是否有内漏..结果14例均成功植入支架,患者疼痛症状消失。升主动脉造影示真腔扩大,假腔消失12例,小内漏2例(经球囊扩张后仍有)。术后1周,1、6个月行强化CT检查示真腔扩大,假腔内血栓形成并缩小,远断血运改善,无截瘫、左上肢缺血及支架移位等并发症.结论覆膜支架治疗Ⅲ型主动夹脉层创伤小,操做简单,手术死亡率低,并发症少.恢复快,近期效果好. 相似文献
17.
18.
Predictors, costs and characteristics of out of area placement for people with intellectual disability and challenging behaviour 总被引:1,自引:0,他引:1
D. G. Allen K. Lowe K. Moore & S. Brophy 《Journal of intellectual disability research : JIDR》2007,51(6):409-416
Background Out of area placements for people with challenging behaviour represent an expensive and often ineffective strategy for meeting the needs of this service user group. Methods More than 800 agencies and service settings in a large area of South Wales were screened to identify children and adults with challenging behaviour against a number of defined operational criteria. Detailed data on identified individuals and the services they received were collected by interviewing key informants. Univariate and multivariate statistics were employed to identify predictors of out of area placement. Results In total, 1458 people were identified. Full data were available for 901 participants, 97 of whom were placed out of area. Predictors of out of area placement included behaviours resulting in physical injury and exclusion from service settings, a history of formal detention under the mental health act, the presence of mental health problems, a diagnosis of autism and higher total score on the Adaptive Behaviour Scale. Out of area placements were typically of high cost, and associated with only limited evidence of improved service quality. Conclusions Identifying predictors for out of area placement can be used to highlight deficiencies in local services and individuals at increased risk of exclusion from local services. 相似文献
19.
Charles Seydoux Danièle Gillard Berguer Eric Eeckhout Frank Stumpe Michel Hurni Patrick Ruchat Hossein Sadeghi Jean-Jacques Goy 《Transplant international》1996,9(4):433-436
Transplant atherosclerotic coronary disease remains the leading cause of death in heart transplant recipients. We report the first case of coronary stent implantation in a heart graft for epicardial focal stenosis. Due to the lower rate of restenosis after stenting in the native coronary artery, we suggest that coronary stenting be considered an acceptable, first intention therapeutic option instead of angioplasty alone whenever possible. 相似文献
20.
目的 总结腔内隔绝术治疗Stanford B型胸主动脉夹层动脉瘤某些特殊情况下近端内漏的治疗方法,比较延伸移植物(cuff)延伸释放法和后撤释放法的价值。方法 2001年以来,stanford B型胸主动脉夹层动脉瘤腔内隔绝术中发生近端内漏6例,分别采用向近端延伸法和后撤法植入cuff封闭内漏。结果 3例采用延伸法,其中1倒采用1枚cuff,1例采用5枚cuff,均完全封闭内漏;1例采用1枚cuff封闭不完全,带漏返回。3例采用后撤法,各用l枚cuff一次性将近端内漏消除。结论 主动脉弓远端或降主动脉近端成角明显时,如腔内隔绝术治疗Stanford B型主动脉夹层动脉瘤术中发生近端内漏,采用后撤法植入cuff是一种效果满意的方法。 相似文献