食管支架治疗食管良恶性狭窄的临床应用

对16例食管良恶性狭窄患者采用食管支架置入进行治疗。其中食管-胃吻合口狭窄9例，食管癌7例，全部支架置入术均经口腔在X线监视下进行。支架置入后24小时随访观察，食管留置均获成功，未出现技术问题。支架置入后临床症状均得到缓解，所有病人摄食能力均有不同程度的改善。作者认为：食管支架对食管良恶性狭窄的治疗是一种方便、安全、有效的治疗方法，并可提高患者的生活质量。     

Stepwise interventional approach in a neonate with pulmonary valve atresia and intact ventricular septum

In neonates with pulmonary atresia and intact ventricular septum the aims of therapy are maintenance of pulmonary blood flow and right ventricular decompression in order to achieve right ventricular support of the pulmonary circulation. Recent developments in interventional heart catheterization with pulmonary radiofrequency-assisted balloon valvuloplasty and ductal stent implantation offer an alternative to the classical surgical approach. We report on a neonate with membranous pulmonary atresia and intact ventricular septum, in whom a large interatrial right-to-left shunt via the foramen ovale persisted after radiofrequency-assisted pulmonary balloon valvuloplasty on the 2nd day of life. The interatrial shunt prevented adequate right ventricular filling and antegrade pulmonary perfusion leading to severe cyanosis (transcutaneous oxygen saturation 40%). In order to increase pulmonary blood flow and raise left atrial pressure, the arterial duct was stented. After ductal stenting, prostaglandin was discontinued and the transcutaneous oxygen saturation remained stable around 89%. At follow up after 7 weeks the foramen ovale had decreased in size and only a small left-to-right shunt was present, documenting the effectiveness of this approach. Conclusion Based on the present case we propose a stepwise interventional approach for the neonate with pulmonary atresia and intact ventricular septum. If cyanosis persists after isolated pulmonary valvuloplasty despite adequate right ventricular function, ductal stent implantation can reduce interatrial shunting and thus improve oxygen saturation. Received: 12 January 1998 / Accepted: 15 February 1998     

颈动脉狭窄成形术中的支架和脑保护装置选择

颈动脉狭窄是缺血性脑卒中的主要发病原因之一，而颈动脉支架及其脑保护装置是经血管内治疗颈动脉狭窄的有益材料。通过了解和熟悉不同类型的支架和脑保护装置的特点、特性、应用方法和并发症预防．有助于提高颈动脉狭窄成形治疗的临床水平。     

镍钛记忆合金支架管治疗尿道下裂术后尿道狭窄18例

目的:探讨镍钛记忆合金支架管治疗尿道下裂术后尿道狭窄手术方法及临床效果。方法:对18例I期尿道成形术后尿道狭窄患者采用氯胺酮麻醉加骶麻,以尿道扩张器对狭窄段尿道进行扩张后,放置记忆金属支架管。如扩张尿道时损伤尿道或出现夹道,则尿道切开直视下放置金属支架管。合金支架管在术后3个月取出。结果:本组治愈17例,治愈率83%(17/18).3个月内金属支架管脱落1例,再次出现尿道狭窄。结论:镍钛记忆金属支架管治疗尿道下裂术后尿道狭窄,是简便易行,安全性高,创伤小,疗效肯定的治疗方法。     

冠心病合并糖尿病患者应用雷帕霉素洗脱支架和紫杉醇涂层支架的疗效观察

目的:评价雷帕霉索洗脱支架(Cypher~(TM))和紫杉醇涂层支架(Taxus~(TM))治疗冠心病(CAD)合并2型糖尿病(DM)患者短期疗效和安全性。方法:从2002年12月至2006年3月共116例合并CAD和DM的患者入选本研究,共植入药物涂层支架186个(雷帕霉素洗脱支架97个,紫杉醇涂层支架89个)。观察6个月的主要心血管不良事件(MACE)。结果:接受两种支架植入的患者基本临床特征相似。支架植入成功率100%,95%的患者完成了6个月的随访。雷帕霉素洗脱支架组总的MACE事件发生率约为6．78%(4/59),紫杉醇涂层支架组总的MACE事件发生率约为7．02%(4/57),两组相比无统计学差异。结论:雷帕霉素洗脱支架和紫杉醇涂层支架治疗CAD合并2型DM的患者有相似的疗效。     

Prospects for the research and application of biodegradable ureteral stents: from bench to bedside

Abstract

Ureteral stents are commonly used in urological practices but are frequently associated with patient discomfort, encrustation and stent-related infection. And a second procedure is needed to remove the stent. New biomaterials and designs have been attempted to solve these problems. The development of biodegradable ureteral stent shows promising prospects in future clinical applications. This article reviews the biomaterials and preparation methods commonly used in the present study of biodegradable ureteral stents. To date, none of the technological developments has lead to the ‘ideal’ biodegradable ureteral stent, but much progress has been made in the stent design by improving the physical characteristics and biocompatibility of the biomaterials. The controllability of degradation, the biggest problem faced currently, still needs to be further improved. In the future, the nanotechnology and chemical modification of biomaterials may be able to further optimize the properties of degradation.     

支架取栓术治疗急性缺血性脑卒中的 效果及不良事件发生率分析

〔摘 要〕 目的：探讨支架取栓术用于急性缺血性脑卒中患者治疗的效果及不良事件发生率。方法：2021 年 3 月 至 2022 年 5 月取南阳市中心医院收治的 110 例急性缺血性脑卒中患者作为研究对象，以计算机随机化方法分组，分 为对照组与观察组两组，各 55 例，对照组为静脉溶栓方案，观察组为支架取栓术方案，比较两组患者治疗后血管再 通情况、神经功能缺损程度、预后情况、不良事件发生情况。结果： 两组患者血管再通率、预后良好率相比，观察组 均高于对照组，差异均具有统计学意义（P ＜ 0.05）；治疗后，两组患者的美国国立卫生研究院脑卒中量表（NIHSS） 评分均低于治疗前，且观察组患者治疗后的 NIHSS 评分较对照组更低，差异均具有统计学意义（P ＜ 0.05）；观察 组患者不良事件发生率为 9.09 %，较对照组的 23.64 % 更低，差异具有统计学意义（P ＜ 0.05）。结论：急性缺血性 脑卒中者以支架取栓术方案治疗，相比于静脉溶栓方案，能提高血管再通率、预后良好率，以及能更好地改善神经功 能缺损程度，降低不良事件的发生率。     

Studying the non-uniform expansion of a stent influenced by the balloon

Non-uniform expansion of cardiovascular stents, which exists widely in experiments, has a large influence on stent safety, but has seldom been studied in depth until now. In this paper we use a folded balloon with friction to expand a stent through finite element method (FEM), and study how this influences non-uniform expansion of the stent. The simulations were carried out using ABAQUES software. The results show that the stent expands non-uniformly only when the fold and friction are considered together in the FEM model. The extent of non-uniformity during expansion increases with rising friction coefficient values; with the same friction coefficient but different stent locations on the balloon the extent of non-uniform deformation is different. On the other hand, compared to a tri-folded balloon, a six-folded balloon clearly decreases the expansive non-uniformity, which means that by increasing the number of the folded parts of balloon the stent expands more uniformly.     

支架在消化道狭窄治疗中的应用研究进展

近年来,支架在消化道狭窄治疗中取得了广泛应用。但具体应用指征,术后并发症及支架对预后影响尚有争议,本文就此做一综述。