Postpartum hemorrhage with pelvic arterial embolization,study of 33 cases

Objective: To describe our cases of postpartum hemorrhage (PPH) with pelvic arterial embolization (PAE).

Material and methods: All patients with PPH who underwent PAE in our center in the interval 2011–1016 were retrospectively studied, evaluating the technical procedure, clinical results, and subsequent fertility.

Results: There were 33 cases of PPH with PAE. The majority occurred in primiparous women (N?=?22, 66.6%) who delivered vaginally (N?=?20, 61%). In addition, most PPH with PAE cases had an early onset (N?=?26, 79%) and were caused by uterine atony (N?=?14, 42.4%). Success of PAE occurred in 27 (81.8%) cases and a satisfactory clinical follow-up was the rule, with 21 (64%) women recovering their normal menstruation, and six (18.2%) becoming pregnant in the following years.

Conclusions: PAE is a safe and efficacious technique with minor complications. Moreover, it allows conservation of the uterus with preservation of fertility.     

肝移植拔除T管后胆漏的超声介入治疗

目的探讨超声引导下置管引流在肝移植拔除T管后胆漏中的价值,并与其他处理方法作比较。方法2001年8月至2005年3月肝移植行胆管端端吻合或胆肠吻合放置T管患者76例,拔除T管后发生胆漏9例,其中8例患者行超声引导下置管引流,男性7例,女性1例,年龄22-59岁,平均46.7岁。穿刺置管引流术方法为确定穿刺点,在超声引导下采用Seldinger法徒手操作,18G穿刺针穿入积液内,观察到针尖进入积液区后拔出针芯,见液体流出或抽出液体后放入导丝,退出穿刺针放置带内套针的7F直通管,导管进入积液内退出内套针和导丝,局部固定包敷引流管。结果8例患者拔除T管后分别出现剧烈腹痛、发烧、大汗淋漓等症状,超声检查发现均有盆腔积液,积液最大深度范围为3～7cm。8例超声引导下置管引流均一次成功,引流出淡黄色或金黄色胆汁,1d内症状均迅速改善或消失。5～10d后见管内无引流液后拔管,无并发症发生。结论超声引导下置管引流对肝移植拔除T管后胆漏的治疗是安全、有效的,具有重要价值。     

以健择为主介入治疗联合化疗治疗晚期胰腺癌20例

目的探讨以健择为主介入治疗联合全身化疗治疗晚期胰腺癌的疗效。方法在X光监视下将导管插入十二指肠上下动脉,将健择1000mg／m^2以0．9％氯化钠溶液（NS）溶解后每次注入1/2量,氟脲苷（FUDR）0．5g、顺铂（DDP）60mg同样以0．9％氯化钠溶液（NS）溶解后每次靶动脉注入1／2量,d2～d5予全身联合化疗,28d为1周期,完成3个周期评价疗效。结果全组无CR病例,PR11例（55％）,NC6例（30％）,总有效率为55％。结论健择为主介入治疗联合全身化疗治疗晚期胰腺癌有较好的疗效,同时能减轻症状,提高病人的生存质量,但确切疗效有待扩大样本进一步探讨。     

Transcatheter closure of inferior sinus venosus defect using a patent ductus arteriosus occluder following simulation with a 3D-printed model

BackgroundTranscatheter closure of inferior sinus venosus defect (ISVD) is still contraindication. To explore whether transcatheter closure with patent ductus arteriosus (PDA) occluders is possible for ISVD.MethodsFrom June 2014 to March 2021, 12 patients were recruited diagnosed as <25 mm ISVD. The three-dimensional printing (3DP) heart model was produced based on multi-slice computed tomography (MSCT) scans. Preoperative closure simulation was planned on the personalized 3D model for each patient. Follow-up including electrocardiography (ECG), transthoracic echocardiography (TTE), and X-ray was traced.Results3DP models of 12 patients were successfully printed. Twelve patients had been diagnosed with <25 mm ISVD and 4 of them had another secundum atrial septal defect (ASD). All patients were produced interventional therapy successfully. PDA occluder was implanted to closed ISVD, and ASD was closed using ASD occluder simultaneously. The average diameter of ISVD measured by TTE was (12.67±3.80), and the average diameter of sagittal axes and longitudinal axes measured by the 3D-printed model was (17.08±3.20) and (18.42±4.62) mm, respectively. The average size of PDA (diameter of pulmonary artery side) was (28.17±3.35) mm. Compared with the preoperative, the X-ray cardiothoracic ratio (0.51±0.04 vs. 0.47±0.06, P=0.007) and the right ventricle anterior-posterior diameter (31.17±5.65 vs. 24.58±3.75 mm, P<0.001) of postoperative was significantly decreased. During the average (47.75±27.52) months follow-up, it has achieved satisfying results, and there were no severe adverse events such as device transposition, death, and pericardial tamponade occurred.ConclusionsAssisting by 3D heart model, transcatheter closure of ISVD with PDA occluder had an excellent outcome. This method provides a new considerable treatment strategy for ISVD.     

Reweighted ℓ1 referenceless PRF shift thermometry

Temperature estimation in proton resonance frequency (PRF) shift MR thermometry requires a reference, or pretreatment, phase image that is subtracted from image phase during thermal treatment to yield a phase difference image proportional to temperature change. Referenceless thermometry methods derive a reference phase image from the treatment image itself by assuming that in the absence of a hot spot, the image phase can be accurately represented in a smooth (usually low order polynomial) basis. By masking the hot spot out of a least squares (?₂) regression, the reference phase image's coefficients on the polynomial basis are estimated and a reference image is derived by evaluating the polynomial inside the hot spot area. Referenceless methods are therefore insensitive to motion and bulk main field shifts, however, currently these methods require user interaction or sophisticated tracking to ensure that the hot spot is masked out of the polynomial regression. This article introduces an approach to reference PRF shift thermometry that uses reweighted ?₁ regression, a form of robust regression, to obtain background phase coefficients without hot spot tracking and masking. The method is compared to conventional referenceless thermometry, and demonstrated experimentally in monitoring HIFU heating in a phantom and canine prostate, as well as in a healthy human liver. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

介入治疗激素性股骨头坏死的实验研究

目的评价介入治疗股骨头坏死的可行性。材料与方法采用中国白兔２０只，随机分成３组。Ａ组为注射激素组，Ｂ组为注射激素后进行介入治疗组，Ｃ组为对照组。介入治疗是将溶栓药物、扩血管药物及改善微循环药物直接注入股骨头供血动脉。对股骨头进行Ｘ线摄片和显微镜观察，研究股骨头的Ｘ线平片表现及病理变化。结果Ｂ组股骨头空缺的骨陷窝数及骨髓腔内脂肪细胞平均直径虽没达到正常水平，但有明显的改善，软骨下区血管数目基本达到正常，血管直径明显增大，Ｘ线平片可见股骨头明显修复。结论通过介入方法治疗股骨头坏死是一种能在临床上广泛应用的新方法。     

血管内介入取栓联合局部溶栓治疗颅内静脉窦血栓1例

患者女,35岁,因"无明显诱因头痛、头晕伴恶心、呕吐3天,加重伴右侧肢体乏力8h"入院;既往体健。查体:伸舌右偏,颈稍抵抗,右上肢肌力2级,右下肢肌力3级,右侧腱反射亢进,右侧Babinski征(+)。头部CT示右枕部条索状高密度影,CT值74HU,考虑血管影(图1A);CTA见矢状窦不显影,考虑静脉窦血栓形成。实验室检查:D-二聚体明显升高(5.02mg/L),活化部分凝血活酶时间72.5s,凝血酶时间75s。     

宫颈癌的介入化疗与栓塞

目的：评价超选择介入化疗与栓塞在宫颈癌中的作用。方法：1997-2000年15例宫颈癌患者行介入治疗,12例于介入术1-4个疗程后再行肿瘤切除术。结果：（1）宫颈癌介入治疗有效率为80%：（2）介入术后宫颈癌切除术率为80%;（3）副作用主要为胃肠道反应和骨髓抑制反应。结论：超选择髂内动脉插管化疗与栓塞可使宫颈癌缩小,为手术治疗创造条件,是治疗宫颈癌的一种新的有效辅助疗法。     

微波辅助介入治疗肝癌43例

目的 观察肝癌患者动脉灌注与栓塞配合热疗的治疗效果。方法 1999/2003对43例肝癌患者进行动脉超选灌注加热至43℃的顺铂80mg+阿毒素20mg,然后经导管灌注混有阿霉素20mg+丝裂霉素20mg的超液态碘油乳化剂进行栓塞,术中和术后4d,8d,12d,16d运用WF-2102A微波热疗治疗仪进行配合治疗,每次40min,电脑显示测温要求在43℃。结果半年生存率(39/43)90％,la生存率(27/23)62.7％,2a生存率(9/43)20.9％,3a生存率(6/43)13.9％。结论肝癌动脉灌注与栓塞配合热疗临床观察表明,该方法疗效显著,应成为一项重要的非手术治疗方案。