射频消融术后尿潴留患者的护理

分析86例射频消融术后患者出现尿潴留的不同原因，包括不习惯床上排尿、精神因素、疼痛等。护理对策包括：减少卧床时间，心理护理，变换体位，物理诱导，术后多饮水等，结果81例患者排尿成功，只有5例(5．8％)男性前列腺肥大患者需要导尿。     

红斑反应与理想光子嫩肤术关系的研究

目的 观察红斑反应与理想光子嫩肤术的关系,为临床提供参考.方法 采用34 J/cm2的强脉冲光,对10只兔子(4个部位)分别照射1、2、3、4次,记录出现红斑反应的照射次数,术后第15天观察治疗部位切片,记录使皮肤真皮胶原蛋白增生的照射次数.结果 红斑反应的阈刺激照射次数是(2.60±0.52)次,真皮胶原蛋白增生的阈刺激照射次数是(3.00±0.67)次.两者比较无显著差异.结论 IPL致红斑反应的能量大小,与理想光子嫩肤术所需的能量接近.     

双极射频电热固缩治疗前交叉韧带松弛临床研究

目的:对15例前交叉韧带双极射频电热固缩治疗进行回顾性研究,评估其临床疗效。方法:从2000年1月至2005年1月采用双极射频对16例前交叉韧带松弛的患者进行电热固缩治疗。完整随访者15例,男性11例,女性4例,平均年龄29岁。12例前交叉韧带部分损伤,3例为自体绳肌重建术后。电热射频设备输出功率为284W,组织内作用温度为65℃。术后患者采用支具制动,康复计划与前交叉韧带重建术后基本相同。结果:随访时间平均15·6个月(4~25个月)。Lysholm评分,术前74·27±5·51分(66~84分),术后3个月89·6±7·11分(72~99分),两者相比有显著性差异(P<0·01);术后最终评分83·33±11·81分(56~95分),虽仍显著高于术前评分(P<0·05),但与术后3个月比较有所降低。KT-1000测量结果,术前两侧胫骨前移差值为5·47mm±1·61mm(3·5mm~10mm),术后3个月为2·67mm±1·35mm(2~7mm),与术前测量值对比存在显著性差异(P<0·01);最终测量结果为3·8mm±1·96mm(2~9mm),虽仍显著低于术前测量值(P<0·05),但较术后3个月有所增加。所有患者均未出现明显的术后并发症。2例患者(13·3%)术后失效,接受了二期重建手术。结论:电热固缩治疗前交叉韧带松弛可获得较好的短期主、客观疗效,但长期随访疗效有所下降。建议慎重选择手术适应症。     

Percutaneous recanalization of chronic subclavian artery occlusion using optical coherence reflectometry-guided radiofrequency ablation guidewire.

Subclavian artery lesion that is associated with low complication rate could be treated by percutaneous intervention effectively. However, the success of endovascular therapy for occlusive lesion may be limited by failure to cross with a guidewire. We describe the use of a system using optical coherence reflectometry for navigation and radiofrequency ablation to enable wire passage through subclavian artery occlusion that could not be crossed by conventional guidewires.     

鼻内镜下等离子低温射频治疗常年性变应性鼻炎的临床观察

目的探讨鼻内镜下等离子低温射频治疗常年性变应性鼻炎(PAR)的疗效及其优越性。方法在鼻内镜下用等离子低温射频治疗PAR48例,按照海口会议修订的“过敏性鼻炎诊断和疗效评定标准”,用计分法分别评定其疗效。结果该组48例术后随访半年进行评价,其中显效27.1%(13/48),有效58.3%(28/48),无效14.6%(7/48),总有效率为85.4%。疗效评分显示治疗前平均总分为(9.58±1.69)分,治疗后为(5.63±1.15)分(P<0.05)。结论鼻内镜下等离子低温射频烧灼筛前神经终末区域治疗PAR,具有简便、安全等优点,短期效果显著,特别适用于临床上应用抗组胺类药物及鼻内应用糖皮质激素治疗效果不甚理想及由于各种原因不能长期接受抗组胺类药物及鼻内应用糖皮质激素治疗的患者;但长期疗效有待进一步研究。     

A Decrease in Pulmonary Vein Diameter After Radiofrequency Ablation Predicts the Development of Severe Stenosis

A decrease in ostial pulmonary vein (PV) diameter was observed in patients on the day after radiofrequency ablation of atrial fibrillation (AF). This study examined whether a relative reduction in PV diameter on day 1 (RRPVD1) after the procedure predicts the late development of severe PV stenosis (PVS). The study included 104 consecutive patients (mean age = 55 years, range 46–61, 34 women) with drug refractory AF. Pulmonary vein diameter was measured using MR angiography (MRA) on the day before and on day 1 after the ablation procedure. The MRA was repeated every 3 months after the procedure. Severe PVS was defined as a >70% diameter reduction from the initial ostial diameter. The cut-off of RRPVD1 was prespecified as 25% decrease in initial diameter. The data are presented as medians and interquartile range. A total of 357 PV were treated. The RRPVD1 was 0.0% (0.0–11.1%). Severe PVS was found in 18 PV during a follow-up of 12 months (range 6–13). The log-rank analysis confirmed a strong association between a RRPVD1 ≥25% and the development of PVS (hazard ratio: 7.1; 95% confidence interval 3.8–13.5, P < 0.0001). By multivariate Cox regression model, after adjustment of procedure variables, RRPVD1 was the strongest predictor of development of severe PVS. RRPVD1 ≥25% was a strong independent predictor of development of severe PVS.     

Radiofrequency Procedures

Abstract:   Radiofrequency is a minimally invasive, target-selective technique that has been in clinical use for more than 25 years and has demonstrated success at reducing pain in several chronic pain conditions, including trigeminal neuralgia, chronic low back pain, postherpetic neuralgia, and complex regional pain syndrome. However, the success of radiofrequency in chronic pain has not been adequately reproduced in good-quality, randomized controlled trials, and its use in the management of neuropathic pain is under some debate. In addition, conventional radiofrequency occasionally leads to worsening and even new onset of neuropathic pain. Nevertheless, clinical experience suggests that radiofrequency may be a useful tool in the overall management of refractory neuropathic pain. Pulsed radiofrequency in particular is a minimally destructive procedure that may offer new opportunities and a broader perspective for therapy with radiofrequency.     

Epicardial radiofrequency ablation for chronic atrial fibrillation undergoing simultaneous on-pump beating coronary artery bypass grafting

Off-pump coronary artery bypass grafting has become an attractive surgical alternative for myocar-dial revascularization because of the advantage of myocardial protection and other benefits of patients. However, it is still regarded as a controversial treatment for the coronary artery disease accompanied by atrial fibrillation (AF). A significant number of patients in need of coronary revascularization have chronic AF. Although the Cox-Maze III procedure is the gold standard for the surgical treatment of AF, few of these patients undergo AF operations at the time of their coronary bypass grafting. We report herein a case of the pulmonary vein isolation to eliminate the AF by means of epicardial radiofrequency ablation combined with 2 vessels coronary artery bypass grafting on the beating heart with the aid of cardiopulmonary bypass.     

强脉冲光对大鼠皮肤胶原蛋白影响的定量分析

目的　定量分析强脉冲光对大鼠皮肤胶原蛋白含量的影响,进一步明确强脉冲光在治疗皮肤光老化中的作用机制。方法　选择15只SD大鼠,每只选3个部位用强脉冲光治疗,采用同一治疗参数,能量密度34J/cm2 ,分为3个脉冲,脉宽各为4ms、5ms、6ms,脉冲延时为2 0ms及2 5ms。分别切取治疗后第1、3、5、7、15、30天皮肤和未治疗部位皮肤,进行组织学观察。结果　治疗后,第1、3、5、7天皮肤胶原蛋白染色与未治疗部位比较无明显差别,第15天强于未治疗部位,第30天明显强于未治疗部位,免疫组化染色Ⅰ、Ⅲ型胶原明显增多(P <0 .0 0 1)。结论　强脉冲光治疗大鼠皮肤后可引起胶原含量的增加,在实验基础上为强脉冲光的临床应用提供了理论依据。     

The effects of radiofrequency catheter ablation on the metabolic enzymes and Ca++-ATPase of myocytes

Summary Using histochemical technique, the effects of radiofrequency catheter ablation (RFCA) on the activities of LDH, SDH, CCO, and Ca⁺⁺-ATPase of guinea-pig ventricular myocytes were examined. The histological changes were observed for comparison. Radiofrequency energy (500 kHz) delivered was 20 WX 10 s. The results were as follows: RFCA resulted in significant impairments in all the four kinds of enzymes but without statistical differences in the areas involved in this energy level. No statistically significant difference was found between the ranges of enzymatic damages and areas of pathological lesions. These findings showed a consistency in areas of the histological and histochemical lesions resulted from RFCA.