电解可脱性铂弹簧圈栓塞治疗颅内动脉瘤26例

目的：报告使用电解可脱性钱弹簧圈（Ｇｕｇｌｉｅｌｍｉ ｄｅｔａｃｈａｂｌｅ ｃｏｉｌ,ＧＤＣ）栓塞治疗颅内动脉瘤的情况。方法：气管内插管全订和肝素抗凝下,使用Ｓｅｌｄｉｎｇｅｒ’ｓ技术,经Ｔｒａｃｋｅｒ微导管放置ＧＤＣ栓塞颅内动脉瘤。成功栓塞２６例３１个颅内动脉瘤,其中２７个为１００％栓塞,３个为９５％,１个为９０％。３个９５％栓塞均为宽颈动脉瘤。１个９０％栓塞者,为Ｈｕｎｔ分级Ⅳ级,存在严重脑血     

45例肾血管肌脂瘤的治疗

目的：探讨肾血管肌脂瘤的治疗方法。方法：４５例患者中２３例未作特殊治疗;６例超选择性动脉栓塞治疗、７例行肿瘤剜除术或肾部分切除术、９例行全肾切除术。结果：随访２１例,平均随访时间３．６ａ。未作特殊治疗的病例中未发现肿瘤破裂出血,２便肿瘤体积增大但我症状;超选择性动脉栓塞病例无症状复发、无破裂出血、肾功能稳定。手术患者均保持肾功能稳定,无肿瘤复发。结论：对本病采取保守性治疗原则。超选择肾动脉栓塞是简     

Prognostic value of the Spetzler's grading system in a series of cerebral AVMs treated by a combined management

Summary The prognostic value of the Spetzler's grading system is studied in a series of 52 AVMs treated by a combined management, using one or several of the 3 available techniques: surgical resection, endovascular embolization, radiosurgery.The symptoms at the time of treatment were haemorrhage 50%, seizures 31%, headache and deficit 19%. Three grade groups were considered: I and II (31%), III (33%), IV and V (36%). Overall, AVMs were managed as follows: resection alone 25%, embolization plus resection 23%, embolization alone 23%, radiosurgery with various combinations 29%. According to the grade groups, the most frequently used technique was resection alone for grade I–II AVMs (44%), radiosurgery for grade III AVMs (41%) and embolization alone for grade IV–V AVMs (42%).The clinical outcome was evaluated in terms of deterioration due to treatment. The best results were obtained in grade I–II AVMs (81% with no deterioration) then in grade III AVMs (65%) and in grade IV–V (58%). However, when we consider the outcome in terms of favourable results (no or only minor deterioration) we obtained a similar outcome for grade I–II and grade III AVMs (94% each), and only 79% for grade IV–V malformations. The angiographic outcome showed a better eradication rate in grade III AVMs (88% complete eradication), than in grade I–II AVMs (75%) and in grade IV–V (47%).Our conclusion is that the Spetzler's grading system in this series was well correlated with both the clinical and the angiographic outcome. However, we found no real difference between grade I–II and grade III AVMs. So, in terms of prognostic value, the grade I, II, and III AVMs could be considered together as low-grade malformations, with a better prognosis than the high-grade malformations (grade IV and V).     

肝癌介入治疗药动学及其临床意义探讨

本研究通过测定血清阿霉素浓度,分析了原发性肝癌阿霉素肝动脉灌注(A 组)、阿霉素碘油乳化后栓塞(B 组)及阿霉素微囊栓塞化疗(C 组)后药动学变化及其临床意义。A 组药动学变化与静脉给药相似,但峰值浓度高。B 组峰浓度低,半衰期延长,显示缓释和降低血浓度的作用。C 组峰浓度不明显,表现为长时、稳定的释放,血浓度低,具有保持局部长时间高浓度作用。结果揭示了肝癌介入治疗不同给药方法疗效差异的药动学依据。     

介入栓塞治疗用电解脱弹簧圈的电化学研究

本文研究了用 于介入栓塞颅内 动脉瘤的不锈 钢弹簧圈在 生理盐 水中阳 极溶解 电化 学过程, 确定 了溶断弹簧圈的 电流范围。分析 了不同材料及 表面预处理 对不锈 钢孔蚀 电位的 影响, 为电解 脱离 弹簧圈的选择提 供了依据     

白及微球的研制及其肝动脉栓塞实验研究

用乳化－冷凝技术首次制备出白及微球,并通过正交实验,确定了制备特定粒径微球的最佳工艺条件。对微球的外观、粒径与分布、溶胀度及血液相容性等进行了研究。微球平均粒径为５４．３６μｍ,粒径范围５０～９０μｍ,占总数的７８．３７％;微球在ｐＨ＝７．４的缓冲液中有一定的溶胀性;血液相溶性良好。实验小猪微球栓塞后的肝动脉造影表明白及微球可致肝右动脉一级、二级分支完全栓塞;病理检查表明梗死区可见肝组织呈肝硬化改变,大量的假小叶形成。微球栓塞后,ＧＰＴ有一过性升高,３周后恢复正常。实验结果表明,以白及胶为材料制备的微球将为癌症的治疗提供一种新型的栓塞治疗剂     

ITP患者脾动脉栓塞前后血小板的检测及其临床意义

应用自动血细胞计数仪检测ＩＴＰ患者脾动脉栓塞前后不同时期血小板的变化。结果栓塞后患者血小板计数（ＰＬＴ）和平均血小板体积（ＭＰＶ）的变化呈负相关,但ＰＬＴ恢复正常后,ＭＰＶ仍高于正常。提示脾动脉栓塞后血小板计数增高的机理不同于激素治疗。     

New aspects in the treatment of priapism

Recent advances in the understanding of erectile physiology have improved the prompt diagnosis and treatment of priapism. During initial assessment, the physician must distinguish between veno-occlusive low flow (ischemic) and arterial high flow (nonischemic) in order to choose the correct treatment option for each type of priapism. Patient history, physical examination, penile haemodynamics and corporeal metabolic blood quality assist the distinction between static and dynamic priapism. Normally, priapism is effectively treated with intracavernous vasoconstrictive agents or surgical shunting. However, when these two methods fail, subsequent treatment procedures are a matter for debate. Alternative options, such as intracavernous injection of methylene blue or selective penile arterial embolization, for the management of high and low flow priapism are described and a survey of current treatment modalities is presented.     

介入化疗栓塞治疗32例宫颈癌合并出血的临床疗效分析

目的探讨介入化疗栓塞治疗宫颈癌合并出血的临床意义。方法对３２例宫颈癌合并出血的患者采用子宫动脉灌注５－氟尿嘧啶（５－Ｆｕ）、顺铂（ＰＤＤ）、丝裂霉素（ＭＭＣ）加碘油行子宫动脉化疗栓塞,再用明胶海绵栓塞止血。结果①盆腔动脉造影能清楚显示肿瘤血管及范围,明确出血部位,经化疗栓塞后全部病例得以止血。②介入治疗能够短时间内控制巨大肿瘤,但难以使肿瘤完全坏死。结论介入化疗栓塞能够取得满意的止血效果,是其他治疗手段不可比拟的。介入治疗能够提高宫颈癌的近期疗效,但单纯用介入治疗难以根治,必须配合手术治疗或放射治疗。     

Selective arterial embolization in the treatment of aneurysmal bone cyst and angioma of bone

Nineteen aneurysmal bone cysts and five angiomas of bone were treated by selective arterial embolization. The median follow-up was 22 months. In 17 patients healing occurred with complete relief of symptoms; in 11 of these almost complete ossification of the lesion resulted. In the remaining cases, little or no ossification was apparent but ossification may take 1 year or more to occur. No recurrence was observed in any of these cases. Recurrence occurred only in two cases. In one, growth of the recurrence stopped after a second embolization, and the X-rays showed no change. Selective arterial embolization represents a treatment of choice in aneurysmal bone cyst and angioma of bone especially of the spine, sacrum, or pelvis. In these sites embolization replaces surgery which might be hazardous due to intraoperative bleeding.Supported in part with Rizzoli Research Funds