儿童动脉缺血性脑卒中研究进展

儿童动脉缺血性脑卒中(AIS)是重要的全球健康问题。近年来多项国际合作研究的开展使儿童AIS的诊疗有了重要进展。文章对儿童AIS的诊疗新进展进行综述,主要内容包括脑动脉病的分类和诊治进展、AIS相关基因及再灌注治疗三个方面。     

激光疏通血管的实验研究

作者自1985年以来进行了153条血管激光疏通实验.最初用不同能量的激光照射100条离体血管,摸索实验方法和参数。此后对活体动物53条血管进行血栓形成实验,成栓率80.6％。接着对其中完全栓塞的20条血管作激光疏通实验,疏通率达85％。     

The histological measurement of laser-induced thermal damage in vascular tissue using the stain picrosirius red F3BA

A histological technique for the measurement of laser-induced thermal tissue damage is described using the stain picrosirius red F3BA. This stain enhances the birefringence of normal collagen when viewed in polarized light. Areas of (thermally) denatured collagen, however, have no optical activity and can be measured directly by optical micrometry. The technique has been applied to experimental studies on both laser angioplasty and laser vascular anastomosis.The tissue ablation characteristics of various 2.2 mm diameter rounded sapphire laser angioplasty probes were compared by lasing (at 1064 nm) segments of porcine aorta under blood in vitro. A marked difference was observed between probes from different manufacturers, the Surgical Laser Technologies probe producing significantly greater forward tissue ablation with less associated lateral thermal damage.The relative degree of thermal damage caused by argon (488/514 nm) and Nd-YAG lasers during in vitro arteriotomy repair was also investigated. No difference was seen between the two wavelengths. However, the use of absorption-enhancing chromophore dyes as an aid to laser welding significantly reduced damage, particularly for the argon laser.In conclusion, we suggest that this histological technique is of considerable value in the investigation of the thermal effects of continuous-wave lasers.     

Radial artery catheterization by surgical exposure in infants

56 radial arteries were cannulated by cutdown technique in 54 critically ill infants (age (mean±SD) 12.2±25.9 days, weight 2710±910 g) for continuous pressure monitoring and repeated blood sampling. 30 patients survived their illness, 24 died. The mean catheterization time in the survivors was 8.1±4.1 in the non-survivors 6.9±5.6 days. Most cannulae were removed electively. 27 of the surviving infants were followed up after 10.5±5.1 months. 25 (86%) vessels were patent, 4 (14%) occluded. No trophic changes of hands or fingers were noted. We conclude that radial artery cannulation by cutdown in infants is a quick and safe technique and is suitable in patients with severe peripheral vasoconstriction.     

输卵管再通术结合中药治疗阻塞性不孕症的临床应用

目的：评价输卵管再通术结合中药治疗阻塞性不孕症的临床疗效和价值。材料与方法：对31例输卵管阻塞性不孕症患者采用选择性输卵管造影、输卵管再通术和中药治疗，术后3个月复查输卵管通畅情况，6～12个月后随访受孕情况。结果：31例中经常规子宫输卵管造影发现60条输卵管阻塞，有51条被疏通，再通率为85％。共中间质部阻塞再通成功率为95．7％，峡部阻塞再通成功率为88．5％，壶腹部阻塞再通成功率为66．7％，伞端阻塞再通成功率为0％。术后随访3至12个月，受孕率32．3％，再闭塞率为9．8％。未发现严重并发症。结论：输卵管再通术结合中药治疗输卵管阻塞性不孕症疗效确切。特别是对输卵管近端阻塞效果更好。术后再闭塞率低。     

异位妊娠药物及腹腔镜保守治疗后输卵管再通及再孕的比较

目的:探讨异位妊娠药物治疗及腹腔镜保守治疗后输卵管再通及再孕的临床效果.方法:对116例患者按照异位妊娠治疗的标准分为两组,其中腹腔镜下保守性手术65例,药物治疗51例,分别于治愈后第2～3个月在经净3～7天行输卵管碘油造影了解输卵管通畅情况,并随访其再次妊娠情况.结果:腹腔镜手术中输卵管完全通畅47例,再次妊娠38例;药物保守治疗中输卵管完全通畅24例,再次妊娠21例.两者比较(P＜0.05),差异有显著性.结论:腹腔镜下异位妊娠保守性手术后输卵管再通率及再次妊娠率较保守治疗高,值得临床推广.     

子宫输卵管造影及介入再通术的应用价值

目的探讨经宫颈选择性输卵管造影（selective salpingography,SSG）和输卵管再通术（selective transcervical fallopian tube recanalization,STFTR）在输卵管阻塞性不孕中的应用价值。方法对468例临床诊断不孕症的患者行子宫输卵管造影（hysterosalpingo graphy,HSG）。对其中326例证实为输卵管狭窄或阻塞原因所致不孕的患者,在X线透视监视下,通过同轴导管配合导丝技术经宫颈将5F导管选择性插至子宫角部或输卵管问质部,并借助0.018in微导丝、3F微导管的扩张作用和药液的冲胀作用,使阻塞的输卵管再通,最后向输卵管内灌注消炎、抗粘连药物。结果326例有639条输卵管狭窄或阻塞,行选择性输卵管造影和输卵管再通术,导丝均能选择性插入输卵管内,本组插管成功率达100％。427条输卵管介入治疗后再通,再通率达95.4％。结论输卵管再通术简单快速,安全有效,经济实用,值得推广。     

选择性输卵管造影与再通术治疗不孕症的研究

目的评价选择性输卵管造影与再通术在输卵管阻塞性不孕症中的安全性和有效性。方法选择经输卵管造影证实输卵管间质部、峡部或壶腹部阻塞的109例不孕妇女的207支输卵管进行选择性输卵管造影及再通术,术中灌注抗粘连药物（含庆大霉素16万U、糜蛋白酶10mg、地塞米松10mg）。术后随访6～24个月。结果再通成功率85.5%,妊娠率38.5%,无严重并发症。结论选择性输卵管造影和再通术是目前诊治输卵管阻塞性不孕症的一种安全有效且值得推广的方法。     

自创多腔一体式输卵管再通器在临床中的应用(附380例分析)

目的 研究自创多腔一体式输卵管再通器在临床中应用的价值.方法 380例输卵管阻塞所致不孕患者应用自创的输卵管再通器,行选择性输卵管造影和介入再通术.结果 发现708条输卵管阻塞,疏通678条,再通率95.8%(678/708).怀孕率47.4%(180/380),无严重并发症.结论 输卵管再通术中应用该自创输卵管再通器是安全、高效的.