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21.
目的观察不同麻醉方式的手术患者留置尿管的最佳时间。方法将2011年1月至2014年1月该院收治的28例因外科手术需要留置尿管的患者,根据麻醉方式及导尿时机选择将其分为腰-硬联合麻醉前留置尿管(Ⅰ前组)、腰-硬联合麻醉10 min后留置尿管(Ⅰ后组)、全身麻醉前留置尿管(Ⅱ前组)、全身麻醉10 min后留置尿管(Ⅱ后组)共四组,各7例。收集、分析相关数据,比较四组患者插管时心率、血压、并发症等各项指标。结果不同麻醉方式麻醉10 min后留置尿管,患者插管前后心率和血压比同种床醉方式麻醉前留置尿管稳定,且患者舒适度好、并发症少,差异均有统计学意义(P〈0.05)。结论无论是腰-硬联合麻醉还是全身麻醉的手术患者,留置尿管的最佳时间均为麻醉10 min后。 相似文献
22.
J W Hirshfeld W Laskey J L Martin W C Groh W Untereker G L Wolf 《Journal of the American College of Cardiology》1983,2(5):954-957
The hemodynamic and electrocardiographic changes induced by left ventriculography and coronary arteriography with ioxaglate (a new low osmolality angiographic contrast agent) were characterized and compared with the changes induced by a commercial formulation of the commonly used angiographic contrast agent, diatrizoate (Renografin-76). Left ventriculography and coronary arteriography were performed in 25 patients utilizing ioxaglate and in another 25 patients utilizing diatrizoate. Both agents increased left ventricular end-diastolic pressure and decreased arteriovenous oxygen difference after left ventriculography, but the magnitude of the increase caused by ioxaglate was significantly less than that caused by diatrizoate (changes in left ventricular end-diastolic pressure was 5.3 +/- 1.3 mm Hg with ioxaglate and 9.5 +/- 1.5 mm Hg with diatrizoate [p less than 0.02] ). Change in arteriovenous oxygen difference was -0.33 +/- 0.19 ml/100 ml with ioxaglate and -0.85 +/- 0.13 ml/100 ml with diatrizoate (p less than 0.05). Both agents were well tolerated when used for coronary arteriography with no adverse events occurring in either group. Ioxaglate is a well tolerated cardiac angiographic contrast agent that produces less hemodynamic disturbance than diatrizoate. Accordingly, it may be particularly well suited to use in patients with impaired left ventricular function. 相似文献
23.
Jin-Seok Yi Hyung-Jin Lee Hong-Jae Lee Ji-Ho Yang 《Journal of Korean Neurosurgical Society》2014,55(2):96-98
Vascular complications after percutaneous angiography include hematoma, pseudoaneurysm, arteriovenous fistula, thromboembolism, arterial laceration and infection. Hematomas may occur in the groin, thigh, retroperitoneal, intraperitoneal, or abdominal wall. A 54-year-old female underwent percutaneous transfemoral angiography for the evaluation of cerebral aneurysm. Renal subcapsular hematoma developed 3 hours after the procedure. Renal subcapsular hematoma after percutaneous angiography is very rare. We investigated the possible causes of renal subcapsular hematoma. To avoid this rare complication, we need to perform guide-wire passage carefully from the beginning of the procedure under full visual monitoring. 相似文献
24.
Naoko Takaoka Kenichi Tsujita Koichi Kaikita Seiji Hokimoto Michio Mizobe Masahide Nagano Eiji Horio Koji Sato Naoki Nakayama Hiromi Yoshimura Kenshi Yamanaga Naohiro Komura Sunao Kojima Shinji Tayama Sunao Nakamura Hisao Ogawa 《International journal of cardiology》2014
Background
Some plaques lead to ST-segment elevation myocardial infarction (STEMI), whereas others cause non-ST-segment elevation acute coronary syndrome (NSTEACS). We used angiography and intravascular ultrasound (IVUS) to investigate the difference of culprit lesion morphologies in ACS.Methods
Consecutive 158 ACS patients whose culprit lesions were imaged by preintervention IVUS were enrolled (STEMI = 81; NSTEACS = 77). IVUS and angiographic findings of the culprit lesions, and clinical characteristics were compared between the groups.Results
There were no significant differences in patients' characteristics except for lower rate of statin use in patients with STEMI (20% vs 44%, p = 0.001). Although angiographic complex culprit morphology (Ambrose classification) and thrombus were more common in STEMI than in NSTEACS (84% vs 62%, p = 0.002; 51% vs 5%, p < 0.0001, respectively), SYNTAX score was lower in STEMI (8.6 ± 5.4 vs 11.5 ± 7.1, p = 0.01). In patients with STEMI, culprit echogenicity was more hypoechoic (64% vs 40%, p = 0.01), and the incidence of plaque rupture, attenuation and “microcalcification” were significantly higher (56% vs 17%, p < 0.0001; 85% vs 69%, p = 0.01; 77% vs 61%, p = 0.04, respectively). Furthermore, the maximum area of ruptured cavity, echolucent zone and arc of microcalcification were significantly greater in STEMI compared with NSTEACS (1.80 ± 0.99 mm2 vs 1.13 ± 0.86 mm2, p = 0.006; 1.52 ± 0.74 mm2 vs 1.21 ± 0.81 mm2, p = 0.004; 99.9 ± 54.6° vs 77.4 ± 51.2°, p = 0.01, respectively). Quantitative IVUS analysis showed that vessel and plaque area were significantly larger at minimum lumen area site (16.6 ± 5.4 mm2 vs 14.2 ± 5.5 mm2, p = 0.003; 13.9 ± 5.1 mm2 vs 11.6 ± 5.2 mm2, p = 0.003, respectively).Conclusion
Morphological feature (outward vessel remodeling, plaque buildup and IVUS vulnerability of culprit lesions) might relate to clinical presentation in patients with ACS. 相似文献25.
《Journal of cardiology》2014,63(3):239-243
BackgroundThe past decade has witnessed considerable improvement in implantation techniques for percutaneous closure of ruptured sinus of Valsalva aneurysm. This study was undertaken to compare the immediate results and mid-term follow-up of traditional surgery and percutaneous closure of ruptured sinus of Valsalva aneurysm in China.MethodsBetween January 1993 and January 2013, a total of 35 patients with ruptured sinus of Valsalva aneurysm were enrolled for attempted closure in our institution. Twenty patients (57.1%) underwent surgical repair and the other 15 patients (42.9%) underwent percutaneous closure.ResultsNineteen patients (95.0%) in the surgical group had complete closure and 14 patients (93.3%) in the percutaneous closure group were treated successfully (p = 0.681). Twelve patients with ruptured sinus of Valsalva aneurysm combined with subarterial ventricular septal defect (VSD) underwent surgical repair concomitantly. Two patients in the percutaneous closure group were treated for ruptured sinus of Valsalva aneurysm and perimembranous VSD using occluders concomitantly. One case of severe hemolysis developed 8 h after the procedure in the percutaneous closure group. One death and one case of patch leak occurred in the surgical group during hospitalization. The time of hospital stay in the percutaneous closure group was shorter than that in the surgical group (p = 0.004). The total medical cost of isolated ruptured sinus of Valsalva aneurysm in the percutaneous closure group was lower compared with that in the surgical group (p = 0.046). During a median follow-up of 15 months (2–240 months), there were no deaths, infective endocarditis, device embolization, or malposition.ConclusionsPercutaneous closure is an attractive alternative to surgery in selected patients with ruptured sinus of Valsalva aneurysm for the better clinical advantages and economic benefits. 相似文献
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28.
目的分析肾盂输尿管连接部梗阻(ureteropelvic junction obstruction,UPJO)患儿双J管置入膀胱失败的危险因素,为选择合适的治疗方法提供依据。方法回顾性收集山西省儿童医院2012年6月至2017年9月因UPJO行离断性肾盂输尿管再吻合术的96例患儿作为研究对象,年龄3个月至12岁,男78例,女18例。左侧60例,右侧23例,双侧13例。依据术中双J管置入成功与否分为成功组(n=74)和失败组(n=22)。结果失败组和成功组输尿管远端狭窄的比例分别是8/22(36.4%)和0/74(0.0%),差异有统计学意义(χ2=29.350,P<0.001)。失败组与成功组合并对侧肾积水的比例分别为7/22(31.8%)和7/74(9.6%),差异有统计学意义(χ2=6.648,P=0.010)。泌尿系统感染史、输尿管操作史、合并肾发育不良和腹痛史在两组间的差异无统计学意义(P>0.05)。结论双J管通过受阻时要考虑输尿管膀胱交界处狭窄,UPJO合并对侧肾积水预示着双J管置入失败的概率增大,治疗上宜选择传统的肾造瘘术。 相似文献
29.
介入技术清除心血管腔内异物 总被引:1,自引:0,他引:1
目的:评价经皮心血管腔内异物取出术处理多种介入诊断及治疗中异物残留并发症的临床价值,探讨不同情况下手术技术、技巧的合理运用。方法:自2002年3月~2004年11月,根据不同异物的种类、大小、残留位置、血管直径等特征,分别采用圈套器、网篮导管、异物钳、导丝自制圈套器等器械共处理介入诊断或治疗中异物残留事件的患者12例,包括各类脱落(脱载)封堵器4例(房间隔缺损封堵器2例、动脉导管未闭封堵器1例、室间隔缺损封堵器1例),各种残留的断裂导管4例(共计 9段),脱落导丝2根,其它残留物2例。所有异物取出过程均采用经皮介入方式完成。结果:12例患者心血管腔内残留异物均全部取出,并顺利完成既定诊断或介入治疗,无断片残留,无一例发生心包填塞或严重血管损伤,仅2例出现少量皮下淤血,未见其它不良反应。结论:经皮心血管腔内异物取出术能及时、有效地处理异物残留—这一介入诊断或治疗过程中的严重并发症,使患者避免了手术风险。 相似文献
30.
心导管术后假性动脉瘤超声引导压迫修复 总被引:17,自引:0,他引:17
目的 评价超声引导压迫修复心导管术后假性动脉瘤的治疗效果。方法 心导管术后导致假性动脉瘤 18例。利用 Philips ATL 5 0 0 0彩色多普勒超声诊断仪的凸阵探头行压迫修复。结果 18例假性动脉瘤均压迫修复成功 ,治愈率 10 0 %。结论 心导管术后假性动脉瘤超声引导压迫修复是一种简单、有效、经济、安全的方法 ,并可省时及减少患者痛苦 相似文献