经股动脉插管超选择肾动脉栓塞治疗顽固性血尿（附13例报告）

目的：探讨经股动脉超选择插管动脉栓塞术治疗各种原因引起的顽固性血尿临床疗效。方法回顾性分析13例经内科药物治疗无效的顽固性血尿患者经股动脉超选择插管肾动脉或髂内动脉栓塞（或同时化疗药灌注）的临床资料。结果13例患者中5例晚期未手术膀胱癌,2例膀胱癌术后,2例经皮肾镜取石,2例晚期肾癌（后证实为1例肾结核）,1例移植肾出血,1例阴茎海绵体血管瘤伴动脉畸形出血;术后1～3 d完全或基本止血,2例无效（1例通过抗结核4d止血1例膀胱全切双肾造瘘尿道残端出血未能止血）。结论经股动脉插管行动脉栓塞术治疗各种顽固性血尿有显著疗效。     

气管插管后持续性声嘶的原因及其治疗

目的：探讨气管插管后持续性声嘶的原因及评估杓状软骨复位的治疗效果。方法：对78例病人通过检查及疗效观察,确定声嘶原因,采用杓状软骨复位术及肉芽摘除术治疗。结果：78例中,71例为杓状软骨脱位（91．03％）,5例声带麻痹（6．41％）,2例喉内肉芽形成（2．56％）,杓状软骨脱位的病人全部治愈;声带麻痹治疗无效,喉肉芽形成的病人,1例治愈,另1例发音改善,结论：杓状软骨脱位,声带麻痹及喉内肉芽形成是气管插管后持续性声嘶的主要原因;杓状软骨复位术对杓状软骨脱位所致的声嘶疗效明显。     

中西医结合治疗输卵管性不孕60例分析

目的:研究中西医结合方法治疗输卵管性不孕的临床疗效。方法:输卵管性不孕患者共60例,随机分为两组,中西医结合治疗组及单纯西医治疗组,各30例。结果:输卵管性不孕患者其中西医结合综合疗法治疗组(治疗组)的临床疗效明显高于西医治疗组(对照组),差异有显著性(P<0.05)。结论:中西医结合治疗输卵管性不孕的疗效明显高于单纯西医治疗。     

儿童无创通气的局限性及气管插管介入时机选择

近年来,无创通气在儿童呼吸支持领域有了较快发展。无创通气无需气管插管,操作简便,对部分呼吸道疾病有较为满意的疗效。但是,无创通气不能完全替代有创机械通气。在有些疾病无创通气不仅有着较高的失败率,而且会因气管插管的延误导致病情恶化,增加患儿的病死率。在行无创通气之前需评估患儿是否适宜进行无创通气治疗。对于进行无创通气治疗的患儿需严密监护,动态观察生理指标和监测数据的变化,掌握好气管插管的时机,以免造成有创机械通气治疗的延误。     

IVF-ET术后宫内妊娠合并输卵管妊娠的诊治及妊娠结局分析

目的 分析体外受精-胚胎移植(1VF-ET)术后宫内妊娠合并输卵管妊娠的诊治及妊娠结局.方法 回顾性分析2014年3月至2019年6月于我院诊治的IVF-ET周期宫内妊娠合并输卵管妊娠患者50例的临床资料.分析其临床特征、超声表现、治疗方式及妊娠结局等.结果 (1)本研究50例患者中10例(20.0％)无明显症状,16...     

Premedication for tracheal intubation in neonates: confusion or controversy?

Tracheal intubation is performed frequently in the NICU and delivery room. This procedure is extremely distressing, painful, and has the potential for airway injury. Premedication with sedatives, analgesics, and muscle relaxants is standard practice for pediatric and adult intubation, yet the use of these drugs is not common for intubation in neonates. The risks and benefits of using premedications for intubating unstable newborns are hotly debated, although recent evidence shows that premedication for non-urgent or semi-urgent intubations is safer and more effective than awake intubations. This article reviews clinical practices reported in surveys on premedication for neonatal intubation, the physiological effects of laryngoscopy and intubation on awake neonates, as well as the clinical and physiological effects of different drug combinations used for intubation. A wide variety of drugs, either alone or in combination, have been used as premedication for elective intubation in neonates. Schematically, these studies have been of three main types: (a) studies comparing awake intubation versus those with sedation or analgesia, (b) studies comparing different premedication regimens comprising sedatives, analgesics, and anesthetics, and (c) case series of neonates in which some authors have reported their experience with a specific premedication regimen. The clinical benefits described in these studies and the need for pain control in neonates make the case for using appropriate premedication routinely for elective or semi-urgent intubations. Tracheal intubation without the use of analgesia or sedation should be performed only for urgent resuscitations in the delivery room or other life-threatening situations when intravenous access is unavailable.     

Laparoscopic salpingectomy in tubal pregnancy: prospective randomized trial using endoloop versus electrocautery

AIM: Ectopic pregnancy is conventionally managed by laparoscopic salpingectomy. Electrocautery has been used widely to secure hemostasis during salpingectomy. However, this method is associated with a risk of thermal injury to the visceral organs. Endoloop, a pre-tied suture used in laparoscopic surgery may be an alternative treatment tool and its potential use in the management of ectopic pregnancy is explored here. Our study aims to compare the effectiveness of the endoloop technique to electrocautery during laparoscopic salpingectomy for tubal pregnancy. METHODS: A prospective randomized controlled study was conducted over 24 months at the Hospital Universiti Kebangsaan Malaysia. One hundred and two patients with tubal pregnancy were randomized into two treatment groups: those treated with endoloop and those treated with electrocautery during laparoscopic salpingectomy. RESULTS: The use of an endoloop was associated with a shorter operating time (48.85 min +/- 21.019 vs 61.14 min +/- 22.603, 95% CI -20.864 to -3.724), lower visual analog scores for postoperative pain at day 1 (2.02 +/- 0.960 vs 2.74 +/- 0.828, 95% CI -1.074 to -0.368) and day 7 (0.85 +/- 0.802 vs 1.44 +/- 0.837, 95% CI -0.916 to -0.272), and lesser total analgesia required by patients at day 7 after the operation (7.65 +/- 6.119 vs 15.32 +/- 8.326, 95% CI -10.529 to -4.804). There was no significant difference in the ability to secure hemostasis when both techniques were compared. Duration of hospitalization (2.37 days +/- 0.817 vs 2.34 days +/- 0.519, 95% CI -0.245 to -0.296) and interval from operation to discharge were similar. CONCLUSION: The endoloop appeared to be as effective as electrocautery and is a safe alternative to electrocautery for laparoscopic salpingectomy in tubal pregnancy.