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目的:通过对高血压脑出血患者采用微创血肿穿刺术治疗,评估其疗效及对炎性因子表达水平的影响。方法:对本院74例高血压脑出血患者依据建档顺序分2组,各37例。对照组采用小骨窗血肿清除术,研究组采用微创血肿穿刺术,术后3~6个月进行随访。对比两组手术情况、临床疗效、并发症发生率,评估术前及末次随访时两组神经功能缺损评分(NIHSS)、日常生活能力评分(BI)及检测其血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、高敏C反应蛋白(hs-CRP)]水平变化。结果:①手术情况:研究组手术用时(12.34±5.54)min,术中失血量(40.31±10.27)mL,下床活动时间(5.04±2.82)d,住院时间(16.30±2.61)d,均少于对照组,差异有统计学意义(P<0.05);②神经功能及日常生活能力:术前两组NIHSS评分及BI评分比较,差异无统计学意义(P>0.05),术后研究组NIHSS评分[(4.08±1.35)分]低于对照组[(6.49±1.13)分],BI评分[(60.63±8.08)分]高于对照组[(46.82±6.81)分],差异有统计学意义(P<0.05);③临床疗效:研究组治疗有效率91.89%(34/37)高于对照组72.97%(27/37),差异有统计学意义(P<0.05);④血清炎性因子:术前两组hs-CRP、IL-6、TNF-α水平比较,差异无统计学意义(P>0.05),术后1周2组血清炎性因子水平均较术前降低,且研究组hs-CRP(7.14±3.05)mg/L、IL-6(14.18±3.16)ng/L、TNF-α(40.10±3.03)μg/L,低于对照组[(12.11±3.35)mg/L、IL-6(27.19±3.98)ng/L、TNF-α(53.22±3.32)μg/L],差异有统计学意义(P<0.05);⑤并发症发生率:研究组并发症发生率5.41%(2/37)低于对照组24.32%(9/37),差异有统计学意义(P<0.05)。结论:采用微创血肿穿刺术治疗高血压脑出血效果显著,可有效改善患者神经功能及日常生活能力,减少手术用时及术中失血量,降低血清炎性因子水平,提高治疗效果,且安全性较高。 相似文献
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Lei Gao Jieming Lu Peipei Zhang Zhi-Nuan Hong Mingqiang Kang 《Journal of gastrointestinal oncology.》2022,13(2):478
BackgroundMore and more evidence has confirmed the efficacy and safety of immunotherapy drugs, such as camrelizumab and pembrolizumab. There are several phase-I/II studies showing that toripalimab has an acceptable safety profile and promising clinical activity in patients with advanced solid tumors. To further confirm its efficacy and safety, the aim of the study was to evaluate toripalimab combined with docetaxel and cisplatin neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma (ESCC).MethodsThis study was an investigator-initiated, open-label, non-randomized, single-arm, single-center phase II trial (registration number: ChiCTR2100052784). The patients eligible for inclusion criteria at Fujian Medical University Union Hospital from October 2019 to October 2020 were included in this study. Patients who were suitable for surgery underwent minimally invasive esophagectomy (MIE) within 4–6 weeks after neoadjuvant therapy. Pathological complete response (pCR) and adverse events (AEs) were the primary end points. Secondary endpoints included R0 resection rate, major pathological response (MPR), interval to surgery, and 30-day complications.ResultsA total of 20 patients were enrolled from October 2019 to October 2020. All patients successfully completed 2 cycles of neoadjuvant therapy. Treatment-related AEs were common during neoadjuvant therapy, with leucopenia the most frequently occurring AE (4/20, 25%). With respect to immune-related AEs, immune dermatitis occurred in 2 patients, including 1 patient with grade I and 1 patient with grade III. Based on radiologic evaluation, the objective response rate (ORR) was 70% (14/20). Twelve patients underwent McKeown MIE. The pCR rate of the primary tumor was 16.7% (2/12), and the MPR rate of the primary tumor was 5/12 (41.7%). The mean interval to surgery was 33.2 days, and no patients experienced delayed surgery due to treatment-related AEs. Pneumonia was the most common 30-day postoperative complication (3/12, 25%). Anastomotic leakage (AL) only occurred in 1 patient during the hospital stay. There were no treatment- or surgery-related deaths.ConclusionsBased on our results, toripalimab combined with docetaxel and cisplatin as a novel neoadjuvant therapy was safe and effective in locally advanced ESCC. 相似文献
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目的:探讨超声定位在经皮肾镜取石术中的应用效果。方法选取我院2014年1月至2015年3月期间行经皮肾穿刺钬激光碎石术患者215例。所有患者采用超声定位引导下行经皮肾穿刺,建立通道,术中协助处理残余结石。结果所有患者均成功建立经皮肾通道,行钬激光碎石清石,其中1针穿刺成功185例,2针穿刺成功21例,多针穿刺成功9例。一步扩张法建立通道后置入内窥镜行钬激光碎石术,一期结石清除率为75.3%(162/215),二期结石清除率为92.1%(198/215)。术后出现2例继发性出血,经行超选择性肾动脉栓塞后治愈。术后住院时间6~9 d,平均7.5 d。随访全部病例2~12个月,腰部疼痛、血尿等症状均消失,无结石复发。结论超声定位引导下经皮肾穿刺具有使用灵活方便、定位准确、成功率高的优点。其可避开穿刺路径上的脏器及帮助术中寻找结石,但超声较X线直观性差,需要掌握一定的操作技巧才可灵活使用。 相似文献
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《Hospital practice (1995)》2013,41(1):232-235
AbstractA coronary artery chronic total occlusion (CTO) represents a coronary artery that has been occluded for a long period of time, typically months. Coronary artery CTOs are common and occur in approximately one-third of patients referred for coronary angiography. Revascularization of CTO is technically challenging and has historically been associated with lower procedural success rates and higher complication rates. Technical success of CTO revascularization has significantly improved given remarkable advances in interventional cardiology over the past 3 decades. However, the decision to perform CTO revascularization remains a dilemma, given the lack of robust clinical evidence to support its use. 相似文献
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