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201.
风心病并发脑栓塞病人的瓣膜替换术 总被引:11,自引:0,他引:11
报告64例风心病并发脑栓塞病人的瓣膜替换术。术前心功能I级10例、II级38例、IV级16例。伴房颤者54例。脑栓塞史半年以上者44例,6个月以内20例,其中2个月以内者14例。34例有程度不同的脑栓塞后遗症。行二尖瓣替换术47例、双瓣膜替换术17例,同期行三尖瓣环环缩或成形术43例。术中证实有左房血栓25例(39%)。手术死亡率6.25%。术后并发颅内出血和栓塞各1例。结果表明风心病并发脑栓塞病人的手术效果良好。作者指出,脑栓塞2个月以上者应尽早手术,2个月以内者则应根据脑栓塞程度、恢复情况及有无左房血栓,选择手术时机。并介绍了围术期的处理经验。 相似文献
202.
完全性肺静脉异位引流的手术治疗经验 总被引:15,自引:1,他引:14
为评估影响完全性肺静脉异位引流(TAPVD)手术纠治的因素,本组纳入了28例在中度低温体外循环和15例在深低温停循环下手术纠治者。结果手术死亡4例,死亡率9.3%。随访32例,2例肺静脉回流梗阻分别于术后5个月和2年3个月死亡。结论认为,TAPVD必须早期手术防止肺血管阻塞性病变;术后定期随访;改进手术方法,防止心房内补片粘连所致肺静脉回流梗阻。 相似文献
203.
Symptomatic and Clinical Improvement in Morbidly Obese Patients with Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass 总被引:3,自引:0,他引:3
Background: Patients who suffer with gastroesophageal reflux Disease (GERD) endure a worsening of symptoms as their weight
increases. When medical treatment of this condition in the morbidly obese patients fails, surgical intervention may be indicated.
Choosing a procedure which not only helps achieve weight control but which also relieves symptoms and complications of GERD
is the goal. We present a review of patients who have undergone Roux-en-Y Gastric Bypass (RYGBP) and related procedures for
this disease. Methods: One hundred eighty-eight patients undergoing surgery for morbid obesity and for GERD in 1992-1996 were
contacted by mail or phone. All of these patients had undergone preoperative esophagogastroduodenoscopy to grade the severity
of their disease. Their preoperative symptoms were compared to those experienced postoperatively. Results: One hundred thirty
patients underwent a RYGBP with modified Hill fundopexy, 22 patients underwent a distal gastrectomy with modified Hill fundopexy,
8 patients underwent distal gastrectomy alone and 28 patients underwent RYGBP alone. There have been no deaths. There were
nine surgical complications, eight early and one at 2.5 years postoperation. Follow-up is 4-48 months. The average BMI dropped
from 43 to 30.2 kg/m2. Whereas all patients were on some form of medical therapy before surgery, only 14 reported the need for medication postoperatively.
Conclusions: Surgical intervention for weight control and treatment of GERD has been highly successful in our experience both
with respect to weight control and to the reduction of reflux symptoms. Depending upon endoscopic and operative findings a
RYGBP with or without an antireflux procedure can provide dramatic improvement. Gastrectomy with antireflux modifications
is appropriate in selected cases. 相似文献
204.
205.
We assessed the mechanics and morphology of the lung in 165 rats treated neonatally with either room air (RA), O2, RA + steroids, or O2, + steroids. Newborn Sprague-Dawley male rats were randomly assigned to these groups. O2,-exposure (0.96-1.0 FiO2 lasted 5 days, and dexamethasone treatment consisted of eight daily S.C. injections of drug or buffer in successive doses of 0.5,0.4.0.3,0.2,0.1, 0.1. 0.1. and 0.1 mg/kg. At 58 days, right ventricular systolic pressure (RVP) was measured. At 60 days, all rats were sacrificed for obtaining lung weight and DNA, saline pressure-volume (P-V) curves, and morphometry. We weighed right ventricles (RV) and left ventricles + septa (LV). Hyperoxia alone did not, but steroid decreased survival rate to 79.4% (95.3% in RA rats, P < 0.02). Only 21 of 40 (52%) O2 + steroids rats survived, less than in both RA groups (P < 0.001). RV weight, RVP and muscularization of alveolar duct arteries were significantly increased in O2 vs. RA rats. In RA + steroids rats, weight of the LV was decreased but RV, RVP, and lung vasculature were not affected. These effects were additive in the O2 + steroid group. Wet lung weights and DNA were increased for RA + steroid rats over all others. O2 and steroids shifted the P-V curve to the left and O2+ steroids still further. Maximal lung volume increased significantly with RA + steroids and still further in O2 + steroids but not in O2 alone. O2 and steroids significantly increased the mean linear intercept and O2 + steroids even more so. In O2- and steroid-treated rats, the parenchymal air space increased. In conclusion, both neonatal hyperoxia and steroid administration caused aberrations in the growth of lung and connective tissue. The effects of the two were additive. The vascular system, maximal lung volume, and DNA responded differently, presumably by different modes of action. Pediatr Pulmonol. 1993; 16:81–88. © 1993 Wiley-Liss, Inc. 相似文献
206.
探讨儿童间歇性深吸气症的诊断及治疗.方法 对我院1990~1996年以间歇性深吸气为主诉就诊的60例儿童进行病因、临床表现、诊断方法和主要治疗措施等方面的临床分析.结果 此症患儿有心理障碍和情绪因素的占63.3%,其中最重要的是家庭和学校环境因素的影响,习惯因素占20%.另外,还有气质因素的影响等.并提出本症的诊断依据.通过心理治疗,绝大多数病例可以治愈.结论 本症是一种较常见的心因性疾病,提出的诊断依据是实用的,心理治疗可获得满意疗效. 相似文献
207.
成人高原心脏病临床分型的探讨 总被引:1,自引:1,他引:0
本文总结了680例成人高原心脏病临床资料,依照其临床表现、X线、心电图等项检查,提出了临床上较为实用的诊断和分型意见。 相似文献
208.
Gail Pairitz Jarvik Terri H. Beaty Paul R. Gallagher Paul M. Coates Jean A. Cortner 《Genetic epidemiology》1993,10(4):257-270
A sample enriched for familial combined hyperlipidemia (FCHL) was examined for evidence of an association between genotype at an apolipoprotein B (apoB) elevating locus defined by complex segregation analysis and FCHL. Complex segregation analysis detected a locus with a large effect on plasma apoB levels and was used to compute the most probable genotype of family members. None of the 35 normolipidemic adults carried a copy of the allele associated with elevated apoB levels, yet 58% of the 109 adults with FCHL carried 1 (29%) or 2 (28%) copies. Two of 28 (7%) normal children had 1 copy of this allele and none had 2 copies, while 88 of 182 (48%) children with FCHL had 1 (26%) or 2 (22%) copies. Further, 4l of 48 (85%) individuals classified as having hyperapobetalipoproteinemia did not carry a copy of this “elevated apoB” allele. Therefore, the presence of the allele associated with elevation of apoB level is highly predictive of FCHL and this association cannot be explained solely by the presence of elevated apoB levels in FCHL, suggesting that the locus controlling apoB levels may play an etiologic role in FCHL. © 1993 Wiley-Liss, Inc. 相似文献
209.
1962~1986年25年间,经尸检病理确诊的29例新生儿肺出血,以早产儿和低出生体重儿为主,生后一周内发病者27例。本组20例有窒息史,口鼻有血性分泌物流出者17例。本文描述了新生儿肺出血的临床表现和病理特征,以及对新生儿肺出血的病因作了讨论。 相似文献
210.
Dennis J. Murphy 《Drug development research》1994,32(4):237-246
The known effects of drugs from a variety of pharmacologic/therapeutic classes on the respiratory system and worldwide regulatory requirements support the need for conducting respiratory evaluations in safety pharmacology. The objective of these studies is to evaluate the potential for drugs to cause secondary pharmacologic or toxicologic effects that influence respiratory function. Changes in respiratory function can result either from alterations in the pumping apparatus that controls the pattern of pulmonary ventilation or from changes in the mechanical properties of the lung that determine the transpulmonary pressures (work) required for lung inflation and deflation. Defects in the pumping apparatus are classified as hypo- or hyperventilation syndromes and are evaluated by examining ventilatory parameters in a conscious animal model. The ventilatory parameters include respiratory rate, tidal volume, minute volume, peak (or mean) inspiratory flow, peak (or mean) expiratory flow, and fractional inspiratory time. Defects in mechanical properties of the lung are classified as obstructive or restrictive disorders and can be evaluated in animal models by performing flow-volume and pressure-volume maneuvers, respectively. The parameters used to detect airway obstruction include peak expiratory flow, forced expiratory flow at 25 and 75% of forced vital capacity, and a timed forced expiratory volume, while the parameters used to detect lung restriction include total lung capacity, inspiratory capacity, functional residual capacity, and compliance. Measurement of dynamic lung resistance and compliance, obtained continuously during tidal breathing, is an alternative method for evaluating obstructive and restrictive disorders, respectively, and is used when the response to drug treatment is expected to be immediate (within minutes post-dose). The species used in the safety pharmacology studies conducted in our laboratory are the same as those used in toxicology studies since pharmacokinetic and toxicologic/pathologic data are available in these species. These data can be used to help select test measurement intervals and doses and to aid in the interpretation of functional change. The techniques and procedures for measuring respiratory function parameters are well established in guinea pigs, rats, and dogs. 相似文献