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脂联素是脂肪细胞分泌的脂肪因子之一,与代谢综合征的各组分关系密切,成为近来研究的热点。本文就脂联素与冠心病及其危险因素关系的最新研究进展进行综述。 相似文献
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目的:分析对比青年与中老年主动脉夹层患者的临床资料,了解青年主动脉夹层患者的临床特点。方法:回顾性分析542例主动脉夹层患者的临床资料,根据年龄将其分为青年组(年龄≤44岁)及中老年组(年龄>44岁),其中青年组126例,中老年组416例。结果:2组在起病是否有诱因、入院是否有疼痛方面无明显统计学差异。与中老年组相比,青年组中高血压患者比例低(X2=15.22,P<0.001),吸烟者比例低(X2=10.67,P=0.001),饮酒者比例低(X2=4.58,P=0.038),Marfan综合征者比例高(X2=108.56,P<0.001),既往有糖尿病病史、冠心病病史者2组无明显统计学差异,青年组入院时平均心率较快(P=0.001),甘油三酯(TG)水平较高(P=0.001),入院后血压控制至达标水平(<120/80mmHg)所需的时间较长(P=0.042),青年组行介入及外科手术治疗者的比例较高(X2=27.04,P<0.001),入院时收缩压(SBP)、舒张压(DBP)、胆固醇(TC)、低密度脂蛋白(LDL)、肌酐(Cr)、尿素氮(BUN)、住院期间病死率等方面2组之间均无明显统计学差异。结论:与中老年主动脉夹层患者相比,青年主动脉夹层患者有其自身的临床特点,青年主动脉夹层患者采取介入及外科手术比例较高。 相似文献
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目的:探讨主动脉夹层首发症状与内膜原发破口位置和撕裂范围的关系。方法:回顾性总结931例主动脉夹层患者的首发症状、疼痛部位、是否有转移性疼痛、撕裂范围等情况,分析不同症状与原发破口和撕裂范围的关系。结果:疼痛占夹层首发症状的91.2%,其中以胸痛(40.3%)、胸背痛(25.9%)和腹痛(11.7%)最多见,17.6%的患者合并有转移性疼痛。表现为无痛(包括晕厥、胸闷、气短)或仅为胸痛症状的患者以A型夹层多见(均P0.05)。而以背痛、腹痛、腰痛等为首发症状的多见于B型夹层(均P0.05),且此类患者的内膜撕裂终点多位于腹主动脉及以下血管,而首发症状为头、颈或咽喉部疼痛的患者夹层撕裂范围多局限于胸降主动脉。结论:主动脉夹层症状呈多样性特点,首发症状与原发破口位置和撕裂范围之间存在规律性,此有助于对急诊疑似主动脉夹层进行初步的诊断。 相似文献
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患者男,65岁.横结肠造口术后8年,伴造口及造口旁膨出6年且逐渐加重入院.患者8年前接受2次痔注射术后肛门狭窄并急性肠梗阻在外院急诊行横结肠双腔造口.肠造口后2年出现造口及造口旁膨出且逐渐加重,当地医院多次就诊肛门狭窄无法有效治疗造口不能还纳,因明显腹胀并严重影响生活到我科就诊. 相似文献
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吻合器痔上粘膜环切术对肛肠动力学影响的临床研究 总被引:1,自引:0,他引:1
目的:比较吻合器痔上粘膜环切术(PPH手术)与传统痔外剥内扎术对肛门直肠动力学影响的差异。方法:采用瑞典生产的肛肠测压仪测量PPH术和传统常规手术术前及术后3月患者的肛管静息压(RASP)、肛管收缩压(MASP)、直肠感知阈值(RSTV)、直肠最大容量阈值(RMTV)的变化,切除标本送病理检查,观察有无肌肉组织和痔组织。结果:PPH术后肛管RASP较术前明显降低(P〈0.01),肛管MASP、直肠RSTV、直肠RMTV较术前有轻微降低但无显著性差异(P〉0.05),肛管RASP在PPH手术组恢复至正常水平,而在传统手术组肛管MASP、直肠RSTV、直肠RMTV较术前和正常值均有显著性降低。病理检查切除标本中无肌肉组织,仅含少量痔组织。结论:PPH手术使重度痔患者的肛管高压明显改变,使肛垫得到保护,而对直肠功能影响较小,使直肠功能得到最大保护。 相似文献
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目的:混合痔术后口服迈之灵对术后水肿、出血、疼痛以及疗程等情况的观察.方法:采用随机对照的方法,治疗组48例患者在术前术后常规治疗的基础上,自手术当天开始连服迈之灵300 mg,每天2次,共10 d.对照组50例患者给予术前术后常规的治疗.术后4 d观察两组患者肛门水肿、出血、疼痛的情况及疗程时间.结果:两组患者术后水肿、出血、疼痛比较,治疗组优于对照组(P<0.05).结论:混合痔术后口服迈之灵可有效缓解水肿、出血、疼痛等症状及缩短了疗程. 相似文献
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目的 评价Altemeier手术在嵌顿性直肠脱垂急诊处理中的应用价值.方法 回顾性分析经Altemeier手术急诊治疗的9例嵌顿性直肠脱垂患者的临床资料.结果本组9例患者均行经会阴直肠乙状结肠部分切除术,手术时间1.0~1.5(平均1.7)h,术中失血50~200(平均109)ml,术后首次排便时间1~6(平均2.8)d,总住院时间3~10(平均5.3)d.术后无吻合口瘘、腹腔感染、泌尿生殖功能障碍等并发症发生,1例患者术后直肠系膜血栓形成,1例患者出现肛门不适症状.术后经5个月至6.5年(平均3.5年)的随访,所有患者未出现再次脱垂.术后6个月肛门功能Kirwan Ⅰ级8例,Ⅱ级1例;所有患者均感到满意.结论 Altemeier手术治疗嵌顿性直肠脱垂术后肛门功能良好,可作为嵌顿性直肠脱垂急诊处理的首选术式之一. 相似文献
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Objective To study the combination of trans-anal intersphincteric resection and trans- abdominal total mesorectal excision for anus-retained ultra-low rectal tumors. Methods Clinical data of 34 ultra-low rectal tumor patients without external anal sphincter involved, who underwent the combination surgery, were retrospectively analyzed Results The distance from the distal incisal margin of the rectum to the inferior margin of the tumor ranged from 1.8 cm to 3.0 cm on an average of 2. 1 cm. For pathological types, there were 23 cases of adenocarcinoma (9 well differentiated and 14 moderately differentiated), 1 papillary carcinoma, 2 rectal stromal tumor, 5 rectal villous adenoma with canceration and 3 giant villous adenoma. For pathological stages, there were 18 eases at stage pTNM Ⅰ , 5 at Ⅱ A, 1 at Ⅱ B, 4 at ⅢA, 1 at ⅢB and for T grading, there were 15 cases at stage T1, 5 at T2, 8 at T3, 1 at T4. In these 34 patients, there were 3 cases with postoperative anastomotic stenosis, 2 with postoperative anastomotic rupture, 2 with rectovaginal fistula and no operative death. Because of the dysfunction of bowel control, bowel frequency varied from 3 to 12 in the early stage after operation, but with the recovery of anus function, bowel frequency decreased and ranged form 1 to 5 times a day and the time of formed bowel control could be more than 5 min in 6-12 months after operation. However, patients underwent total resection of internal anal sphincter still suffered from incontinence of loose stool after 1 year. After operation, anastomotic recurrence was found in 1 case in 5 months, liver metastasis in 1 case in 10 months and 28 months respectively, cardiac sudden death in 1 case in 26 months. Conclusion The combination of trans-anal ISR and trans-abdominal TME for anus-retained ultra low rectal tumor is not only coincident with radical tumor principle but also retains the function of anus, on the premise of the strict indication. 相似文献
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Objective To study the combination of trans-anal intersphincteric resection and trans- abdominal total mesorectal excision for anus-retained ultra-low rectal tumors. Methods Clinical data of 34 ultra-low rectal tumor patients without external anal sphincter involved, who underwent the combination surgery, were retrospectively analyzed Results The distance from the distal incisal margin of the rectum to the inferior margin of the tumor ranged from 1.8 cm to 3.0 cm on an average of 2. 1 cm. For pathological types, there were 23 cases of adenocarcinoma (9 well differentiated and 14 moderately differentiated), 1 papillary carcinoma, 2 rectal stromal tumor, 5 rectal villous adenoma with canceration and 3 giant villous adenoma. For pathological stages, there were 18 eases at stage pTNM Ⅰ , 5 at Ⅱ A, 1 at Ⅱ B, 4 at ⅢA, 1 at ⅢB and for T grading, there were 15 cases at stage T1, 5 at T2, 8 at T3, 1 at T4. In these 34 patients, there were 3 cases with postoperative anastomotic stenosis, 2 with postoperative anastomotic rupture, 2 with rectovaginal fistula and no operative death. Because of the dysfunction of bowel control, bowel frequency varied from 3 to 12 in the early stage after operation, but with the recovery of anus function, bowel frequency decreased and ranged form 1 to 5 times a day and the time of formed bowel control could be more than 5 min in 6-12 months after operation. However, patients underwent total resection of internal anal sphincter still suffered from incontinence of loose stool after 1 year. After operation, anastomotic recurrence was found in 1 case in 5 months, liver metastasis in 1 case in 10 months and 28 months respectively, cardiac sudden death in 1 case in 26 months. Conclusion The combination of trans-anal ISR and trans-abdominal TME for anus-retained ultra low rectal tumor is not only coincident with radical tumor principle but also retains the function of anus, on the premise of the strict indication. 相似文献