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无创搏动性血氧饱和度仪,已广泛地用于麻醉。监测的意义和价值,越来越引起人们的重视。腹部手术,采取硬膜外麻醉时,术中及术后常发生较严重的心血管及肺功能障碍,造成呼吸抑制低血氧症和血压下降,术后并发症亦相应增多。本文目的在于讨论麻醉手术中SPO2观察及临床意义。1病例选 相似文献
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Molecular-targeted therapy is a new method and tendency in the treatment of hepatocellular carcinoma (HCC). To date, sorafinib, a multi-targeted gent, is the only one proved to be effective in improving the survival of patients with advanced HCC. Sorafinib is also the first line systemic agent for advanced HCC. Other multi-targeted agents, such as sunitinib, are also proved to be effective. Erlotinib, gefitinib and eetuximab, which target epidermal growth factor receptor, show effectiveness but still need further investigation. Bevacizumab, which targets vascular endothelial growth factor and vascular endothelial growth factor receptor, shows excellent results and deserves more clinical trials. The effects of bortezomib, sirolimus and imatinib, which target other pathways, are still under investigation. The future studies of molecular-targeted therapy for HCC should be focused on the combination of different targeted medicine, and combination of molecular-targeted therapy and chemotherapy, as well as individualized therapy. 相似文献
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目的 比较经皮射频消融(PRFA)与再手术切除治疗单个直径≤3 cm的复发性肝癌的疗效.方法 回顾性分析1999年1月至2009年12月中山大学肿瘤防治中心收治的151例复发性肝癌(单个肿瘤直径≤3 cm)患者的临床资料,其中79例患者行PRFA(PRFA组),72例行肿瘤再手术切除(再手术切除组).比较两组患者的生存率、并发症发生率及肿瘤复发情况.计量资料比较采用t检验,计数资料比较采用x2检验,生存率计算采用寿命表法,生存曲线采用Kaplan-Meier法绘制,组间比较采用Log-rank检验.结果 PRFA组和再手术切除组并发症发生率分别为13%(10/79)和36%(26/72),两组比较,差异有统计学意义(x2=11.411,P<0.05).PRFA组和再手术切除组1~5年累积生存率分别为89.7%、75.2%、67.1%、61.5%、56.6%和86.0%、67.6%、53.6%、44.1%、40.2%,两组总体生存曲线比较,差异无统计学意义(x2=1.610,P>0.05).PRFA组4、5年累积生存率显著高于再手术切除组(x2=4.682,4.196,P<0.05).PRFA组肿瘤局部复发率为5%(4/79),再手术切除组切缘复发率为3%(2/72),两组比较,差异无统计学意义(x2=0.565,P>0.05).结论 PRFA治疗单个直径≤3 cm的复发性肝癌的长期疗效优于再手术切除,且具有微创的优势.Abstract: Objective To compare the efficacy of percutaneous radiofrequency ablation (PRFA) and repeat hepatectomy for solitary recurrent hepatocellular carcinoma (HCC) with the diameter≤3 cm. Methods The clinical data of 151 patients with recurrent HCC (diameter≤3 cm) who were admitted to the Cancer Center of Sun Yat-Sen University from January 1999 to December 2009 were retrospectively analyzed. Of all the patients, 79received PRFA (PRFA group) and 72 received repeat hepatectomy (repeat hepatectomy group). The survival rate, morbidity and recurrence of the tumor between the two groups were compared. All data were analyzed using t test, chi-square test or Log-rank test, and the survival of the patients were analyzed using the Kaplan-Meier method. Results The mobidities of the PRFA group and repeat hepatectomy group were 13% (10/79) and 36%(26/72), respectively, with a significant difference between the two groups (x2=11.411, P<0.05). The cumulative 1-, 2-, 3-, 4-, 5-year survival rates were 89.7%, 75.2%, 67.1%, 61.5%, 56.6% in the PRFA group, and 86.0%, 67.6%, 53.6%, 44.1%, 40.2% in the repeat hepatectomy group, with no significant difference between the two groups (x2=1.610, P>0.05). The cumulative 4-, 5-year survival rates of the PRFA group were significant higher than those in the repeat hepatectomy group (x2=4.682, 4. 196, P < 0.05). The local tumor recurrence rate of the PRFA group was 5% (4/79), and the incisal margin recurrence rate was 3% (2/72) in the repeat hepatectomy group, with no significant difference between the two groups (x2=0.565, P>0.05). Conclusion As a less invasive treatment method, PRFA is superior to repeat hepatectomy for solitary recurrent HCC with the diameter≤3 cm. 相似文献
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基于DICOM标准的医学图像存储与访问的研究 总被引:2,自引:0,他引:2
本文详细介绍了基于DICOM标准的医学图像文件格式和数据元素结构,介绍了我们在Windows环境下利用C 研制实现了一个基于DICOM标准的医学图像存储与访问系统,描述了系统中医学图像的存储结构与读写算法,该方案在一个实用的口腔数字影像系统中通过了验证。 相似文献
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射频消融联合经导管肝动脉栓塞化疗治疗肝癌疗效分析 总被引:7,自引:0,他引:7
目的 分析射频消融(RFA)联合经导管肝动脉栓塞化疗(TACE)治疗原发性肝癌的近期和远期疗效.方法 回顾性分析中山大学肿瘤防治中心肝胆外科2000年9月至2007年8月临床诊断为原发性肝细胞性肝癌114例,并行射频消融联合导管肝动脉栓塞化疗,对其进行生存分析.结果 全部病例1、2、3、4、5年总体生存率分别为90.4%、82.6%、73.2%、63.5%、49.1%、1、2、3、4、5年肿瘤无进展生存率分别为:77.1%、64.6%、54.6%、46.8%、36.4%.其中,病灶最大直径≤5 cm和5.1~7cm的1、2、3、4、5年生存率分别为95.5%、84.6%、73.1%、61.5%、50.6%及80.2%、64.9%、56.3%、45.3%、39.5%(P=0.041),单个病灶和多个(不多于3个病灶)病灶的1、2、3、4、5年生存率分另4为95.8%、89.1%、78.1%、67.1%、56.7%及80.0%、60.6%、46.6%、33.4%、21.5%(P=0.001).结论 RFA联合TACE是一种治疗肝癌的有效方法,直径≤5 cm、单个病灶的肝癌效果明显好于直径5.1~7 cm、多个病灶的肝癌.白蛋白水平、甲胎蛋白水平、肿瘤病灶边界是否清楚及病灶数目是影响联合治疗疗效的预后因素. 相似文献
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目的建立HPLC法测定生脉饮(党参方)中五味子醇甲的含量。方法采用十八烷基硅烷键合相为填充剂,以甲醇-水(60:40)为流动相,流速:1.0ml/min,检测波长:250nm。结果五味子醇甲的线性范围是33.36-333.6μg/ml,平均加样回收率是100.34%,RSD为0.56%。结论建立的定性定量方法简便,重现性好,线性良好,可作生脉饮(党参方)中五味子醇甲的定性定量鉴别方法。 相似文献
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开放性胫腓骨骨折是创伤急症,其中粉碎性骨折合并严重的软组织缺损时易发生感染,处理较为棘手。2006年1月-2008年3月,我院采用负压封闭引流(vacuum sealing drainage,VSD)治疗严重胫腓骨骨折并软组织缺损患者18例,取得较好效果,现报告如下。 相似文献
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目的 探讨多针双电极射频适形消融治疗肝癌的原理和近期疗效。方法 采用多针双电极射频消融肝肿瘤16例,全部采用超声引导下经皮穿剌,单纯射频消融治疗15例,射频消融联合瘤内无水酒精注射术治疗1例。结果 全组有12例患者治疗1次后影像学检查见肿瘤完全消融,4例首次射频治疗后1个月影像学检查见肿瘤消融不完全,2例再次行射频消融后肿瘤完全消融。甲胎蛋白阳性者6例治疗后全部转为阴性。结论 多针双电极射频不仅能增大消融范围,而且可以根据肿瘤形态适形消融肿瘤,是1种新的有效射频消融技术。 相似文献
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射频消融或联合经皮瘤内无水乙醇注射治疗小肝癌181例疗效分析 总被引:12,自引:2,他引:10
目的总结经皮射频消融(radiofrequency ablation, RFA)治疗小肝癌的疗效. 方法应用RFA治疗小肝癌(≤5 cm)181例,其中RFA治疗128例,经皮瘤内无水乙醇注射(percutaneous ethanol injection, PEI)-RFA治疗53例. 结果全部病例随访1~46月(中位时间17月).1,2,3年生存率分别为89.47%,74.42%,49.88%.单发病灶直径<3.0 cm组,1,2,3年生存率分别为94.63%,83.69%,70.47%;单发直径3.0~5.0 cm组为89.01%,69.39%,50.11%;多发病灶直径之和≤5.0 cm 组为78.28%,62.82%,0(P=0.041 9).RFA,PEI-RFA组1,2,3年生存率分别为88.23%,73.58%,45.97%和92.73%,76.83%,76.83%(P=0.316 8). 结论 RFA是一种安全有效的治疗手段,其结果受病灶大小和肿瘤数目的影响,与PEI联合应用或许可以提高疗效. 相似文献