目的 探讨不能手术治疗的恶性梗阻性黄疸给予介入治疗及术后行放射治疗的效果。方法 对笔者所在单位2006年6月至2011年6月期间收治的68例不能手术治疗的恶性梗阻性黄疸患者在X线导向下行经皮经肝胆道内外引流及金属内支架引流术，对胆道金属内支架置入术后行放射治疗的临床资料进行回顾性分析与总结。结果 行内外引流管引流28例次，金属内支架置入63例次。55例胆管癌患者胆道金属内支架置入后再行放射治疗，13例患者单纯行胆道内外引流管引流，全部患者的黄疸均得到改善。行胆管肿瘤组织活检51例和胆汁脱落细胞学检查68例，总阳性率为58.8% （40/68），术后0.5、1及3年存活率分别为95.6% （65/68），70.6% （48/68）和14.7% （10/68）。结论 恶性梗阻性黄疸在失去手术治疗机会后采用介入治疗解除胆管梗阻，减轻肝脏损害，胆道金属内支架置入术后再行放射治疗，有助于提高患者生存质量，延长患者生存时间。
【摘要】 目的 评估经桡静脉途径介入治疗冠状动脉病变的临床效果及安全性。 方法 将2003年7月-2009年7月接受治疗的174例冠状动脉病变患者随机分为对照组及观察组，对照组采用经典股动脉途径行冠脉介入治疗，观察组采用桡动脉途径介入治疗。观察两组患者穿刺时间、手术时间、穿刺成功率、手术成功率、并发症发生率。 结果 两组穿刺时间、手术时间、手术成功率差异无统计学意义，观察组并发症发生率少于对照组，穿刺成功率低于对照组。 结论 经桡动脉途径介入治疗冠状动脉病变能够减少手术后并发症的发生，临床疗效确切。【Abstract】 Objective To explore the clinical effect of intervention treatment through radial arteries on coranaria disease and its safety. Methods A total of 174 patients with coranaria disease from July 2003 to July 2009 were randomly divided into a control group and an observed group. The patients underwent the intervention treatment through femoral arteries in control group and through radial arteries in observed group. The duration and achievement rate of paracentesis and operation, and the incidence rate of complications were observed and the results in the two groups were compared. Results There were no differences in the duration and achievement rate of paracentesis and operation, and the achievement rate of operation between the control and observed groups. Compared with the control group, the incidence rate of complications and achievement rate of paracentesis were lower in observed group. Conclusion Intervention treatment through radial arteries on coranaria disease could reduce the post-operative complications with reliable therapeutic effect.
摘要:目的: 探讨经子宫动脉介入化疗栓塞治疗剖宫产切口瘢痕妊娠的应用价值。 方法 :回顾分析本院自2006年7月至2007年12月子宫动脉介入治疗的15例剖宫产切口瘢痕妊娠病例资料。 结果 :15例介入治疗均成功,其中8例化疗及明胶海绵栓塞后加用弹簧圈栓塞,术后阴道流血停止,孕囊明显缩小,血清人绒毛膜促性腺激素明显下降。术后清宫无大出血,病理检查示子宫瘢痕部位绒毛、蜕膜或胎盘组织,有变性、坏死。 结论 :经子宫动脉介入治疗剖宫产瘢痕妊娠,能有效预防和控制出血,减小清宫危险,并保留子宫,是剖宫产瘢痕妊娠安全、有效的治疗方法之一。 Abstract: Objective: To investigate the value of uterine artery chemotherapy and embolization in the treatment of cesarean scar pregnancy. Methods : Fifteen cases with cesarean scar pregnancy performed with uterine artery interventional therapy were retrospectively analyzed from July, 2006 to December, 2007 in our hospital. Results : All cases were treated successfully by uterine artery chemotherapy and embolism. All cases were embolized with gelatin sponge after chemotherapy, and eight with spring ring additionally. Vaginal bleedings were stopped after uterine artery embolization. Gestation sacculi deflated obviously. Serum human chorionic gonadotrophin descended dramatically. There was no severe vaginal bleeding by curettage after interventional therapy. The villi, decidua, or placental tissues were observed with degeneration and necrosis by pathology. Conclusion : Uterine artery chemotherapy and embolization was proved to be a safe and useful procedure for preventing and controlling vaginal bleeding, diminishing the risk of curettage and avoiding the loss of uterus.
目的分析比较肝血管瘤不同栓塞剂的栓塞治疗结果，寻找更为理想、合理的方法。方法对12例肝血管瘤16例次经皮穿刺超选择性肝动脉插管行栓塞治疗，其中单纯碘化油栓塞2例次，碘化油+明胶海绵颗粒栓塞6例次，碘化油+聚乙烯醇（PVA）微球栓塞5 例次，碘化油+平阳霉素栓塞3例次。随访10~32个月。结果全部病例均取得较肯定的疗效，无并发症发生。碘化油+平阳霉素和碘化油+PVA微球两种方法疗效稳定，复发率低，优于前两种方法。结论肝动脉栓塞治疗肝血管瘤疗效肯定，几种栓塞剂中，碘化油+平阳霉素及碘化油+PVA微球最佳。
With the prevalence of atrial fibrillation and the increasing use of intracardiac pacemakers, the incidence of isolated tricuspid regurgitation is gradually increasing. Severe isolated tricuspid regurgitation has a seriously negative effect on the survival rate and life quality of patients. As the major invasive therapy, surgery is not routinely carried out due to high perioperative mortality. This article attempts to summarize the etiology, natural course and adverse consequences of isolated tricuspid regurgitation, current treatment strategies, surgical indications and techniques, efficacy evaluation, prognostic factors and transcatheter treatment progress of isolated tricuspid regurgitation, aiming to provide references for cardiologists and further researches.
【摘要】 目的 探讨超声引导介入治疗卵巢囊肿的经验和方法。 方法 回顾性分析2004年8月－2009年12月超声引导下治疗卵巢囊肿180例，抽出囊肿内液后注入无水乙醇，观察临床疗效。 结果 179例（99.4%）治疗成功，无严重并发症发生，术后2年随访，3例（1.7%）复发。 结论 超声引导介入治疗卵巢囊肿疗效满意。【Abstract】 Objective To investigate the experiences and methods of interventional ultrasound treatment of ovarian cysts. Methods We retrospectively analyze the clinical data of 180 patients with ovarian cysts undergoing ultrasound-guided treatment. The clinical effect was observed after alcohol sclerosis therapy. Results A total of 179 patients (99.4%) were successfully treated by the ultrasound-guided aspiration without severe significant complications. Three patients (1.7%) recurred during the 24-month follow-up. Conclusion The clinical effect of ultrasound-guided aspiration and alcohol sclerosis was satisfactory.
目的探讨介入治疗在肝外伤术后胆道出血和胆瘘并发症中的作用。方法6例肝外伤术后胆道并发症（胆道出血1例，胆瘘3例，胆道出血合并胆瘘2例）采用介入治疗。胆道出血行肝动脉出血分支血管栓塞，胆瘘采用B超引导下穿刺置管引流。结果3 例胆道出血（肝动脉出血）血管成功栓塞，随访3~6个月未再发生出血。5例胆瘘行B超引导下穿刺置管引流，3例引流3~4周痊愈，1例因引流效果差改手术置管引流6周痊愈，1例伴脓肿者手术置管引流2个半月痊愈。结论介入治疗是处理胆道出血和胆瘘并发症的有效措施。
Objective To evaluate the therapeutic efficacy of percutaneous transhepatic portal vein catheterization and thrombolysis on acute superior mesenteric vein thrombosis. Methods The treatment and therapeutic efficacy of 7 cases of acute superior mesenteric vein thrombosis underwent percutaneous transhepatic portal vein catheterization and thrombolysis under ultrasound guidance from August 2005 to April 2009 were analyzed. Results All the patients succeeded in portal vein catheterization and no bile leakage or abdominal bleeding occurred during the procedure. The clinical symptoms such as abdominal pain, abdominal distension， and passing bloody stool relieved were relieved and liquid diet began at postoperative of day 2-5. Emergency operation was done in one case and there was no intestinal fistula. The angiography after the operation showed that the majority of thrombosis were cleared and the blood of portal vein and superior mesenteric vein flowed smoothly. During the follow-up of 3 months to 3 years, all the patients’ status maintained well and no recurrence occurred. Conclusion Treatment of acute superior mesenteric vein thrombosis by percutaneous transhepatic portal vein thrombolysis is safe and effective.