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find Keyword "动脉栓塞" 46 results
  • Traditional Chinese Medicine plus Transcatheter Arterial Chemoembolization for Unresectable Hepatocellular Carcinoma: A Meta-analysis of Randomized Controlled Trials

    Objective To evaluate the effectiveness and safety of traditional Chinese medicine (TCM) plus transcatheter arterial chemoembolization (TACE) compared with TACE alone, in the treatment of unresectable hepatocellular carcinoma (HCC). Methods The Cochrane Library, MEDLINE, EMBASE, CANCERLIT, CBM, CNKI and VIP were searched electronically. Relevant journals and conference proceedings were also handsearched. The quality of included studies was assessed according to the criteria recommended by the Cochrane Handbook for Systematic Reviews of Interventions, and meta-analyses were performed for homogeneous studies using The Cochrane Collaboration’s RevMan 4.2.10 software. Subgroup analyses by frequency of TACE (lt;3 or ≥3 times) were also performed. Results Thirty seven trials, all published in China, involving 2 653 participants were included. The quality of 2 studies was graded B (medium) and that of the other 35 was graded C (low). Meta-analyses showed that TCM plus TACE, compared with TACE alone, could significantly improve survival, tumor response (complete and partial), quality of life and clinical symptoms, and was also associated with a lower incidence of adverse reactions. Subgroup analyses indicated that, patients with less than three TACE had more significant improvement in survival and clinical symptoms, while patients with three or more TACE had more significant improvement in tumor response and quality of life. The incidence of adverse reactions was similar between these two different frequencies of TACE. Conclusions The treatment regimen of TCM plus TACE is superior to TACE alone in patients with unresectable HCC. As the existing data have a high risk of bias, the current evidence is insufficient to define the efficacy of the combination treatment, and further large-scale, high-quality randomized controlled trials are needed.

    Release date:2016-08-25 03:36 Export PDF Favorites Scan
  • 子宫动脉化疗栓塞在子宫切口妊娠中的研究进展

    【摘要】 剖宫产术后子宫切口妊娠(cesarean scar pregnancy,CSP)是指孕卵或胚囊着床于剖宫产术后子宫切口瘢痕处的一种少见而危险的异位妊娠,是剖宫产的远期并发症之一。若诊治不当,有引起子宫破裂和无法控制阴道大出血的风险,危及患者生命。近年来,随着微创介入治疗技术的发展,子宫动脉栓塞术被广泛用于CSP的治疗,并且可联合甲氨蝶呤动脉灌注,迅速有效止血,保留患者子宫和生育功能,为以后清宫治疗提供了必要条件,安全有效。现就子宫动脉化疗栓塞在CSP中的研究进展阐述如下。

    Release date:2016-08-26 02:18 Export PDF Favorites Scan
  • Treatment of Acute Limb Arterial Embolism and Influencing Factors of Its Prognosis

    Objective To present and summarize the data concerning the treatment and prognosis of acute limb arterial embolism in West China Hospital. Methods Forty three patients with 52 limbs of acute arterial embolism were treated in West China Hospital from January 2003 to March 2006. There were 15 males and 28 females, aging from 26 years to 77 years 〔(58.88±13.90) years〕. The diagnosis was based on clinical manifestations and results of color Doppler sonography or DSA. The follow-up ranged from 1 month to 39 months. The following factors, which might influence the prognosis, were analysed through multiple linear regression of SPSS 10.0: age, sex, uper limb or lower limb, location of embolus, ischemic time, clinical categories of acute limb ischemia, history of smoking, atherosclerosis and other combined diseases, pervious history of acute limb arterial embolism, operative or nonoperative treatment, and postoperative complications. Results  Clinical categories of acute limb ischemia include: Ⅰ (n=0),Ⅱa (n=16), Ⅱb (n=29), Ⅲ (n=7). The ischemic time varied from 3 h to 2 weeks. The sources of embolus: heart (n=39), vessle (n=7), iatrogenic origin (n=1), unidentidied origin (n=5). The therapies included embolectomy (n=38), catheter-directed thrombolysis (n=2) and medical treatment (n=12). The following postoperative complications occured: compartment syndrome (n=12), respiratory failure (n=3), alkalolsis (n=3), acute renal failure (n=2), wound infection (n=2) and pulmonary infection (n=1). Two patients died of cerebral infarction in hospital and one patient died of heart failure 3 months after discharge. Thirty-eight patients with 45 diseased limbs were followed up. The results were excellent in 13 limbs, good in 15 ones, fair in 8 ones and poor in 9 ones. The statistically significant influencing factors of prognosis include ischemic time, clinical categories of acute limb ischemia and history of smoking (P<0.05). Conclusion  The operation of embolectomy is the main treatment of acute limb arterial embolism. In selected patients, catheter-directed thrombolysis and medical treatment could be used to alleviate the limb ischemia. The treatment against the etiological factors should not be ignored. The prognosis of this disease could be influenced by ischemic time, clinical categories of acute limb ischemia and history of smoking.

    Release date:2016-08-28 04:08 Export PDF Favorites Scan
  • Treatment of Myonephropathic-Metabolic Syndrome Caused by Acute Arterial Embolism

    目的  总结急性动脉栓塞致肌病肾病代谢综合征(myonephropathic-metabolic syndrome,MNMS)的诊治经验。方法 回顾性分析2005年1月至2006年3月由急性动脉栓塞导致的11例MNMS的临床资料。结果 5例存活(保肢4例); 2例死于高钾血症引起的心搏骤停,4例死于以急性肾功能衰竭为首发的多器官功能不全综合征。结论 急性动脉栓塞一旦确诊,尽早手术。MNMS是急性动脉栓塞的常见、严重并发症,急性动脉栓塞时尽快重建血流、骨筋膜室综合征尽早行筋膜室切开术及坏疽肢体尽早截肢是预防和治疗MNMS的关键。

    Release date:2016-08-28 04:08 Export PDF Favorites Scan
  • Emergency Transcatheter Arterial Embolization for Spontaneous Rupture of Hepatocellular Carcinoma(Report of 38 Cases)

    目的探讨急诊肝动脉栓塞(TAE)治疗原发性肝癌破裂出血的临床效果和意义。方法收集我院近10年来收治的38例原发性肝癌破裂出血的资料,按治疗方法不同分为保守治疗组、急诊手术组及急诊TAE治疗组,比较3组间的输血量、术后肝功恢复率、住院时间及死亡率。结果急诊TAE治疗组与保守治疗组及急诊手术组比较,输血量少,术后肝功恢复率高,住院时间短和死亡率低,差异有统计学意义(Plt;0.05,Plt;0.01)。结论对于失去根治切除机会或不能耐受手术的原发性肝癌破裂出血的患者,可首选急诊TAE方法,并且还可为一部分患者将来行二次根治切除手术创造机会。

    Release date:2016-08-28 04:49 Export PDF Favorites Scan
  • ANEXPERIMENTAL STUDY OF 131I—LIPIODOL HEPATIC ARTERIAL EMBOLIZATION.

    131I was labeled on lipiodol molecule by an iodine exchange reaction. The labeling rate was 95%. No dehalogenation was detected within 15 days at room temperature or after slerilization. Animal experiments showed that after hepatic arteial injection, 131I-lipiodol was selectively accumulated in the embolizated local area. No increased acti-vity was observed in thyroid, lung or other areas in the body. The blood radioactivity per ml was 0.09±0.04% of the injectd dose. The result suggest that 131I-lipiodol is very stable and suitable for clinical application.

    Release date:2016-08-29 03:44 Export PDF Favorites Scan
  • Diagnosis and Treatment of Spontaneous Rupture of Bronchial Artery Aneurysm in Mediastinum

    Objective To summarize the diagnosis and treatment of spontaneous rupture of bronchial artery aneurysm in mediastinum.Methods Two cases diagnosed as bronchial artery aneurysmby methods of enhanced-CT plus independent post-procedure techniques and bronchial artery selective angiography were cured by different intervention surgeries in our hospital. The clinical data of these two patients and different interventional treatments were summarized.Results Case 1 was a 38-year old male.He was given coils and PVC micro-particles, and bronchial artery selective angiography showed distal vascular occlusion and aneurysmsize decreased. Case 2 was a 59-year old female. She was also given coils, but digital subtraction angiography showed bleeding of bronchial artery whose opening was near to the aorta.Then a stent was implanted in the descending aorta to isolate the bleeding bronchial artery, and bronchial artery selective angiography showed blood flow was completely blocked. Conclusions Enhanced-CT plus vascular three-dimensional reconstruction and bronchial artery selective angiography is a chief method to diagnose bronchial artery aneurysm. Bronchial artery embolization and/ or isolating surgery with covered stent are minimally invasive, efficient, trustworthy treatment for spontaneous rupture of bronchial-artery aneurysmin mediastinum. Different techniques of interventional treatment are selected depending on lesion.

    Release date:2016-09-13 03:50 Export PDF Favorites Scan
  • Diagnosis and Treatment for Acute Pulmonary Embolism after Video-assisted Thoracoscopic Lobectomy

    Abstract: Objective To investigate strategies for prevention,early diagnosis,and prompt treatment for acute pulmonary embolism(PE)after video-assisted thoracoscopic surgery(VATS)lobectomy. Methods From January 2007 to November 2010, 1 115 patients with lung cancer underwent VATS lobectomy in the First Affiliated Hospital of Guangzhou Medical College. Among them, 13 patients had acute PE postoperatively, including 6 male patients and 7 female patients with their mean age of 62.3 years(ranging from 42 to 73 years).All the patients were diagnosed by spiral CT pulmonary artery angiography(SCTPA), and received anticoagulation therapy with low molecular weight heparin and warfarin. Results The incidence of acute PE after VATS lobectomy was 1.17%(13/1 115), and the patients with low PE-related early mortality risk accounted for a large proportion(11/13). There were 12 patients with right-side PE. All the patients’ signs and symptoms were significantly alleviated after administration of anticoagulation therapy. Nine patients received SCTPA review after treatment which showed that their PE had disappeared or been significantly absorbed. No hematological complications including thoracic hemorrhage or wound errhysis occurred after treatment. All surviving patients were followed up for 1 month to 3 months. During follow-up, these patients were alive without PE recurrence. Conclusion SCTPA is the first-choice examination for the diagnosis of acute PE after VATS lobectomy. Prophylaxis against PE and prompt treatment are necessary depending on individual manifestations. VATS lobectomy should be favored as a minimally invasive surgical treatment for patients with lung cancer, for the low incidence of postoperative PE and low PE-related early mortality risk.

    Release date:2016-08-30 05:49 Export PDF Favorites Scan
  • The Early and Middle- long Term Clinical Outcome of Surgical Treatment of Pulmonary Embolism

    Abstract:  Objective To invest igate the early and m iddle2long term clinical outcome of surgical t reatment for pulmonary th romboembo lism (PTE).  Methods The data of 57 cases of surgical t reatment fo r pulmonary embolism from O ctober 1994 to O ctober 2007 in A nzhen Ho sp italw ere analyzed ret ro spect ively, of w h ich 47 casesw ere ch ronic PTE done w ith pulmonary th romboendarterectomy, and 10 w ere acute PTE done w ith pulmonary embo lectomy.  Results There w ere 6 (12. 8%) perioperat ive death s in ch ronic PTE and 4 (40. 0%) death s in acute PTE (P =0.030). F ifteen cases suffered w ith residual pulmonary hypertension and 25 casesw ith severe pulmonary reperfusion injury. The pulmonary artery systo lic p ressure (PA SP) and the pulmonary vascular resistance (PVR ) of 41 cases with ch ronic PTE at 72 hours after surgery w ere low ered significant ly than tho se befo re surgery (52. 9±26. 1 mmHg vs. 91. 2±37. 4 mmHg; 410. 3±345. 6 dyn?s/ cm5 vs. 921. 3±497. 8 dyn?s/ cm5). The arterial oxygen saturat ion (SaO 2) and the arterial part ial p ressure of oxygen (PaO 2 ) at 72 hours after surgery w ere h igher significant ly than tho se befo re surgery (94.8% ±2.7% vs. 86.7% ±4.3%; 84. 4±5. 4 mmHg vs. 51. 8±6. 4 mmHg, P lt; 0. 05). With the fo llow -up of 44. 6±39. 3 month s (cumulat ive fo llow -up w as 160. 1 pat ient-years) of the 47 perioperative survivo rs, there w ere 5 late death s, of w h ich 4 ch ronic PTE and 1 acute PTE. A cco rding to Kap lan-Meier survival curve, the 5 years survival rate w as 89. 43%±5. 80% fo r ch ronic PTE and 83. 33%±15. 21% fo r acute PTE (Log rank test= 1.57, P = 0. 2103). The lineal bleeding rate related to ant icoagulat ion w as 1. 25% pat ient-years, and the lineal th romboembo lic rate related to ant icoagulat ion w as 0. 62% pat ient-years. A nd of the 42 mid-long term survivo r, the heart funct ion in 29 cases w as N ew Yo rk Heart A ssociat ion (NYHA ) class I , 10 cases NYHA class II , 3 cases N YHA class III. A cco rding to logist ic regression, the risk facto rs fo r the early death w ere acute PTE (OR = 3.28, peripheral type of PTE (OR = 2. 45) , unadop t ive of deep hypertherm ia and circulato ry arrest (OR = 2.86) ; and the risk facto rs fo r late death w ere peripheral type of PTE (OR = 2. 69) , lower limb edema p rep rocedure (OR = 2.79).  Conclus ion The operat ive mo rtality in acute PTE is significant ly h igher than that in ch ronic PTE, and the mid-long term survival rate is agreeable in bo th acute and ch ronic PTE, and the comp licat ions rate related to ant icoagulat ion is relat ively accep table.

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • 急性肺动脉栓塞的诊断与治疗

    目的 提高对肺癌开胸术后发生急性肺动脉栓塞(acute pulmonary thromboembolism,APTE)的认识,以预防术后APTE的发生,并降低其死亡率。 方法 回顾分析2003年1月至2006年6月期间876例肺癌患者在我院行开胸手术治疗的临床资料,术后均经临床和实验室检查发生APTE17例,其中手术治疗2例,药物抗凝、溶栓治疗15例。 结果 本组有4例(23.53%)于围手术期死亡,分别死于低氧血症和右心衰竭;13例经积极治疗得以恢复、痊愈。 结论 大的栓子栓塞肺动脉是肺切除术后早期较常见的致命并发症。对开胸手术的肺癌,尤其是肺腺癌患者,应该采取措施,以预防APTE的发生; 对中心型肺动脉栓塞患者,手术取栓子是挽救生命的惟一方法。

    Release date:2016-08-30 06:16 Export PDF Favorites Scan
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