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find Author "方方" 3 results
  • Clinical Application of Pulmonary Artery Banding

    Objective To summarize our clinical experience of pulmonary artery banding (PAB) for the treatment of complex congenital heart diseases as a palliative procedure.?Methods?From January 1997 to November 2010, 138 patients with complex congenital heart diseases underwent PAB in Fu Wai Hospital. There were 87 male patients and 51 female patients with their age of 22.2±26.5 months and average body weight of 7.5±4.6 kg. All the 138 patients were divided into 3 groups according to the purpose of PAB:left ventricular retraining (group 1, n=55), initial procedure for functional single ventricle with unobstructed pulmonary blood flow (group 2, n=32) and initial palliative procedure followed by later biventricular repair (group 3, n=51). The intraoperative and postoperative clinical parameters of all participants were observed, and follow-up was made for these 3 groups of patients.?Results?The in-hospital mortality of PAB was 5.1% (7/138). Three patients underwent re-banding procedure to adjust the size of banding. In group 1, there was 1 postoperative death. Among the 55 patients, 36 patients with dextro-transposition of great arteries received PAB at an average age of 19.6±29.5 months, 29 patients of whom underwent concomitant modified Blalock-Taussig shunt. After an average training interval for 42 days, 83.3% of them(30/36)successfully received arterial switch operation. The other 19 patients in group 1 with isolated corrected transposition of great arteries received PAB at an average age of 45.3±27.2 months. Afteran average training interval for 9 months, 42.1% of them (8/19) successfully received double-switch operation. In group 2, there was 2 postoperative death. Thirty-two patients with functional single ventricle and unobstructed pulmonary blood flow received PAB at an average age of 14.1±14.9 months. Their postoperative mean pulmonary artery pressure decreased significantly from 34.00±10.00 mm Hg to 23.00±7.40 mm Hg, and their oxygen saturation of blood (SpO2) significantly decreased from 92.60%±5.90% to 83.30%±6.30%. After a median interval of 2 years, 18.8% of them (6/32) underwent right heart bypass operation. In group 3, there was 4 postoperative death. Fifty-one patients received PAB at an average age of 20.60±25.60 months. After PAB procedure, the ratio of systolic pulmonary artery pressure and systolic blood pressure significantly decreased from 0.81±0.14 to 0.46±0.15, and their SpO2 significantly decreased from 93.10%±7.60% to 85.00%±10.00%. After a median interval of 6 months, 23.5% of them (12/51) received biventricular repair.?ConclusionAlthough PAB is a palliative procedure with comparatively high risks, it still plays an indispensable role in terms of protecting pulmonary vascular beds, retraining ventricular function and two-stage surgical correction for the treatment of complex congenital heart diseases.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 《7T-MRI 癫痫特别工作组关于 7T-MRI 临床应用的专家共识》解读

    通过磁共振成像(MRI)识别脑结构性病变对癫痫具有重要意义,是药物难治性局灶性癫痫患者术后癫痫无发作最重要的影响因素。然而,约 1/3 的癫痫患者在常规磁场强度(1.5T 和 3T)MRI 检查无法发现病变。现有研究已证明 7T- MRI 在 1.5T 和/或 3T-MRI 检查中有或无已知致痫性病变的患者中有应用价值。然而,将 7T-MRI 用于临床仍具挑战性,尤其是在刚开始或准备开始应用的癫痫中心,并且有必要对 7T-MRI 在癫痫患者临床管理中的应用提出具体推荐意见。7T 癫痫特别工作小组(一个代表有 2 000 例癫痫患者扫描经验的 21 个 7T-MRI 中心专家组成的国际小组)于 2020 年 12 月在《Neurology》上发表了《7R-MRI 癫痫特别工作组关于 7T-MRI 临床应用的专家共识》(下文简称为“共识”)。该《共识》针对 7T-MRI 在癫痫患者中应用的适应证、患者准备、扫描协议和设置、技术挑战、图像分析等进行了指导,并对 7T- MRI 在癫痫患者中未来的分子和功能显像进行了讨论。当然仍有检查的年龄、如何缩短扫描时间、阅图规范等问题未得到解决。不过鉴于 7T-MRI 已被批准用于临床,我国已有部分医院开始引进 7T-MRI 设备,本文旨在解读《共识》,希望对推荐转诊、合适的 7T-MRI 扫描方案和图像分析来指导临床 7T-MRI 在癫痫管理中应用。

    Release date:2021-04-25 09:50 Export PDF Favorites Scan
  • 应用头皮脑电高频振荡自动检测方法评估婴儿痉挛症经 ACTH 冲击治疗的疗效和预后

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