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find Author "谢飞" 14 results
  • Surgical Treatment of Low-grade Glioma on Functional Areas

    ObjectiveTo summarize the surgical experiences of low-grade glioma on functional areas. MethodsFifty-four patients with low-grade glioma on functional areas were treated in our department from December 2009 to December 2012. We retrospectively analyzed their clinical data. ResultsThirty-six cases were located preoperatively by diffusion tensor imaging, 13 patients underwent intraoperative B ultrasound tumor localization, and 5 underwent intraoperative wake-up anesthesia. Total resection of tumors was performed on 42 patients, subtotal resection on 10, and partial resection on 2, and no patient died during the operation. The follow-up ranged from 6 to 24 months averaging 12. There was no significant difference in Karnofsky performance scale before and after surgery (P>0.05). ConclusionThe comprehensive application of various localization methods can protect function to the best advantage and resect tumor to the largest degree, and thus improves patients' quality of life.

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  • 脑功能区胶质瘤手术策略的研究进展

    【摘要】 大脑功能区胶质瘤的手术治疗是神经外科临床工作非常棘手的问题。最大限度地切除病变、最大程度地保护功能区、避免术后神经功能缺失、提高患者术后生活质量,是脑功能区胶质瘤手术治疗的最高目标。术前功能神经影像、术中神经导航和超声、CT、MRI、肿瘤显色、电生理监测的应用,已成为当前脑功能区胶质瘤手术的重要策略。现就脑功能区手术策略的研究进行综述。

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
  • Diagnosis and Monitoring of Acute Heart Transplant Rejection with Cardiovascular Magnetic Resonance

    Heart transplantation is a most efficacious therapy for end-stage heart failure, but acute rejection (AR) is the biggest problem to threat longer-term survival of post-transplant patients. Currently, endomyocardial biopsy is the gold standard for the diagnosis of AR. Due to limited sample size and different tissue locations, this invasive examination may cause sampling error and significant difference between biopsy-based diagnosis and AR severity. Therefore, we need a noninvasive and repeatable method to accurately diagnose and monitor AR after heart transplantation. Cardiovascular magnetic resonance can not only observe histological changes directly from the imaging when AR occurs, but also monitor and make diagnosis of AR by evaluating T2 relaxation time, cell labeling, cardiac functional parameters and morphological changes.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • 活性氧簇对创口愈合过程中血管新生的影响

    活性氧族是一类氧衍生的代谢物,被广泛地认为是多种生理过程以及病理状态下关键的调节剂,在血管系统中主要由还原型辅酶Ⅱ氧化酶生成。慢性创口的愈合涉及2种不同形式的血管新生:血管发生(骨髓来源分化而成的循环内皮祖细胞形成)和血管生成(已存在血管局部内皮细胞的芽生而形成)。活性氧族通过对血管新生过程中所涉及的内皮祖细胞、内皮细胞和血管平滑肌细胞功能的调节,影响创口愈合。

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  • Microsurgery for Posterior Communicating Artery Aneurysms

    ObjectiveTo summarize the experience of microsurgery in primary hospital for the posterior communicating artery aneurysms (PCOAan). MethodsThe clinical data of 48 patients with PCOAan who underwent microsurgery from January 2008 to December 2012 were retrospectively analyzed. ResultsAll the necks of aneurysms of 48 cases were successfully clipped, Acording to the Glasgow outcome score (GOS), the early curative effects were good in 36 cases (75.0%, GOS 4-5) poor in 10 cases (20.8%, GOS 2-3) and death in 3 cases (2.1%, GOS 1). After the operation was carried out, the operation time was shorten, aneurysm intraoperative rupture rate was lower, postoperative complications were lower, and the average medical expense was reduced; the difference was significant in 24 cases before and after the operation (P<0.05). ConclusionMicrosurgery for PCOAan is an effective method which should be popularized in primary hospitals.

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  • 超声引导下经皮穿刺置管引流与腹腔镜手术治疗阑尾周围脓肿的随机对照研究

    目的探讨超声引导下经皮穿刺置管引流治疗阑尾周围脓肿的疗效与优势。 方法前瞻性收集四川省内江市第一人民医院于2009年12月至2015年12月期间收治的120例阑尾周围脓肿患者,通过随机数字表法将患者随机分为超声引导经皮穿刺置管引流组56例(置管引流组)和腹腔镜组64例,分别行超声引导经皮穿刺置管引流和腹腔镜手术,比较2组患者的体温恢复时间、白细胞计数恢复时间、引流时间、抗生素应用时间、住院时间、住院费用以及并发症发生情况。 结果置管引流组的体温恢复时间〔(22.23±2.54)h比(31.53±2.77)h〕、白细胞计数恢复时间〔(25.85±2.60)h比(36.58±2.87)h〕、抗生素应用时间〔(3.68±0.77)d比(5.39±0.89)d〕、住院时间〔(5.34±0.61)d比(6.91±0.81)d〕、住院费用〔(5 344.76±912.98)元比(7 632.50±1 198.57)元〕及并发症发生率〔1.8%(1/56)比14.1%(9/64)〕均短于(低于)腹腔镜组(P<0.050),但引流时间却长于腹腔镜组〔(8.31±0.80)d比(4.49± 0.92)d,P<0.001〕。 结论超声引导下经皮穿刺置管引流治疗阑尾周围脓肿不仅安全、有效,而且并发症少、住院费用低、住院时间短、创伤小,值得应用。

    Release date:2016-12-21 03:35 Export PDF Favorites Scan
  • “半兜状”自体心包片吻合技术治疗左冠状动脉开口较低且合并主动脉瓣病变的升主动脉瘤

    目的 探讨在冠状动脉移植时应用“半兜状”自体心包片吻合技术治疗左冠状动脉开口较低且合并主动脉瓣病变的升主动脉瘤的临床效果。 方法 回顾性分析我院心外二科 2012 年 11 月至 2016 年 1 月应用“半兜状”自体心包片吻合技术治疗 7 例左冠状动脉开口较低行 Bentall 术患者的临床资料,其中男 5 例、女 2 例,年龄(45.2±3.1)岁,术前主动脉 CT 血管造影(CTA)提示升主动脉瘤样扩张,直径(6.8±0.8) cm,合并主动脉瓣重度狭窄 2 例,余 5 例主动脉瓣中-重度关闭不全。手术在常规 Bentall 术式的基础上对左冠状动脉移植进行改良。应用自体心包片修剪成梭形,使之呈“半兜状” 兜住左冠状动脉开口下缘,将左冠状动脉开口上缘与人工血管打孔处上缘直接缝合,完成左冠状动脉移植。 结果 全组无死亡病例,体外循环时间(168.0±38.2)min,其中主动脉阻断时间(98.0±28.1) min。术后 24 h 引流量(575.0±65.0)ml。出院前复查心电图及心肌酶学指标(血清肌钙蛋白I、肌酸激酶同工酶、肌酸激酶)均正常。出院随访左室舒张期末内径与术前差异有统计学意义[(5.4±0.5)cm vs.(7.0±0.6)cm,P<0.001]。 结论 本技术手术操作相对简单、吻合方便、吻合口张力较小、出血风险小、止血方便。冠状动脉吻合口无扭曲及牵拉,不影响冠状动脉血流。术后患者心功能恢复良好,取得了良好的早、中期效果。

    Release date:2018-05-02 02:38 Export PDF Favorites Scan
  • Perioperative changes of parathyroid hormone and cardiac function in patients with rheumatic heart disease

    ObjectiveTo investigate the perioperative change of parathyroid hormone (PTH) and its effect on cardiac function in patients with rheumatic heart disease.MethodsFrom January 2018 to June 2019, 76 patients were randomly divided into calcium supplement group (n=39) and control group (n=37). Mitral valve replacement was performed in both groups with cardiopulmonary bypass (CPB). Blood gas was measured immediately and every 6 h within 24 h after CPB. The patients in the calcium supplement group were given 1 g of calcium gluconate when hypocalcemia occurred, while the control group received no calcium supplementation. Values of radial arterial blood PTH and calcium ion (Ca2+) were measured in the two groups before operation (T1), at 30 min after starting CPB (T2), immediately after stopping CPB (T3), at 24 h after operation (T4), and at 48 h after operation (T5), respectively.ResultsThere were 71 patients enrolled in this study finally, including 38 in the calcium supplement group and 33 in the control group. The PTH values of patients in the two groups gradually increased, reached the peak at T3 time-point, then began to recover gradually. There was no significant difference between the two groups at T1, T2 or T3 time-point (P>0.05), while there were significant differences at T4 and T5 time-points (P<0.05). The Ca2+ values of the two groups gradually decreased after CPB, and gradually increased after blood ultrafiltration. There was no significant difference between the two groups at T1 or T3 time-point (P>0.05), while there were significant differences at T2, T4 and T5 time-points (P<0.05). The postoperative 24-hour values of ejection fraction (EF) and cardiac troponin T (cTnT) and the 72-hour total amount of epinephrine used in the calcium supplement group were (42.66±4.18)%, (1 881.17±745.71) ng/L, and (3.04±0.86) mg, respectively, and those in the control group were (40.76±3.39)%, (2 725.30±1 062.50) ng/L, and (4.69±1.37) mg, respectively. There were statistically significant differences in EF, cTnT and the 72-hour total amount of epinephrine used between the two groups (P<0.05). Values of PTH at T4 and T5 time-points were respectively negatively correlated with postoperative 24-hour value of EF (r=-0.324, P=0.006; r=-0.359, P=0.002), positively correlated with postoperative 24-hour value of cTnT (r=0.238, P=0.046; r=0.248, P=0.037) and the 72-hour total amount of epinephrine used (r=0.324, P=0.006; r=0.383, P=0.001).ConclusionsHyperparathyroidism occures after CPB, and calcium supplementation could relieve the hyperparathyroidism. Hyperparathyroidism may be related to postoperative cardiac insufficiency.

    Release date:2020-11-25 07:18 Export PDF Favorites Scan
  • Research progress of portal vein thrombosis after splenectomy

    ObjectiveTo summarize the pathogenesis, epidemiology, and risk factors of portal vein thrombosis after splenectomy, and combined with the latest advances in clinical prevention, diagnosis, and treatment of portal vein thrombosis after splenectomy, so as to provide some references for clinical prevention and treatment in the future.MethodLiteratures on portal vein thrombosis after splenectomy were collected and reviewed.ResultsThe incidence of portal vein thrombosis after splenectomy was high and its occurrence was the result of multiple factors. It was mainly related to the change of splenic venous blood flow mechanics after splenectomy. In terms of diagnosis, enhanced CT scan was the first choice. Currently, there was no consensus on treatment options, which mainly focused on individualized treatment and emphasized that preventive anticoagulant use of low-molecular-weight heparin may reduce the risk of portal vein thrombosis.ConclusionThe concept of tertiary prevention of portal vein thrombosis after splenectomy should be established, and individualized treatment should be adopted in combination with the patient’s condition.

    Release date:2020-12-25 06:09 Export PDF Favorites Scan
  • Percutaneous Ethanol Injection to Treat Hepatocellular Carcinoma of 3 cm or Less: A Systematic Review

    Objective To evaluate the efficacy and safety of percutaneous ethanol injection for hepatocellular carcinomas of 3 cm or less. Methods Randomized controlled trials (RCTs) from the Cochrane Controlled Trials Register (Cochrane Library issue 2, 2008), PubMed (1966 to 2008), EMbase (1966 to 2008), CBMdisc (1978 to 2008), and CNKI (1979 to 2008) were electronically searched. We hand searched related published and unpublished data and their references. Randomized controlled trials of percutaneous ethanol injection to treat hepatocellular carcinomas of 3 cm or less were included. Data were extracted and evaluated by two reviewers independently using a designed extraction form. RevMan 4.2.10 software was used for data analysis. Results Seven RCTs involving 891 patients were included. We conducted subgroup analyses based on outcome measures and interventions. Compared with RFA, for treatment of hepatocellular carcinomas of 3 cm or less, PEI showed statistical differences in one and three-year survival rates and one and three-year local recurrence rates after treatment(RR=0.95, 95%CI 0.91 to 1.00; RR=0.80, 95%CI 0.71 to 0.91; RR=2.18, 95%CI 1.11 to 4.30; RR=2.59, 95%CI 1.55 to 4.32). As for hepatocellular carcinomas of 2-3 cm, PEI showed statistical difference in three year cancer free survival rates after treatment (RR=0.47, 95%CI 0.24 to 0.93) .Conclusion Considering the relatively poor quality of most included trials and small sample size, insufficient evidence was obtained in this systematic review. Therefore, more randomized controlled trials with high quality are still needed to assess and verify the efficacy and safety of this treatment.

    Release date:2016-09-07 02:09 Export PDF Favorites Scan
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