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find Keyword "迷走神经" 36 results
  • 贲门癌手术对胆囊收缩功能的影响

    目的 研究贲门癌患者围手术期对胆囊功能的影响,减少术后消化道并发症。方法 将82例贲门癌患者按手术中是否保留迷走神经,分为两组,Ⅰ组(n=65): 手术中未保留迷走神经;Ⅱ组(n=17): 手术中保留迷走神经。用B型超声波测量胆囊容积、胆囊收缩功能,并进行手术前后自身对照和两种术式的对比研究。结果 Ⅰ组胆囊容积、收缩功能术前与术后比较差别具有显著性意义(P<0.01),Ⅱ组改变不明显(P>0.05);术后胆囊容积两组比较差别具有显著性意义(P<0.01);Ⅰ组患者术后消化道症状明显,胆囊结石发生明显增多。结论 保留迷走神经干的贲门癌切除术有利于患者术后的胆囊功能恢复和提高生活质量。

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • Estimation of the Power Spectrum of Heart Rate Variability Using Improved Welch Method to Analyze the Degree of Fatigue

    Heart rate variability (HRV) is an important point to judge a person’s state in modern medicine. This paper is aimed to research a person’s fatigue level connected with vagal nerve based on the HRV using the improved Welch method. The process of this method is that it firstly uses a time window function on the signal to be processed, then sets the length of time according to the requirement, and finally makes frequency domain analysis. Compared with classical periodogram method, the variance and consistency of the present method have been improved. We can set time span freely using this method (at present, the time of international standard to measure HRV is 5 minutes). This paper analyses the HRV’s characteristics of fatigue crowd based on the database provided by PhysioNet. We therefore draw the conclusion that the accuracy of Welch analyzing HRV combining with appropriate window function has been improved enormously, and when the person changes to fatigue, the vagal activity is diminished and sympathetic activity is raised.

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  • 迷走神经刺激术治疗药物难治性癫痫中影响治疗效果的相关因素分析

    迷走神经刺激术(Vagus nerve stimulation,VNS)自 1997 年经美国食品药品监督局批准以来,应用越来越广泛,目前为止,全世界约有 80 000 多例药物难治性癫痫患者接受了 VNS 治疗。大量文献证实,VNS 不仅能减少药物难治性癫痫患者的发作频率,还能减轻癫痫发作严重程度、缩短发作的持续时间或发作后的恢复时间,改善患者生活质量。尽管如此,仍有一部分药物难治性癫痫患者 VNS 治疗效果不理想,甚至无效。为此,选择适合 VNS 治疗的患者,术前根据相关影响因素预测治疗效果尤为重要。文章以综述形式阐述可能影响 VNS 治疗癫痫效果的因素。

    Release date:2018-05-22 02:14 Export PDF Favorites Scan
  • THE EARLY AND LATE CLINIC INVESTIGATION AFTER HIGH SELECTIVE VAGOTOMY AND MUCOSAL ANTRECTOMY FOR DUODENAL ULCER

    Objective To study the earlier and later clinic results of 64 chronic duodenal ulcer patients treated with high selective vagotomy and mucosal antrectomy (HSV+MA). Methods The clinic results of the patients and the changes of gastrin, motilin and somatostatin in the blood were prospectively investigated. Results Fifty nine (92.2%) patients after 3-6 months of follow-up and 26 (92.9%) patients after 5-8 years of follow-up achieved Visick grates Ⅰ-Ⅱ. No patients died. Gastric acid secretion and infection rate of helicobacter pylori in antral mucosa were significantly reduced after operation. No significant difference was showed in bile acids and total bacterial counts of gastric juice before and after operation. No ulcer recurrence was found by barium meal and endoscopy. There was no significant difference in serum gastrin and plasma motilin before and after operation. The level of somatostatin in the blood of patients after 5-8 years of follow-up was decreased. Conclusion HSV+MA is the better operative treatment for duodenal ulcer, since it can not only effectively and lastingly decrease acid secretion and rates of ulcer recurrence, but also preserve the function of the antrum and pylorus and keep the gastric milieu interne relatively stable.

    Release date:2016-09-08 01:59 Export PDF Favorites Scan
  • Efficacy and predictive factors analysis of vagus nerve stimulation in patients with refractory MRI-negative epilepsy

    ObjectiveTo investigate the efficacy of vagus nerve stimulation (VNS) in patients with refractory magnetic resonance imaging (MRI)-negative epilepsy and to evaluate potential clinical predictors. MethodsA retrospective collection of efficacy data was conducted on 24 patients with intractable MRI-negative epilepsy treated with VNS, who were followed up for more than six months, at Beijing Tiantan Hospital and Beijing Fengtai Hospital from January 2016 to September 2023. Patients were divided into two subgroups based on their response to VNS: responders (≥50% reduction in seizure frequency) and non-responders (<50% reduction in seizure frequency). The relationship between preoperative clinical data and VNS efficacy was further analyzed to identify potential predictors of VNS efficacy. ResultsA total of 24 patients were included, with an average age of (14.26±8.39) years old. Seizure frequency was reduced by more than 50% in 37.5% of patients, and 8.3% of patients achieved seizure-free after VNS treatment. Preoperative seizure frequency and interictal epileptiform discharge type were significantly associated with VNS efficacy (P<0.05). Multivariate regression analysis showed that a monthly seizure frequency of less than 100 and focal interictal epileptiform discharges were independent predictors of VNS efficacy (P<0.05). ConclusionVNS is an effective treatment for patients with refractory MRI-negative epilepsy. Lower monthly seizure frequency and focal interictal epileptiform discharges are potential predictors of VNS efficacy. These findings provide important references for clinicians in selecting and evaluating patients for VNS treatment.

    Release date:2024-08-23 04:11 Export PDF Favorites Scan
  • 迷走神经刺激术治疗儿童难治性癫痫的研究进展

    癫痫是一种严重威胁人类身心健康的慢性功能性神经疾病,是几个世纪以来困扰医学界的难题之一。药物难治性癫痫以反复癫痫发作为主要特征,通常规范使用 2 种及以上抗癫痫药物(AEDs)症状难以控制,伴有认知功能损害的疾病。迷走神经刺激术(Vagus nerve stimulation,VNS)是一种无需开颅、通过神经调控治疗难治性癫痫的方法,在不损害重要神经功能的前提下,通过手术的方式阻断癫痫发作时电流传导通路,从而减少或者控制癫痫发作,可以降低因痫性放电继发脑损害,进而减少抗癫痫药物使用产生的副作用。自 1997 年美国食品药品监督局批准 VNS 上市应用于治疗癫痫以来,其适应证已经从成人逐步扩展到了儿童。儿童作为癫痫患者的特殊群体,处于生长发育关键期,有效、及时的调控干预可以为患儿中枢神经系统发育创造时机,为难治性癫痫患者治疗提供新思路。文章探讨了 VNS 的年龄适应证以及在不同年龄段儿童中的应用,并对 VNS 在改善儿童认知行为,儿童遗传性癫痫、发育性和癫痫性脑病、儿童结构性病因相关性癫痫治疗的有效性,VNS 使用的安全性和不良反应等方面作一综述。

    Release date:2021-02-27 02:57 Export PDF Favorites Scan
  • HIGHLY SELECTIVE VAGOTOMY FOR THE TREATMENT OF DUODENAL ULCER(REPORT OF 217 CASES)

    Modified Goligher’s highly selective vagotomy (HSV) for 217 cases of duodenal ulcers is reported. In this series they were: duodenal ulcer (100 cases), combined gastric and duodenal ulcers (79 cases) and complicated perforating, bleeding or stenosed ulcers (38 cases). In the complicated duodenal ulcer, HSV was usually carried out with suturing bleeding point, perforated ulcer or with pyloroplasty. With a follow-up of 3~20 years, the recurrence rate werelt;2% and 85.7% of cases had excellent or good results as Visick classification. Considerations relevant to the HSV technic are deemed worthy of emphasis; complete resection of gastric branches of anterior and posterior vagal trunks and preservation of the first limb of the "Crow’s foot", extended dissection of the distal 5-7cm of the esophagus and division of the distal 8-10cm of the bundle of the gastroepiploic vessels in order to deprive the whole parietal cell mass of its vagal supply. In 4 patients, recurrence were easily controlled with remedies or operation for gastric retention by rational type. The authors suggest that the modified HSV plus mucusdeprived antrectomy be the rational surgical choice for duodenal ulcer.

    Release date:2016-08-29 03:26 Export PDF Favorites Scan
  • Establishment of a risk nomogram model for predicting the excitatory response of vagus nerve in patients with functional epilepsy after radiofrequency thermocoagulation

    ObjectiveTo investigate the establishment of a risk nomogram model for predicting vagus excitatory response in patients with functional epilepsy after radiofrequency thermocoagulation.MethodsA total of 106 patients with epilepsy admitted to the neurosurgery department of our hospital from January 2016 to June 2020 were selected and divided into the Vagus excitatory response (VER) group and the non-VER group according to their occurrence or absence. Logistic regression analysis was used to screen out the risk factors of VER during SEEG-guided Percutaneous radiofrequency thermocoagulation (PRFT) in patients with functional epilepsy, and R software was used to establish a histogram model affecting VER in SEEG-guided PRFT. Bootstrap method was used for internal verification. C-index, correction curve and ROC curve were used to evaluate the prediction ability of the model.ResultsLogistic regression analysis showed that age [OR=0.235, 95%CI (0.564, 3.076)], preoperative fugl-meyer score [OR=4.356, 95%CI (1.537, 6.621)], depression [OR=0.995, 95%CI (1.068, 7.404)], and lesion range [OR=1.512, 95%CI (0.073, 3.453)] were independent risk factors for the occurrence of VER in PRFT under the guidance of SEEG (P<0.05), and were highly correlated with the occurrence of VER in PRFT. Based on the above six indicators, a SEEG-guided colograph model of VER risk in PRFT was established, and the model was validated internally. The results showed that the C-index of the modeling set and validation set were 0.779 [95%CI (0.689, 0.869)] and 0.782 [95%CI (0.692, 0.872)], respectively. The calibration curves of the two groups fit well with the standard curves. The areas under the ROC curve (AUC) of the two groups were 0.779 and 0.782 respectively, which proved that the model had good prediction accuracy.ConclusionFor patients with functional epilepsy requiring seeg-guided PRFT therapy, age, preoperative Fugl-meyer score, depression and lesion range should be taken into full consideration to comprehensively assess the incidence of VER, and early intervention measures should be taken to reduce and reduce the incidence, which has good clinical application value.

    Release date:2021-08-30 02:33 Export PDF Favorites Scan
  • Research progress on mediastinal lymph node dissection with preservation of the posterior pulmonary vagus nerve branches

    The mediastinal lymph node dissection (MLND) with preservation of the posterior pulmonary vagus nerve branches is an emerging function-preserving strategy in lung cancer surgery, its application in clinical practice has received increasing attention. However, the available evidence-based medical evidence for this approach is still insufficient. This review aims to systematically review and summarize the current literature on MLND with preservation of the posterior pulmonary vagus nerve branches in lung cancer surgery, covering its definition, anatomical and physiological basis, surgical technical points, oncological outcomes, postoperative complications and functional benefits, indications and contraindications, as well as the current consensus, controversies and future development directions. This review provides references for clinical practice and future research.

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  • 贲门周围血管离断加胃底折叠钉合术治疗门脉高压症27例报告

    Release date:2016-08-29 09:18 Export PDF Favorites Scan
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