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find Author "陈长志" 4 results
  • 肺动脉介入化疗在Ⅲa期非小细胞肺癌患者术 后治疗中的应用

    目的 总结Ⅲa期非小细胞肺癌患者根治术后行肺动脉介入化疗的临床经验。 方法 对2000年10月至2003年10月收治的非小细胞肺癌患者行手术根治治疗,术后住院号为偶数的前20例患者(肺动脉介入组)行肺动脉介入化疗,采用卡铂(60~80mg/m2•d)1~3d,足叶乙甙(60mg/m2•d)1~3d,丝裂霉素(4 mg/m2•d)1d,或5氟脲嘧啶(250 mg/m2•d)1~3d,每4周为1个周期,共4个周期。住院号为奇数的前20例患者(对照组)术后给予外周静脉化疗,作为对照。采用卡铂(100mg/m2•d)1~3d,足叶乙甙(120mg/m2•d)1~3d,丝裂霉素(8 mg/m2•d)1d,或5氟脲嘧啶(500mg/m2•d)1~3d,每4周为1个周期,共4个周期。 结果 全组患者无手术死亡,肺动脉介入组患者骨髓抑制和消化道反应均较对照组明显减轻。肺动脉介入组患者2年、3年生存率高于对照组(Plt;0.05),N1患者生存率高于N2患者。肺动脉介入组肿瘤远处转移部位为骨、脑,而对照组转移部位为骨、脑、纵隔、对侧肺、肝和肾上腺等器官。 结论 Ⅲa期非小细胞肺癌患者行根治术后采用肺动脉介入化疗的效果优于外周静脉化疗法。

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • 食管癌切除术后胸胃排空障碍的治疗

    目的 探讨食管癌切除术后机械性非完全性及功能性胸胃排空障碍的有效治疗方法。 方法 1993年7月至2005年7月共收治20例食管癌切除术后机械性非完全性及功能性胸胃排空障碍患者,其中13例行保守治疗2周后症状无改善,积极予以剖腹探查、松解粘连、倒置胃管引流、空肠造瘘和胃液回输等治疗,并给予肠内、肠外营养支持和药物调理胃肠道功能等处理;2例机械性梗阻为粘连束带压迫,1例为凝血块压迫, 1例为胸胃发生90°扭转。另7例患者给予鼻胃管胃肠减压、肠外营养支持、消炎和药物调理胃肠道功能的保守治疗。 结果 经手术治疗的13例患者术后无手术并发症,无死亡。所有患者于术后2~4周痊愈出院,恶心、呕吐症状消失,二次手术后胃液引流量较术前减少,胸胃功能逐渐恢复。胸部X线检查示:二次手术后胸胃液平消失,吞服钡剂均能通过幽门,24 h后复查无胸胃钡剂潴留。 7例经保守治疗的患者中4例出现肺不张,2例发生吸入性肺炎,死亡2例。 随访14例,于出院后2~3个月来本院门诊复查,进普通食物无呕吐,消化道X线钡餐造影检查:吞服钡剂后胸胃无潴留,扩张的胸胃有所回缩。结论 对食管癌切除术后机械性非完全性及功能性胸胃排空障碍患者给予积极的综合治疗,创伤小、效果好,能促进患者胸胃功能的恢复,提高生活质量。

    Release date:2016-08-30 06:13 Export PDF Favorites Scan
  • Maintenance of Hemodynamics with a Pulsatile Catheter Pump in a Sheep Model of Acute Left Heart Failure

    Objective To assess the efficiency and safety of pulsatile catheter (PUCA) pump support during acute ischemic heart failure in sheep. Methods After heart failure model was induced successfully in 10 sheep, PUCA pump was inserted through aorta and the aortic valve orifice with its tip located in the left ventricle. It was then activated to support the hemodynamics for 3 hours. Hemodynamic parameters were monitored and recorded before thoracotomy, heart failure, and every 60 min after the support. Platelet and plasma free hemoglobin were tested during the experiment. Thrombosis in kidney, membrane-pump, and catheter were examined at the end of study. Results PUCA pump support was successful in 7 sheep for 3 hours and failed in 3 due to technical problems. During support with the PUCA pump, mean arterial pressure(MAP), systolic blood pressure (SBP) and diastolic blood pressure(DBP) increased gradually and close to the baseline at the end of experiment. No significant change in platelet and plasma free hemoglobin were found during the whole period of the PUCA pump support. No thrombosis was found as well by means of examining kidney, membrane-pump and catheter. Conclusions PUCA pump can successfully maintain the hemodynamics in a sheep acute heart failure model associated with few blood destruction and thrombosis. It is thus suitable for clinical application to heart failure patients for the maintenance of hemodynamics.

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
  • 心外膜高频刺激心脏植物神经节丛的时间累积和疲劳效应

    目的 观察术中经心外膜对心包内植物神经节丛行高频刺激(HFS)时出现的时间累积效应和疲劳效应,初步探讨其产生的原因和临床意义。 方法 对江苏昆山宗仁卿纪念医院收治的16例行心脏手术患者同期行同步HFS心脏植物神经节丛,刺激时程从50 ms逐渐延长至100 ms及200 ms,观察P-R间期延长和房室传导阻滞的发生情况。 结果 16例患者中2例患者被排除,14例患者均在同步HFS时程为50 ms时出现P-R间期延长,100 ms时出现P-R间期进一步延长,200 ms时出现房室传导阻滞的时间累积效应;4例患者发生迷走效应出现后又再次消失的疲劳现象。 结论 术中经心外膜探查心脏植物神经节丛需重视迷走效应的时间累积和疲劳效应,提高神经节的检出率,并提高心房颤动消融的疗效。

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