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find Author "韩哲" 2 results
  • 核素扫描为假阴性原发性甲状旁腺功能亢进症手术时机及治疗策略的把握

    目的结合临床病例分析原发性甲状旁腺功能亢进症(PHPT)患者行 99锝m-甲氧基异丁基异腈(99Tcm-MIBI)SPECT/CT 核素扫描结果为假阴性的原因,为在临床工作中核素扫描结果为假阴性或与其他影像学定位结果不一致的 PHPT 患者提供把握手术时机及治疗策略的思路。方法回顾性分析吉林大学第一医院甲状腺外科收治的 4 例核素扫描结果为假阴性的 PHPT 患者的临床病理资料。结果PHPT 患者甲状旁腺病灶的大小、是否伴有出血、坏死、囊性变以及是否为恶性肿瘤伴发广泛转移都可导致 99Tcm-MIBI SPECT/CT 呈现假阴性结果。结论99Tcm-MIBI SPECT/CT 扫描结果不能作为 PHPT 是否行手术治疗的判定标准,在临床工作中当 99Tcm-MIBI SPECT/CT 结果呈现假阴性或与其他影像学定位结果不一致时,应结合患者实验室检查及其他影像学检查结果综合考虑,定位病灶,避免临床误诊,把握好手术时机以避免遗漏多发甲状旁腺病灶,减少不必要的双侧颈部探查,提高手术成功率。

    Release date:2020-07-26 02:35 Export PDF Favorites Scan
  • Research progress of rapid surgery for hip fracture in elderly patients

    Objective To review the research progress of rapid surgery for hip fracture in elderly patients. Methods The published studies, expert consensus, and guidelines at home and abroad were systematically summarized from the aspects of the characteristics of aging population, the benefits of rapid surgery, the disadvantages of delayed surgery, and the recommendations of current guidelines, so as to further guide clinical practice. Results Hip fracture is a common fracture type in the elderly population. As elderly patients generally have poor physique and often have a variety of underlying diseases, such as hypostatic pneumonia, bedsore, lower limb vein thrombosis, and other complications in conservative treatment, its disability rate and mortality are high, so surgical treatment is the first choice. At present, most relevant studies and expert consensus and guidelines at home and abroad support rapid surgery, that is, preoperative examination should be started immediately after admission, and adverse factors such as taking anticoagulant drugs, serious cardiovascular diseases, and severe anemia should be clearly and actively corrected, and surgery should be completed within 48 hours after admission as far as possible. Rapid surgery can not only significantly reduce the mortality of patients, but also reduce the length of hospital stay and the incidence of perioperative cognitive impairment, which is conducive to the recovery of patients with pain during hospitalization and postoperative function, and improve the prognosis of patients. Conclusion In order to avoid many problems caused by delayed surgery, the elderly patients with hip fracture should be operated as soon as possible under the condition of actively correcting the adverse factors. Comprehensive evaluation and preparation, the development of an individualized surgical plan, and the formation of a multidisciplinary medical team can reduce surgical risks and improve effectiveness.

    Release date:2023-12-12 05:09 Export PDF Favorites Scan
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