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Differential Diagnosis between the Gallbladder Cancer and Xanthogranulomatous Cholecystitis by Multiple Percutaneous Biopsies 预览
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作者 Jinju Choi Yong-Tae Kim 《药剂与药理学:英文版》 2019年第5期229-233,共5页
Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic inflammatory disease that is often mistaken for gallbladder (GB) cancer. Differential diagnosis based on clinical features or imaging scan is virtually... Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic inflammatory disease that is often mistaken for gallbladder (GB) cancer. Differential diagnosis based on clinical features or imaging scan is virtually impossible and pathological confirmation is crucial for diagnosis. A 72-year-old man was referred to an oncologist for suspicion of unresectable GB cancer with liver metastasis. He was admitted and underwent three percutaneous needle biopsies. However, all specimens showed non-neoplastic hepatic parenchyma with the third biopsy indicating xanthogranulomatous inflammation with abscess formation. The final biopsy changed the diagnosis from GB cancer to XGC. He was prescribed oral antibiotics and discharged after multiple ERBD stenting because of benign biliary stricture. He regularly visited an outpatient clinic and a follow-up CT scan showed a decrease of gallbladder mass. In conclusion, xanthogranulomatous cholecystitis should be considered in the differential diagnoses of GB mass and clinical suspicion is very important for a precise diagnosis. 展开更多
关键词 XANTHOGRANULOMATOUS CHOLECYSTITIS BENIGN GALLBLADDER mass GALLBLADDER cancer
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从胆论治创伤后应激障碍
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作者 孙天石 李卫红 +6 位作者 宋月晗 胡艳红 张凡 张楚焌 董一昕 刘燕 于雪 《吉林中医药》 2019年第5期581-584,共4页
创伤后应激障碍,中医治疗大多将病位定位于肝和脑,但治疗效果欠佳。中医理论认为,胆的异常变化可导致脏腑和气机的变化,以胆为切入点,从中医特有理论出发探讨胆与该疾病发生发展的关系,从气机和五脏的变化探讨胆腑失常导致该病的发生和... 创伤后应激障碍,中医治疗大多将病位定位于肝和脑,但治疗效果欠佳。中医理论认为,胆的异常变化可导致脏腑和气机的变化,以胆为切入点,从中医特有理论出发探讨胆与该疾病发生发展的关系,从气机和五脏的变化探讨胆腑失常导致该病的发生和发展,证实胆的功能变化在创伤后应激的发生与发展中起到重要的作用。从胆论治创伤后应激的理论拓宽了中医对该病的认识,以期找到新的治疗方法和有效药物。 展开更多
关键词 创伤后应激障碍 气机 五脏 精神病学
腹腔镜与小切口手术切除胆囊治疗胆结石的应用价值体会 预览
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作者 毛蕾芳 《国际医药卫生导报》 2019年第5期775-777,共3页
目的探索腹腔镜与小切口手术切除胆囊治疗胆结石的应用价值。方法选取2017年4月22日至2018年4月22日期间本院胆囊炎、胆结石患者100例,实施奇偶数法分组模式分为两组,各50例。对照组进行小切口手术切除胆囊治疗,观察组进行腹腔镜手术治... 目的探索腹腔镜与小切口手术切除胆囊治疗胆结石的应用价值。方法选取2017年4月22日至2018年4月22日期间本院胆囊炎、胆结石患者100例,实施奇偶数法分组模式分为两组,各50例。对照组进行小切口手术切除胆囊治疗,观察组进行腹腔镜手术治疗,对比两组切口长度、胃肠功能恢复时间、肛门排气时间、手术时间、并发症发生率。结果观察组切口长度、胃肠功能恢复时间、肛门排气时间、手术时间分别为(3.56±1.78)cm、(17.28±2.44)h、(15.19±1.72)h、(62.13±5.28)min、均优于对照组,差异均有统计学意义(均P<0.05);观察组并发症发生率4.00%,低于对照组26.00%,差异有统计学意义(P<0.05)。结论对胆囊炎、胆结石患者实施腹腔镜手术治疗效果更为显著。 展开更多
关键词 腹腔镜 小切口手术切除 胆囊 胆结石 体会
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孕晚期胎儿胆囊的磁共振监测指标研究
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作者 崔春明 范闻诗 +2 位作者 王静石 于泓 孙强 《中国医师进修杂志》 2019年第5期454-457,共4页
目的测量妊娠28~35周胎儿胆囊的磁共振正常值,并观察胎儿胆囊的生长发育情况,为产前检查评价胎儿胆囊发育提供新的检测方法。方法选取大连市妇女儿童医疗中心2017年6月至2018年5月行胎儿腹部磁共振检查的单胎孕妇100例,将孕妇按孕龄分... 目的测量妊娠28~35周胎儿胆囊的磁共振正常值,并观察胎儿胆囊的生长发育情况,为产前检查评价胎儿胆囊发育提供新的检测方法。方法选取大连市妇女儿童医疗中心2017年6月至2018年5月行胎儿腹部磁共振检查的单胎孕妇100例,将孕妇按孕龄分为两组:A组妊娠28~31周,64例;B组妊娠32~35周,36例。记录磁共振测量的胎儿胆囊长度、宽度、横径,计算胆囊体积。结果A组磁共振胆囊未显示1例,示胎儿双胆囊1例,出生后复查均正常。胆囊显示率A组为98.4%(63/64),B组为100.0%(36/36);异常率A组为3.1%(2/64),B组为0。B组胆囊长度、宽度、橫径和体积均明显大于A组[(16.5±6.0)mm比(13.2±4.2)mm、(6.5±3.5)mm比(5.2±1.1)mm、(6.8±2.6)mm比(6.4±3.4)mm和(373.3±284.1)mm^3比(258.5±232.4)mm^3],差异有统计学意义(P<0.05)。结论孕晚期胎儿磁共振检查是产前评价胎儿生长发育的新手段,有临床应用价值。 展开更多
关键词 磁共振成像 胎儿 胆囊 胚胎发育
Effects of Bazhen Pills on Quality of Life and Immune Function of Postoperative Chemotherapy in Patients with Gallbladder Cancer 预览
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作者 邓平 《世界中西医结合杂志(英文)》 2019年第2期26-31,共6页
OBJECTIVE: To investigate the effects of Bazhen Pills on quality of life and immune function of patients undergoing chemotherapy after gallbladder cancer surgery. METHODS: A total of 64 patients with gallbladder cance... OBJECTIVE: To investigate the effects of Bazhen Pills on quality of life and immune function of patients undergoing chemotherapy after gallbladder cancer surgery. METHODS: A total of 64 patients with gallbladder cancer treated by surgery and postoperative basic nutritional support and symptomatic treatment in our hospital were selected and randomly divided into the control group and the observation group, with 32 cases in each group.The control group was treated with chemotherapy from 4th to 6th week after surgery. The observation group was treated by Bazhen Pills on the basis of the treatment in the control group. The blood cell count, immune function,TCM symptom scores, KPS scores, quality of life and adverse reactions were compared between the 2 groups.RESULTS: The WBC and PLT in 2 groups were decreased after the treatment, and the data in the observation group were higher than that in the control group(P < 0.05). The levels of CD3+, CD4+ and CD8+ in the 2 groups were increased after the treatment(P < 0.05), and the data in the observation group were higher than that in the control group(P < 0.05). TCM syndrome scores of the 2 groups were decreased after the treatment(P < 0.05),and the KPS scores were increased after the treatment(P < 0.05). The improvement degrees of the 2 scores in the observation group were higher than that of the control group(P < 0.05). The fatigue symptom scores of the 2 groups were decreased while scores of physical function, role function and overall health were increased after the treatment(P < 0.05). The scores of the observation group were better than those of the control group(P < 0.05). The total incidence of grade I-II hematological toxicity and grade I-II gastrointestinal reactions in the observation group was lower than that in the control group(21.88% vs 50.00%)(P < 0.05). CONCLUSION: Bazhen Pills can effectively relieve clinical symptoms of patients undergoing chemotherapy after gallbladder cancer surgery, and improve their immune function and quality of life, with safety. 展开更多
关键词 Bazhen PILLS GALLBLADDER cancer CHEMOTHERAPY IMMUNE function Quality of life
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Banxia Xiexin Decoction(半夏泻心汤)Combined with Afatinib in Treatment of Advanced Gallbladder Cancer:Case Report and Literature Review
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作者 SU Li WANG Miao-miao +7 位作者 XU Meng-ran WANG Xiao XIA Hong-zhen ZHANG Mei ZHENG Lei ZHU Yao-dong WANG Ming-qi LI Ping 《中国结合医学杂志:英文版》 SCIE CAS CSCD 2019年第4期303-306,共4页
Gallbladder cancer(GBC)is a malignancy of biliary tract which is infrequent in developed countries but common in some specific geographical regions of developingCurrently,GBC has a low early diagnosis rate and an extr... Gallbladder cancer(GBC)is a malignancy of biliary tract which is infrequent in developed countries but common in some specific geographical regions of developingCurrently,GBC has a low early diagnosis rate and an extremely poor prognosis,leading to major problems for treatment of GBC.Liver invasion and metastasis one of the main causes of its poor prognosis,with its average overall survival of 6 months. 展开更多
关键词 Banxia Xiexin Decoction 半夏泻心汤 COMBINED with AFATINIB in TREATMENT of ADVANCED GALLBLADDER Cancer:Case Report and Literature Review GBC
三维超声XI-VOCAL技术在胎儿胆囊容积估测的应用
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作者 胡祎 罗瑜 +2 位作者 黄丽琼 冯梦娟 马晓娟 《中国超声医学杂志》 CSCD 北大核心 2019年第3期260-262,共3页
目的应用XI-VOCAL技术估测胎儿胆囊容积,探讨该技术估测胎儿胆囊容积的可行性。方法纳入260例孕妇,采集胎儿胆囊容积,应用XI-VOCAL容积测量技术估算胎儿胆囊容积。结果 XI-VOCAL估测正常胎儿胆囊容积与孕周呈曲线"S"形。结论 ... 目的应用XI-VOCAL技术估测胎儿胆囊容积,探讨该技术估测胎儿胆囊容积的可行性。方法纳入260例孕妇,采集胎儿胆囊容积,应用XI-VOCAL容积测量技术估算胎儿胆囊容积。结果 XI-VOCAL估测正常胎儿胆囊容积与孕周呈曲线"S"形。结论 XI-VOCAL技术可用于估测胎儿胆囊容积,同时显示胆囊与周围器官空间位置关系,为胆系异常提供更多依据。 展开更多
关键词 胎儿 胆囊 扩展成像虚拟器官计算机辅助分析
KML001,an arsenic compound,as salvage chemotherapy in refractory biliary tract cancers:A prospective study 预览
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作者 Jung Hyun Jo Huapyong Kang +5 位作者 Hee Seung Lee Moon Jae Chung Jeong Youp Park Seungmin Bang Seung Woo Park Si Young Song 《国际肝胆胰疾病杂志:英文版》 SCIE CAS CSCD 2019年第1期62-66,共5页
Background:Sodium meta-arsenite(NaAsO2,KML001)is a potential oral anticancer agent acting on telomerase and telomere length.This prospective study evaluated its safety,tolerability,and effectiveness as salvage chemoth... Background:Sodium meta-arsenite(NaAsO2,KML001)is a potential oral anticancer agent acting on telomerase and telomere length.This prospective study evaluated its safety,tolerability,and effectiveness as salvage chemotherapy in patients with advanced biliary tract cancer(BTC)resistant to gemcitabinebased chemotherapy.Methods:Forty-four patients(21 women and 23 men)with advanced BTC and failure history of gemcitabine-based chemotherapy,performance status(PS)0–2,normal cardiac,hepatic,and renal function were enrolled.Daily dose of KML001(7.5 mg.p.o.)was administered to eligible subjects for 24 weeks divided into six treatment cycles.Response was evaluated bimonthly using CT.Results:After an average of 1.5 months of treatment(range:0.5–10.0),3 patients(6.8%)obtained progression-free status,23 patients(52.3%)had disease progression,and 18 patients(40.9%)dropped out before evaluation.One patient(2.3%)completed six treatment cycles without progression.During the treatment,morphine dosage kept the same or decreased in 20 patients(47.6%).Nine patients(20.5%)experienced grade-3 adverse events(AEs),while no patient experienced grade-4 AEs.The most common AEs were liver enzyme elevation(11/44,25%)and anemia(10/44,22.7%).KML001 was discontinued in six patients(13.6%)due to AEs,including liver toxicity(n=3),QTc prolongation(n=2),and abdominal pain(n=1).Conclusions:KML001 did not have enough anticancer effect on patients with advanced BTC resistant to gemcitabine.However,KML001 was safe and well-tolerable in terms of AEs and pain control when used as salvage therapy.Further studies are needed to establish arsenic agents as a reliable treatment option in patients with BTC. 展开更多
关键词 BILIARY TRACT NEOPLASMS CHOLANGIOCARCINOMA GALLBLADDER NEOPLASMS KML001 Sodium meta-arsenite
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Cancer risk in primary sclerosing cholangitis:Epidemiology,prevention,and surveillance strategies 预览
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作者 Brian M Fung Keith D Lindor James H Tabibian 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第6期659-671,共13页
Primary sclerosing cholangitis(PSC)is a rare cholestatic liver disease characterized by progressive fibroinflammatory destruction of the intra-and/or extrahepatic biliary ducts.While its features and disease course ca... Primary sclerosing cholangitis(PSC)is a rare cholestatic liver disease characterized by progressive fibroinflammatory destruction of the intra-and/or extrahepatic biliary ducts.While its features and disease course can be variable,most patients with PSC have concurrent inflammatory bowel disease and will eventually develop liver cirrhosis and end-stage liver disease,with liver transplantation representing the only potentially curative option.Importantly,PSC is associated with a significantly increased risk of malignancy compared to the general population,mainly cholangiocarcinoma,gallbladder carcinoma,hepatocellular carcinoma,and colorectal cancer,with nearly 50%of deaths in patients with PSC being due to cancer.Therefore,robust surveillance strategies are needed,though uncertainty remains regarding how to best do so.In this review,we discuss the epidemiology,prevention,and surveillance of cancers in patients with PSC.Where evidence is limited,we present pragmatic approaches based on currently available data and expert opinion. 展开更多
关键词 BILE duct diseases CHOLANGIOCARCINOMA GALLBLADDER CARCINOMA Hepatocellular CARCINOMA Colorectal cancer CHEMOPROTECTION Inflammatory bowel disease
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Imaging of gall bladder by endoscopic ultrasound 预览
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作者 Malay Sharma Piyush Somani Tagore Sunkara 《世界胃肠内镜杂志:英文版(电子版)》 2018年第1期10-15,共6页
Endoscopic ultrasonography(EUS)is considered a superior investigation when compared to conventional ultrasonography for imaging gall bladder(GB)lesions as it can provide high-resolution images of small lesions with hi... Endoscopic ultrasonography(EUS)is considered a superior investigation when compared to conventional ultrasonography for imaging gall bladder(GB)lesions as it can provide high-resolution images of small lesions with higher ultrasound frequencies.Examination of GB is frequently the primary indication of EUS imaging.Imaging during EUS may not remain restricted to one station and multi-station imaging may provide useful information.This review describes the techniques of imaging of GB by linear EUS from three different stations.The basic difference of imaging between the three stations is that effective imaging from station 1 is done above the neck of GB,from station 2 at the level of the neck of GB and from station 3 below the level of the neck of GB. 展开更多
关键词 GALLBLADDER GALLBLADDER cancer GALLSTONES BILIARY sludge ANTRUM DUODENAL BULB Endoscopic ultrasound
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value of contrast-enhanced ultrasound in the differential diagnosis of gallbladder lesion 预览
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作者 Hui-Ping Zhang Min Bai +3 位作者 Ji-Ying Gu Ying-Qian He Xiao-Hui Qiao Lian-Fang Du 《世界胃肠病学杂志:英文版》 SCIE CAS 2018年第6期744-751,共8页
AIM To describe contrast-enhanced ultrasound(CEUS)features and evaluate differential diagnosis value of CEUS and conventional ultrasound for patients with benign and malignant gallbladder lesions.METHODS This study in... AIM To describe contrast-enhanced ultrasound(CEUS)features and evaluate differential diagnosis value of CEUS and conventional ultrasound for patients with benign and malignant gallbladder lesions.METHODS This study included 105 gallbladder lesions.Before surgical resection and pathological examination,conventional ultrasound and CEUS were performed to examine for lesions.Then,all the lesions were diagnosed as(1)benign,(2)probably benign,(3)probably malignant or(4)malignant using both conventional ultrasound and CEUS.The CEUS features of these gallbladder lesions were analyzed and diagnostic efficiency between conventional ultrasound and CEUS was compared.RESULTS There were total 17 cases of gallbladder cancer and 88 cases of benign lesion.Some gallbladder lesions had typical characteristics on CEUS(e.g.,gallbladder adenomyomatosis had typical characteristics of small nonenhanced areas on CEUS).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CEUS were 94.1%,95.5%,80.0%,98.8%and 95.2%,respectively.These were significantly higher than conventional ultrasound(82.4%,89.8%,60.9%,96.3%and 88.6%,respectively).CEUS had an accuracy of 100%for gallbladder sludge and CEUS helped in differential diagnosis among gallbladder polyps,gallbladder adenoma and gallbladder cancer.CONCLUSION CEUS may provide more useful information and improve the diagnosis efficiency for the diagnosis of gallbladder lesions than conventional ultrasound. 展开更多
关键词 CONTRAST enhanced ULTRASOUND Conventional ULTRASOUND GALLBLADDER carcinoma GALLBLADDER ADENOMYOMATOSIS
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Current practices and future prospects for the management of gallbladder polyps:A topical review 预览
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作者 R Stephen McCain Anna Diamond +1 位作者 Claire Jones Helen G Coleman 《世界胃肠病学杂志:英文版》 SCIE CAS 2018年第26期2844-2852,共9页
A gallbladder polyp is an elevation of the gallbladder mucosa that protrudes into the gallbladder lumen.Gallbladder polyps have an estimated prevalence in adults of between 0.3%-12.3%.However,only 5%of polyps are cons... A gallbladder polyp is an elevation of the gallbladder mucosa that protrudes into the gallbladder lumen.Gallbladder polyps have an estimated prevalence in adults of between 0.3%-12.3%.However,only 5%of polyps are considered to be“true”gallbladder polyps,meaning that they are malignant or have malignant potential.The main radiological modality used for diagnosing and surveilling gallbladder polyps is transabdominal ultrasonography.However,evidence shows that other modalities such as endoscopic ultrasound may improve diagnostic accuracy.These are discussed in turn during the course of this review.Current guidelines recommend cholecystectomy for gallbladder polyps sized 10 mm and greater,although this threshold is lowered when other risk factors are identified.The evidence behind this practice is relatively low quality.This review identifies current gaps in the available evidence and highlights the necessity for further research to enable better decision making regarding which patients should undergo cholecystectomy,and/or radiological follow-up. 展开更多
关键词 GALLBLADDER POLYPS GALLBLADDER cancer TRUE POLYPS PSEUDO POLYPS
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Hepatectomy for gallbladder-cancer with unclassified anomaly of right-sided ligamentum teres:A case report and review of the literature 预览
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作者 Toru Goto Hiroaki Terajima +1 位作者 Takehito Yamamoto Yoichiro Uchida 《世界肝病学杂志:英文版(电子版)》 2018年第7期523-529,共7页
Right-sided ligamentum teres(RSLT)is a congenital anomaly in which the right umbilical ligament becomes dominant and anomalous ramifications of the hepatic vessels and biliary system are present.A male patient in his ... Right-sided ligamentum teres(RSLT)is a congenital anomaly in which the right umbilical ligament becomes dominant and anomalous ramifications of the hepatic vessels and biliary system are present.A male patient in his 70s was diagnosed with advanced gallbladder cancer directly infiltrating the right hepatic duct(RHD),together with RSLT.Preoperative three-dimensional simulation of the liver based on multiple detector computed tomography images after cholangiography revealed ramifications of all segmental portal veins from the portal trunk and discordance of the arterial and biliary branching patterns of segment 8.Fusion analysis of the biliary architecture and segmental volumetry showed that the RHD drained segments 1r,5,6,and 7.We successfully performed a modified right-sided hepatectomy sparing segment 8(i.e.,resection of the RHD drainage territory),with negative surgical margins.This report is the first to describe major hepatectomy for advanced gallbladder cancer with RSLT. 展开更多
关键词 Right-sided ligamentum teres HEPATECTOMY GALLBLADDER cancer PREOPERATIVE liver simulation ANOMALY of the portal vein
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应用二维超声联合XI-VOCAL容积测量技术评估胎儿胆囊与孕周的关系 预览
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作者 胡祎 罗瑜 +3 位作者 周微尘 黄丽琼 冯梦娟 马晓娟 《中国生育健康杂志》 2018年第6期511-518,601,602共10页
目的 建立胎儿胆囊二维测值与相应孕周的正常值范围;应用XI-VOCAL容积测量技术,获得胎儿胆囊容积生长曲线方程,探讨胎儿胆囊容积与孕周的关系。方法选取2014年12月—2017年8月于本院行产前筛查的556例13~40周的单胎胎儿,孕妇无妊娠并发... 目的 建立胎儿胆囊二维测值与相应孕周的正常值范围;应用XI-VOCAL容积测量技术,获得胎儿胆囊容积生长曲线方程,探讨胎儿胆囊容积与孕周的关系。方法选取2014年12月—2017年8月于本院行产前筛查的556例13~40周的单胎胎儿,孕妇无妊娠并发症且长期生活在成都地区,测量胎儿胆囊二维径线,采集孕22~32周260例胎儿胆囊容积,利用XI-VOCAL容积测量技术估算胎儿胆囊容积。结果正常胎儿胆囊二维、容积测值与孕周呈正相关,二维测值快速便捷,容积测值更为精确。结论胎儿胆囊大小异常多与染色体疾病相关,建立胎儿胆囊大小参考值对胎儿胆道系统发育情况、及早发现不良妊娠结局均有重要意义,二维超声联合容积成像可为观察胎儿胆系异常提供有价值的信息。 展开更多
关键词 胎儿 孕周 胆囊 容积自动测量技术
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胆囊切除术两种术式术后远期发生胆囊切除术后综合征的临床研究 预览
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作者 张文 王敏 黄永生 《中国当代医药》 2018年第19期36-38,共3页
目的探析胆囊切除术两种术式术后远期发生胆囊切除术后综合征的临床疗效情况。方法选取2016年3月~2018年3月我院收治的60例行胆囊切除术的患者作为研究对象,随机分为对照组与治疗组,每组各30例。对照组采用传统开腹胆囊切除术疗法,治... 目的探析胆囊切除术两种术式术后远期发生胆囊切除术后综合征的临床疗效情况。方法选取2016年3月~2018年3月我院收治的60例行胆囊切除术的患者作为研究对象,随机分为对照组与治疗组,每组各30例。对照组采用传统开腹胆囊切除术疗法,治疗组采用腹腔镜胆囊切除术疗法。比较两组患者的出血量和总住院时间、手术时间和下床活动时间等各项指标,以及术后综合征发生率情况。结果治疗组患者的出血量和总住院时间、手术时间和下床活动时间情况均显著低于对照组,差异有统计学意义(P〈0.05);治疗组患者出现胆囊切除术综合征的发生率为6.67%,显著低于对照组患者的30.00%,差异有统计学意义(P〈0.05)。结论对行胆囊切除术的患者实施腔镜胆囊切除术治疗,其治疗效果显著优于行开腹胆囊切除术治疗的临床效果,而且还有助于术后综合征发生率的降低。 展开更多
关键词 胆囊结石 胆囊 腹腔镜 微创外科 并发症
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2例胆囊癌肉瘤及肉瘤样癌临床病理分析 预览
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作者 任亚敏 胡惠敏 《临床与病理杂志》 2018年第2期456-461,共6页
采用光镜及免疫组织化学(immunohistochemistry,IHC)等方法对2例胆囊癌肉瘤及肉瘤样癌进行临床、病理回顾性分析并综合文献复习。2名患者均因腹部不适入院,胆囊癌肉瘤光镜下可见癌区、软骨肉瘤及未分化梭形细胞肉瘤区,且癌与肉瘤性结... 采用光镜及免疫组织化学(immunohistochemistry,IHC)等方法对2例胆囊癌肉瘤及肉瘤样癌进行临床、病理回顾性分析并综合文献复习。2名患者均因腹部不适入院,胆囊癌肉瘤光镜下可见癌区、软骨肉瘤及未分化梭形细胞肉瘤区,且癌与肉瘤性结构之间未见明显移行过渡,IHC示癌区表达上皮标志,肉瘤区表达间叶标志;胆囊肉瘤样癌光镜下可见癌区及肉瘤样区,二者之间可见移行过渡,IHC癌区表达上皮标志,肉瘤样区同时表达上皮及间叶标志。胆囊癌肉瘤及肉瘤样癌均比较少见,临床诊断困难,明确诊断需要病理广泛仔细取材及IHC检测。 展开更多
关键词 胆囊 癌肉瘤 肉瘤样癌 病理 诊断
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单孔腹腔镜保胆取石治疗儿童胆囊结石的临床体会
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作者 沈刚 李功俊 +3 位作者 白毅 周立军 陈媛 王晓一 《中华小儿外科杂志》 CSCD 北大核心 2018年第10期748-751,共4页
目的探讨单孔腹腔镜保胆取石治疗儿童胆囊结石的可行性和有效性。方法回顾性分析2014年12月至2017年6月大连市儿童医院小儿普外科经单孔腹腔镜保胆取石治疗胆囊结石14例患儿的临床资料,男6例,女8例;年龄为(9.5±3.6)岁,范围4... 目的探讨单孔腹腔镜保胆取石治疗儿童胆囊结石的可行性和有效性。方法回顾性分析2014年12月至2017年6月大连市儿童医院小儿普外科经单孔腹腔镜保胆取石治疗胆囊结石14例患儿的临床资料,男6例,女8例;年龄为(9.5±3.6)岁,范围4~14岁;胆囊单发结石9例,多发结石5例;体质量指数为(24.2±6.5) kg/m^2,范围为19~28 kg/m^2;单纯肥胖2例、高脂蛋白饮食3例、既往有胆汁淤积病史3例、未发现特殊病因的胆囊结石6例。患儿术后均接受3~34个月的随访。结果14例患儿均经超声及磁共振胰胆管成像(MRCP)检查确诊,无胰胆管合流异常,所有患儿成功实施单孔腹腔镜保胆取石手术,无中转行胆囊切除。术前胆囊排空指数为(61.4±12.8)%,范围为52%~73%;术后3个月测定胆囊排空指数为(58.9±12.4)%,范围为51%~70%,与术前比较差异没有统计学意义(P〉0.05)。手术时间为(46.5±14.2) min,范围为32~70 min;出血量为(7.8±2.6) ml,范围为4~10 ml,无术中输血;术后住院时间为(3.6±1.1) d,范围为3~5 d;治疗期间未发生胆漏、术后出血、胆管损伤、胆源性胰腺炎及其他并发症。随访3~34个月,超声检查胆囊结石均未复发。结论儿童胆囊结石行单孔腹腔镜保胆取石手术可保留有功能的胆囊及胆道的完整性,操作简单、创伤小、恢复快、手术确切可靠,在严格掌握手术指征的情况下,该术式是治疗儿童胆囊结石的可行性方法。 展开更多
关键词 胆囊结石病 腹腔镜检查 胆囊
三维超声容积自动测量技术不同旋转步进角度测量胎儿胆囊体积 预览 被引量:1
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作者 罗瑜 冯梦娟 +4 位作者 胡祎 周微尘 徐莲 杨芳 马晓娟 《中国医学影像技术》 CSCD 北大核心 2018年第5期739-742,共4页
目的探讨采用三维超声容积自动测量(VOCAL)技术不同旋转步进角度测量中晚孕期胎儿胆囊体积的一致性,并分析其与孕周的相关性。方法对157名接受产前筛查的孕妇,采用三维超声VOCAL技术,分别选择旋转步进角度30°、18°、12... 目的探讨采用三维超声容积自动测量(VOCAL)技术不同旋转步进角度测量中晚孕期胎儿胆囊体积的一致性,并分析其与孕周的相关性。方法对157名接受产前筛查的孕妇,采用三维超声VOCAL技术,分别选择旋转步进角度30°、18°、12°,测量胎儿胆囊体积,观察胎儿胆囊体积与孕周的相关性,并比较3种旋转步进角度测量胎儿胆囊体积的一致性。结果 30°、18°、12°旋转步进角度测得胎儿胆囊体积值均与孕周相关性高(r=0.92、0.88、0.90,P均〈0.001),且30°与18°(ICC=0.94)、30°与12°(ICC=0.97)及18°与12°(ICC=0.94)测量胎儿胆囊体积的一致性均良好。结论采用三维超声VOCAL技术不同旋转步进角度测量胎儿胆囊体积值的一致性良好,且均与孕周高度相关。 展开更多
关键词 胎儿 胆囊 体积 图像处理 计算机辅助 超声检查 产前
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“君主之官”与“中正之官”新解 预览
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作者 高雅 安宏 徐世杰 《中国医药导报》 CAS 2018年第36期129-131,143共4页
既往对“君主之官”与“中正之官”多理解为官职。本文以诠释学的方法,通过释义、明理和致用等三方面,揭示“君主之官”和“中正之官”的天文学含义,指出心、胆的位置、功能是北斗授时和立中测影活动在人体的投射,而心、胆的关系也是两... 既往对“君主之官”与“中正之官”多理解为官职。本文以诠释学的方法,通过释义、明理和致用等三方面,揭示“君主之官”和“中正之官”的天文学含义,指出心、胆的位置、功能是北斗授时和立中测影活动在人体的投射,而心、胆的关系也是两种授时方法关系的体现,从而称之为“君主之官”与“中正之官”,进一步阐述其深层含义——无为与有为,并从调心理神、运胆治形和心胆互治三方面进行心胆调治,治病养生。 展开更多
关键词 君主之官 中正之官
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Prognostic significance of combined preoperative fibrinogen and CA199 in gallbladder cancer patients 预览
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作者 Wei-Yu Xu Hao-Hai Zhang +7 位作者 Xiao-Bo Yang Yi Bai Jian-Zhen Lin Jun-Yu Long Jian-Ping Xiong Jun-Wei Zhang Xin-Ting Sang Hai-Tao Zhao 《世界胃肠病学杂志:英文版》 SCIE CAS 2018年第13期1451-1463,共13页
AIM To investigate the prognostic value of the combination of preoperative plasma fibrinogen and CA199 in patients with gallbladder carcinoma(GBC).METHODS The clinicopathological data of 154 GBC patients were retrospe... AIM To investigate the prognostic value of the combination of preoperative plasma fibrinogen and CA199 in patients with gallbladder carcinoma(GBC).METHODS The clinicopathological data of 154 GBC patients were retrospectively reviewed after surgery.A receiver operating characteristic(ROC)curve was plotted to verify the optimum cut-off values for plasma fibrinogen and CA199.Univariate and multivariate survival analyses were performed to identify the factors associated with GBC prognosis.Based on the HRs calculated via multivariate survival analyses,patients with elevated plasma fibrinogen and CA199 levels were allocated a score of 2.1;those with an elevated plasma fibrinogen level only were allocated a score of 1,those with an elevated CA199 level only were allocated a score of 1.1,and those with neither of these abnormalities were allocated a score of 0.RESULTS ROC curve analysis showed that the optimum cut-off values for preoperative plasma fibrinogen and CA199 were 3.47 g/L and 25.45 U/mL,respectively.Multivariate analysis indicated that elevated preoperative plasma fibrinogen and CA199 levels were significantly correlated with worse overall survival(OS)(HR=1.711,95%CI:1.114-2.627,P=0.014,and HR=1.842,95%CI:1.111-3.056,P=0.018).When we combined these two parameters,the area under the ROC curve increased from 0.735(for preoperative plasma fibrinogen only)and 0.729(for preoperative CA199 only)to 0.765.When this combined variable was added to the multivariate analysis,the combination of plasma fibrinogen and CA199(P<0.001),resection margin(P<0.001)and TNM stage(P=0.010)were independent prognostic factors for GBC.CONCLUSION The combination of plasma fibrinogen and CA199 may serve as a more efficient independent prognostic biomarker for postoperative GBC patients than either parameter alone. 展开更多
关键词 PROGNOSTIC factor Plasma FIBRINOGEN CA199 SURVIVAL GALLBLADDER cancer
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