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Comprehensive review on EUS-guided biliary drainage 预览
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作者 Raffaele Salerno Sophia Elizabeth Campbell Davies +1 位作者 Nicolo Mezzina Sandro Ardizzone 《世界胃肠内镜杂志:英文版(电子版)》 2019年第5期354-364,共11页
Feasibility of endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage is not always applicable due to anatomical alterations or to inability to access the papilla. Percutaneous transhepatic biliary... Feasibility of endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage is not always applicable due to anatomical alterations or to inability to access the papilla. Percutaneous transhepatic biliary drainage has always been considered the only alternative for this indication. However, endoscopic ultrasonography-guided biliary drainage represents a valid option to replace percutaneous transhepatic biliary drainage when ERCP fails. According to the access site to the biliary tree, two kinds of approaches may be described: the intrahepatic and the extrahepatic. Endoscopic ultrasonography-guided rendezvous transpapillary drainage is performed where the second portion of the duodenum is easily reached but conventional ERCP fails. The recent introduction of self-expandable metal stents and lumen-apposing metal stents has improved this field. However, the role of the latter is still controversial. Echoendoscopic transmural biliary drainage can be challenging with potential severe adverse events. Therefore, trained endoscopists, in both ERCP and endoscopic ultrasonography are needed with surgical and radiological backup. 展开更多
关键词 ENDOSCOPIC ultrasonography-guided BILIARY drainage EUS Percutaneous transhepatic BILIARY drainage ENDOSCOPIC ultrasonography-guided hepatogastric anastomosis ENDOSCOPIC ultrasonography-guided ANTEGRADE stent placement ENDOSCOPIC ultrasonography-guided CHOLEDOCHODUODENOSTOMY ENDOSCOPIC ultrasonography-guided transgallbladder ENDOSCOPIC ultrasonography-guided rendezvous
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Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy 预览
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作者 Chonlada Krutsri Mitsuhiro Kida +3 位作者 Hiroshi Yamauchi Tomohisa Iwai Hiroshi Imaizumi Wasaburo Koizumi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第26期3313-3333,共21页
Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types o... Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types of reconstruction,cannulating a papilla with a reverse orientation,and performing therapeutic interventions with uncommon endoscopic accessories.The development of endoscopic techniques has led to higher success rates in this group of patients.Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction;however,these success rate is lower in long-limb reconstruction.ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length;however,it must be performed by a highly experienced and skilled endoscopist.Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography,but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy.Laparoscopic-assisted ERCP has an almost 100%success rate in longlimb reconstruction because of the use of a conventional side-view duodenoscope,which is compatible with standard accessories.This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy.This review focuses on the advantages,disadvantages,and outcomes of various procedures that are suitable in different situations and reconstruction types.Emerging new techniques and their outcomes are also discussed. 展开更多
关键词 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY Surgically ALTERED ANATOMY ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY in Billroth II ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY post-Whipple ENDOSCOPIC ultrasonography-guided ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
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Present state of endoscopic ultrasonography-guided fine needle aspiration for the diagnosis of autoimmune pancreatitis type 1 预览
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作者 Mitsuru Sugimoto Tadayuki Takagi +11 位作者 Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Ko Watanabe Jun Nakamura Hitomi Kikuchi Mika Takasumi Minami Hashimoto Takuto Hikichi Hiromasa Ohira 《世界荟萃分析杂志》 2019年第5期218-223,共6页
Autoimmune pancreatitis(AIP)is defined as pancreatitis caused by irregular narrowing of the pancreatic duct accompanied by pancreatic swelling,fibrosis and lymphocyte infiltration,events that are related to autoimmune... Autoimmune pancreatitis(AIP)is defined as pancreatitis caused by irregular narrowing of the pancreatic duct accompanied by pancreatic swelling,fibrosis and lymphocyte infiltration,events that are related to autoimmune mechanisms.The 2010 International Consensus Diagnostic Criteria for AIP defined pancreatitis as“type 1”when increased levels of serum IgG4 were present and other organs were involved;lymphoplasmacytic sclerosing pancreatitis was the main histological characteristic.Apart from surgery,endoscopic ultrasonographyguided fine needle aspiration(EUS-FNA)is the only method for the histological diagnosis of AIP;however,this method is difficult.The use of larger-diameter FNA needles and trucut biopsy did not improve the diagnostic performance of EUS-FNA,but it has improved gradually.In this review,we look back at past efforts to improve the diagnostic performance of EUS-FNA and reveal the present state of EUS-FNA for the histological diagnosis of AIP type 1. 展开更多
关键词 AUTOIMMUNE PANCREATITIS TYPE 1 Endoscopic ultrasonography-guided fine needle ASPIRATION IgG4-related disease Lymphoplasmacytic SCLEROSING PANCREATITIS
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可视球囊扩张导管在经皮肾镜取石术中的应用(附20例报告) 预览
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作者 张军晖 张际青 +1 位作者 蒋宇光 张小东 《中国内镜杂志》 2019年第3期74-77,共4页
目的评价可视球囊扩张在经皮肾镜取石术(PCNL)中的可行性和安全性。方法回顾性分析2017年3月-2018年3月应用可视球囊扩张导管建立通道行PCNL的20例肾结石患者的病例资料。结果 20例均成功应用可视球囊建立皮肾通道,通道建立时间为5.0~13... 目的评价可视球囊扩张在经皮肾镜取石术(PCNL)中的可行性和安全性。方法回顾性分析2017年3月-2018年3月应用可视球囊扩张导管建立通道行PCNL的20例肾结石患者的病例资料。结果 20例均成功应用可视球囊建立皮肾通道,通道建立时间为5.0~13.5 min,平均(7.2±2.1)min,手术时间为30.0~120.0 min,平均(59.1±21.9)min。术后血尿(ClavienⅠ)2例,经保守治疗好转。发热(ClavienⅡ)1例,经抗生素治疗好转。1例残留结石行体外冲击波治疗。术后1个月无石率和手术成功率分别为90.00%和95.00%,术后3个月无石率为100.00%。结论可视球囊有助于提高建立皮肾通道的准确性和提高手术成功率。 展开更多
关键词 肾结石 经皮肾镜取石术 球囊扩张 超声引导 放射线
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超声引导高位髂筋膜间隙阻滞在老年髋部骨折手术中的应用 预览
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作者 王皓 徐洪刚 《锦州医科大学学报》 CAS 2019年第3期63-66,共4页
目的评价高位髂筋膜间隙阻滞对于老年髋部骨折患者体位改变的镇痛效果。方法选择行择期股骨近端骨折(股骨颈骨折和粗隆间骨折)手术患者60例,年龄60~80岁,ASA分级Ⅱ~Ⅲ级,随机均分为高位髂筋膜间隙阻滞组(H组)和常规髂筋膜间隙阻滞组(F... 目的评价高位髂筋膜间隙阻滞对于老年髋部骨折患者体位改变的镇痛效果。方法选择行择期股骨近端骨折(股骨颈骨折和粗隆间骨折)手术患者60例,年龄60~80岁,ASA分级Ⅱ~Ⅲ级,随机均分为高位髂筋膜间隙阻滞组(H组)和常规髂筋膜间隙阻滞组(F组),于入室前20min行髂筋膜间隙阻滞,H组采用超声引导下高位髂筋膜间隙阻滞,将探头垂直股骨沟韧带放置,于髂前上棘与耻骨结节连线中外1/3交接点向尾侧2cm处长轴平面内向头侧进针,给予0.3%罗哌卡因30mL,F组采用常规超声引导髂筋膜间隙阻滞给予0.3%罗哌卡因30mL。分别记录两组患者神经阻滞起效时间,记录两组患者神经阻滞前(T0)、入手术室(T1)、过床时(T2)、摆放侧卧位时(T3)、椎管内麻醉后10min(T4)VAS疼痛评分。结果H组股神经、股外侧皮神经、闭孔神经起效时间均短于F组(P<0.05)。T1~T3时点H组VAS评分明显低于F组(P<0.05)。结论相比常规髂筋膜间隙阻滞,超声引导高位髂筋膜间隙阻滞能够有效缩短髂筋膜内三支神经阻滞(股神经、股外侧皮神经、闭孔神经)的起效时间,并提高髂筋膜间隙阻滞在老年股骨近端骨折患者麻醉体位摆放过程中的镇痛效果。 展开更多
关键词 超声引导 神经传导阻滞 麻醉药 局部 老年患者
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Appropriate number of biliary biopsies and endoscopic retrograde cholangiopancreatography sessions for diagnosing biliary tract cancer 预览
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作者 Tadayuki Takagi Mitsuru Sugimoto +11 位作者 Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Ko Watanabe Jun Nakamura Hitomi Kikuchi Mika Takasumi Minami Hashimoto Takuto Hikichi Hiromasa Ohira 《世界胃肠内镜杂志:英文版(电子版)》 2019年第3期231-238,共8页
BACKGROUND Biliary ductal cancer(BDC) is a lethal disease;however, diagnosing BDC is challenging. Biliary biopsies are performed to pathologically diagnose BDC, but the appropriate parameters for biliary biopsy [numbe... BACKGROUND Biliary ductal cancer(BDC) is a lethal disease;however, diagnosing BDC is challenging. Biliary biopsies are performed to pathologically diagnose BDC, but the appropriate parameters for biliary biopsy [number of biliary biopsies, number of endoscopic retrograde cholangiopancreatography(ERCP) sessions, etc.] are unknown.AIM To clarify what constitutes an adequate method for biliary biopsy.METHODS In total, 95 patients who underwent endoscopic biliary biopsy without choledochoscopy and who were pathologically diagnosed with BDC were enrolled in this study. The patients were divided into two groups. Seventy-six patients who were diagnosed by biliary biopsy were defined as the positive group(P group), and nineteen patients who were not diagnosed by biliary biopsy were defined as the negative group(N group). The patient characteristics and ERCP-related procedures were compared between the P and N groups.RESULTS The numbers of ERCP sessions and biliary biopsies were significantly different between the two groups (ERCP sessions(one/two), P group 72/4 vs N group15/4, P value = 0.048;number of biliary biopsies, P group 2(1-6) vs N group 2(1-7), P value = 0.039)In a multivariate analysis, fewer than 2 ERCP sessions was an independent factor influencing the positivity of the biliary biopsies.CONCLUSION This study clarified that ERCP and biliary ductal biopsy should only be performed once. If biliary cancer is not pathologically diagnosed after the first ERCP session, other methods(Endoscopic ultrasonography-guided fine needle aspiration or choledochoscopy-guided biliary ductal biopsy) should be employed. 展开更多
关键词 BILIARY DUCTAL cancer BILIARY biopsy ENDOSCOPIC retrograde cholangiopancreatography ENDOSCOPIC ultrasonography-guided fine needle aspiration CHOLEDOCHOSCOPY
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Current clinical management of gastrointestinal stromal tumor 预览
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作者 Kazuya Akahoshi Masafumi Oya +1 位作者 Tadashi Koga Yuki Shiratsuchi 《世界胃肠病学杂志:英文版》 SCIE CAS 2018年第26期2806-2817,共12页
Gastrointestinal stromal tumors(GISTs)are the most common malignant subepithelial lesions(SELs)of the gastrointestinal tract.They originate from the interstitial cells of Cajal located within the muscle layer and are ... Gastrointestinal stromal tumors(GISTs)are the most common malignant subepithelial lesions(SELs)of the gastrointestinal tract.They originate from the interstitial cells of Cajal located within the muscle layer and are characterized by over-expression of the tyrosine kinase receptor KIT.Pathologically,diagnosis of a GIST relies on morphology and immunohistochemistry[KIT and/or discovered on gastrointestinal stromal tumor 1(DOG1)is generally positive].The prognosis of this disease is associated with the tumor size and mitotic index.The standard treatment of a GIST without metastasis is surgical resection.A GIST with metastasis is usually only treated by tyrosine kinase inhibitors without radical cure;thus,early diagnosis is the only way to improve its prognosis.However,a GIST is usually detected as a SEL during endoscopy,and many benign and malignant conditions may manifest as SELs.Conventional endoscopic biopsy is difficult for tumors without ulceration.Most SELs have therefore been managed without a histological diagnosis.However,a favorable prognosis of a GIST is associated with early histological diagnosis and R0 resection.Endoscopic ultrasonography(EUS)and EUS-guided fine needle aspiration(EUSFNA)are critical for an accurate diagnosis of SELs.EUSFNA is safe and effective in enabling an early histological diagnosis and adequate treatment.This review outlines the current evidence for the diagnosis and management of GISTs,with an emphasis on early management of small SELs. 展开更多
关键词 GASTROINTESTINAL STROMAL tumor ENDOSCOPIC ultrasonography-guided fine needle ASPIRATION ENDOSCOPIC ULTRASONOGRAPHY Diagnosis Therapy
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超声引导喉上神经阻滞在老年患者纤维支气管镜检查术中的应用 预览
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作者 杨芳 冯学亮 +1 位作者 王国慧 耿智隆 《西北国防医学杂志》 CAS 2018年第8期536-540,共5页
目的:探讨超声引导双侧喉上神经阻滞在老年纤维支气管镜检查术中的应用价值。方法:选取我院拟行纤维支气管镜检查术的老年患者40例,根据术前麻醉方式的不同随机分为研究组和对照组,每组20例。研究组在超声引导下双侧喉上神经阻滞的基... 目的:探讨超声引导双侧喉上神经阻滞在老年纤维支气管镜检查术中的应用价值。方法:选取我院拟行纤维支气管镜检查术的老年患者40例,根据术前麻醉方式的不同随机分为研究组和对照组,每组20例。研究组在超声引导下双侧喉上神经阻滞的基础上行纤维支气管镜检查;对照组行纤维支气管镜检查时,于纤维支气管镜通过声门前、后经支气管镜侧孔各注入2%利多卡因3ml、5ml。两组患者术前均先用利多卡因行舌根部喷雾表面麻醉。测量并比较两组入室时(T1)、纤维支气管镜至咽部(T2)、入声门即刻(T3)、入声门1min(T4)、入声门5min(T5)时点的心率、血压、血氧饱和度;比较两组的喉上神经一次阻滞成功率、患者呛咳程度、耐受程度、并发症发生情况等。结果:两组各时点血氧饱和度均〉94%。对照组T2、T3时点血压、心率均较T1时点升高(P〈0.05)。对照组不同时点呛咳程度、纤维支气管镜耐受程度为3、4级的病例数明显多于研究组(P〈0.05)。结论:超声引导喉上神经阻滞能更好地抑制患者声门反射、减少心血管应激反应,可为老年患者更加舒适地完成纤维支气管镜检查提供满意条件。 展开更多
关键词 超声引导 喉上神经阻滞 纤维支气管镜
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超声引导下甲状腺结节粗针穿刺活检术的护理配合 被引量:2
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作者 梁丽 马步云 +3 位作者 赵俐红 张琼 向俐娟 周洁宏 《华西医学》 CAS 2017年第2期233-236,共4页
目的探讨超声引导下甲状腺结节患者行粗针穿刺活检术的护理配合措施。方法回顾性分析2010年6月—2014年5月行超声引导下甲状腺结节粗针穿刺活检术的1 900例患者的护理配合经验及要点。结果 1 900例患者顺利完成穿刺活检术,护理配合时间5... 目的探讨超声引导下甲状腺结节患者行粗针穿刺活检术的护理配合措施。方法回顾性分析2010年6月—2014年5月行超声引导下甲状腺结节粗针穿刺活检术的1 900例患者的护理配合经验及要点。结果 1 900例患者顺利完成穿刺活检术,护理配合时间5~15 min,平均(8.0±3.7)min。并发症包括血肿(25例,占1.3%)和晕针反应(30例,占1.6%),经对症处理后恢复,无神经损伤、麻醉意外和死亡等并发症发生。未发生因标本错误或标本丢失而引发的医疗纠纷。标本的取材成功率为98.4%(1 870/1 900),诊断准确率为95.3%(1 812/1 900)。结论超声引导下甲状腺结节粗针穿刺活检术具有操作简便、安全、取材成功率及诊断准确率高、并发症少等特点。熟悉护理配合流程以及穿刺标本的正确处置与交接是确保甲状腺结节患者行粗针穿刺活检术成功的关键。 展开更多
关键词 甲状腺结节 超声引导 粗针活检 护理配合
Ten-year survival of hepatocellular carcinoma patients undergoing radiofrequency ablation as a first-line treatment 预览
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作者 Wei Yang Kun Yan +6 位作者 S Nahum Goldberg Muneeb Ahmed Jung-Chieh Lee Wei Wu Zhong-Yi Zhang Song Wang Min-Hua Chen 《世界胃肠病学杂志:英文版》 SCIE CAS 2016年第10期2993-3005,共13页
AIM: To investigate the long-term survival and prognostic factors in hepatocellular carcinoma(HCC) patients undergoing radiofrequency ablation(RFA) as a first-line treatment.METHODS: From 2000 to 2013, 316 consecutive... AIM: To investigate the long-term survival and prognostic factors in hepatocellular carcinoma(HCC) patients undergoing radiofrequency ablation(RFA) as a first-line treatment.METHODS: From 2000 to 2013, 316 consecutivepatients with 404 HCC(1.0-5.0 cm; mean: 3.2 ± 1.1 cm) underwent ultrasonography-guided percutaneous RFA as a first-line treatment. There were 250 males and 66 females with an average age of 60.1 ± 10.8 years(24-87 years). Patients were followed for 1 year to > 10 years after RFA(234, 181, 136, and 71 for 3, 5, 7, and 10 years, respectively). Overall local response rates and long-term survival rates were assessed. Survival results were generated using Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression model. RESULTS: In total, 548 RFA sessions were performed and major complications occurred in 10 sessions(1.8%). Local tumor progression and/or new tumor development were observed in 43.3%(132/305) of the patients during the follow-up period. Overall 5-and 10-year survival rates were 49.7% and 28.4%, respectively. Based on multivariate analysis, three factors were identified as independent prognostic factors for overall survival: Child-Pugh classification(HR = 4.054, P < 0.001), portal vein hypertension(HR = 2.743, P = 0.002), and tumor number(HR = 2.693, P = 0.003). The local progression-free 5- and 10-year survival rates were 42.7% and 19.5%. In addition to the Child-Pugh classification and the number of tumors, the number of RFA sessions(HR = 1.550, P = 0.002) was associated with local progression-free survival.CONCLUSION: RFA can achieve acceptable outcomes for HCC patients as a first-line treatment, especially for patients with Child-Pugh class A, patients with a single tumor and patients without portal vein hypertension. 展开更多
关键词 RADIOFREQUENCY ablation Hepatocellular carcinoma PERCUTANEOUS Ultrasonography-guided Long TERM survi
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Endoscopic ultrasonography guided-fine needle aspirationfor the diagnosis of solid pancreaticobiliary lesions: Clinicalaspects to improve the diagnosis 预览 被引量:1
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《世界胃肠病学杂志:英文版》 SCIE CAS 2016年第2期628-640,共13页
Endoscopic ultrasonography-guided fine-needleaspiration (EUS-FNA) has been applied to pancreaticobiliarylesions since the 1990s and is in widespreaduse throughout the world today. We used this methodto confirm the p... Endoscopic ultrasonography-guided fine-needleaspiration (EUS-FNA) has been applied to pancreaticobiliarylesions since the 1990s and is in widespreaduse throughout the world today. We used this methodto confirm the pathological evidence of the pancreaticobiliarylesions and to perform suitable therapies.Complications of EUS-FNA are quite rare, but some ofthem are severe. Operators should master conventionalEUS observation and experience a minimum of 20-30cases of supervised EUS-FNA on non-pancreaticand pancreatic lesions before attempting solo EUSFNA.Studies conducted on pancreaticobiliary EUSFNAhave focused on selection of suitable instruments(e.g. , needle selection) and sampling techniques (e.g. ,fanning method, suction level, with or without a stylet,optimum number of passes). Today, the diagnosticability of EUS-FNA is still improving; the detection ofpancreatic cancer (PC) currently has a sensitivity of90%-95% and specificity of 95%-100%. In additionto PC, a variety of rare pancreatic tumors can bediscriminated by conducting immunohistochemistryon the FNA materials. A flexible, large caliber needlehas been used to obtain a large piece of tissue, whichcan provide sufficient histological information to behelpful in classifying benign pancreaticlesions. EUSFNAcan supply high diagnostic yields even for biliarylesions or peri-pancreaticobiliary lymph nodes. Thisreview focuses on the clinical aspects of EUS-FNA inthe pancreaticobiliary field, with the aim of providinginformation that can enable more accurate and efficientdiagnosis. 展开更多
关键词 ENDOSCOPIC ultrasonography-guided fineneedleaspiration DIAGNOSIS Pancreaticobiliary PANCREATIC Cancer
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经皮微波消融治疗肝硬化脾功能亢进症的临床研究 预览 被引量:1
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作者 何锋坚 李立夫 +6 位作者 刘素英 龙沛琪 彭芊芊 邓三花 陈培生 杨文娟 岳辉 《中国医学物理学杂志》 CSCD 2016年第5期510-514,共5页
目的:探讨经皮穿刺微波消融治疗肝硬化脾功能亢进症的安全性、疗效和临床应用前景。方法:2012年8月至2015年4月在超声引导下对50例(29例患者1次微波消融,12例患者重复2次微波消融,9例患者重复3次微波消融)肝硬化脾功能亢进症患者实... 目的:探讨经皮穿刺微波消融治疗肝硬化脾功能亢进症的安全性、疗效和临床应用前景。方法:2012年8月至2015年4月在超声引导下对50例(29例患者1次微波消融,12例患者重复2次微波消融,9例患者重复3次微波消融)肝硬化脾功能亢进症患者实施经皮穿刺脾脏微波消融治疗,对脾微波消融术过程中的术前及术后观察进行总结。结果:平均手术时间为(2.1±0.9)h,平均消融时间为(1.5±0.6)h;术后3 d外周血小板计数较术前明显下降;术后6个月随访发现患者白细胞以及血小板计数均较术前改善,差异有统计学意义(P〈0.05),肝肾功能指标、凝血功能、红细胞计数无明显差异(P〉0.05)。术后白细胞计数指标在Child-Pugh分组和消融次数分组中存在显著差异(P〈0.05),术后血小板计数指标在消融次数分组和脾大程度分组中存在显著差异(P〈0.05)。结论:经皮穿刺微波消融治疗肝硬化脾功能亢进症是一项具有临床应用前景的微创治疗方法,对患者白细胞及血小板指标的改善有显著作用。 展开更多
关键词 超声引导 微波消融 肝硬化 脾功能亢进
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平面内与平面外技术在超声引导下外周静脉置入中心静脉导管的效果观察 预览 被引量:5
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作者 李承文 《海军医学杂志》 2016年第5期415-416,420共3页
目的探讨在彩色多普勒引导下经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)置管穿刺过程中,采用平面内技术与平面外技术的应用效果.方法选取2015年1-12月在我院行超声引导下PICC置管患者130例,经患者知... 目的探讨在彩色多普勒引导下经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)置管穿刺过程中,采用平面内技术与平面外技术的应用效果.方法选取2015年1-12月在我院行超声引导下PICC置管患者130例,经患者知情同意,按数字表法随机分为2组:超声引导下平面内技术组和平面外技术组,每组65例.观察2组穿刺用时和一针穿刺成功率.结果彩色多普勒引导下PICC置管穿刺过程中,平面内技术组穿刺时间为(180.0±35.0)s,平面外技术组为(98.0±24.1)s,2组比较差异有统计学意义(P〈0.05);平面内技术组一针穿束喊功率为66.2%,平面外技术组为96.9%,2组比较差异有统计学意义(P〈0.05).结论超声引导下PICC置管平面外技术穿刺用时短,一针穿刺成功率高,适于在临床推广. 展开更多
关键词 经外周置入中心静脉导管 超声引导 平面内技术 平面外技术
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Resected tumor seeding in stomach wall due to endoscopicultrasonography-guided fine needle aspiration of pancreaticadenocarcinoma 预览
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《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS 2015年第27期8458-8461,共4页
Endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) is a useful and relatively safe tool for thediagnosis and staging of pancreatic cancer. However,there have recently been several reports of tumor see... Endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) is a useful and relatively safe tool for thediagnosis and staging of pancreatic cancer. However,there have recently been several reports of tumor seedingafter EUS-FNA of adenocarcinomas. A 78-year-old manwas admitted to our hospital due to upper gastric pain.Examinations revealed a 20 mm mass in the pancreaticbody, for which EUS-FNA was performed. The cytologyof the lesion was adenocarcinoma, and the stage of thecancer was T3N0M0. The patient underwent surgery withcurative intent, followed by adjuvant chemotherapy withS-1. An enlarging gastric submucosal tumor was foundon gastroscopy at 28 mo after surgery accompanied by arising level of CA19-9. Biopsy result was adenocarcinoma,consistent with a pancreatic primary tumor. Tumorseeding after EUS-FNA was strongly suspected. Thepatient underwent surgical resection of the gastrictumor with curative intent. The pathological result ofthe resected gastric specimen was adenocarcinoma witha perfectly matched mucin special stain result with thepreviously resected pancreatic cancer. This is the firstcase report of tumor seeding after EUS-FNA which wassurgically resected and inspected pathologically. 展开更多
关键词 Endoscopic ultrasonography-guided fine NEEDLE ASPIRATION Tumor SEEDING PANCREATIC cancer
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甲状腺良性结节射频消融治疗研究 预览 被引量:1
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作者 鲍山林 移志刚 +5 位作者 张宇 余生林 江宁祥 许瑞庭 张锦洲 余建军 《宁夏医学杂志》 CAS 2015年第6期490-492,共3页
目的 探讨和研究射频消融在甲状腺良性结节治疗中的安全性、有效性和具体操作技术。方法 针对选取的49例病人中67枚甲状腺良性结节进行B超引导下射频消融治疗。B 超随访观察结节缩小情况及甲状腺功能变化。结果 消融前甲状腺结节体积为... 目的 探讨和研究射频消融在甲状腺良性结节治疗中的安全性、有效性和具体操作技术。方法 针对选取的49例病人中67枚甲状腺良性结节进行B超引导下射频消融治疗。B 超随访观察结节缩小情况及甲状腺功能变化。结果 消融前甲状腺结节体积为(4.41±3.31)mL。结节体积缩小率在射频消融治疗 1 月、3 月、6 月后分别为 55.12%、71.31%、79.46%(P〈0.05)。术后体积缩小率大于 50%的约为 86.5%(n=58 枚)。有 25%(n=18 枚)结节术后B 超随访消失。在最后一次随访中没有发现有结节体积增大的情况。出现并发症 15 例(30%),多较轻微,短时期内即恢复。甲状腺功能术前术后无明显变化。结论 射频消融治疗是甲状腺良性结节治疗中安全、微创、有效的治疗方法 展开更多
关键词 甲状腺良性结节 射频消融 超声引导 微创
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Historical transition of management of sarcoidosis 预览
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作者 Minoru Inomata Satoshi Konno Arata Azuma 《世界呼吸病学杂志》 2015年第1期4-16,共13页
Sarcoidosis is a systemic granulomatous disease of undetermined etiology,and it primarily affects the lungs and lymphatic system but may involve other organs.Recently,there have been several new insights in Japanese p... Sarcoidosis is a systemic granulomatous disease of undetermined etiology,and it primarily affects the lungs and lymphatic system but may involve other organs.Recently,there have been several new insights in Japanese patients.The frequency of cardiac,ocular,and cutaneous sarcoidosis has increased in Japan,whereas,the proportion of patients with bilateral hilar lymphadenopathy decreased from 1960 to 2004.Propionibacterium acnes(P.acnes)has been studied extensively as one of the causative microorganism for granuloma formation,particularly in Japan.P.acnes-specific monoclonal antibodies are useful for diagnosing sarcoidosis.The potential association between smoking and sarcoidosis has been evaluated in a Japanese study,which found a higher prevalence of sarcoidosis among young smokers than that in previous reports.Recently,18F-fluorodeoxyglucose positron-emission tomography,which permits visualization of activated inflammation,and endobronchial ultrasonography-guided transbronchial needle aspiration have been increasingly used to diagnose sarcoidosis.Cardiac sarcoidosis is found to be the main cause of death in Japan.The 2006 revised Japanese guidelines for diagnosing cardiac sarcoidosis are useful,particularly for subclinical cardiac sarcoidosis patients.Further studies and international communication and evaluation are needed to determine the causes of sarcoidosis,identify the risk factors for progressive disease,and develop new and effective treatments. 展开更多
关键词 Japan PROPIONIBACTERIUM acnes SMOKING Cardiac SARCOIDOSIS Positron-emission tomography ENDOBRONCHIAL ultrasonography-guided transbronchial needle ASPIRATION
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超声引导下穿刺治疗颌面间隙感染的临床研究 预览 被引量:1
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作者 刘晖 《中国医学创新》 CAS 2014年第7期21-22,共2页
目的:探讨颌面间隙感染患者在超声引导下完成穿刺治疗的效果。方法:选取本院2010年12月-2012年12月颌面间隙感染患者90例,通过随机数表法将所有患者平均分成A1组与A2组,每组45例。A1组患者通过超声引导完成穿刺治疗,A2组患者采用... 目的:探讨颌面间隙感染患者在超声引导下完成穿刺治疗的效果。方法:选取本院2010年12月-2012年12月颌面间隙感染患者90例,通过随机数表法将所有患者平均分成A1组与A2组,每组45例。A1组患者通过超声引导完成穿刺治疗,A2组患者采用抗菌药物进行治疗。比较A1组、A2组患者治疗的总有效率以及治疗的显效时间等。结果:A1组患者完成治疗后显效时间为(6.9±1.7)d,A2组为(10.6±2.1)d,两组比较差异有统计学意义(P〈0.05)。A1组治疗总有效率为97.78%,A2组为44.44%,两组比较差异有统计学意义(P〈0.05)。结论:针对颌面间隙感染患者,通过超声引导对患者进行穿刺治疗,最终患者的临床治疗效果表现确切,患者的感染情况得到了有效的控制。 展开更多
关键词 超声引导 穿刺治疗 颌面间隙感染 临床治疗效果
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B超引导下活检针穿刺对可疑甲状腺癌结节的诊断意义 预览 被引量:7
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作者 袁明 徐月阳 《中国医学创新》 2014年第17期33-35,共3页
目的:探讨超声引导下活检针穿刺对可疑甲状腺癌结节的诊断价值。方法:在512例患有可疑甲状腺癌结节的患者中,按完全随机设计的原则抽取120例作为研究对象,在术前均行超声引导下活检针穿刺术。计算kappa值、准确率、灵敏度、特异度... 目的:探讨超声引导下活检针穿刺对可疑甲状腺癌结节的诊断价值。方法:在512例患有可疑甲状腺癌结节的患者中,按完全随机设计的原则抽取120例作为研究对象,在术前均行超声引导下活检针穿刺术。计算kappa值、准确率、灵敏度、特异度、漏诊率、误诊率、阳性预测值、阴性预测值、约登指数、阳性似然比、阴性似然比。结果:经术后病理证实84例为甲状腺癌,活检针穿刺正确79例,漏诊5例,不能确定5例。kappa值0.844、一致率0.933、灵敏度0.94、特异度0.917、漏诊率0.06、误诊率0.083、阳性预测值0.963、阴性预测值0.868、阳性似然比11.286、阴性似然比0.065、约登指数0.857。结论:超声引导下活检针穿刺对可疑甲状腺癌结节有较高的诊断价值,可作为判断良恶性结节的首选。 展开更多
关键词 B超引导 活检针穿刺 甲癌结节
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子宫动脉栓塞术联合B超引导下清宫术治疗剖宫产疤痕妊娠的应用研究 预览 被引量:28
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作者 冯卫彤 黄卓敏 +1 位作者 古衍 彭艳 《暨南大学学报:自然科学与医学版》 CAS CSCD 北大核心 2014年第6期543-546,共4页
目的探讨子宫动脉栓塞术联合B超引导下清宫术治疗剖宫产疤痕妊娠的临床价值.方法:对47例剖宫产疤痕妊娠的患者进行子宫动脉栓塞术,24h内在B超引导下清宫术,进行回顾性分析.结果:所有病例均-次栓塞成功,清宫术中出血量少.43例经子宫动... 目的探讨子宫动脉栓塞术联合B超引导下清宫术治疗剖宫产疤痕妊娠的临床价值.方法:对47例剖宫产疤痕妊娠的患者进行子宫动脉栓塞术,24h内在B超引导下清宫术,进行回顾性分析.结果:所有病例均-次栓塞成功,清宫术中出血量少.43例经子宫动脉栓塞术联合B超引导下清宫术治愈;2例经后续补充MTX治愈;2例经后续补充宫腔镜手术治愈.所有患者成功保留子宫,并恢复正常月经.无感染等严重并发症发生.结论:子宫动脉栓塞术联合B超引导下清宫术治疗剖宫产疤痕妊娠手术创伤小、疗效确切、并发症少、能保留子宫,在有条件的医院可作为首选的治疗方法. 展开更多
关键词 剖宫产疤痕妊娠 子宫动脉栓塞术 B超引导 清宫术
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麦默通旋切系统在乳腺导管内乳头状瘤诊疗中的应用 被引量:2
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作者 张晓申 叶熹罡 +1 位作者 潘凌霄 郑文博 《广州医学院学报》 2013年第2期70-72,共3页
目的:探讨超声引导下麦默通旋切系统对乳腺导管内乳头状瘤(IP)的诊断与治疗价值,、方法:回顾性分析2008年8月至2011年9月广州医学院第一附属医院收治的31例(35个病灶)IP患者的临床资料,均采用超声引导下麦默通旋切系统进行诊断... 目的:探讨超声引导下麦默通旋切系统对乳腺导管内乳头状瘤(IP)的诊断与治疗价值,、方法:回顾性分析2008年8月至2011年9月广州医学院第一附属医院收治的31例(35个病灶)IP患者的临床资料,均采用超声引导下麦默通旋切系统进行诊断和治疗,结果:所有病灶定位准确.手术时间5-20min,平均手术时间(9.2±12.7)mln,.术中及术后患者均无明显疼痛.术后无血肿形成、病理检查示6例(19.4%)为不典型IP,接受开放手术切除,其中1例(16.7%)为浸润性导管癌,改行单纯乳房切除+前哨淋巴结活检术;25例(80.6%)为良性IP,接受定期超声检查术后3个月复查,患者伤口均愈合良好,无明显疤痕形成。1例术后15个月复发,接受开放手术切除,结论:超声引导下麦默通旋切系统可准确定位并切除IP,具有微创、美观、并发症少等优点,值得进一步推广当病理为不典型导管内乳头状瘤时.需进一步行开放手术切除。 展开更多
关键词 麦默通旋切系统 微创手术 超声引导 导管内乳头状瘤
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