【摘要】 目的 探讨腰部放置衬垫物对经皮冠状动脉介入手术后卧床患者的作用。 方法 选取2008年7〖CD3/5〗12月于我科行经皮冠状动脉介入手术后50例患者,随机分为试验组25例和对照组 25 例。试验组在常规护理基础上予腰部放置衬垫物,对照组25例予常规护理,手术次日对患者进行视觉模拟量表测试方法(VAS)评分。 结果 试验组VAS评分秩和检验低于对照组,差异有统计学意义(Plt;0001);两组除烦躁外其他并发症无显著差异。 结论 冠状动脉介入手术后患者在平卧位制动时予腰椎弯曲处放置衬垫物可降低患者腰部疼痛程度。【Abstract】 Objective To investigate the effects of lumbar pad on bed patients who uhderwent percutaneous coronary intervention operation. Methods The 50 patients who uhderwent percutaneous coronary intervention operation in our deparment from July to December 2008，then randomly divided into experimental group(25 patients)and control group(25 patients). Control group were received conventional care，the experimental group were received lumbar pad based on the conventional care. The second day after operation，the patients were scored by visual analog scale test method (VAS). Results The VAS scores of experimental group was lower than control group，the difference was statistically significant (Plt;0001). The differences of other complications between two groups except fidgety were not statistically significant. Conclusions Coronary intervention after surgery，the patients in peripharyngeal braking to bend lumbar pad material can reduce the waist ache degree.
Trans-radial access (TRA) has been a common approach to percutaneous coronary intervention (PCI). Comparing with trans-femoral access (TFA), TRA is used as an alternative approach for PCI with less local complications, higher comfort level, and better outcome. In recent years, TRA has been paid more and more attention in peripheral vascular interventions. We reviewed recent developments in peripheral vascular intervention using TRA, with detail summary of the effectiveness, safety, limits, and future developments of it, aiming to improve the understanding and performance of TRA in interventionalists to benefit patients.
Objective To construct and compare logistic regression and decision tree models for predicting systemic inflammatory response syndrome (SIRS) in patients with type B aortic dissection (TBAD) after interventional surgery. Methods A retrospective analysis was conducted on clinical data of TBAD patients at Peking University Shenzhen Hospital from 2020 to 2024. The patients were divided into a SIRS group and a non SIRS group based on whether SIRS occurred within 24 hours after surgery. Multivariate logistic regression was used to analyze the influencing factors of SIRS occurrence in TBAD intervention patients, and a decision tree model was constructed using SPSS Modeler to compare the predictive performance of the two models. Results A total of 742 patients with TBAD were included, including 579 males and 163 females, aged between 27 and 97 (58.85±10.79) years. Within 24 hours after intervention, a total of 506 patients developed SIRS, with an incidence rate of 68.19%. Logistic regression analysis showed that the extensive involvement of the dissection, the surgical time≥ 2 hours, PET coated stents implanted, serum creatinine, white blood cell count, C-reactive protein, monocyte count (MONO), neutrophil count levels elevated, estimated glomerular filtration rate and decreased albumin levels were independent risk factors for SIRS (P<0.05). The decision tree model selected a total of 10 explanatory variables and 6 layers with 37 nodes, among which MONO was the most important predictor. The area under the decision tree model curve was 0.829 [95% CI (0.800, 0.856)], which was better than the logistic regression model's 0.690 [95% CI (0.655, 0.723)], and the difference was statistically significant (P<0.001). Conclusion The incidence of SIRS after TBAD intervention is high, and the decision tree model has better predictive performance than logistic regression. It can identify high-risk patients with higher accuracy and provide a practical tool for early clinical intervention.
Interventional radiology is an emerging discipline based on image-guided minimally invasive diagnosis and treatment. The number of interventional procedures performed is increasing year by year, resulting in a dramatic increase in the demand for interventional radiologists. Procedure training systems based on virtual reality (VR) technology simulate real interventional procedure through real-time interaction between hand manipulators and virtual environments, allowing physicians to experience real interventional procedures during training and reducing training time and costs. A growing number of medical schools are now adopting VR simulated training systems for interventional procedure training. This article reviews the relevant research progress of VR simulation interventional procedure training system in recent years and discusses the development prospects of VR technology in interventional procedure training.
ObjectiveTo investigate the significance of Fogarty catheter embolectomy combined with multiple minimally invasive techniques for acute limb ischemia. MethodsClinical data of 88 cases(88 limbs) of lower limb ischemia who were treated in our hospital from Feb. 2007 to Jan. 2011 were collected and analyzed. Of the 88 patients, 46 cases were operated by Fogarty catheter embolectomy(embolectomy group), 42 cases were operated by Fogarty catheter embolectomy combined with multiple minimally invasive techniques(combination group). Comparisons of the clinical indexes of ankle-brachial index(ABI), saturation of blood oxygen(SO2) of toes, and temperature of foot skin before and after operation were performed between the 2 groups, as well as the incidence of mortality, complication, and amputation after operation. ResultsCompared with before operation in the same group, the value of ABI, SO2, and temperature of foot skin in the 2 groups were higher(P<0.05), as well as the 3 kinds of indexes were both higher in combination group after operation(P<0.05). The rates of mortality, amputation, myonephropathic metabolic syndrome(MNMS), osteofascial compartment syndrome, and transient renal insufficiency were 13.04%(6/46), 17.39%(8/46), 26.09% (12/46), 26.09%(12/46), and 13.04%(6/46) respectively, the corresponding rates in combination group were 4.76% (2/42), 7.14%(3/42), 14.29%(6/42), 9.52%(4/42), and 9.52%(4/42) respectively, which were all lower in combination group(P<0.05). ConclusionFogarty catheter embolectomy combined with multiple minimally invasive techniques can be one of the surgical treatment methods for acute limb ischemia, which is characterized by minimally invasive surgery and effective treatment.
Interventional radiology (IR) has developed rapidly since its introduction into our country. More and more patients choose this minimally invasive procedure for treatment, but the incidence of infectious complications and potential mortality following IR procedures should not be underestimated. As the number and breadth of IR procedures grow, it becomes increasingly evident that interventional radiologists and infection control practitioners must possess a thorough understanding of these potential infectious complications and put more emphasis on the quality of care, so as to control the infections and expenses, and maximize the patient safety. This article reviews infectious complications associated with percutaneous ablation of liver tumors, transarterial embolization of liver tumors, percutaneous transhepatic cholangial drainage, and intravascular stents or grafts. Emphasis is placed on incidence, risk factors, and prevention. With the use of these strategies, IR procedures can be performed with reduced risk of infectious complications.
ObjectiveTo evaluate the occupational exposures and protective condition of medical staff in operating room for interventional therapy. MethodsFrom September to November in 2014, 46 medical staff in the operating room for interventional therapy were adopted to complete the occupational exposures and protection situation survey. After that, we analyzed and scored all the questionnaires. ResultsThe awareness of the medical staff about occupational exposures and occupational protection in the operating room was low; the awareness rates of doctors, nurses, and radiology technicians were 74.2%, 63.0% and 66.7%, respectively. The general condition of implement of occupational protection measures of the medical staff was bad, and the average rate of the doctors, nurses and radiology technicians was 51.3%, 43.9%, and 15.2%. ConclusionThe implement rates of occupational protection measures of the medical staff in Operating Room for interventional therapy differ much from the awareness rates. The rates in doctors and nurses are higher than that in radiology technicians. We should strengthen the education of radiation damage and protection measures in doctors, and enhance the training of iatrogenic injuries related knowledge in clinical radiology technicians to reduce occupational hazards.
Objective To investigate the effect of percutaneous balloon mitral valvuloplasty under echocardiographic guidance for patients with moderate to severe mitral stenosis during pregnancy. Methods A retrospective observational study was conducted to include pregnant women who were diagnosed with moderate to severe mitral stenosis and underwent percutaneous balloon mitral valvuloplasty under echocardiographic guidance in Fuwai Hospital from August 2018 to June 2022, and their baseline characteristics, surgical outcomes, echocardiographic results, and follow-up results were analyzed. Results A total of 3 pregnant women aged 30-35 years, with gestational age of 19-26 weeks, and New York Heart Association (NYHA) function class Ⅲ were included. All the procedures were successfully performed. The mitral valve orifice area increased from 0.9 cm2 preoperatively to 2.1 cm2 postoperatively. The mean transvalvular pressure gradient decreased from 15.0 mm Hg preoperatively to 6.7 mm Hg postoperatively. No perioperative adverse events occurred. The follow-up time ranged from 3 to 48 months. All patients delivered uneventfully and returned to normal life, with maternal-fetal safety. Conclusion Percutaneous balloon mitral valvuloplasty under echocardiographic guidance is a feasible and effective procedure for the treatment of patients with moderate to severe mitral stenosis in pregnancy, with satisfactory maternal-fetal outcomes.
ObjectiveTo investigate the effect of vascular interventional technique in arterial injuries of damage control surgery.MethodsA retrospective review was made on clinical data of 31 arterial injuries cases who received damage control surgery from March 2011 to June 2018. All cases underwent endovascular therapy for arterial injuries in No. 960 Hospital of Chinese People’s Liberation Army, and then the definitive operation was operated as soon as the vital signs became stable.ResultsThe surgery was successful in all patients, and the operation time was 43–100 min (average of 57 min), the intraoperative blood loss was 50–200 mL (average of 80 mL). Bleeding was successful controlled in 11 cases with covered stents, 9 cases with multiple overlapping bare stents, and 11 cases with spring coil, all cases with shock were improved immediately. There were no perioperative mortality or procedure-related complication occurred. All cases were discharged from hospital smoothly after two-phase surgery. All the patients were followed up for 6 to 24 months [(17±5) months]. Two patients with covered stent lumen stenosis less than 50% as showed by angiography, and no secondary treatment was required. In addition, blood flow patency was kept in the rest of artery, no bleeding occurred in injured artery. During the follow-up period, the collateral vessels of 9 patients treated with multi-layerbare stent overlapping technique were unobstructed. Stent migration, fracture or leakage was not found during the follow-up period. Patients recovered well after definitive surgery, they had good fracture healing with a disability rate of 0.ConclusionRational application of vascular interventional technique in damage control surgery is a safe and effective treatment method for arterial injuries combined with other traumas.