目的 总结超声引导下经皮经肝穿刺胆管引流术(PTCD)的优、缺点,为临床治疗重症急性胆管炎（SAC）提供参考。方法 回顾性分析我院1994年8月至2008年7月期间对156例老年SAC患者行在超声引导下的PTCD治疗的临床资料。结果 156例行PTCD均获成功,1次穿刺成功140例，其成功率达89.7%（140/156）; 16例首次穿刺失败后再次穿刺均成功。无一例发生腹腔出血、胆汁性腹膜炎等并发症。本组引流效果较好,中毒危象缓解，黄疸减退，肝功能改善。结论 PTCD较外科手术创伤小、操作简单、快速,具有微创的特点,对老年、有严重合并症及复杂疾病不能耐受手术及麻醉的SAC患者，其作为紧急抢救措施切实可行,并为后期施行根治性手术争取了时间。
An elderly female patient, with systemic multiple organ dysfunction, suffered from severe aortic valve stenosis, was to undergo transcatheter aortic valve replacement (TAVR). She was intolerance of the computed tomography examination before surgery. Bedside echocardiography was employed to evaluate the patient’s aortic valve stenosis, valve anatomy and type, the condition of aortic root, the distance from coronary to aortic root, and lower-extremity vascular access. Finally, the emergent TAVR was successfully performed under general anesthesia, and the aortic valve trans-prosthetic gradient met a remarkable decrease after surgery.
ObjectiveTo compare the diagnostic accuracy, sampling satisfaction, and safety of ultrasound-guided core needle biopsy (CNB) and fine needle aspiration biopsy (FNA) for thyroid nodules.MethodsThe databases of PubMed, Medline, Web of Science, Cochrane Library, Wanfang, CNKI, and CBM were searched to collect the relevant studies on the diagnostic performance, sampling satisfaction, and safety of ultrasound-guided CNB and FNA for thyroid nodules. Revman 5.3 and Stata 15 software were used for meta-analysis.ResultsA total of 24 studies involving 25 388 patients were included. Meta analysis showed that: compared with CNB, FNA had poor diagnostic accuracy ［OR=0.26, 95%CI (0.15, 0.46), P<0.000 01］, poor sampling satisfaction ［OR=0.20, 95%CI (0.12, 0.33), P<0.000 01］, lower incidence of total complications ［OR=0.28, 95%CI (0.16, 0.50), P<0.000 1］, and lower incidence of bleeding after biopsy ［OR=0.62, 95%CI (0.48, 0.81), P=0.000 3］. However, there was no significant difference in the pain score ［WMD=–0.21, 95%CI (–0.57, 0.15), P=0.26］ between the two groups. Subgroup analysis showed that there was no significant difference in the accuracy of biopsy diagnosis of thyroid nodules with diameter less than 10 mm between the two groups ［OR=0.52, 95%CI (0.15, 1.81), P=0.30］, however, the accuracy of CNB in the diagnosis of thyroid nodules with diameter ≥ 10 mm was still better than FNA ［OR=0.26, 95%CI (0.12, 0.56), P=0.000 5］.ConclusionsCompared with FNA, ultrasound-guided CNB has a certain advantages in sampling satisfaction and the diagnosis accuracy of thyroid nodules with diameter ≥ 10 mm. CNB is better than FNA, but will bring higher risk of complication.
Objective To study the efficiency of percutaneous acetic acid injection (PAI) or percutaneous ethanol injection (PEI) in the treatment of primary hepatic carcinoma (PHC). Methods Seventeen and 24 patients with PHC were treated, respectively by PAI or by PEI in our hospital. According to hepatic function test, soluble intereukin-2 receptor (sIL-2R), AFP, biopsy and size of tumor, the evaluation was made.Results Effective rate was 88.2% in PAI group and 87.5% in PEI group, respectively. There was no obvious influence to sIL-2R in serum in the two groups (Ｐ＞0.05). Obvious differences in impairment of hepatic functions between PAI and PEI groups were found (Ｐ＜0.01), it also showed that smaller amounts of acetic acid and less puncture frequency were required for the treatment than that of ethanol. Conclusion PAI is superior to PEI in the treatment of those patients who are complicated with cirrhosis or other vital disease.
摘要:目的：探讨超声引导下组织间插植内照射治疗中晚期宫颈癌的意义和效果。方法:回顾性分析32例中晚期宫颈癌患者,采用超声引导下肿瘤组织间插植内照射+外照射。结果：有23例肿瘤脱落,宫颈原形出现,其余7例肿瘤缩小50%以上,持续时间均≥1个月,另有2例肿块缩小＜50%,即CR为719%,PR为218%,NC为63%,PD为0%。结论：超声引导下插植内照射是一种治疗中晚期宫颈癌的安全有效的近距离放疗技术。Abstract: Objective: To evaluate the efficacies of interstitial implant brachytherapy by ultrasoundguided for moderately advanced and advanced cervical carcinoma. Methods: Thirytwo patients with cervical cancer ⅡbⅣ who received interstitial implant brachytherapy by ultrasoundguided and routine irradiation. Results: 719% cases achieved complete remission (CR), 219% cases partial remission (PR), 63% cases no change(NC),0% case progressed disease（PD）. Conclusion: Interstitial implant brachytherapy by ultrasoundguided is an effective method for cervical tumor.
目的 评价依托芬那酯凝胶治疗腱鞘炎在超声引导下微创术后肿痛的有效性和安全性。 方法 采用随机、对照的设计，将2011年5月－2012年7月，在四川省人民医院门诊接受腱鞘炎超声引导微创术后的患者157例，分为两组，治疗组（n=81）采用依托芬那酯凝胶外用，对照组（n=76）不使用外用药物。 结果 两组治疗后24 h及3 d的疼痛评分、压痛及关节功能缓解率与治疗前自身比较及组间比较，差别均有统计学意义（P＜0.05），7 d时治疗组临床总有效率为90.12%，对照组为89.47%，组间比较无统计学意义（P＞0.05），治疗组在使用应急药物上明显优于对照组。两组安全性评价比较差异无统计学意义（P＞0.05）。 结论 依托芬那酯凝胶能快速、有效、安全地缓解腱鞘炎超声引导微创术后局部肿胀疼痛的症状。