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find Keyword "血管畸形" 12 results
  • A PRELIMINARY STUDY ON CLINICAL FEATURE OF INFANTILE HEMANGIOMA AND VASCULAR MALFORMATION

    Objective To study the cl inical features of infantile hemangioma and vascular malformation, to find out a proper strategy of deal ing with them. Methods From March 2000 to August 2007, 2 957 cases of infantile hemangioma and vascular malformation were treated, including 860 operative cases and 2 097 non-operative cases. There were 441 male and419 female patients in operation group, aging 6 months to 18 years (median 5 years). In 1 950 hemangioma patients of nonoperation group, there were 575 male and 1 375 female patients, aging 1 month to 14 years (median 6 months); in 147 vascular malformation patients of non-operation group, there 67 male and 80 female patients, aging 2 years to 17 years (median 7 years). In non-operative group, 147 vascular malformation patients and 1 525 infantile hemangioma patients were followed up without any medical intervention, while other 425 hemangioma patients recceived triamcinolone plus dexamethasone intralesional injection treatment. All the treatments and outcomes were recorded. Results Vascular malformation cases and infantile hemangioma cases presented totally different cl inical features. To the deadl ine of this study, 522 (34%) of 1 525 un-intervented hemangioma cases turned into involuted phase and 383 (90%) of 425 cases receiving triamcinolone plus dexamethasone intralesional injection treatment turned into involuted phase after injection treatment; no regression was noted in 147 cases of vascular malformation. The constituent ratio of infantile hemangioma in 860 operative cases was decreased gradually and the constituent ratio of vascular malformation was increased gradually as the age increasing. Conclusion Infantile hemangioma has a distinct l ife pattern. Except several specific cases need medical intervention for their special location or large ambit and unacceptable growth, most infantile hemangioma need no medical intervention. Most vascular malformations can not regress spontaneously, proper intervention is in need.

    Release date:2016-09-01 09:06 Export PDF Favorites Scan
  • 下肢血管畸形的手术治疗

    目的 总结下肢血管畸形的手术方法及疗效。 方法 2012 年 7 月—2015 年 7 月,收治下肢血管畸形患者 138 例。男 51 例,女 87 例;年龄 3~55 岁,平均 28.3 岁。静脉畸形 98 例,动静脉畸形 40 例。病变部位:臀部 24 例,大腿 30 例,臀部及大腿 23 例,小腿 35 例,大腿及小腿 9 例,累及整个下肢 17 例。其中 106 例行单纯手术切除,32 例行术前髂外动脉球囊栓塞+手术切除。 结果 术后 4 例植皮区发生部分皮片坏死,经换药后 Ⅱ 期愈合;余患者皮瓣及移植皮片均顺利成活,创面及供区切口均 Ⅰ 期愈合。患者均获随访,随访时间 4 个月~3 年,平均 18 个月。手术治愈率 84.8%(117/138)。复发患者均给予局部注射鱼肝油酸钠后,无再次复发。 结论 在严格掌握手术指征前提下,单纯手术切除或联合术前髂外动脉球囊栓塞可有效治疗下肢血管畸形。

    Release date:2017-05-05 03:16 Export PDF Favorites Scan
  • Features of Cardiacvascular Abnormalities and Clinical Results in Patients with Fontan Operation for Heterotaxy Syndrome

    ObjectiveTo summarize the cardiac-vascular abnormalities and clinical results in patients with Fontan operation for heterotaxy syndrome. MethodWe retrospectively analyzed the medical records of 81 patients who underwent the Fontan operation with heterotaxy syndrome between September 2008 and September 2013. There were 49 male and 32 female patients at age of 3.79 (range 2.07-13.02) years with preoperative room air saturation of 81% (range 63%-97%) and weight of 14.8 (10.0-36.0) kg. ResultsThere were 70 patients in the right atrial isomerism group and left in 11 patients. Dextrocardia was seen in 16 patients, and single atrium in 50 patients. Single ventricle was found in 44 patients, conotruncal defects in 40 patients, pulmonary stenosis in 72 patients, pulmonray atresia in 8 patients, common atrioventricular valve in 61 patients, and bilateral superior vena cava in 54 patients. The staged Fontan procedure was applied in 57 patients and one stage in 24 patients. Operation strategies were included intra/extracardiac conduit (n=17), extracardiac conduit (n=48), lateral tunnel (n=14) and direct cavopulmonray connection (n=2).There were 15 early deaths. Postoperative complications included low cardiac output in 15 patients, hepatic insufficiency in 35 patients, renal insufficiency in 55 patients required peritoneal dialysis and arrhythmia in 28 patients. The room air saturation was 89% (range 78%-98%) before discharge and time of follow-up was from 2 months to 6 years in 64 patients. Thromboembolic events were found in 2 patients who had accomplished conduit replacement operation. ConclusionCompared with reported literatures in western countries, heteraotaxia patients are mostly with right atrial isomerism. Fontan palliation is still the main treatment option and strict indication was needed for satisfactory clinical results.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Perioperative Management of Anomalous Origin of the Left Coronary Artery from Pulmonary Artery

    ObjectiveTo summarize perioperative management experience of 16 patients undergoing surgical correction of anomalous origin of the left coronary artery from pulmonary artery (ALCAPA). MethodsWe performed a retrospective analysis of 16 patients who received surgical correction of ALCAPA between January 2005 and December 2013 in Cardiovascular Center of Children's Hospital of Fudan University. There were 6 males and 10 females with their age ranging from 2 months to 13 years (mean age of 23.25±0.63 months) and body weight ranging from 5 to 30 kg (mean body weight of 19.77±0.75 kg). All the patients underwent direct implantation of the anomalous coronary artery into the ascending aorta, and received comprehensive management regarding left ventricular ejection fraction (LVEF), heart rate, blood pressure, arterial blood gas, urinary volume, blood lactic acid and central venous pressure. ResultsPostoperative complications were low cardiac output syndrome (LCOS) in 9 patients (including intractable LCOS in 2 patients) and arrhythmia in 1 patient. One patient with intractable LCOS and arrhythmia died postoperatively with the mortality of 6.25%. Cardiopulmonary bypass time was 85-260 (135.61±35.01) minutes, aortic cross-clamping time was 40-97 (57.32±16.02) minutes, mechanical ventilation time was 34-187 (106.34±41.62) hours, length of CICU stay was 2-21 (8.13±5.02) days, and hospital stay was 12-51 (22.14±5.00) days. Postoperative LVEF and left ventricular fractional shortening were significantly higher than preoperative values (P < 0.05). ConclusionKey points for successful surgical correction of ALCAPA include meticulous perioperative management, preoperative heart function improvement, prevention of postoperative complications and use of new techniques.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • 泡沫硬化剂治疗皮肤血管瘤及血管畸形的临床疗效

    目的观察泡沫硬化剂注射治疗皮肤血管瘤及血管畸形的疗效。 方法2011年11月至2014年11月期间,对笔者所在医院科室收治的53例不同类型的皮肤血管瘤及血管畸形患者采用泡沫硬化剂瘤内注射治疗,根据患者年龄、瘤体大小和深度决定用药剂量和注射次数,注射最大剂量不超过6 mL/次,2次注射的间隔时间为2~4周。 结果53例患者中男20例,女33例;年龄1个月~40岁,中位年龄1.6岁;瘤体大小为1.0 cm×(1.0~2.0)cm×5.0 cm。53例患者均完成全程治疗,注射治疗1~6次,平均注射治疗3次,并经6个月随访,其中达到Ⅰ级疗效者2 例(3.8%),Ⅱ级疗效者5例(9.4%),Ⅲ级疗效者10例(18.9%),Ⅳ级疗效者36例(67.9%);1例出现局部皮肤破溃,经换药处理后创面愈合。 结论泡沫硬化剂注射治疗皮肤血管瘤及血管畸形安全有效。

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  • Value of DSA in Diagnosis and Interventional Treatment of Intestinal Vascular Malformalion

    目的:探讨DSA诊断小肠血管畸形的价值。方法:本文分析21例小肠血管畸形患者的临床及DSA特征,其中男性14例,女性7例,所有患者均行肠系膜上、下动脉造影。结果:临床特征:①急性消化道出血为主症状;②常规检查一般为阴性;③血红蛋白含量短期内降至4~6 g/mL。DSA特征:①动静脉瘘;②局部肠壁染色增浓;③局部血管异常增多,结构紊乱。其中12例进行了动脉导丝栓塞,2例栓塞后出血,进行外科手术切除。结论:DSA是诊断血管畸形所致小肠出血的最有效的方法,动脉导丝栓塞是安全,有效的治疗方法,同时为外科手术切除提供的正确部位。

    Release date:2016-09-08 09:54 Export PDF Favorites Scan
  • 平阳霉素结合无水乙醇介入治疗体表血管畸形的护理

    目的 采用平阳霉素结合无水乙醇选择性治疗体表血管畸形,通过加强围手术期的护理,从而提高患者依从性及临床疗效。 方法 2005年5月-2008年8月对53例体表血管畸形患者,使用平阳霉素与碘化油的混悬液结合无水乙醇进行治疗。 结果 治愈32例, 治愈率为60.4%;好转19例, 占35.8%;无效2例,占3.8%。未发现显著的不良反应。 结论 选择性治疗体表血管畸形具有简便、疗效显著、微创的特点,在介入手术全程,给予有针对性的围手术期护理,可提高患者的依从性,有效预防并发症,促进患者早日康复。

    Release date:2016-09-08 09:49 Export PDF Favorites Scan
  • 脊髓出血

    脊髓出血是脊柱外科急症之一,该病较为罕见,病情复杂,来势凶险,不及时给予恰当的治疗,会导致患者死亡或者永久性神经功能障碍。及早抢救治疗有望降低病死率,减少后遗症,故临床医生对该病应有一定的认识并保持高度的警惕。现对脊髓出血的病因和发病机制、临床表现、辅助检查、诊断及治疗等进行归纳总结,为早期发现治疗脊髓出血提供科学的理论依据。

    Release date:2016-09-07 02:33 Export PDF Favorites Scan
  • Clinical analysis of unroofed coronary sinus syndrome with endocardial cushion defect

    Objective To analyze pathologic features and surgical procedures for patients with unroofed coronary sinus syndrome (UCSS) associated with endocardial cushion defect (ECD). Methods The clinical data of 44 patients with UCSS and ECD from May 1998 to July 2016 were retrospectively reviewed. There were 18 males and 26 females with a mean age of 10.4±12.1 years (range: 5.0 months to 44.0 years) and mean weight of 25.2±20.9 kg (range 5.2-80.0 kg). According to the Kirklin and Barratt-Boyes classification, 28 patients were categorized into type Ⅰ, 5 typeⅡ , 4 type Ⅲ and 7 type Ⅳ. Among them 25 patients suffered partial ECD, 10 complete ECD, 9 transitional ECD, and 27 were associated with single atrium, 34 involved persistent left superior vena cava (PLSVC), and in 27 of the 34 patients PLSVC directly drained into the left atrium (LA). Among the 44 patients, 1 patient associated with complex anomalies underwent palliative operation, and other cardiac malformations were corrected simultaneously by surgical correction. PLSVC was ligated in 2 patients, and the intracardiac tunnels or baffles to drain PLSVC to right atrium (RA) were reconstructed in 25 patients. The associated cardiac lesions were corrected concomitantly. Results In-hospital death occurred in 2 patients, among whom 1 died of low cardiac output syndrome on postoperative day 8 and the other pulmonary infection on postoperative day 21. Thirty-one were followed up from 1 month to 10 years, and there was no death or severe complications. Conclusion When ECD is associated with PLSVC and a single atrium, UCSS may develop. Repair according to the type of UCSS is effective.

    Release date:2017-09-04 11:20 Export PDF Favorites Scan
  • Forensic Pathological Analysis of Death from Cerebrovascular Malformation

    ObjectiveTo provide references in the forensic identification of injury and cerebrovascular malformation involved death cases, and to reduce the relevant medical dispute by exploring the forensic pathological features, identification of medical dispute as well as relationship between injury and disease. MethodsWe collected 33 cases of cerebrovascular malformation from January 2006 to December 2014 in West China Center of Forensic Medicine, including details of cases, clinical medical record and forensic pathology examination, and then the cases were retrospectively analyzed. ResultsIn the 33 cases, the average age of the individuals was 37.4 years old, and the male/female ratio was 23/10. Nineteen patients (57.6%) died within 1 hour. Seventeen patients with mixed pathological type of cerebrovascular malformation dominated (51.5%). Medical dispute happened in 7 cases (21.1%), 4 of which were identified to be led by medical fault and 3 with no medical fault. Relationship between injury and disease was analyzed in 11 cases (33.3%), in which injury was identified to take full responsibility in 1 case, inductive cause of death in 9 cases, and no relationship between injury and death in 1 case. ConclusionComprehensive and systematic investigation of forensic pathology plays an important role in the proper settlement of medical disputes as well as the identification of cause of death and relationship between injury and disease.

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