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Surgical Closure of Coronary Cameral Fistula Draining into the Left Ventricle via a “Fistula Lake” 认领
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作者 Risa Shimbori 《心血管病(英文)》 2020年第8期545-549,共5页
A left-sided lesion of a coronary cameral fistula (CCF) is extremely rare. Surgical closure of the fistula is indicated when symptoms emerge or as a preventive strategy, while surgical approaches depend on the individ... A left-sided lesion of a coronary cameral fistula (CCF) is extremely rare. Surgical closure of the fistula is indicated when symptoms emerge or as a preventive strategy, while surgical approaches depend on the individual anatomical structures. In particular, a CCF forming a “fistula lake” with multiple inflow vessels is so unique that few studies have focused on the technique to close it. We report the successful management of a CCF originating from multiple coronary arteries and draining into the left ventricle via a “fistula lake” by ligation and clipping of associated communication tracts. On the postoperative coronary computed tomography angiography, the fistula lake and the small vessels entering it had all disappeared. 展开更多
关键词 Coronary Cameral Fistula Fistula Lake Surgical Repair
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Iatrogenic Female Genital Fistula, 35 Cases Report 认领
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作者 N. Idi I. Abdoulaye +1 位作者 F. Chaibou Nomao Z. Assoumane 《妇产科期刊(英文)》 2020年第9期1156-1162,共7页
<p> <b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:""><span style="font-family:Verdana;">Female gen... <p> <b><span style="font-family:Verdana;">Introduction: </span></b><span style="font-family:""><span style="font-family:Verdana;">Female genital fistula (FGF), remains a world concern, especially in low developed country. Obstructive (blocked) delivery labor is his principal cause, sometimes by pelvic surgery (urogenital or obstetrical, rectal) more rarely by congenital urogenital malformation, excision, pelvic neoplasm, pelvic radiotherapy. We were interested in iatrogenic FGF treated in the special referral fistula center. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">We report 35 cases of iatrogenic female genital fistula. Are included only cases by urogenital surgery, excision in the National Referal Center of Obstetrical Fistula. Were not included cases happened by over 12 hours blocked delivery labor, caustic destruction, pelvic cancer pelvic infection and those with incomplete file. The epidemiologic, clinical and therapeutic information were studied. All ethical protocols were respected. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">CNRFO recorded 743 cases of female genital fistula from May 23 2013 to May 23 May 2018 within 35 iatrogenic cases (4.71%). Patients were 19 - 29 years old (42.85%), average age 35 years old, extremes 19 - 60 years, without occupation (82.86), grand multiparous 48.57%, with a mean of 4 previous deliveries. The principal constancies were hysterectomies 71.43%, caesarean section 17.14%, genital excision 11.42%, and cystocele cure 11.42%. The anatomical finds were soft vagina tissue 97.14% uretero-vaginal fistula 45.71% (2 cases post Caesarean, 14 cases post hysterectomy), vesico-vaginal 31.43% (all post hysterectomy), ureteral 11.42% (all post caesarean), 1 vesico-uterine 5.71% (case post caesarean), 1 case after a cystocele cure, 2 uretro-vaginal 11.42% secondary of genital excision. Treatment was ureteral reimplantation (18/31) cases by abdominal way, fistulorraphy (1 展开更多
关键词 Female Genital Fistula Iatrogenic Fistula EXCISION Pelvic Surgery Caesarian HYSTERECTOMY
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When the bowel meets the bladder: Optimal management of colorectal pathology with urological involvement 认领
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作者 Conor Keady Daniel Hechtl Myles Joyce 《世界胃肠外科杂志:英文版(电子版)》 SCIE CAS 2020年第5期208-225,共18页
Fistulae between the gastrointestinal and urinary systems are rare but becoming increasingly more common in current surgical practice.They are a heterogeneous group of pathological entities that are uncommon complicat... Fistulae between the gastrointestinal and urinary systems are rare but becoming increasingly more common in current surgical practice.They are a heterogeneous group of pathological entities that are uncommon complications of both benign and malignant processes.As the incidence of complicated diverticular disease and colorectal malignancy increases,so too does the extent of fistulous connections between the gastrointestinal and urinary systems.These complex problems will be more common as a factor of an aging population with increased life expectancy.Diverticular disease is the most commonly encountered aetiology,accounting for up to 80%of cases,followed by colorectal malignancy in up to 20%.A high index of suspicion is required in order to make the diagnosis,with ever improving imaging techniques playing an important role in the diagnostic algorithm.Management strategies vary,with most surgeons now advocating for a single-stage approach to enterovesical fistulae,particularly in the elective setting.Concomitant bladder management techniques are also disputed.Traditionally,open techniques were the standard;however,increased experience and advances in surgical technology have contributed to refined and improved laparoscopic management.Unfortunately,due to the relative rarity of these entities,no randomised studies have been performed to ascertain the most appropriate management strategy.Rectourinary fistulae have dramatically increased in incidence with advances in the non-operative management of prostate cancer.With radiotherapy being a major contributing factor in the development of these complex fistulae,optimum surgical approach and exposure has changed accordingly to optimise their management.Conservative management in the form of diversion therapy is effective in temporising the situation and allowing for the diversion of faecal contents if there is associated soiling,macerated tissues or associated co-morbidities.One may plan for definitive surgical intervention at a later stage.Less contaminated cases with n 展开更多
关键词 Colovesical fistula Enterovesical fistula Rectourinary fistula Intestinal fistula Diverticular fistula Diverticular disease Laparoscopic surgery Colorectal cancer
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Preoperative Tracheoscopy for Esophageal Atresia and/or Congenital Esoaerian Fistula: Experience at Cliniques Universitaires Saint Luc in Brussels 认领
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作者 Natacha Boumas Beelke D’Hondt +2 位作者 Catherine De Magnee Raymond Reding Francis Veyckemans 《外科学(英文)》 2020年第1期9-14,共6页
Introduction: Congenital septal anomalies between the trachea and the esophagus are rare conditions. It seemed to us interesting to recall the contribution of tracheoscopy in the diagnostic and therapeutic strategy of... Introduction: Congenital septal anomalies between the trachea and the esophagus are rare conditions. It seemed to us interesting to recall the contribution of tracheoscopy in the diagnostic and therapeutic strategy of esophageal atresia and congenital esoaerian fistulas. Patients and methods: This is a retrospective study between June 1994 and June 2014 of children who underwent a tracheoscopy, at the Saint-Luc University Clinics in Brussels, the diagnostic set of esophageal atresia (EA) or a congenital esoaerian fistula was suspected. Results: A total of 43 children with esophageal atresia or congenital esoaerian fistula underwent tracheoscopy. Before the tracheoscopy, the diagnosis of the anatomical type of atresia of the esophagus and esoaerian fistula was as follows: type C, 34 (79.1%);type A, 4 (9.3%);type E, 5 (11.6%). After performing the tracheoscopy, the diagnosis was changed as follows: type C, 34 (79.1%);type A, 3 (7%);type E, 4 (9.3%);type B, 1 (2.3%), a patient with a tracheoesophageal laryngo cleft (2.3%). Tracheoscopy also made it possible to find 2 cases of tracheomalacia, 2 cases with 3 bronchial tubes and one case associating a diverticulum of the trachea. No complications were correlated with the performance of the tracheoscopy. Conclusion: Our study confirms the benefits of tracheoscopy in the laden price of esophageal atresia or congenital esoaerian fistula. 展开更多
关键词 Esophageal ATRESIA Esotracheal FISTULA Tracheobronchoscopy
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Clinical Value of Transperineal 3D Volume Ultrasound Combined with 2D High Frequency Ultrasound in Anal Fistula 认领
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作者 Dan Yang Xiufen Yao 《生物科学与医学(英文)》 2020年第5期12-19,共8页
Objective: To explore the clinical diagnostic value of transperineal volume ultrasound combined with two-dimensional high-frequency ultrasound for anal fistula. Methods: A total of 52 patients with anal fistula admitt... Objective: To explore the clinical diagnostic value of transperineal volume ultrasound combined with two-dimensional high-frequency ultrasound for anal fistula. Methods: A total of 52 patients with anal fistula admitted to the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from December 2017 to July 2018 were selected. They were all undergoing transperineal 3D volume ultrasound combined with 2D high-frequency ultrasound examination, and the diagnosis results were analyzed. The results of ultrasonography and surgical pathology were compared. Results: Among 52 patients, 3D volume ultrasound combined with 2D high-frequency ultrasound were used to diagnose 32 cases of anal fistula intersphincteric type, 14 cases of transsphincter type, 5 cases of supra-sphincter type, and 1 case of extra-sphincter type. T supervisor classification accuracy rate is 90%. The detection rate of branch pipes was 92%, and the compliance rate of internal fistula was 95%. Two-dimensional high-frequency ultrasound was used to diagnose 34 cases of anal fistula intersphincteric type, 14 cases of transsphincter type, 4 cases of supra-sphincter type, and 0 cases of extra-sphincter type. The detection rate of branch canals was 42%, and the accuracy of type classification was 90%. The coincidence rate was 95%. There was a statistically significant difference in the detection rate of the anal fistula branch and the coincidence rate of the internal fistula between the two methods (both P Conclusion: 1) The overall coincidence rate of three-dimensional volumetric ultrasound combined with two-dimensional high-frequency ultrasound in the diagnosis of anal fistula is high;2) Three-dimensional volumetric ultrasound technology has great application prospects in infants and anal fistulas. 展开更多
关键词 TWO-DIMENSIONAL HIGH-FREQUENCY ULTRASOUND Anal Fistula Three-Dimensional VOLUME ULTRASOUND COMBINED with TWO-DIMENSIONAL HIGH-FREQUENCY ULTRASOUND
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Post-Operative Mortality after Ileal Perforation at a Teaching Hospital in Dhaka City 认领
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作者 Mahbuba Begum Mohammad A. Majid +3 位作者 Din Mohammad Wahida Begum Md. Abdullah Yusuf Shamima Sultana 《外科学(英文)》 2020年第2期25-31,共7页
Background: Ileal perforation is a very critical condition. Objectives: The purpose of the present study was to see the post-operative mortality after ileal perforation. Methodology: This prospective cohort study was ... Background: Ileal perforation is a very critical condition. Objectives: The purpose of the present study was to see the post-operative mortality after ileal perforation. Methodology: This prospective cohort study was conducted in the Department of Surgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from September 2000 to December 2002 for period of 2 years and 3 months. All the patients presented with ileal perforation at any age with both sexes were included in this study. Patients were selected consecutively and the patients who showed ileal perforation at laparotomy were included in this study. Preoperative diagnosis was based on detailed history, complete physical examinations supported by plain x-ray abdomen in erect posture including both domes of diaphragm. After immediate resuscitation surgical treatment was undertaken as soon as possible following admission in all cases. The patients were followed up and the mortality profiles were recorded after surgical intervention. Result: Out of 53 patients having postoperative complications 38 patients were survived and 15 patients were expired. So total survivors were 85% and non-survivors 15%. In this study most of the mortality (12%) was attributed to septicemia and mode of death was multiple organ failure. Respiratory complications caused 2% mortality one patient died of ARDS and another elderly patient with preexisting bronchial asthma developed respiratory failure and was unresponsive to treatment. One death was related to faecal fistula followed by severe fluid, electrolyte and acid-base imbalance with peritonitis and gross sepsis. Conclusion: In conclusion, the mortality is significantly high due to septicemia, ARDS and faecal fistula. 展开更多
关键词 POST-OPERATIVE MORTALITY ILEAL PERFORATION FAECAL FISTULA
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The Fetal Outcome and Fetal Wastage Pattern among Different Types of Obstetric Fistula at the National Obstetric Fistula Centre, Abakaliki, Nigeria 认领
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作者 Kenneth Chinedu Ekwedigwe Onwe O. Emeka +6 位作者 Isikhuemen E. Maradona Iwe Bobby Azubuike K. Onyebuchi Obuna Johnson Ezeonu P. Olisaemeka Onoh C. Robinson Ekwedigwe P. Ifeanyi 《妇产科期刊(英文)》 2020年第4期538-545,共8页
BACKGROUND: Obstetric Fistula is a major public health problem in developing world. It is associated with a high fetal wastage rate. The objective of this study was to evaluate different types of obstetric fistula and... BACKGROUND: Obstetric Fistula is a major public health problem in developing world. It is associated with a high fetal wastage rate. The objective of this study was to evaluate different types of obstetric fistula and their fetal wastage rate. METHOD: A retrospective population study was done at the National Obstetric Fistula Centre, Abakaliki between 1st January-31st December, 2016. The calculated minimum sample size was 3, however, the total number of 203 patients were studied. The case notes of all the women who had obstetric fistula repairs over the period were analyzed. RESULTS: The mean age from this study was 38 ± 12.1 years. The fetal wastage rate from this study was 82.76% while the live birth was 17.24%. Seventy percent of the stillbirth were delivered via SVD, while 11% of stillbirth were delivered through EmCS. Twelve different types of fistula were identified in this study using anatomical classifications. Large extensive fistula, urethral loss and multiple fistula had the highest fetal wastage of 100% respectively. This was followed by mid-vaginal fistula (95.7%), Juxtaurethral fistula 94.4%, Juxtacervical fistula 88.5%, Intracervical fistula 85.71%, Ureteric fistula 85.71%, Vesicouterine 84.21%, Vault fistula 62.5%. Rectovaginal fistula had the least fetal wastage of 15.79% and the highest live birth of 84.2%. CONCLUSION: The findings showed a high fetal wastage rate amongst women with obstetric fistula. There was high fetal wastage across different types of obstetric fistula. Rectovaginal fistula had the best outcome in terms of live births. 展开更多
关键词 OBSTETRIC FISTULA FETAL Wastage/Stillbirth Live BIRTH
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Adult Presentation of a Complete Second Branchial Cleft Fistula Diagnosed by US and CT, Autosomal Dominant Transmission in Three Members of the Family: Case Report 认领
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作者 Yorick Lismonde 《医学影像期刊(英文)》 2020年第2期125-131,共7页
Branchial arch anomalies can arise from the four first branchial arches, but the most encountered cases are from the second one. Second branchial arch cysts and abscesses occur mainly in older children or young adults... Branchial arch anomalies can arise from the four first branchial arches, but the most encountered cases are from the second one. Second branchial arch cysts and abscesses occur mainly in older children or young adults while fistulae are discovered in young children. We report a case of complete second branchial arch fistula of Bailey III type with adult complaints of painful swelling and local reddishness followed by spontaneous discharge and disappearance of complaints. Diagnosis was based on ultrasound and confirmed by CT scan, with the classic “beak sign” visible on both exams. Three cases were encountered in the family, with no otologic or kidney symptoms, which is quite different from the classical branchiootorenal syndrome which associates severe inner ear and kidney congenital anomalies. 展开更多
关键词 Branchial Cyst Branchial Arc FISTULA CT Scanner ULTRASOUND
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Hypospadias: Evaluation of Therapeutic Outcomes and Sexual Function in Adulthood in a University Hospital Setting 认领
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作者 El Hadji Malick Diaw Modou Ndiaye +15 位作者 Ousmane Sow Abdoulaye Ndiath Alioune Sarr Boubacar Fall Babacar Sine Aboubacar Traore bdourahmane Ndong Cyrille Ze Ondo Amath Thiam Oumar Gaye Ndiaga Seck Ndour Ngor Mack Thiam Yaya Sow Babacar Diao Papa Ahmed Fall Alain Khassim Ndoye 《泌尿学期刊(英文)》 2020年第9期245-252,共8页
<strong>Background:</strong> Hypospadias is a congenital malformation resulting from hypoplasia of the tissues forming the ventral face of the penis. It is associated to variable degrees with an ectopic ur... <strong>Background:</strong> Hypospadias is a congenital malformation resulting from hypoplasia of the tissues forming the ventral face of the penis. It is associated to variable degrees with an ectopic urethral meatus, a penis curvature and a sapper’s apron foreskin <a href="#ref1">[1]</a>. The incidence of this malformation varies from country to country. It is estimated at 1/300 male births in France and 0.26/ 1000 in Mexico <a href="#ref1">[1]</a>. In Senegal, the prevalence of this malformation is unknown. Hypospadias surgery has improved significantly in recent years due to a better understanding of the anatomy on the one hand and the improvement of the instruments used during surgery on the other (suture material, surgical magnification, urethral catheter of suitable size). In sub-Saharan Africa and particularly in Senegal, hypospadias surgery remains a challenge due to the unavailability of adequate equipment (lack of microsurgical instruments and surgical loupes). <strong>Objective:</strong> To evaluate the outcomes of the treatment of hypospadias by the different surgical techniques used in our center as well as their sexual function in adulthood. <strong>Patients and Methods:</strong> This is a retrospective study, including all patients operated for hypospadias between January 2009 and December 2017 in Urology-Andrology department of Aristide Le Dantec hospital. The studied parameters were: frequency, age, clinical and therapeutic aspects, and their sexual function in adulthood after treatment. The outcomes of the treatment were judged good or poor depending of the quality of penile straightening, the aesthetic appearance of the penis, the position of the urethral neo-meatus, the permeability of the urethra and the existence or not of fistula. The sexual function was assessed by the International Index of Erectile Function 15 (IIEF) score. <strong>Results:</strong> Fifty-five patients were included. The median age was 6 years (P25 = 2.8 and P75 = 13 years). After a mean follow-up of 58 ± 33 months, 展开更多
关键词 Urogenital Malformation Penile Enlargement URETHROPLASTY Urethrocutaneous Fistula
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Practice Patterns and Adequacy of Maintenance Hemodialysis in Rio Grande, RS, Brazil 认领
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作者 Luiz Eduardo Corrê a Schein Juraci Almeida Cesar 《肾脏病(英文)》 2020年第2期102-116,共15页
<strong>Introduction:</strong> Hemodialysis is the most common end-stage renal disease treatment worldwide. Several factors may influence treatment outcomes. Adequacy (dose) of hemodialysis remains controv... <strong>Introduction:</strong> Hemodialysis is the most common end-stage renal disease treatment worldwide. Several factors may influence treatment outcomes. Adequacy (dose) of hemodialysis remains controversial;however, investigations on the effectiveness rate (Kt/V ≥ 1.2), which could reflect morbimortality, are preferred. <strong>Objective:</strong> This study aimed to describe the level of adequacy of hemodialysis among patients undergoing treatment in the city of Rio Grande (RS), Brazil. <strong>Method:</strong> In this prospective cohort study, 156 patients undergoing hemodialysis treatment between July 2016 and June 2017 in the two hemodialysis centers in the city of Rio Grande (RS), Brazil, were included. Frequency distribution as per Kt/V stratification was analyzed. Chi-square test was used to compare proportions. <strong>Results:</strong> Adequate hemodialysis (Kt/V ≥ 1.2) was observed in 105 patients (67%), 88% were from the municipality (mean age, 59 years), and 43% had visited the hospital before knowing about their kidney disease. Most of them were referred to a nephrologist (70%). Of the 156 patients, 114 patients (73%) remained in dialysis treatment, 10 (6%) underwent transplantation, 9 (6%) were transferred, and 23 (15%) died at the end of 12 months. <strong>Conclusion:</strong> Primary care should be expanded for early diagnosis of chronic kidney disease, improved venous access preparation, and increased number of patients with hemodialysis adequacy. Hemodialysis adequacy in patients undergoing treatment in the city of Rio Grande (RS), Brazil, needs to be improved. 展开更多
关键词 Chronic Kidney Failure HEMODIALYSIS Quality Control Hemodialysis Adequacy Arteriovenous Fistula
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The Medical Care of Multiple Disciplinary Team Reduces the Risks of Complications in Patients after Arteriovenous Fistula Operation 认领
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作者 Yu Chen 《肾脏病(英文)》 2020年第2期117-124,共8页
Introduction: Arteriovenous fistula (AVF) operation is recognized a gold standard of hemodialysis for end-stage renal disease. Because various complications may occur during perioperative period, medical care plays an... Introduction: Arteriovenous fistula (AVF) operation is recognized a gold standard of hemodialysis for end-stage renal disease. Because various complications may occur during perioperative period, medical care plays an important role in improving the possibility of AVF operation. The objective of the study was to explore the effect of the mode of multiple disciplinary team (MDT) medical care on the patients with end-stage renal disease treated by arteriovenous fistula (AVF) operation. Method: 98 patients with end-stage renal disease under the AVF operation were divided into observation group and control group. The control group was performed with regular medical care and for the observation group was treated under the mode of MDT medical care. Complications after operation, hospitalized time and medical satisfaction were comprehensively compared between the both groups. Results: The overall complications including swelling, bleeding, infection and thrombosis in observation group accounted for 5%, however, 19% of patients suffered different complications in the control group. The total complications significantly decreased in the observation group compared with control group (P < 0.001). The hospitalization time was shortened to 9.8 ± 5.6 days in the observation group, and the average hospitalization in control group was 17.8 ± 8.9 days. The medical satisfaction was increased by 20.83 percent in the observation group compared with the control group (P < 0.001). 75% patients in control group were satisfied with medical care, and 98.53% patients were satisfied for observation group. Conclusion: The mode of MDT medical care was beneficial for patients with end-stage renal disease after AVF operation, which could significantly reduce complications, hospitalized time and improve patients’ degree of satisfaction. Thus, it should be recommended in the clinical work. 展开更多
关键词 Multiple Disciplinary Team Medical Care HEMODIALYSIS Arteriovenous Fistula
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部分无管化与留置肾造瘘管经皮肾镜取石术治疗上尿路结石的对照分析 认领
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作者 张骞 《中国医药指南》 2020年第12期155-156,共2页
目的对比部分无管化与留置肾造瘘管经皮肾镜取石术治疗上尿路结石的临床效果。方法选取本院2015年6月至2018年6月收治的92例上尿路结石患者,全部患者均行经皮肾镜取石术治疗,根据不同的置管方式将其分为两组各46例,对照组留置肾造瘘管,... 目的对比部分无管化与留置肾造瘘管经皮肾镜取石术治疗上尿路结石的临床效果。方法选取本院2015年6月至2018年6月收治的92例上尿路结石患者,全部患者均行经皮肾镜取石术治疗,根据不同的置管方式将其分为两组各46例,对照组留置肾造瘘管,观察组采用部分无管化,不留置肾造瘘管,但体内留置双J管,比较两组患者的碎石效果、手术治疗情况及并发症发生情况。结果两组患者碎石成功率、手术时间、并发症发生率比较无明显差异(P>0.05);观察组漏尿时间、术后尿管留置时间均明显短于对照组(P<0.05);观察组术后1 d疼痛评分(5.91±1.24)分明显低于对照组的(6.63±1.38)分,术后住院时间(5.73±0.82)d明显短于对照组的(7.95±0.76)d(P<0.05);观察组术后双氯芬酸钠用量显著低于对照组(P<0.05)。结论部分无管化与留置肾造瘘管经皮肾镜取石术治疗上尿路结石疗效确切,安全性可靠,但前者能够有效减轻患者术后疼痛感,缩短患者术后恢复时间。 展开更多
关键词 部分无管化 造瘘管 上尿路结石 并发症 碎石
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Enteral fistula as initial manifestation of primary intestinal lymphoma 认领
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作者 Rui-Jie Zhao Chun-Lan Zhang +5 位作者 Yan Zhang Xi-Yu Sun Yue-Hui Ni Ya-Ping Luo Ji Li Jia-Ming Qian 《中华医学杂志:英文版》 SCIE CAS CSCD 2020年第1期101-102,共2页
To the Editor:Enteral fistula(EF)is a rare complication mostly caused by inflammatory bowel disease and in some cases by duodenal ulcer,intestinal tuberculosis,intestinal lymphoma,abdominal surgery,or necrotizing ente... To the Editor:Enteral fistula(EF)is a rare complication mostly caused by inflammatory bowel disease and in some cases by duodenal ulcer,intestinal tuberculosis,intestinal lymphoma,abdominal surgery,or necrotizing enterocolitis.[1,2]Perforative complications including perforation and EF are major complications of primary intestinal lymphoma(PIL).Vaidya et al[2]reported that in a cohort of 1062 patients with gastrointestinal lymphoma,bowel perforation occurred in 9%of the patients,and among them,the small intestine was the most common site(81%).Furthermore,perforation events occurred as the initial presentation in 51%of these patients. 展开更多
关键词 LYMPHOMA FISTULA INTESTINE
T4 cervical esophageal cancer cured with modern chemoradiotherapy: A case report 认领
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作者 Chia Ching Lee Chong Ming Yeo +2 位作者 Wee Khoon Ng Akash Verma Jeremy CS Tey 《世界临床病例杂志》 SCIE 2020年第10期1950-1957,共8页
BACKGROUND T4 esophageal cancer portends a poor prognosis,particularly when it is complicated by a tracheoesophageal fistula(TEF)either resulting from disease or occurring as a complication of treatment.Patients with ... BACKGROUND T4 esophageal cancer portends a poor prognosis,particularly when it is complicated by a tracheoesophageal fistula(TEF)either resulting from disease or occurring as a complication of treatment.Patients with TEF that occurs during treatment are commonly treated with palliative intent because fistula-associated treatment complications such as aspiration pneumonia and mediastinitis are associated with high morbidity and mortality.To date,there is no clear evidence on the optimal treatment of T4 esophageal cancer,particularly when a TEF formation occurs.CASE SUMMARY A 67-year-old gentleman who presented with dysphagia and weight loss.Endoscopy and imaging revealed a T4N1M0 cervical esophageal squamous cell carcinoma.He received image-guided intensity-modulated radiation therapy,with concurrent weekly carboplatin(area under curve 2 mg/mL per minute)and paclitaxel(50 mg/m2 of body surface area).One week after treatment initiation(16.2 Gy thus far),he developed cough on swallowing.A TEF was detected on image-guided radiation therapy using cone-beam computed tomography during the treatment course,for which a tracheal stent was inserted.After discussing the risks and morbidity of continuing treatment,he resumed chemoradiotherapy with an additional radiation dose of 45 Gy in 25 fractions.Three months after completion of chemoradiotherapy,he developed an esophageal stricture that required esophageal stenting and dilatation.The patient remains cancer-free at two year on follow-up.Complete response of esophageal cancer was evident on post-treatment endoscopy and computed tomography imaging,with successful closure of TEF.CONCLUSION This case highlights that successful curative treatment for esophageal cancer complicated by a TEF is possible using novel chemotherapeutic regimens and modern radiation technologies. 展开更多
关键词 Esophageal cancer CHEMORADIOTHERAPY FISTULA STENTING T4 Case report
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以突眼为表现的眼部血管病——颈动脉海绵窦瘘的介入治疗 认领
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作者 王铭义 刘永晟 +5 位作者 李克 刘勇建 张国栋 安祥博 吴邯 王峰 《中华介入放射学电子杂志》 2020年第3期199-204,共6页
目的探讨颈动脉海绵窦瘘眼部表现特点、影像学检查及介入治疗方法。方法回顾分析5年中18例首诊于我院眼科的颈动脉海绵窦瘘者的眼部症状及体征、影像学检查、治疗方法等。18例患者均行介入手术治疗,其中应用可解脱球囊封堵瘘口12例,应... 目的探讨颈动脉海绵窦瘘眼部表现特点、影像学检查及介入治疗方法。方法回顾分析5年中18例首诊于我院眼科的颈动脉海绵窦瘘者的眼部症状及体征、影像学检查、治疗方法等。18例患者均行介入手术治疗,其中应用可解脱球囊封堵瘘口12例,应用弹簧圈+Onyx胶封堵瘘口3例,覆膜支架隔绝瘘口3例。结果所有病例中最常见的眼部表现为搏动性眼球突出、球结膜充血水肿、眼球运动障碍等。头颅或眼部CT平扫检查所有病例均显示患侧眼球突出,眼上静脉增粗;全部患者均行数字减影血管造影检查明确诊断。本组18例(20眼)均行介入手术治疗,其中应用可解脱球囊封堵瘘口12例(14眼),结果10例(12眼)瘘口完全闭塞,发生并发症2例,无严重并发症或死亡病例。应用弹簧圈+Onyx胶封堵瘘口3例(3眼)、覆膜支架隔绝瘘口3例(3眼),瘘口均完全闭塞,无并发症或死亡病例。全部手术患者眼部症状和体征均得到明显改善。随访时间(12±3.4)个月,无复发病例,颈动脉覆膜支架内未发生狭窄及闭塞。结论对于以突眼及其他相关症状就诊于眼科的患者,应考虑颈动脉海绵窦瘘的可能,血管造影是该病诊断的金标准,介入手术治疗对颈动脉海绵窦瘘是安全有效的。 展开更多
关键词 颈动脉-海绵窦 突眼 介入治疗
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Direct approach to thrombosed superior ophthalmic vein of recalcitrant indirect carotid cavernous fistula in thrombocythemia failed with multiple conventional embolization treatment 认领
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作者 Jungyul Park Jae-Il Lee +1 位作者 Hyeshin Jeon Hee-Young Choi 《国际眼科杂志:英文版》 SCIE CAS 2020年第4期687-692,共6页
Dear Editor,I am Dr. Jungyul Park from the Division of Oculoplasty, Department of Ophthalmology, Pusan National University Hospital, Busan, Korea. I am writing to present a case of direct approach to thrombosed superi... Dear Editor,I am Dr. Jungyul Park from the Division of Oculoplasty, Department of Ophthalmology, Pusan National University Hospital, Busan, Korea. I am writing to present a case of direct approach to thrombosed superior ophthalmic vein of recalcitrant indirect carotid cavernous fistula which was failed to treat with multiple conventional embolization treatment. To our knowledge this is very challenging procedure to the ophthalmologist, and not well described in literatures, especially in thrombocythemia patient with thrombosed superior ophthalmic vein. 展开更多
关键词 THROMBO FISTULA carotid
基于数据挖掘的唐汉钧治疗复杂性窦道经验研究 认领
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作者 邢捷 阙华发 《上海中医药杂志》 2020年第9期27-31,共5页
目的运用数据挖掘方法,分析唐汉钧教授临床治疗复杂性窦道内治用药及外治方法的使用规律,总结其学术思想。方法整理唐汉钧教授治疗复杂性窦道的病历资料,建立复杂性窦道中医临床诊疗信息数据库,使用频数分析、关联分析等数据挖掘技术,... 目的运用数据挖掘方法,分析唐汉钧教授临床治疗复杂性窦道内治用药及外治方法的使用规律,总结其学术思想。方法整理唐汉钧教授治疗复杂性窦道的病历资料,建立复杂性窦道中医临床诊疗信息数据库,使用频数分析、关联分析等数据挖掘技术,分析患者的一般特征、内治处方中的组方配伍规律及外治方法使用情况。结果①本研究共纳入265份病历资料,涉及265例患者,男性多于女性,中位年龄55岁,中位病程210 d;合并有糖尿病、乙型病毒性肝炎等其他疾病者共计136例(占51.32%),最常见的发病部位为胸壁(34.7%),最常见的病因为手术(64.53%)和感染(23.40%);中医辨证分型以余毒未尽证最为常见(78.87%),其次为气血两虚证(20.38%),正虚毒恋证相对少见(0.75%)。②共有229例患者内服中药,涉及229种药物,总计使用频次4234,使用频次>100的中药共有13味,主要集中在益气健脾、健脾活血和益气渗湿类药物。③关联分析结果显示,最为常用的2味药物配伍组合主要是益气健脾、健脾活血和益气渗湿药,3味药物配伍组合主要是健脾养血、健脾活血、益气健脾、健脾渗湿、健脾托毒药,4味药物配伍组合主要是生黄芪、白术、茯苓合渗湿、活血、托毒药物组合,5味药物配伍组合是生黄芪、白术、茯苓、赤芍、丹参组成的益气健脾扶正、凉血活血祛滞药物组合。④常用的外治方法有外用掺药、贴敷、冲洗灌注疗法、药捻、纱条引流等。结论唐汉钧教授治疗复杂性窦道重视扶正,尤重脾胃,补益、疏调气血经络的同时又不忘托毒、解毒,体现了其扶正治疗外科疾病的学术思想;在内治的同时灵活运用多种外治法,取得满意疗效。 展开更多
关键词 复杂性窦道 窦瘘 名医经验 数据挖掘 唐汉钧
人文关怀护理对直肠癌结肠造瘘口患者围手术期自我护理能力的影响 认领
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作者 陈威 《中国医药指南》 2020年第26期162-163,共2页
目的探讨人文关怀护理对直肠癌结肠造瘘口患者围手术期自我护理能力的影响。方法选取2018年2月至2019年2月新民市医院收治的66例直肠癌结肠造瘘口患者为研究对象,按照围手术期是否行人文关怀护理将其分为对照组(33例,行常规护理)和试验... 目的探讨人文关怀护理对直肠癌结肠造瘘口患者围手术期自我护理能力的影响。方法选取2018年2月至2019年2月新民市医院收治的66例直肠癌结肠造瘘口患者为研究对象,按照围手术期是否行人文关怀护理将其分为对照组(33例,行常规护理)和试验组(33例,行人文关怀护理),比较两组患者预后。结果护理干预72 h后,试验组患者的SF-36简明健康状况量表(SF-36)评分及自我护理能力测定量表(ESCA)评分均高于对照组,差异均有统计学意义(P <0.05)。护理干预72 h后,试验组患者的IgG、CD_3~+、CD_4~+、CD_4~+/CD_8~+水平均高于对照组,差异均有统计学意义(P <0.05);试验组患者的血浆白蛋白、血红蛋白、转铁蛋白水平均高于对照组,差异均有统计学意义(P <0.05)。结论在直肠癌结肠造瘘口患者的围手术期实施人文关怀护理干预的效果明显优于常规护理干预效果,可有效改善患者的免疫功能及营养状况,并提升患者的自我护理能力。 展开更多
关键词 直肠癌 肠瘘口 人文关怀护理 围手术期 自我护理能力
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克罗恩病家庭肠内营养现状及护理进展 认领
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作者 梁枫 龚剑峰 +2 位作者 彭南海 曾星 黄迎春 《中西医结合护理(中英文)》 2020年第7期239-244,共6页
克罗恩病(CD)是慢性肠道性疾病,常合并肠道狭窄及瘘管形成,并伴有肠外并发症,受多种因素影响,CD患者易出现营养不良。肠内营养是CD患者主要的协同治疗方法之一,家庭肠内营养治疗(HEN)在CD患者的治疗中发挥了重要作用。本文主要对CD患者... 克罗恩病(CD)是慢性肠道性疾病,常合并肠道狭窄及瘘管形成,并伴有肠外并发症,受多种因素影响,CD患者易出现营养不良。肠内营养是CD患者主要的协同治疗方法之一,家庭肠内营养治疗(HEN)在CD患者的治疗中发挥了重要作用。本文主要对CD患者营养不良现状、营养支持的作用、影响HEN开展的相关因素以及HEN的护理进展作一综述,以为进一步完善CD患者HEN相关护理干预提供参考。 展开更多
关键词 克罗恩病 家庭肠内营养 胃肠道 鼻饲 瘘管 营养不良
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Mucinous adenocarcinoma of the buttock associated with hidradenitis:A case report 认领
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作者 Sung Jin Kim Tae Gon Kim +1 位作者 Mi Jin Gu Sohyun Kim 《世界临床病例杂志》 SCIE 2020年第18期4200-4206,共7页
BACKGROUND Mucinous adenocarcinomas of the buttock are rare and have an uncertain etiology and natural course.They are usually related to chronic anal fistulas,hidradenitis suppurativa,or Crohn's disease.Here,we r... BACKGROUND Mucinous adenocarcinomas of the buttock are rare and have an uncertain etiology and natural course.They are usually related to chronic anal fistulas,hidradenitis suppurativa,or Crohn's disease.Here,we report a case of mucinous adenocarcinoma associated with hidradenitis and contradictory immunochemistry results.CASE SUMMARY A 62-year-old man complained of recurrent abscesses of the buttock for 3 years.He had several scars and nodules in bilateral buttocks,with purulent discharge.The skin lesions did not appear to originate from the anus.The patient was diagnosed with recurrent abscesses due to hidradenitis suppurativa at the first visit.He showed purulent and subsequent mucin discharge in the first operation and was diagnosed with mucinous adenocarcinoma.Several examinations were performed to determine disease origin and staging.There were no significant findings or evidence of anal fistulas.Hence,he underwent wide local excision and V-Y advancement flap in the second operation.The final diagnosis was mucinous adenocarcinoma without any evidence of anal fistulas.Additional immunochemistry test results were negative for cytokeratin(CK)7 and positive for CK20 and CDX2,with a colorectal origin.A pathologist suggested that the disease originated from a chronic anal fistula.The patient has remained free of recurrence for 24 mo.CONCLUSION Although the patient with mucinous adenocarcinoma showed an atypical course,immunochemistry helped detect the disease origin. 展开更多
关键词 Mucinous adenocarcinoma Anal fistula Hidradenitis suppurativa Wide excision Immunochemistry test Case report
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