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灌注,局部

灌注,局部的相关文献在1997年到2018年内共计292篇,主要集中在肿瘤学、外科学、内科学 等领域,其中期刊论文292篇、专利文献46136篇;相关期刊103种,包括中国骨伤、医学临床研究、中国医学影像技术等; 灌注,局部的相关文献由1063位作者贡献,包括高友兵、徐克、高培毅等。

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灌注,局部

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  • 高友兵
  • 徐克
  • 高培毅
  • 高思佳
  • 黄福贵
  • 何建苗
  • 刘伟
  • 刘士远
  • 刘静红
  • 周兴
  • 期刊论文
  • 专利文献

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    • 沈超; 徐晓阳
    • 摘要: [目的]探讨安维汀联合5-氟尿嘧啶(5-FU)、顺铂(DDP)灌注治疗胃癌恶性腹水的临床疗效.[方法]90例胃癌伴恶性腹水患者随机分为两组,各45例,对照组采用5-FU、顺铂腹腔内灌注化疗,观察组加用安雏汀.比较两组疗效,治疗前后腹部B超液性暗区深度的变化及腹水糖链抗原(CA125)、癌胚抗原(CEA)、CA199、血管内皮生长因子(VEGF)的变化,统计两组毒副反应发生率.[结果]①观察组总缓解率略高于对照组,但两组比较差异无显著性(P>0.05);②观察组腹水控制总有效率高于对照组(P<0.05);③治疗前两组腹水VEGF、CEA、CA199、CA125水平比较差异无显著性(P>0.05),治疗后两组腹水VEGF及上述肿瘤标志物水平均降低(P<0.05),且观察组治疗后各指标均低于对照组(P<0.05);④两组各级毒副反应发生率比较差异无显著性(P>0.05).[结论]安维汀联合5-Fu、DDP腹腔灌注治疗胃癌合并恶性腹水可提高腹水控制率,降低VEGF及肿瘤标志物表达,且患者耐受性好.
    • 程培丽; 石进; 张卫清; 郑进; 张英谦; 吕强; 宋云龙
    • 摘要: Objective To observe the change of cereberal perfusion parameters in patients with unilateral middle cerebral artery stenosis during a short-term follow-up time.Methods Nineteen of the 35 patients with unilateral middle cerebral artery stenosis who underwent CTP were followed up and divided into moderate stenosis (50%-69%) group (n=10) and severe stenosis (70%-99%) group (n=9) according to their middle cerebral artery stenosis.Their cerebral blood flow (CBF),cerebral volume (CBV),mean transit time (MTT) and time to peak (TTP) were recorded in the interested regions of basal ganglia,corona radiate and centrum semiovale and compared with rCBF,rCBV,rMTT and rTTP in the normal side.The cerebral perfusion parameters before and 3 months after CTP were compared.Results Of the 19 patients with unilateral middle cerebral artery stenosis,7 (36.8%) had improvement in their CTP parameters,7 (36.8%) had no improvement in their CTP parameters,5 (26.3%) were deteriorated in their CTP parameters.The rTTP was longer in 5 pateints and the rCBF was slower in 4 patients.Improvement,no improvement and deterioration were found in 6,3,1 patients of moderate stenosis group and in 1,4,4 patients of severe stenosis group.The rate of improvement was significantly higher in moderate stenosis group than in severe stenosis group (60.0% vs 11.1%,P =0.040).Conclusion CTP parameters will change in patients with symptomatic unilateral symptomatic middle cerebral artery stenosis and improve in some of them during the short-term follow-up time.%目的 观察单侧大脑中动脉狭窄患者脑灌注短期变化.方法 采用CT灌注成像(CTP)检查单侧症状性大脑中动脉狭窄患者35例,有19例完成随访,根据大脑中动脉狭窄程度分为中度狭窄组10例(狭窄率50%~69%)和重度狭窄组9例(狭窄率70%~99%).分别在基底节区,放射冠区、半卵圆中心选择感兴趣区,测量感兴趣区脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP),将狭窄侧参数值比对侧相对正常侧参数值,即获得各感兴趣区相对灌注参数值(rCBF、rCBV、rMTT、rTTP),3个月后复查CTP,比较CTP前后参数值,并比较2组脑灌注差异.结果 19例患者中,脑CTP参数好转7例(36.8%),无变化7例(36.8%),恶化5例(26.3%),其中rTTP延长5例,rCBF下降4例.中度狭窄组好转、无变化和恶化分别为6、3、1例,重度狭窄组好转、无变化和恶化分别为1、4、4例,2组脑灌注好转变化比较,差异有统计学意义(60.0% vs 11.1%,P=0.040).结论 症状性大脑中动脉狭窄CTP检测脑灌注下降患者短期脑灌注可发生变化,部分患者脑灌注改善.
    • 李华
    • 摘要: 目的:为了探讨子宫动脉灌注化疗联合放射治疗局部晚期宫颈癌的效果,应用子宫动脉灌注化疗联合放疗(A组)和单纯放疗(B组)随机对照治疗局部晚期宫颈癌患者64例,A、B各33、31例,比较近期疗效和远期疗效.结果:A组近期有效率90.9%(30/33),B组为70.9%(22/31)x2=4.17,P≤0.05.1年生存率A组为96.9%;B组为77.4%.x2=3.9,P≤0.05,血液毒性反应主要为白细胞下降,A组为76.5%,B组为55.7%,x2=3.1,P>0.05.结论:初步研究结果:子宫动脉灌注化疗联合放射治疗局部晚期宫颈癌较单纯放射治疗显著提高近期疗效及生存率,值得推广.
    • 赵春蕾; 王莹; 李甲辰
    • 摘要: Objective To investigate the efficacy of Kanglaite (KLT ) perfusion in the treatment of malig‐nant pleural effusion .Methods Sixty cases of malignant pleural effusion were chosen from June 2011 to December 2012 in our hospital ,and were divided randomly according to the admission into treatment group and control group ,30 cases each .The control group was put to alleviate the symptoms of pleural effusion ,pleural effusion af‐ter the release of the treatment group given 42 °C KLT 100 mL chest injury ,and chest microwave hyperthermia . Two weeks for treatment ,one month after the impact evaluation .Results The treatment group of KLT‐CHPP show higher effectiveness than that of reference group ,the Karnofsky was higher than the control group .Conclu‐sion KLT pleural perfusion control malignant pleural effusion with good effect ,but also improve the quality of lif e .%目的:探讨康莱特热灌注在治疗恶性胸腔积液中的疗效观察。方法选择2011年6月至2012年12月于我院住院治疗的有恶性胸腔积液患者60例,按入院顺序随机分为治疗组与对照组,各30例。对照组为放胸腔积液缓解症状,治疗组为放胸腔积液后给予42°C康莱特100 m L胸腔灌注,并给予胸部微波热疗。2周为1个疗程,1个月后进行效果评估。结果治疗组疗效明显高于对照组,生活质量评分大于对照组。结论康莱特胸腔热灌注对控制恶性胸腔积液具有较好疗效,同时也提高了生存质量。
    • 张宏民; 刘大为; 王小亭; 陈秀凯; 张青; 汤铂; 丁欣; 陈焕
    • 摘要: 目的 探讨感染性休克患者入ICU早期全身血流动力学与肾血流评分及肾动脉阻力指数的关系.方法 前瞻性观察感染性休克患者,在入室早期复苏阶段(1、6 h)分别进行心脏超声、肾脏超声检查,同时记录患者的平均动脉压(MAP)、中心静脉压(CVP)、心输出量(CO),肾血流评分及肾动脉阻力指数(RI).结果 共收入北京协和医院重症医学科患者39例.根据复苏后CVP的变化,分为CVP不升组和CVP上升组.CVP不升组19例患者中,MAP、CO均上升患者8例,其他患者11例,MAP、CO均上升患者中有6例肾血流评分上升,其他患者只有1例肾血流评分上升(P=0.027).CVP上升组20例患者中,MAP、CO均未上升患者9例,其他患者11例,MAP、CO均未上升患者中有8例肾血流评分下降,其他患者只有2例肾血流评分下降(P=0.086).CVP不升组患者复苏前后RI差异无统计学意义,且MAP、CO均上升患者与其他患者相比,复苏前、复苏后RI均差异无统计学意义;CVP上升组患者复苏前后RI差异无统计学意义,且MAP、CO均未上升患者与其他患者相比,复苏前、复苏后RI均差异无统计学意义;分别按MAP及CO是否上升分组,各组复苏前后阻力指数均差异无统计学意义.结论 感染性休克入ICU早期复苏时细化的肾血流评分在中心静脉压无明显上升时,随CO、MAP的上升而升高.肾动脉RI与CO、MAP及CVP无明显相关性,不宜作为判断感染性休克早期患者肾脏灌注的指标.%Objective To assess the variations of renal vascularization scale and resistive index in septic shock patients during the first 6 h in intensive care unit (ICU).Methods A total of 39 septic shock patients were prospectively enrolled to receive echocardiographic and renal ultrasound examinations.And the data of mean arterial pressure (MAP),central venous pressure (CVP),cardiac output (CO),renal vascularization scale (VS) and resistive index (RI) were recorded.Results Among 19 patients without an increase of CVP,8 of them showed significant increase in MAP and CO.Six of 8 patients with increases both in MAP and CO displayed an increase of VS while only 1 out of the remaining 11 patients had an increase of VS (P =0.027).Among 20 patients with an increase of CVP,9 of them showed no significant increase in MAP or CO.Eight out of 9 patients without significant increase in MAP or CO displayed a decrease of VS while only 2 out of the remaining 11 patients displayed a decrease of VS (P =0.086).They were divided into two groups according to the variations of MAP,CVP and CO respectively.No significant change of RI was found between oh and 6 h in each group.Conclusion The renal vascularization scale increases in patients with increases both in CO and MAP while CVP remains almost unchanged.No significant relationship exists between resistive index and such hemodynamic parameters as CO,MAP and CVP.
    • 郑程程; 蔡兆诚; 冯洁; 牛田力; 苗延巍
    • 摘要: 目的 应用动态磁敏感增强MR灌注成像(DSC-PI)技术对Sturge-Weber综合征(SWS)受累白质区的血流灌注进行定量测量,并和各种癫痫状态指标进行相关性分析,以期合理的解释SWS血流动力学与癫痫状态的关系.材料与方法 14例临床确诊为SWS的患儿进行MRI检查,其中男6例,女8例,平均年龄4.0岁(0.8~10.0岁).所有患儿的病变部位均为单侧大脑半球.MR扫描序列包括:矢状面及轴面T1WI、轴面FSE T2WI、DSC-PI及增强后轴面T1WI.观察所有图像以确认脑内病变位置及范围;利用SPIN(signal process in neuroimage)软件分别测量病变白质区域及相应对侧位置的脑血流量(CBF)、脑血容量(CBV)和平均通过时间(MTT),并计算出灌注比值(CBFr、CBVr及MTTr).根据CBFr值将患儿分为高灌注组(HP)及低灌注组(LP).记录每例患儿的临床资料,尤其有无癫痫发作以及反映发作的各项参数:首次癫痫发作年龄、癫痫发作频率(SSF)及癫痫持续时间.对高、低灌注组病变侧与对侧的CBF、CBV及MTT值进行配对秩和检验;对癫痫状态的各临床参数与各项灌注参数进行Spearman相关分析.结果 14例SWS患者中,9例受累白质区CBF及CBV较对侧明显减低(CBFr值为-0.37±0.24,CBVr=-0.22±0.25,P值均<0.01),为LP组;5例脑内病变侧白质区CBF及CBV较对侧显著增高(CBFr值为0.31±0.05,CBVr值为0.40±0.17,P值均<0.01),为HP组.LP组年龄及癫痫发作频率得分(SSF)较HP组有增大趋势(年龄=63.80月,48.83月;SSF=2.50,1.33),但这差异缺乏统计学意义(P值分别为0.36、0.12).病变侧CBFr值和CBV值与癫痫持续时间呈明显负相关(CBFr:r=-0.58;CBV:r=-0.55,P值均<0.05).CBFr和CBVr与癫痫发作频率呈负相关,即癫痫发作越频繁,CBFr和CBVr越低(CBFr:r=-0.56;CBVr:r=-0.63,P值均<0.05).结论 SWS受累白质区域的血流灌注并非持续降低,而存在相对高灌注状态;灌注异常与癫痫发作的频率和癫痫持续时间有关.
    • 成磊; 简志宏; 谢源阳; 廖艺玮; 袁健; 袁贤瑞
    • 摘要: 目的 建立一种稳定的单侧岩静脉离断动物模型.方法 家兔16只,其中用于制作尸头硅胶灌注标本6只,观察家兔颅后窝静脉引流特点,并与人静脉引流情况比较;另外10只模拟神经外科手术入路,在显微镜下电凝并切断岩静脉,建立单侧岩静脉离断动物模型.结果 在硅橡胶灌注的6具兔头标本中,有1具仅灌出动脉,其余兔尸头灌注情况均较满意.用于制作岩静脉单侧离断模型的10只家兔中,建模成功8只,失败2只.结论 开颅电凝切断家兔岩静脉建立单侧岩静脉离断动物模型是可行的.%Objective To establish a stable animal model of unilateral petrosal vein disconnection. Methods Sixteen rabbits were randomly divided into 2 groups. The cadaver head specimens were made by infusion of silicone rubber in 6 rabbits to observe the characteristics of vein drainage in the posterior cranial fossa in rabbits, and compared them with human situation of vein drainage. The other 10 rabbits were cut of unilateral petrosal vein with electric coagulation under microscope via a simulated neurosurgical approach for establishing the animal model of unilateral petrosal vein disconnection. Results Among the 6 cadaver head specimens, 1 showed only the artery infusion and the others were infused well. Among the 10 rabbits used to establish the animal model of unilateral petrosal vein mutilation, the modeling was successful in 8 and failed in 2. Conclusions The establishment of animal model of unilateral petrosal vein disconnection by craniotomy with electric coagulation of the vessel in rabbit is feasible.
    • 刘昱彰; 张兆杰; 马明; 张世民; 董福慧; 周卫; 李星; 张禄堂; 章永东; 黎作旭; 吴冠男
    • 摘要: 目的:探讨腰椎内固定术后切口早期深部感染的原因、诊断要点及治疗手段.方法:自2001年1月至2011年12月,对10例采用椎间隙灌注冲洗法治疗的腰椎后路内固定术后切口早期深部感染患者的临床资料进行回顾性分析.其中男1例,女9例;平均年龄63岁,感染发病时间平均为术后第6天.主要临床表现包括不同程度腰腿痛加重、体温升高、伤口新鲜渗液及血炎性指标增高等,疗效评估则以伤口是否Ⅰ期愈合为主要标准.结果:10例患者均获得随访,随访时间平均为1年5个月.9例伤口Ⅰ期愈合,无复发,也无术后并发症出现,1例患者后续进行多次清创术,疗程共7个月,最后将椎弓根螺钉取出后伤口愈合,随访1.5年未复发.结论:腰椎内固定术后深部感染尽早行手术清创及椎间隙灌注冲洗法治疗,可获得满意疗效并能最终保留内固定,避免过多切除软组织及椎间隙深层置管是手术成功的关键.%Objective: To explore the reason, diagnose outline, therapeutic tool of the incisions deep infections at early stage after lumber internal fixation. Methods: From January 2001 to December 2011 ,10 patients with incisions deep infections at the early stage after the posterior lumber internal fixation were treated with intervertebral space lavaging. There were 1 male and 9 females with an average age of 63 years, and an average infection started at the 6th day after operation. The main clinical features including backleg pain aggravating,fervescence,fresh seepage from the wound,and blood inflammatory index increased, etc. According to whether the wound could heal at the first treatment stage as a evaluation standard of curative effect. Results:Ten cases were followed up with an average period of 17 months. The wounds of 9 cases healed at the first stage and no recurrence and complications were found. One case underwent debridgement of many times with the therapic period of 7 months,at last,after taking out the vertebral pedicle bolt,the wound healed,and no recurrence after follow-up of 18 months. Conclusion:The deep wound infections after the lumber internal fixation should receive intervertebral space lavaging as soon as possible. The method can finally remain internal fixations and obtain satisfactory effects,but avoiding too much tissue cutting and tube setting in the deep intervertebral space are the keys to the successful fixation.
    • 李洁
    • 摘要: 目的:探讨药物局部封闭加KS光照射治疗外阴白斑病的治疗效果.方法:对58例外阴白斑病采用药物(重组人白介素-2注射液30万U+维生素B12注射液0.5mg)局部封闭加KS光照射治疗,并观察其临床疗效.结果:58例患者用药后症状消失58例,局部病灶面积减少50%以上56例,其中单纯型有效率为100%,混合性有效率为89.5%;轻症有效率为100%,重症有效率为93.7%.与治疗前相比有极显著性差异(P<0.01).结论:药物局部封闭加KS光照射治疗白斑病疗效确切,也较为安全.
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