ABSTRACT
Objective:To observe the effects of ultrasound guided transversus abdominis plane block (TAPB) on pain, rehabilitation indexes and immune function of postoperative in patients undergoing laparoscopic colorectal cancer surgery.Methods:A total of 100 patients undergoing laparoscopic colorectal cancer surgery admitted to Jiading Branch of Shanghai First People′s Hospital/Jiangqiao Hospital of Jiading District and Shanghai First People′s Hospital from February 2020 to February 2021 were selected as the study subjects, including 43 patients performed epidural block (control group) and 57 patients performed TAPB (observation group). The clinical indicators, vital signs parameters, pain degree, immune function in the two groups were compared.Results:The exhausting time, defecation time, getting out of bed time and hospitalization time in observation group were shorter than those in control group: (2.71 ± 0.54) d vs. (2.99 ± 0.66) d, (3.02 ± 0.49) d vs. (3.49 ± 0.56) d, (3.20 ± 0.89) d vs. (3.85 ± 1.08) d, (6.81 ± 0.98) d vs. (7.71 ± 1.08) d, there were statistical differences ( P<0.05). The diastolic blood pressure, systolic blood pressure and heart rate at pre-anesthesia, immediate incision of the skin, end of the surgery between two groups had no significant differences ( P>0.05). The scores of visual analogue scale at 4, 24, 48 and 72 h after surgery in the observation group were significantly lower than those in the control group ( P<0.05). The levels of CD 3+, CD 4+, CD 4+/CD 8+ and IgM after surgery for 3 d in the observation group were higher than those in the control group: 0.512 ± 0.054 vs. 0.487 ± 0.051, 0.280 ± 0.036 vs. 0.222 ± 0.032, 1.36 ± 0.29 vs. 1.17 ± 0.26, (152.53 ± 34.3) kU/L vs. (138.86 ± 31.18) kU/L, there were statistical differences ( P<0.05). Conclusions:TAPB can effectively reduce the degree of postoperative pain and immunosuppression after laparoscopic colorectal cancer surgery, so as to promote postoperative rehabilitation of patients.
ABSTRACT
Objective:To study the clinical efficacy of ultrasound-guided radiofrequency acupotomy in early and middle-stage knee osteoarthritis (KOA).Methods:A total of 62 patients with KOA were enrolled and then randomly divided into the radiofrequency acupuncture group and the control group. The two groups were treated with radiofrequency acupotomy and conventional acupotomy under ultrasound guidance, respectively. The treatments were conducted once a week, twice in total. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) of all the patients was evaluated before the treatment as well as the day, 2 weeks, and 1 month after the treatment.Results:Before the treatment, the differences between the two groups in gender, age, body mass index (BMI), WOMAC pain score, WOMAC stiffness score, WOMAC function score, and WOMAC total score were not statistically significant (all P>0.05), indicating the two groups were comparable. On the day, 2 weeks, and 1 month after the treatment, the above WOMAC scores of the two groups were lower than those before the treatment, and the differences were statistically significant (all P<0.01). The WOMAC scores of the radiofrequency acupotomy group were lower than those of the control group at the same period, and the differences were statistically significant (all P<0.05). Conclusions:For patients with early and middle-stage KOA, ultrasound-guided radiofrequency acupotomy therapy has proven clinical efficacy in relieving pain and improving knee joint function.
ABSTRACT
Objective: To explore the clinical value of ultrasound-guided radiofrequency ablation in the treatment of retroperitoneal tumors. Methods: The clinical data of 13 patients with retroperitoneal tumors treated with ultrasound-guided radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020 were analyzed retrospectively. The ablation effect was evaluated and the postoperative complications were observed. The changes of tumor volume before and after radiofrequency ablation were compared. Results: The symptoms of pain and dyspepsia were significantly improved after radiofrequency ablation, and the hospital stay was (9.2±2.9) days. The tumor was ablated completely in 10 cases, tumor residual in 1 case and tumor metastasis in 2 cases. One patient had postoperative duodenal perforation complicated with intra-abdominal infection, and no serious complications occurred in other patients. There were 20 lesions in 13 patients. The maximum diameter of 20 lesions before operation and 1, 3, 6 months after operation were (39.5±15.9) mm, (30.6±4.9)mm, (15.6±7.7) mm and (9.9±3.1) mm, respectively, the maximum diameters of 1, 3 and 6 months after operation were smaller than that before operation (P<0.05). Conclusion: Ultrasound-guided radiofrequency ablation is a real-time, accurate, safe and effective minimally invasive treatment with few complications, and has a high clinical value for retroperitoneal tumors.
Subject(s)
Humans , Catheter Ablation , Radiofrequency Ablation , Retroperitoneal Neoplasms/surgery , Retrospective Studies , Treatment Outcome , Ultrasonography, InterventionalABSTRACT
OBJECTIVE@#To explore the impacts on weight reduction effect treated with acupoint thread embedding therapy at different tissue levels under ultrasonic guidance.@*METHODS@#A total of 70 patients with overweight or obesity were randomized into a shallow-tissue thread embedding group (35 cases, 5 cases dropped off) and a deep-tissue thread embedding group (35 cases, 4 cases dropped off). Under ultrasonic guidance, the thread was embedded in the shallow tissue level and the deep tissue level respectively. The acupoints were Zhongwan (CV 12), Xiawan (CV 10), Shuifen (CV 9), Zhongji (CV 3), etc. The thread embedding therapy was exerted once every 2 weeks, totally for 3 times. Before and 2 weeks after treatment, body mass, body mass index (BMI), waist circumference and hip circumference were recorded in the patients of the two groups separately. After each treatment, the number and the property of blood vessels under each acupoint were detected by ultrasound. Besides, the needling sensation and the intensity were scored and the adverse events were observed after thread embedding therapy.@*RESULTS@#After treatment, the reduction range of body mass, BMI and waist circumference in the deep-tissue thread embedding group were larger than those in the shallow-tissue thread embedding group successively (@*CONCLUSION@#The deep-tissue thread embedding therapy achieves the stronger
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Body Mass Index , Catgut , Ultrasonics , Weight LossABSTRACT
Objective:To investigate the effect of cricopharyngeal injection of Botulinum toxin under ultrasonic guidance for treatment of dysphagia caused by Wallenberg's syndrome. Methods:A case was reviewed. Results:This patient was diagnosed as cricopharyngeal achalasia after dorsal lateral rostral infarction, and responded poor to routine treatment for swallowing disorders, including balloon dilatation. He accepted cricopharyngeal Botulinum toxin injection under ultrasonic guidance. As evaluated with Toshima Ichiro Ingestion-Swallowing Function Rating Scale, Rosenbek Penetration-Aspiration Scale and videofluoroscopic swallowing study (VFSS), his swallowing improved after treatment, and became normal as follow-up one and three months after treatment. Conclusion:Cricopharyngeal Botulinum toxin injection under ultrasonic guidance is feasible for cricopharyngeal achalasia of Wallenberg's syndrome with immediate and long-term effect.
ABSTRACT
Objective To explore the application value of ultrasound-guided stellate ganglion block in patients with aneurysmal cerebral hemorrhage.Methods Eighty patients with subarachnoid hemorrhage caused by aneurysm from November 2017 to March 2019 in Hangzhou Hospital of Zhejiang Medical Health Group were selected.The patients were divided into observation group and control group by random digits table method with 40 cases in each group.All patients were treated with craniotomy hematoma removal.At the conclusion of the surgical procedure,the control group was treated with nimodipine,while the observation group was treated with ultrasound-guided right stellate ganglion block on the basis of nimodipine.The blood flow velocity of middle cerebral artery before operation and 6,24 h after operation by transcranial Doppler sonography were detected to reflect cerebral vasospasm status;the blood samples from the radial artery and internal jugular bulb 24 h after operation were used to detect and count cerebral oxygen metabolism indexes,including the blood oxygen saturation of internal jugular bulb,arteriovenous oxygen content difference and cerebral oxygen uptake rate;the IgG,IgA and IgM 24 h after operation were detected.The patients were followed up at 1 week after operation,and the complication was observed.Results There was no statistical difference in the blood flow velocity of middle cerebral artery before operation between 2 groups (P＞0.05);the blood flow velocity of middle cerebral artery 6 and 24 h after operation in observation group was significantly lower than that in control group:(100.8± 8.2) cm/s vs.(123.5 ± 9.9) cm/s and (89.7 ± 5.3) cm/s vs.(118.9 ± 7.1) cm/s,and there was statistical difference (P＜0.01).The blood oxygen saturation of internal jugular bulb,cerebral oxygen uptake rate,IgG,IgA and IgM 24 h after operation in observation group were significantly higher than those in control group:0.704 ± 0.035 vs.0.598 ± 0.058,(57.5 ± 6.5)％ vs.(49.7 ± 3.6)％,(12.5 ± 0.3) mg/L vs.(5.0 ± 0.1) mg/L,(5.5 ± 0.3) mg/L vs.(2.1 ± 0.1) mg/L and (4.3 ± 0.3) mg/L vs.(1.9 ± 0.2) rg/L,the arteriovenous oxygen content difference and incidence of complication were significantly lower than those in control group:(40.8 ± 3.2) ml/L vs.(58.3 ± 8.6) ml/L and 5.0％ (2/40) vs.25.0％ (10/40),and there were statistical differences (P＜0.01 or ＜0.05).Conclusions For patients with aneurysmal intracerebral hemorrhage,ultrasound-guided stellate ganglion block therapy can effectively improve cerebral blood flow,ensure cerebral oxygen supply,improve humoral immunity,reduce the incidence of postoperative complication,and achieve the purpose of improving clinical therapeutic effect.
ABSTRACT
OBJECTIVE@#To explore the efficacy of ultrasound-guided needle-knife with precise three-dimensional stereotactic localization of points for stenosing tenosynovitis of flexor tendon (trigger finger).@*METHODS@#A total of 74 patients were randomly divided into an observation group and a control group, 37 cases in each group. The patients in the observation group were treated with ultrasound-guided intrathecal injection and releasing method of needle-knife, while the patients in the control group were treated with ultrasound-guided intrathecal injection. The self-made 9-score scale of trigger finger was recorded before treatment, immediately after treatment, 1 month and 3 months after treatment; the curative effect of the two groups was evaluated.@*RESULTS@#The results of self-made 9-score scale in the observation group immediately after treatment, 1 month and 3 months after treatment were lower than that before treatment (all <0.01); the scores in the observation group were lower than those in the control group at each time point after treatment (all <0.01). The excellent and good rate immediately after treatment was 100.0% (37/37) in the observation group, which was superior to 8.1% (3/37) in the control group (<0.05); the cured rates in the observation group were 100.0% (37/37) 1 month after treatment and 97.3% (36/37) 3 months after treatment, which were superior to 13.5% (5/37) and 10.8% (4/37) in the control group, respectively (<0.05).@*CONCLUSION@#The needle-knife with three-dimensional stereotaxic location of point could significantly improve the symptoms of trigger finger, with superior immediate and long-term efficacy.
Subject(s)
Humans , Needles , Tendons , Trigger Finger Disorder , Therapeutics , UltrasonographyABSTRACT
To investigate the safety and feasibility of indocyanine green ( ICG ) fluorescence staining guided by laparoscopic ultrasound guiding portal branch puncture approach in anatomical segmentectomy of the liver . Methods The clinical data of 22 patients with malignant liver diseases underwent anatomical segmentectomy between February 2018 and M ay 2018 were retrospectively analyzed . ICG 0 .125～0 .250 mg was directly injected into the portal branches supplying blood flow to the tumor‐bearing hepatic segment , after puncturing of the target portal branch under intraoperative laparoscopic ultrasound guidance in all patients . T he fluorescence imaging system ( Pinpoint) was used for the resection procedure . Observation indicators :intraoperative conditions ( tumor diameter ,success rate of portal branches puncture ,success rate of staining the target hepatic segment ,intraoperative complications , time of operation ,volume of intraoperative blood loss , blood transfusion , and transit of laparotomy ) . Postoperative conditions :postoperative complications ,and length of hospital stay . Results Twenty‐two patients with liver tumors were all performed anatomical hepatectomy assisted by laparoscopic ultrasound guiding ICG injection for liver segment staining . All the liver tumors were hepatocellular carcinoma . ①Intraoperative conditions : T he portal branches puncture successful rate was 100% ( 22/22 ) . Eighteen patients achieved expected effect of ICG fluorescence staining ,with a satisfaction rate of 81 .8% (18/22) and 4 failed to get expected effect ,including 2 with uneven dying ,and 2 with adjacent hepatic segmental staining induced to unclear boundary . No complication such as allergy occurred in all patients after ICG injection . T he mean operation time was ( 209 ± 89 ) min ( range :97 ～ 325 min) and the target portal branches ICG puncture injection time under intraoperative laparoscopic ultrasound guidance was ( 11 ± 5) min ( range 3－25 min) . T here was no intraoperative blood transfusion or transit of laparotomy .Average tumor diameter was ( 3 .9 ± 1 .3) cm( range :2 .2－7 .0 cm ) . ②Postoperative conditions of 22 patients ,4 with grade Ⅰ － Ⅱ of Clavien‐Dindo classification were improved by drug treatments ( 1 with deep venous thrombosis of the lower extremities and 3 with pleural effusion ) , no patient had grade Ⅲ and above complications , and no perioperative death occurred . Average duration of hospital stay was ( 7 ± 2 ) days in 22 patients ( range :5 .0－14 .0 days) . Conclusions ICG fluorescence staining guided by laparoscopic ultrasound guiding portal branch puncture ,obtains accurate and lasting fluorescence markers on the liver surface and inside the parenchyma . ICG staining guides the selection of liver section in the operation of liver in real time ,and helps surgeons to perform laparoscopic anatomical segmentectomy of the liver .
ABSTRACT
To investigate the feasibility ,safety and clinical effect of No touch liver pedicle microwave ablation . Methods T he clinical data of 229 patients with hepatocellular carcinoma treated in the Department of Hepatology ,Wuhan Tongji Hospital from M ay 2014 to October 2016 were retrospectively analyzed . T he patients were divided into 3 groups .In group A ,82 patients underwent ultrasound‐guided No touch liver pedicle microwave ablation ,69 patients in group B were treated with anatomical hepatectomy ,and 78 patients in group C underwent traditional microwave ablation . T he preoperative basic data ,intraoperative data ( treatment time , intraoperative blood loss ) and postoperative data ( postoperative liver function indicators ,complications ,hospitalization time ,local recurrence ,survival rate) were compared among the 3 groups . Results T he treatment time ,intraoperative blood loss ,postoperative liver function index and hospitalization time in group A and group C were significantly lower than those in group B( all P ＝0 .000) . T here was no difference in complete elimination rate ,between the two groups in group A and group B( P ＞0 .05) ,which was significantly better than those of group C ( P ＝ 0 .019 ) . T here was no significant difference in the local recurrence rate between the three groups after 1 year and 3 years . Conclusions No touch liver pedicle microwave ablation damage is safe and reliable ,in line with the principle of oncology treatment ,it worthes further promotion in the clinic .
ABSTRACT
Objective To evaluate the effect of artificial ascites under ultrasonic guidance in the thermal ablation of liver or kidney tumors ,so as to provide basis for successfully creating artificial ascites , increasing the complete ablation rate of the tumors and reducing the damage of important organs . Methods Seven hundred and thirty-six patients with artificial ascites were performed under ultrasonic guidance during the thermal ablation of liver or kidney tumors and six hundred and seventy-nine patients were successfully performed . The success rate of creating artificial ascites at different sites ,time requirement ,the effect of ascites , puncture times were analyzed , while curative effect and complications were evaluated and summarized . Results The success rate of creating artificial ascites was 92 .3％ ;the average time of creating artificial ascites was( 9 .1 ± 1 .3) minutes ;the average puncture times was( 1 .1 ± 0 .2) times ;complete ablation was 98 .7％ ;the complication of ascites creation was 0 .44％ ,minor complications after ablation was 6 .20％ , severe complications was 0 .59％ . The required fluid volume and success rates for the creation of artificial ascites in different sites were different . The volume of fluid needed was relatively high in the liver-gastric space ,and the success rate was relatively low ;the success rate of liver septum and liver -kidney crypts was the highest . Heat injury complications of the important organs such as gastrointestinal tract ,esophagus , diaphragm near the liver or kidney tumors were 0 . Conclusions The establishment of artificial ascites improves the local curative effect and reduces the complication of tumors ablation in difficult locations . The methods and effect of artificial ascites in different parts of liver or kidney are different .
ABSTRACT
Objective:To explore the clinicaleffect of radial arterial puncture cannulationunder ultrasonic guidance in patients with critical diseases.Methods:From December 2016 to May 2017,120 patients under critical conditions in Department of Intensive Care Unit,Xiangya Hospital,Central South University,who received arterial cannulation,were randomly divided into 2 groups:a control group (traditional blind puncture method) and an observation group (ultrasound-guided radial arterial cannulation) (60 cases in each group).The success ratio of radial arterial puncture cannulation by one time,total success ratio of radial arterial puncture cannulation,numbers of puncture,the rate of complications and the time of consumption were compared between the 2 groups.Results:There was no statistically significant difference in the total success ratio of radial arterial puncture cannulationin the 2 groups (P＞0.05).The success ratio radial arterial puncture cannulation by one time was significantly greater in the observation group than that in the control group (P＜0.05);the numbers of puncture,the rate of complications and the time of consumption in the observation group were lower than those in the control group,with statistically significant (all P＜0.05).Conclusion:The application of ultrasound-guided radial arterial puncturecannulation can improve the success ratio of radial arterial puncturecannulation by one time,decrease the numbers of puncture,reduce the incidence of complications and save operation time.
ABSTRACT
Objective To evaluate the safety and efficacy of ultrasound guided flexible ureteroscopic lithotripsy.Methods From January 2015 to December 2016,a randomized clinical trial enlisted 130 patients,presenting symptomatic renal stones with 1.3-2.0 cm,in our center.Patients were randomly assigned to ultrasound or radical guided retrograde intrarenal surgery (RIRS) with flexible ureteroscope.There were 37 male and 28 female patients in ultrasound group.Their mean age,BMI index and stone size were (47.7 ± 21.3) years,(22.1 ± 4.7) kg/m2 and (1.4 ± 0.2) cm,respectively.In radical group,there were 22 male and 43 female patients.Their mean age,BMI index and stone size were (51.3 ± 19.2) years,(21.6 ± 3.3) kg/m2 and (1.6 ± 0.1) cm,respectively.There was no significant difference of those items between ultrasound and radical group.In ultrasound group,the transducer was placed at the dorsal and ventral to visualize the real time image of ipsilateral renal collecting system.The safety wire placing,ureteroscope passing through the uretheral access sheath and the lithotripsy detail could be easily monitored.We compared stone size,operative time,stone-free status and complication rates between the ultrasound and radical group.Results All patients accepted the operation successfully.Operative time was significantly shorter in the ultrasound group than that in radical group.[(62.4 ± 31.7) min vs.(80.4 ± 42.1)min,P ＜0.05].The average radical exposure during was (37.5 ± 25.2)seconds in radical group.Ureteral injury was seen in 20.0％ (13/65),18.5％ (12/65) cases in ultrasound and radical group,respectively.The mucosal injury rate in each group was 92.3％ (12/13) and 83.3％ (10/12) (P ＞ 0.05),respectively.Muscle layer injury was recorded in 1 case of in ultrasound group and 2 cases in radical group.Clavien grade Ⅳ or higher grade complications was not observed in both groups.Fever,pain,nausea or vomiting,persistent hematuria in ultrasound group were 2 cases,3 cases,1 cases and 5 cases.In radical group,those complications were in 2 cases,3 cases,7 cases and 1 cases,respectively.There was no significant difference between the two groups (P ＞ 0.05).The ultrasound group showed no significant difference in the stone-free rate [90.8％ (118/130)vs.89.2％ (116/130)] or the complication rate compared to those in radical group(P ＞ 0.05).Conclusions The retrograde intra-renal lithotripsy guided solely by ultrasound can be carried out in the general population in an effective and safe fashion without ionizing radiation,which has the potential to replace radical guided in flexible ureteroseopy.
ABSTRACT
Objective To evaluate the safety and efficacy of ultrasound guided flexible ureteroscopic lithotripsy.Methods From January 2015 to December 2016,a randomized clinical trial enlisted 130 patients,presenting symptomatic renal stones with 1.3-2.0 cm,in our center.Patients were randomly assigned to ultrasound or radical guided retrograde intrarenal surgery (RIRS) with flexible ureteroscope.There were 37 male and 28 female patients in ultrasound group.Their mean age,BMI index and stone size were (47.7 ± 21.3) years,(22.1 ± 4.7) kg/m2 and (1.4 ± 0.2) cm,respectively.In radical group,there were 22 male and 43 female patients.Their mean age,BMI index and stone size were (51.3 ± 19.2) years,(21.6 ± 3.3) kg/m2 and (1.6 ± 0.1) cm,respectively.There was no significant difference of those items between ultrasound and radical group.In ultrasound group,the transducer was placed at the dorsal and ventral to visualize the real time image of ipsilateral renal collecting system.The safety wire placing,ureteroscope passing through the uretheral access sheath and the lithotripsy detail could be easily monitored.We compared stone size,operative time,stone-free status and complication rates between the ultrasound and radical group.Results All patients accepted the operation successfully.Operative time was significantly shorter in the ultrasound group than that in radical group.[(62.4 ± 31.7) min vs.(80.4 ± 42.1)min,P ＜0.05].The average radical exposure during was (37.5 ± 25.2)seconds in radical group.Ureteral injury was seen in 20.0％ (13/65),18.5％ (12/65) cases in ultrasound and radical group,respectively.The mucosal injury rate in each group was 92.3％ (12/13) and 83.3％ (10/12) (P ＞ 0.05),respectively.Muscle layer injury was recorded in 1 case of in ultrasound group and 2 cases in radical group.Clavien grade Ⅳ or higher grade complications was not observed in both groups.Fever,pain,nausea or vomiting,persistent hematuria in ultrasound group were 2 cases,3 cases,1 cases and 5 cases.In radical group,those complications were in 2 cases,3 cases,7 cases and 1 cases,respectively.There was no significant difference between the two groups (P ＞ 0.05).The ultrasound group showed no significant difference in the stone-free rate [90.8％ (118/130)vs.89.2％ (116/130)] or the complication rate compared to those in radical group(P ＞ 0.05).Conclusions The retrograde intra-renal lithotripsy guided solely by ultrasound can be carried out in the general population in an effective and safe fashion without ionizing radiation,which has the potential to replace radical guided in flexible ureteroseopy.
ABSTRACT
Objective To assess the clinical safety and feasibility for ultrasound guided paravertebral block anesthesia of percutaneous nephrolithotomy.Methods Between December 2015 to June 2016,180 patients with renal or ureteral calculi were enrolled and evaluated with uhrasonography and CT scan.Of all the 180 patients,108 males and 82 females.Their mean age was 39 years (23-71 years).The clinical characteristics of the patients in each group,such as age,gender,BMI index,ASA status,mean arterial pressure and disease type had no significant differences (P ＞ 0.05).These patients were randomized into general anesthesia group (G group),combined spinal epidural anesthesia group (C group) and paravertebral nerve block anesthesia group (P group).G group:35 males and 25 females.Their mean age was (40.1 ± 11.8) years and BMI was (25.1 ± 3.8) kg/m2;Renal calculi 52 cases,ureteral calculi 8 cases,Average maximum stone diameter was (2.6 ± 0.8)cm.C group:38 males and 22 females.Their mean age was (39.7 ± 12.4) years and BMI was (24.6 ± 4.1) kg/m2;Renal calculi 54 cases,ureteral calculi 6 cases,Average maximum stone diameter was (2.4 ± 0.8) cm.P group:35 males and 25 females.Their mean age was (38.9 ± 12.7) years and BMI was (25.4 ± 4.0) kg/m2;Renal calculi 51 cases,ureteral calculi 9 cases,Average maximum stone diameter was (2.5 ± 0.7) cm.Periprocedural Vital signs,complications,the times of anal discharging gas and postoperative feeding,hospitalized day and expense in these three groups were evaluated.Results Major intraoperative or postoperative complications did not occur in all of the patients.Mean arterial pressure decreased during preoperative changing positions was observed in group G (mean decreased 8.8 mmHg)and group C (mean decreased 1.9 mmHg),with significant difference in intra-group (P ＜ 0.05).Postoperative nausea and vomiting was observed in 8 and 2 patients of group G and group P,respectively (P ＜ 0.05).Postoperative pain was observed in 2 and 7 patients of group C and group P,respectively (P ＞ 0.05).In addition,group P had early post operation feeding time [(6.4 ± 2.4) h],shorter hospitalized day [(4.5 ± 1.1) d] and lower hospitalized expense compared with other groups (P ＜ 0.05).Conclusions Ultrasound guided paravertebral block can provide safe and reliable surgical anesthesia for percutaneous nephrolithotomy.
ABSTRACT
Objective To evaluate the clinical application value of three-dimensional medical image guided ultrasound in the chemotherapy of huge hepatic hemangioma.Methods Seventy-six cases were enrolled in a randomized control study.All cases were randomly divided into two groups (group A and group B).In group A,all cases underwent treatment based on the traditional two-dimensional medical images.Under the assistance of three-dimensional medical image information,preoperative treatment planning was performed in group B.After puncture treatment,therapeutic efficacy was evaluated by color ultrasound during follow-up.Results For treating huge hepatic hemangioma (tumor diameter ≥ 10.0 cm),the insertion number and pingyangmycin dosage in the group B were less than those in the group A [(6.2± 0.5)times vs (9.3±0.6) times,t=24.467,P=0.035;(99.2±8.0) mg vs (148.8±9.6) mg,t=34.613,P=0.029].The success rate of first treatment in the group B was higher than that in group A [73.6％(28/38) vs 100％(38/38),x2=131.91,P=0.032].Conclusion For huge hepatic hemangioma,the three-dimensional medical image information can be applied to reduce the insertion number and anesthetics dosage,improving the success rate of first treatment and therapeutic effect.
ABSTRACT
Objective To evaluate the clinical effectiveness of percutaneous transhepatic gallbladder drainage introduced by bedside ordinary-probe-guidance with free-hand technique in severe cholecystitis. Methods 85 cases treated with the operation were observed and analyzed. Results Infectious bile was successfully drained in all cases without serious complications. 83 cases received satisfactory outcomes. 2 elderly patients died from MODS secondary severe infection. Conclusion Bedside ordinary-probe-guided free-hand percutaneous transhepatic gallbladder drainage is a safe and convenient treatment with minimal invasion for severe cholecystitis, which can be widely used in clinic.
ABSTRACT
Objective To study the therapeutic effect of ultrasonic guidance MTX local injection combined with mifepristone in the treatment of unruptured tubal pregnancy. Methods From January 2013 to February 2014,a total of 120 cases of unruptured tubal pregnancy were given injection of MTX 1 mg /kg in the capsule under ultrasonic guidance and oral administration of mifepristone 75 mg twice a day for 4 days. Results Ultrasound-guided puncture was successfully completed at first time in 1 12 cases and at second time in 8 cases.Four days after treatment,the β-hCG decreased by more than 15% in 80 cases (66.7%),had no significant change in 10 cases (8.3%),and increased by less than 15% in 30 cases (25.0%).The β-hCG decreased by more than 15% at the seventh day in 105 cases (87.5%),and had a further decline at the 14th day,and dropped to normal after a month,with abdominal pain relieved,vaginal bleeding stopped,and abdominal mass shrunk or disappeared.The treatment successful rate was 87.5%(105 /120).The hospitalization costs was 1208.5 -2722.6 yuan,with an average of 1859.4 yuan. Conclusion Under ultrasonic guidance,MTX local injection combined with mifepristone in the treatment of unruptured tubal pregnancy is a simple and safe method.
ABSTRACT
Objective To evaluate the analgesic effect of dexmedetomidine on the ultrasonic guidance brachial plexus block.Methods Sixty patients who underwent elective for one-side upper limb or forearm surgery were selected,they were received ultrasonic guidance brachial plexus block.The patients were divided into observation group and control group by random digits table method with 30 cases each.The observation group received 0.5％ ropivacaine 100 mg and dexmedetomidine 0.75 μg/kg,and the control group received 0.5％ ropivacaine 100 mg alone.The heart rate,mean arterial pressure (MAP),pulse oxygen saturation (SpO2) at the time of entering operating room,brachial plexus block completed,incision and the end of surgery were recorded.After brachial plexus block completed,the visual analogue score (VAS) at the time of incision,1 h during surgery and 1,2,6,12,24,48 h after surgery was recorded.Morphine was given the patients when VAS ＞ 4 scores,and the time to first prescription of morphine and total morphine consumption dose within 48 h after surgery were also detected.The adverse reaction was recorded.Results There were no statistical differences in heart rate and MAP at the time of entering operating room and brachial plexus block completed between the 2 groups (P ＞ 0.05).The heart rate and MAP at the time of incision and the end of surgery in observation group were significantly lower than those at the time of entering operating and the same time of control group,there were statistical differences (P ＜ 0.05).There was no statistical difference in SpO2 between the 2 groups (P ＞0.05).The VAS at the time of 6,12,24 and 48 h after surgery in observation group were significantly lower than those in control group [(3.0 ± 0.9) scores vs.(4.9 ± 0.5) scores,(3.0 ± 0.7) scores vs.(5.6 ± 1.2) scores,(2.2 ± 0.9) scores vs.(4.8 ± 1.8) scores,(1.7 ± 0.5) scores vs.(3.2 ± 1.0) scores],there were statistical differences (P ＜ 0.05).The time to first prescription of morphine in observation group was significantly longer than that in control group [(450 ± 37) min vs.(368 ± 42) min],the total morphine consumption dose was significantly lower than that in control group [(8.3 ± 2.8) mg vs.(15.5 ± 4.5) mg],there were statistical differences (P ＜ 0.05).There was no adverse reaction found.Conclusion Ropivacaine plus 0.75 μ g/kg dexmedetomidine for ultrasonic guidance brachial plexus block may prolong the duration of analgesia,thus reduce morphine consumption within 48 h after surgery without severe adverse reaction.
ABSTRACT
Objective To compare the clinical effects of surgical treatment and ultrasonic guidance percutaneous radiofrequency ablation(PRFA) therapy in the treatment of liver cancer.Methods 78 patiens with live cancer were randomly divided into the operation group and PRFA group,each group had 39 patients.The operation group was treated with traditional open surgery,the PRFA group was treated with radiofrequency ablation.The clinical effect was compared between the two groups.Results All patients were followed up after therapy,the 1,2,3-year survival rate between operation group and PRFA group had no significant differences (all P ＞ 0.05),but in the patients whose tumor were central type and samller than 3cm,the 1,2,3-year survival rate of PRFA group were significantly higher than operation group(x2 =4.819,4.815,4.919,all P ＜ 0.05).Conclusion Ultrasonic guidance percutaneous radiofrequency ablation therapy in the treatment of liver tumor is effective,and the effect is better than operation group,especially for the patients with central type tumor and the tumor samller than 3cm.
ABSTRACT
[Objective] To discuss the nursing to the common complications in perioperational period of lung cancer treated with ultrasonic guidance transdermal radiofrequency ablation(RFA). [Method] 12 cases of peripheral lung cancer treated with ultrasonic guidance transdermal RFA, took active mental nursing, closely cooperated in operation, strictly observed the disease condition after operation, had good nursing of perioperational period, and were strengthened on observation of complications and prevention. [Result] 12 cases had smooth operation, part of them had pain at puncture spot, fever, little aerothorax and hydrops, with blood in sputum at cough, and were relieved timely with active observation and clinical nursing, without other severe complications, final y they were discharged from hospital upon recovery, without death in perioperational period. [Conclusion] The ultrasonic guidance RFA is a safe and effective method to treat peripheral lung cancer with little invasion; the nursing point is to closely observe disease condition before and after operation, and do wel general nursing.