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1.
Br J Radiol ; 93(1109): 20190505, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32101462

RESUMO

OBJECTIVE: Percutaneous transluminal balloon angioplasty (PTA) is recommended as the first choice to treat stenosis of Brescia-Cimino arteriovenous fistulas (B-C AVFs). The ability to predict which B-C AVFs are at risk for recurrent stenosis post-PTA would allow closer monitoring of patients, and possibly result in surgical intervention rather than repeat PTA. The purpose of this study was to identify predictive factors of primary patency after PTA in B-C AVFs. METHODS: Patients diagnosed with B-C AVF primary stenosis and treated by PTA between November 2013 and March 2018 were included in the study. Patient and stenotic lesion characteristics and PTA procedure factors were included in the analysis. The Kaplan-Meier method was used to analyze the primary patency rate. Cox proportional hazard regression analysis was used to identify factors predictive of decreased primary patency. RESULTS: 74 patients (35 males, 39 females) with a mean age of 61.68 ± 11.44 years (range, 36-84 years) were included in the study. The mean B-C AVF age was 16.34 ± 12.93 months (range, 2-84 months), and the median primary patency time was 7.79 ± 0.48 months. Cox proportional hazard regression analysis revealed stenosis location at the inflow artery [hazard ratio (HR)=3.83, 95% confidence interval (CI): 1.46-10.09] or anastomosis (HR = 1.90, 95% CI: 1.09-3.32), dilation >2 times during PTA (HR = 2.30, 95% CI: 1.22-4.34), and residual stenosis >30% (HR = 2.42, 95% CI: 1.26-4.63) were significantly associated with decreased patency. CONCLUSION: In conclusion, the primary patency rate of PTA for B-C AVF dysfunction is reduced by dilation >2 times, residual stenosis >30%, and stenosis located at the inflow artery or anastomosis. These results may help in tailoring surveillance programs, multiple PTA, or a proximal re-anastomosis surgery in patients with AVF dysfunction. ADVANCES IN KNOWLEDGE: A number of studies have been conducted to examine the predictors of primary patency after PTA, however, no definitive conclusions have been reached. Our study revealed that stenosis location at the inflow artery or anastomosis, dilation >2 times during PTA, and residual stenosis >30% were the predictors of primary patency after PTA, which may help in tailoring surveillance programs, multiple PTA, or a proximal re-anastomosis surgery in patients with arteriovenous fistulas dysfunction.


Assuntos
Angioplastia com Balão/métodos , Derivação Arteriovenosa Cirúrgica , Oclusão de Enxerto Vascular/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Constrição Patológica/terapia , Procedimentos Endovasculares/métodos , Falha de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Renal/instrumentação , Resultado do Tratamento , Grau de Desobstrução Vascular/fisiologia
3.
Zhongguo Gu Shang ; 28(3): 256-9, 2015 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-25936197

RESUMO

OBJECTIVE: To study the therapeutic effects of posterolateral depression fractures of the tibial plateau through a modified anterolateral approach. METHODS: From February 2011 to January 2012,13 patients with posterolateral depression fractures of the tibial plateau were treated through a modified anterolateral approach. There were 8 males and 5 females, ranging in age from 28 to 59 years old (49.2 years old on average). Data from patients were collected retrospectively as follows: X-ray, time of fracture healing and the complications of fracture healing. The patients were evaluated both clinically and radiologically according to the Rasmussen score system. RESULTS: All the patients were followed up, and the duration ranged from 6 to 18 months (mean 13.7 months). All the patients got bony union. The average radiographic bony union time was 15.1 weeks (ranged, 11 to 17 weeks). No case of secondary articular depression was found. No complications such as malunion or joint stiffness were found. But 1 patient had superficial infection and 1 patient had common peroneal nerve injury. According to the Rasmussen score system,the mean radiological score was 16.50 ± 0.67 (ranged, 13 to 18), and the mean functional score was 25.20 ± 2.21 (ranged, 13 to 30). The mean range of knee motion was (125.3 ± 9.3)° (ranged, 0° to 135°). CONCLUSION: Treatment of depression fractures of posterolateral tibial plateau with a modified anterolateral approach is a safe method with effective exposure, due to its stable fixation and relatively good outcome with minimal soft-tissue complications. It is regarded as an ideal procedure for depression fractures of posterolateral tibial plateau.


Assuntos
Fixação Interna de Fraturas/métodos , Fraturas da Tíbia/cirurgia , Adulto , Feminino , Consolidação da Fratura , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
4.
Zhongguo Gu Shang ; 25(9): 737-42, 2012 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-23256361

RESUMO

OBJECTIVE: To evaluate the effects of cervical vertebrae degeneration on traumatic cervical cord injury. METHODS: From January 2009 to December 2010, 24 patients with cervical cord injury without obvious fractures and dislocations were treated with operation, and their data were retrospectively analyzed. Among them, 16 males and 8 females, aged from 46 to 70 years old with an average of 59.1 years. Patients were divided into light degeneration group (6 cases), moderate degeneration group (10 cases) and severe degeneration group (8 cases), according to the preoperative degenerative degree of cervical vertebrae. Preoperative neurological dysfunction and postoperative neurological recovery were compared according to the JOA scores of Japanese Orthopaedic Society; quality of life were evaluated according to SF-36 scale (36-item Short Form Health Survey, SF-36). RESULTS: All patients were followed up from 4 to 16 months with an average of 12 months. The JOA score of light, moderate, severe degeneration group were 12.1 +/- 1.5, 10.3 +/- 1.8, 7.3 +/- 1.0, respectively; and were respectively increased to 16.3 +/- 1.0, 15.3 +/- 1.4, 13.0 +/- 2.3 at the 3 months after operation. Postoperative JOA score showed the improvement rate of mid-long-term neurological level was light degeneration group (89.8%) > moderate degeneration group (76.6%) > severe degeneration group (58.8%). The results of preoperative SF-36 scale showed light degeneration group > moderate degeneration group > severe degeneration group; there was significant difference in comparison of two groups (P < 0.05 ). CONCLUSION: Cervical degeneration is an important pathologic basis and risk factor in traumatic cervical cord injury, and the degenerative degree will directly influence the injury degree and prognosis of neurological function, the clinical relationship between them should be sufficiently paid attention to.


Assuntos
Vértebras Cervicais/cirurgia , Traumatismos da Medula Espinal/cirurgia , Doenças da Coluna Vertebral/complicações , Idoso , Vértebras Cervicais/lesões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
Zhongguo Gu Shang ; 24(4): 308-10, 2011 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-21604528

RESUMO

OBJECTIVE: To evaluate the efficacy and the feasibility of bending rod reduction in situ technique in treating low lumbar burst fracture. METHODS: From March 2007 to June 2009, 21 patients with low lumbar burst fracture were retrospectively analyzed, 11 cases were in L3,6 in L4 and 4 in L5. There were 16 males and 5 females, ranging in age from 25 to 59 year with an average of 37.9 years. According to ASIA classification, nerve function was level A in 2 cases, level B in 2, level C in 10, level D in 4 and level E in 3. Pedicle screws were implanted and bending rod reduction in situ technique was applied through posterior approach. Radiographic and neurological scores were compared before and after operation. RESULTS: All patients were followed up from 12 to 39 months with an average of 16.5 months. Radiographic examinations demonstrated that anterior height of fractured vertebral body was from 57.9% preoperatively to 94.1% postoperatively (P < 0.01 ); sagittal index was from 29.1 preoperatively to 0.240 postoperatively (P < 0.01). Spinal canal occupation ratio was from 49.6% preoperatively to 13.4% postoperatively (P < 0.01). Nerve function was level A in 2 cases,level B in 0, level C in 0, level D in 4 and level E in 15. CONCLUSION: Bending rod in situ technique could achieve 3-column reduction in 3-dimentionally at the same time, and reconstruct the stability of low lumbar.


Assuntos
Fixação Interna de Fraturas/métodos , Vértebras Lombares/lesões , Vértebras Lombares/cirurgia , Adulto , Parafusos Ósseos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fraturas da Coluna Vertebral/cirurgia
6.
Zhonghua Yi Xue Za Zhi ; 85(49): 3502-3, 2005 Dec 28.
Artigo em Chinês | MEDLINE | ID: mdl-16686069

RESUMO

OBJECTIVE: To explore the feasibility, safety, and cosmetic efficacy of endoscope-assisted thyroidectomy (EAT) by chest approach. METHODS: Fifty-one patients with single benign thyroid nodule < or = 4.0 cm in diameter, and without history of neck surgery or irradiation, 8 males and 43 females, aged 33.9 (18-64), underwent endoscope-assisted thyroidectomy by chest approach: a skin incision with the length of 4 cm was made in the chest, an endoscope was inserted, and subtotal or total thyroidectomy with the technique similar to that in conventional surgery was performed with naked eyes. RESULTS: Subtotal thyroidectomy was performed in 49 patients, and total excision of unilateral thyroid lobe plus isthmus lobectomy and contralateral partial lobectomy was performed on the other 2 patients. No patient was transferred to traditional surgery. Only one case showed palsy of recurrent nerve. Most patients expressed with the cosmetic results. CONCLUSION: EAT is a feasible and safe procedure with rather good cosmetic


Assuntos
Endoscopia , Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Adolescente , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Glândula Tireoide/patologia , Tireoidectomia/instrumentação , Resultado do Tratamento
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