目的:探索急性Stanford A型主动脉夹层(acute type A aortic dissection,ATAAD)合并肠系膜灌注不良综合征(mesenteric malperfusion,MesMPS)的治疗策略。方法:回顾2019年1月至2022年6月间,河南省胸科医院收治并进行手术的35例ATAAD伴Mes...目的:探索急性Stanford A型主动脉夹层(acute type A aortic dissection,ATAAD)合并肠系膜灌注不良综合征(mesenteric malperfusion,MesMPS)的治疗策略。方法:回顾2019年1月至2022年6月间,河南省胸科医院收治并进行手术的35例ATAAD伴MesMPs患者的病例资料,根据患者是否优先开通肠系膜上动脉(superior mesenteric artery,SMA),分为灌注恢复优先组及对照组。结果:35例患者中,灌注恢复优先组16例,对照组19例。两组患者基线特征及围术期并发症发生率无明显差异。35例患者早期死亡8例,灌注恢复优先组早期死亡率(1例,6.3%)显著低于对照组(7例,36.8%)(P=0.047)。中位随访8个月,有1例(灌注优先恢复组)患者死亡,生存率仍有差异趋势(P=0.118)。结论:对于相对稳定的急性主动脉夹层(StanfordA型)伴肠系膜灌注不良综合征患者,灌注恢复优先策略取得了良好的治疗效果;对于极高危破裂风险患者要个性化选择手术策略。展开更多
The relationship between fracture calcite veins and shale gas enrichment in the deep Ordovician Wufeng Formation-Silurian Longmaxi Formation (Wufeng-Longmaxi) shales in southern Sichuan Basin was investigated through ...The relationship between fracture calcite veins and shale gas enrichment in the deep Ordovician Wufeng Formation-Silurian Longmaxi Formation (Wufeng-Longmaxi) shales in southern Sichuan Basin was investigated through core and thin section observations, cathodoluminescence analysis, isotopic geochemistry analysis, fluid inclusion testing, and basin simulation. Tectonic fracture calcite veins mainly in the undulating part of the structure and non-tectonic fracture calcite veins are mainly formed in the gentle part of the structure. The latter, mainly induced by hydrocarbon generation, occurred at the stage of peak oil and gas generation, while the former turned up with the formation of Luzhou paleouplift during the Indosinian. Under the influence of hydrocarbon generation pressurization process, fractures were opened and closed frequently, and oil and gas episodic activities are recorded by veins. The formation pressure coefficient at the maximum paleodepth exceeds 2.0. The formation uplift stage after the Late Yanshanian is the key period for shale gas migration. Shale gas migrates along the bedding to the high part of the structure. The greater the structural fluctuation is, the more intense the shale gas migration activity is, and the loss is more. The gentler the formation is, the weaker the shale gas migration activity is, and the loss is less. The shale gas enrichment in the core of gentle anticlines and gentle synclines is relatively higher.展开更多
文摘目的:探索急性Stanford A型主动脉夹层(acute type A aortic dissection,ATAAD)合并肠系膜灌注不良综合征(mesenteric malperfusion,MesMPS)的治疗策略。方法:回顾2019年1月至2022年6月间,河南省胸科医院收治并进行手术的35例ATAAD伴MesMPs患者的病例资料,根据患者是否优先开通肠系膜上动脉(superior mesenteric artery,SMA),分为灌注恢复优先组及对照组。结果:35例患者中,灌注恢复优先组16例,对照组19例。两组患者基线特征及围术期并发症发生率无明显差异。35例患者早期死亡8例,灌注恢复优先组早期死亡率(1例,6.3%)显著低于对照组(7例,36.8%)(P=0.047)。中位随访8个月,有1例(灌注优先恢复组)患者死亡,生存率仍有差异趋势(P=0.118)。结论:对于相对稳定的急性主动脉夹层(StanfordA型)伴肠系膜灌注不良综合征患者,灌注恢复优先策略取得了良好的治疗效果;对于极高危破裂风险患者要个性化选择手术策略。
基金Supported by the PetroChina Science and Technology Project(2022KT1205).
文摘The relationship between fracture calcite veins and shale gas enrichment in the deep Ordovician Wufeng Formation-Silurian Longmaxi Formation (Wufeng-Longmaxi) shales in southern Sichuan Basin was investigated through core and thin section observations, cathodoluminescence analysis, isotopic geochemistry analysis, fluid inclusion testing, and basin simulation. Tectonic fracture calcite veins mainly in the undulating part of the structure and non-tectonic fracture calcite veins are mainly formed in the gentle part of the structure. The latter, mainly induced by hydrocarbon generation, occurred at the stage of peak oil and gas generation, while the former turned up with the formation of Luzhou paleouplift during the Indosinian. Under the influence of hydrocarbon generation pressurization process, fractures were opened and closed frequently, and oil and gas episodic activities are recorded by veins. The formation pressure coefficient at the maximum paleodepth exceeds 2.0. The formation uplift stage after the Late Yanshanian is the key period for shale gas migration. Shale gas migrates along the bedding to the high part of the structure. The greater the structural fluctuation is, the more intense the shale gas migration activity is, and the loss is more. The gentler the formation is, the weaker the shale gas migration activity is, and the loss is less. The shale gas enrichment in the core of gentle anticlines and gentle synclines is relatively higher.
