目的探讨解剖性肝叶切除术对原发性肝癌患者肝功能指标的影响。方法根据手术方法的不同将106例原发性肝癌患者分为对照组(n=53)和观察组(n=53),对照组患者给予非解剖性肝叶切除术,观察组患者给予解剖性肝叶切除术。比较两组患者的手术...目的探讨解剖性肝叶切除术对原发性肝癌患者肝功能指标的影响。方法根据手术方法的不同将106例原发性肝癌患者分为对照组(n=53)和观察组(n=53),对照组患者给予非解剖性肝叶切除术,观察组患者给予解剖性肝叶切除术。比较两组患者的手术相关指标、肝功能指标[丙氨酸转氨酶(ALT)、直接胆红素(DBIL)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)]、术后并发症发生情况、黑色素瘤相关抗原1(MAGE1)mRNA和甲胎蛋白(AFP)m RNA的阳性表达率。结果观察组患者手术时间、住院时间均明显短于对照组,术中出血量、术中输血量均明显少于对照组,差异均有统计学意义(P<0.01)。术后7天,两组患者血清ALT、AST、TBIL、DBIL水平均高于本组术前,观察组患者ALT、AST、TBIL、DBIL水平均低于对照组,差异均有统计学意义(P<0.05)。术后4周,两组患者MAGE1、AFP m RNA阳性表达率均低于本组术前,观察组患者MAGE1、AFP mRNA阳性表达率均低于对照组,差异均有统计学意义(P<0.05)。观察组患者的并发症总发生率为26.42%,低于对照组患者的45.28%,差异有统计学意义(P<0.05)。结论解剖性肝叶切除术治疗原发性肝癌,可有效改善患者的手术相关指标及肝功能指标,有利于降低并发症总发生率,安全性较高。展开更多
Objective:To study the laboratory and clinical predictors of hemorrhagic manifestations in dengue virus-infected patients.Methods:This was a single-center hospital-based prospective observational study.200 Dengue sero...Objective:To study the laboratory and clinical predictors of hemorrhagic manifestations in dengue virus-infected patients.Methods:This was a single-center hospital-based prospective observational study.200 Dengue seropositive patients were included in the study.A detailed clinical examination was done and comprehensive laboratory investigations were done.These parameters were compared between patients with and without hemorrhagic manifestations.Results:Out of the 200 patients,47(23.5%)had bleeding.64.5%Patients were males and 76.0%were under the age of 40 years.The most common presenting symptoms were fever(100.0%)followed by myalgia(77.0%),nausea and vomiting(56.0%).Leukocytosis,neutrophilia,thrombocytopenia,hyperbilirubinemia,transaminitis,decreased serum albumins,and raised D-dimer can serve as hematological,biochemical,and coagulation predictors of hemorrhagic manifestations for dengue.Conclusions:Dengue is a tropical infection with various complications.Bleeding complications are one of them.Laboratory parameters like white blood cells,platelets,bilirubin level,liver enzymes,and D-dimer can help to identify patients at risk for bleeding.Early identification and appropriate management can save a lot of resources and lives.展开更多
Endoscopic papillary large balloon dilation(EPLBD)with endoscopic sphincterotomy(EST)has been widely used as the alternative to EST along with endoscopic mechanical lithotripsy(EML)for the removal of large or difficul...Endoscopic papillary large balloon dilation(EPLBD)with endoscopic sphincterotomy(EST)has been widely used as the alternative to EST along with endoscopic mechanical lithotripsy(EML)for the removal of large or difficult bile duct stones.Furthermore,EPLBD without EST was recently introduced as its simplified alternative technique.Thus,we systematically searched PubMed,Medline,the Cochrane Library and EMBASE,and analyzed all gathered data of EPLBD with and without EST,respectively,by using a single standardized definition,reviewing relevant literatures,published between 2003and June 2013,where it was performed with largediameter balloons(12-20 mm).The outcomes,including the initial success rate,the rate of needs for EML,and the overall success rate,and adverse events were assessed in each and compared between both of two procedures:"EPLBD with EST"and"EPLBD without EST".A total of 2511 procedures from 30 published articles were included in EPLBD with EST,while a total of413 procedures from 3 published articles were included in EPLBD without EST.In the results of outcomes,the overall success rate was 96.5%in EPLBD with EST and97.2%in EPLBD without EST,showing no significant difference between both of them.The initial success rate(84.0%vs 76.2%,P<0.001)and the success rate of EPLBD without EML(83.2%vs 76.7%,P=0.001)was significantly higher,while the rate of use of EML was significantly lower(14.1%vs 21.6%,P<0.001),in EPLBD with EST.The rate of overall adverse events,pancreatitis,bleeding,perforation,other adverse events,surgery for adverse events,and fatal adverse events were 8.3%,2.4%,3.6%,0.6%,1.7%,0.2%and 0.2%in EPLBD with EST and 7.0%,3.9%,1.9%,0.5%,0.7%,0%and 0%in EPLBD without EST,respectively,showing no significant difference between both of them.In conclusion,recent accumulated results of EPLBD with or even without EST suggest that it is a safe and effective procedure for the removal of large or difficult bile duct stones without any additional risk of severe adverse events,when performed under appropriate guidelines.展开更多
文摘目的探讨解剖性肝叶切除术对原发性肝癌患者肝功能指标的影响。方法根据手术方法的不同将106例原发性肝癌患者分为对照组(n=53)和观察组(n=53),对照组患者给予非解剖性肝叶切除术,观察组患者给予解剖性肝叶切除术。比较两组患者的手术相关指标、肝功能指标[丙氨酸转氨酶(ALT)、直接胆红素(DBIL)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)]、术后并发症发生情况、黑色素瘤相关抗原1(MAGE1)mRNA和甲胎蛋白(AFP)m RNA的阳性表达率。结果观察组患者手术时间、住院时间均明显短于对照组,术中出血量、术中输血量均明显少于对照组,差异均有统计学意义(P<0.01)。术后7天,两组患者血清ALT、AST、TBIL、DBIL水平均高于本组术前,观察组患者ALT、AST、TBIL、DBIL水平均低于对照组,差异均有统计学意义(P<0.05)。术后4周,两组患者MAGE1、AFP m RNA阳性表达率均低于本组术前,观察组患者MAGE1、AFP mRNA阳性表达率均低于对照组,差异均有统计学意义(P<0.05)。观察组患者的并发症总发生率为26.42%,低于对照组患者的45.28%,差异有统计学意义(P<0.05)。结论解剖性肝叶切除术治疗原发性肝癌,可有效改善患者的手术相关指标及肝功能指标,有利于降低并发症总发生率,安全性较高。
文摘Objective:To study the laboratory and clinical predictors of hemorrhagic manifestations in dengue virus-infected patients.Methods:This was a single-center hospital-based prospective observational study.200 Dengue seropositive patients were included in the study.A detailed clinical examination was done and comprehensive laboratory investigations were done.These parameters were compared between patients with and without hemorrhagic manifestations.Results:Out of the 200 patients,47(23.5%)had bleeding.64.5%Patients were males and 76.0%were under the age of 40 years.The most common presenting symptoms were fever(100.0%)followed by myalgia(77.0%),nausea and vomiting(56.0%).Leukocytosis,neutrophilia,thrombocytopenia,hyperbilirubinemia,transaminitis,decreased serum albumins,and raised D-dimer can serve as hematological,biochemical,and coagulation predictors of hemorrhagic manifestations for dengue.Conclusions:Dengue is a tropical infection with various complications.Bleeding complications are one of them.Laboratory parameters like white blood cells,platelets,bilirubin level,liver enzymes,and D-dimer can help to identify patients at risk for bleeding.Early identification and appropriate management can save a lot of resources and lives.
文摘Endoscopic papillary large balloon dilation(EPLBD)with endoscopic sphincterotomy(EST)has been widely used as the alternative to EST along with endoscopic mechanical lithotripsy(EML)for the removal of large or difficult bile duct stones.Furthermore,EPLBD without EST was recently introduced as its simplified alternative technique.Thus,we systematically searched PubMed,Medline,the Cochrane Library and EMBASE,and analyzed all gathered data of EPLBD with and without EST,respectively,by using a single standardized definition,reviewing relevant literatures,published between 2003and June 2013,where it was performed with largediameter balloons(12-20 mm).The outcomes,including the initial success rate,the rate of needs for EML,and the overall success rate,and adverse events were assessed in each and compared between both of two procedures:"EPLBD with EST"and"EPLBD without EST".A total of 2511 procedures from 30 published articles were included in EPLBD with EST,while a total of413 procedures from 3 published articles were included in EPLBD without EST.In the results of outcomes,the overall success rate was 96.5%in EPLBD with EST and97.2%in EPLBD without EST,showing no significant difference between both of them.The initial success rate(84.0%vs 76.2%,P<0.001)and the success rate of EPLBD without EML(83.2%vs 76.7%,P=0.001)was significantly higher,while the rate of use of EML was significantly lower(14.1%vs 21.6%,P<0.001),in EPLBD with EST.The rate of overall adverse events,pancreatitis,bleeding,perforation,other adverse events,surgery for adverse events,and fatal adverse events were 8.3%,2.4%,3.6%,0.6%,1.7%,0.2%and 0.2%in EPLBD with EST and 7.0%,3.9%,1.9%,0.5%,0.7%,0%and 0%in EPLBD without EST,respectively,showing no significant difference between both of them.In conclusion,recent accumulated results of EPLBD with or even without EST suggest that it is a safe and effective procedure for the removal of large or difficult bile duct stones without any additional risk of severe adverse events,when performed under appropriate guidelines.
