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经皮肝穿胆管引流术治疗急性阻塞性化脓性胆管炎26例临床分析
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作者 叶智宾 沈熙如 《中国急救复苏与灾害医学杂志》 2009年第10期768-770,共3页
目的为了提高急性阻塞性化脓性胆管炎(AOSC)治疗水平。方法回顾性分析26例AOSC患者行经皮肝穿胆管引流术,所有患者给予抗生素及补液治疗。结果26例AOSC患者,经皮肝穿胆管引流术、抗生素及补液,26例好转;经胆囊、胆管切开取石、引... 目的为了提高急性阻塞性化脓性胆管炎(AOSC)治疗水平。方法回顾性分析26例AOSC患者行经皮肝穿胆管引流术,所有患者给予抗生素及补液治疗。结果26例AOSC患者,经皮肝穿胆管引流术、抗生素及补液,26例好转;经胆囊、胆管切开取石、引流术手术治疗,26例治愈;26例进行胆道造影,其中5例产生胆汁外溢,引起胆汁性腹膜炎;并发症5例(19%);26例患者,随访10年无异常。结论经皮肝穿胆管引流术是治疗危重急性阻塞性化脓性胆管炎患者一种简单、安全有效的方法,值得推广。当胆道造影进入胆道造成压力增大,胆汁随经皮穿刺肝内胆管穿刺针周围外溢,对这些患者进行胆道造影是否可取,需引起临床医师注意,或可选择其他方法。 展开更多
关键词 经皮肝穿胆管引流术 治疗 急性阻塞性化脓性胆管炎
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Role of NF-kB in multiple organ dysfunction during acute obstructive cholangitis 被引量:10
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作者 BinTu Jian-PingGong +6 位作者 Hu-YiFeng Chuan-XinWu Yu-JunShi Xu-HongLi YongPeng Chang-AnLiu Sheng-WeiLi 《World Journal of Gastroenterology》 SCIE CAS CSCD 2003年第1期179-183,共5页
AIM:To elucidate the role of NF-kB activation in the development of multiple organ dysfunction(MOD)during acute obstructive cholangitis(AOC)in rats. METHODS:Forty-two Wistar rats were divided into three groups:the AOC... AIM:To elucidate the role of NF-kB activation in the development of multiple organ dysfunction(MOD)during acute obstructive cholangitis(AOC)in rats. METHODS:Forty-two Wistar rats were divided into three groups:the AOC group,the group of bile duct ligation(BDL group),and the sham operation group(SO group).All the animals in the three groups were killed in the 6th and 48th hour after operation.Morphological changes of vital organs were observed under light and electron microscopy.NF-κB activation was determined with Electrophoretic Mobility Shift Assay(EMSA).Arterial blood gas analyses and the serum levels of lactate dehydrogenase(LDH),alanine aminotransferase(ALT),blood urea nitrogen(BUN)and creatinine were performed.The concentrations of TNF-α and IL-6 in plasma were also measured. RESULTS:The significant changes of histology and ultrastructure of vital organs were observed in AOC group. By contrast,in BDL group,all the features of organs damage were greatly reduced.Expression of NF-κB activation in various tissues increased in AOC group when compared to other two groups.At 6 h,the arterial pH in three groups was 7.52±0.01,7.46±0.02,and 7.45±0.02,and the blood pCO_2 was 33.9±0.95 mmHg,38.1±0.89 mmHg,38.9±0.94 mmHg,there was difference in three groups(P<0.05).At 48 h,the blood pH values in three groups was 7.33±0.07, 7.67±0.04,and 7.46±0.03,and blood HCO_3^- was 20.1±1.29 mmol·L^(-1),26.7±1.45 mmol·L^(-1)and 27.4±0.35 mmol·L^(-1),there was also difference in three groups(P<0.05).In AOC group, Levels of LDH,ALT,BUN and creatinine were 16359.9±2278.8 nkat·L^(-1),5796.2±941.9 nkat·L^(-1),55.7±15.3 mg/dl,and 0.72± 0.06 mg/dl,which were higher than in SO group(3739.1± 570.1 nkat·L^(-1),288.4±71.7 nkat·L^(-1),12.5±2.14 mg/dl,and 0.47±0.03 mg/dl)(P<0.05).Levels of plasma TNF-α and IL-6 in AOC at 48 h were 429±56.62 ng·L^(-1)and 562±57 ng·L^(-1), which increased greatly when compared to BDL group (139±16 ng·L^(-1),227±43 ng·L^(-1))and SO group(74±10 ng·L^(-1), 113±19 ng·L^(-1))(P<0.05). CONCLUSION:The pathological damages and the NF-κB activation of many vital organs exised during AOC.These findings have an important implication for the role of NF-κB activation in MOD during AOC. 展开更多
关键词 核因子-ΚB 急性阻塞性胆管炎 多器官功能失调 病理机制 动物模型
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