患者男,71岁,2023年7月27日因颜面部肿胀2周入院。患者既往高血压病史20年,长期口服厄贝沙坦氢氯噻嗪片和硝苯地平控释片治疗,服药期间血压控制平稳;既往2型糖尿病病史3个月,口服盐酸二甲双胍治疗。无药物过敏史。患者入院一般状况良好...患者男,71岁,2023年7月27日因颜面部肿胀2周入院。患者既往高血压病史20年,长期口服厄贝沙坦氢氯噻嗪片和硝苯地平控释片治疗,服药期间血压控制平稳;既往2型糖尿病病史3个月,口服盐酸二甲双胍治疗。无药物过敏史。患者入院一般状况良好,完善胸部CT、电子支气管镜等检查后诊断为右肺上叶鳞癌,c T4N3M0期,临床分期为Ⅲc期,拟行化疗联合免疫治疗。患者因存在上腔静脉重度狭窄,评估右大腿皮肤完好,无肢体肿胀等,遂选择右下肢股静脉行经外周静脉穿刺中心静脉置管(peripherally inserted central catheter,PICC)术。2023年8月3日置管顺利,穿刺部位覆盖纱布。展开更多
目的:观察改良包扎法在中心静脉导管(peripherally lnserted central catheter,PICC)术后淋巴管渗液处理中的效果。方法:选取2018年2月—2020年12月由空军军医大学唐都医院血液内科置入的578例PICC中发生淋巴管渗液的12例患者,采用随机...目的:观察改良包扎法在中心静脉导管(peripherally lnserted central catheter,PICC)术后淋巴管渗液处理中的效果。方法:选取2018年2月—2020年12月由空军军医大学唐都医院血液内科置入的578例PICC中发生淋巴管渗液的12例患者,采用随机法分为对照组4例和观察组8例,对照组采用传统的无菌纱布和纱布绷带加压包扎法,观察组采用改良包扎法。即:藻酸盐敷料和弹力绷带加压包扎法。观察两组治疗淋巴管渗液的治愈时间和人均费用。结果:与对照组相比,观察组治愈时间显著低于对照组,差异有统计学意义(P<0.05);与对照组相比,观察组人均费用显著少于对照组,差异有统计学意义(P<0.05)。结论:改良包扎法对PICC置管后淋巴管渗液具有较好的治疗效果,不仅缩短治愈时间,降低治疗费用,且取材容易,值得今后扩大样本量继续研究,以便临床应用。展开更多
A pancreatic pleural effusion may result from a pancreatopleural fistula. We herein discuss two interesting issues in a similar case report of a pleural effusion caused after splenectomy, which was recently published ...A pancreatic pleural effusion may result from a pancreatopleural fistula. We herein discuss two interesting issues in a similar case report of a pleural effusion caused after splenectomy, which was recently published in the World Journal of Gastroenterology . Pancreatic exudate passes directly through a natural hiatus in the diaphragm or by direct penetration through the dome of the diaphragm from a neighboring subdiaphragmatic collection. The diaphragmatic lymphatic "stomata" does not contribute to the formation of such a pleural effusion, as it is inaccurately mentioned in that report. A strictly conservative approach is recommended in that article as the management of choice. Although this may be an option in selected frail patients, there has been enough accumulative evidence that a pancreaticopleural fistula may be best managed by early endoscopy in order to avoid complications causing prolonged hospitalization.展开更多
文摘患者男,71岁,2023年7月27日因颜面部肿胀2周入院。患者既往高血压病史20年,长期口服厄贝沙坦氢氯噻嗪片和硝苯地平控释片治疗,服药期间血压控制平稳;既往2型糖尿病病史3个月,口服盐酸二甲双胍治疗。无药物过敏史。患者入院一般状况良好,完善胸部CT、电子支气管镜等检查后诊断为右肺上叶鳞癌,c T4N3M0期,临床分期为Ⅲc期,拟行化疗联合免疫治疗。患者因存在上腔静脉重度狭窄,评估右大腿皮肤完好,无肢体肿胀等,遂选择右下肢股静脉行经外周静脉穿刺中心静脉置管(peripherally inserted central catheter,PICC)术。2023年8月3日置管顺利,穿刺部位覆盖纱布。
文摘目的:观察改良包扎法在中心静脉导管(peripherally lnserted central catheter,PICC)术后淋巴管渗液处理中的效果。方法:选取2018年2月—2020年12月由空军军医大学唐都医院血液内科置入的578例PICC中发生淋巴管渗液的12例患者,采用随机法分为对照组4例和观察组8例,对照组采用传统的无菌纱布和纱布绷带加压包扎法,观察组采用改良包扎法。即:藻酸盐敷料和弹力绷带加压包扎法。观察两组治疗淋巴管渗液的治愈时间和人均费用。结果:与对照组相比,观察组治愈时间显著低于对照组,差异有统计学意义(P<0.05);与对照组相比,观察组人均费用显著少于对照组,差异有统计学意义(P<0.05)。结论:改良包扎法对PICC置管后淋巴管渗液具有较好的治疗效果,不仅缩短治愈时间,降低治疗费用,且取材容易,值得今后扩大样本量继续研究,以便临床应用。
文摘A pancreatic pleural effusion may result from a pancreatopleural fistula. We herein discuss two interesting issues in a similar case report of a pleural effusion caused after splenectomy, which was recently published in the World Journal of Gastroenterology . Pancreatic exudate passes directly through a natural hiatus in the diaphragm or by direct penetration through the dome of the diaphragm from a neighboring subdiaphragmatic collection. The diaphragmatic lymphatic "stomata" does not contribute to the formation of such a pleural effusion, as it is inaccurately mentioned in that report. A strictly conservative approach is recommended in that article as the management of choice. Although this may be an option in selected frail patients, there has been enough accumulative evidence that a pancreaticopleural fistula may be best managed by early endoscopy in order to avoid complications causing prolonged hospitalization.
