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负压组合式硬管镜联合输尿管软镜治疗无积水肾结石的可行性分析 被引量:1
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作者 区文贵 余祖辉 陈丙辰 《现代诊断与治疗》 CAS 2023年第3期317-319,共3页
目的分析无积水肾结石患者接受负压组合式硬管镜(硕通镜)联合输尿管软镜治疗效果分析。方法选取2021年10月至2022年10月我院泌尿外科收治的无积水肾结石患者80例,根据随机数字表法分为观察组和对照组各40例。对照组接受经皮肾镜取石(PC... 目的分析无积水肾结石患者接受负压组合式硬管镜(硕通镜)联合输尿管软镜治疗效果分析。方法选取2021年10月至2022年10月我院泌尿外科收治的无积水肾结石患者80例,根据随机数字表法分为观察组和对照组各40例。对照组接受经皮肾镜取石(PCNL)手术,观察组接受硕通镜联合输尿管软镜手术。对比观察两组围术期手术指标情况、术后感染情况以及结石清除率变化。结果观察组手术时间、术中出血量、住院时间、外周血红蛋白浓度下降值等围手术指标显著优于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者CRP、PCT表达水平均低于手术前,且观察组低于对照组,差异有统计学意义(P<0.05)。术后1 d和术后1个月,观察组结石清除率显著高于对照组,差异有统计学意义(P<0.05)。结论对于小于3cm无积水肾结石疾病治疗,患者围手术时期治疗状况欠佳,且存在感染风险,影响结石清除效果,采取硕通镜联合输尿管镜治疗能够获得理想的手术治疗效果。 展开更多
关键词 无积水肾结石 负压组合式硬管镜 输尿管软镜 结石清除率
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纤维支气管镜对老年不典型肺结核的诊断价值 被引量:5
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作者 于湘春 吴华星 《临床荟萃》 CAS 1999年第16期742-743,共2页
随着人口结构中老年人的增多,不典型的老年肺结核误诊屡见不鲜。为引起临床重视,我们总结了68例通过纤维支气管镜(FB)确诊的老年人肺结核及(或)支气管结核的临床资料,评价FB检查对老年人不典型肺结核的诊断价值,现分析如下。1 临床资料1... 随着人口结构中老年人的增多,不典型的老年肺结核误诊屡见不鲜。为引起临床重视,我们总结了68例通过纤维支气管镜(FB)确诊的老年人肺结核及(或)支气管结核的临床资料,评价FB检查对老年人不典型肺结核的诊断价值,现分析如下。1 临床资料1.1 一般资料 68例中男36例,女32例,年龄60~79岁,平均68岁。起病急骤、咳嗽、高热(体温波动在39.0~39.8℃)16例,反复咳嗽、咯痰24例,咯血14例,胸闷、气促8例,低热、消瘦、乏力4例,胸背疼痛2例。其中56例肺部有阳性体征(32例单侧肺闻及哕音,24例双肺闻及哕音),其余12例肺部无异常发现。并存慢性疾病:糖尿病11例,慢性阻塞性肺病16例,慢性肝炎4例,冠心病3例。1.2 胸部X线表现与误诊病种 展开更多
关键词 肺结核 诊断 纤维气支管镜 老年人
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组合式硬管镜经自然通道治疗无积水上尿路结石的围术期护理 被引量:5
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作者 陈婉文 陈深泉 +3 位作者 陈彩眉 伦小竹 刘玉简 吴保忠 《全科护理》 2017年第30期3758-3760,共3页
[目的]探讨采用组合式硬管镜经自然通道治疗无积水上尿路结石的疗效及围术期护理的实施方案。[方法]选取2015年10月—2016年9月在本科住院治疗的无积水上尿路结石病人47例,腰硬联合麻醉下采用组合式硬管镜经输尿管上行至上段或肾盂肾盏... [目的]探讨采用组合式硬管镜经自然通道治疗无积水上尿路结石的疗效及围术期护理的实施方案。[方法]选取2015年10月—2016年9月在本科住院治疗的无积水上尿路结石病人47例,腰硬联合麻醉下采用组合式硬管镜经输尿管上行至上段或肾盂肾盏内,寻及结石,置入200μm钬激光光纤,调节能量0.8 W^1.0 W,频率10Hz^15Hz,蚕食式击碎结石,并负压吸出碎石。术前、术中及术后采取密切护理配合,评估组合式硬管镜的碎石疗效及探讨围术期专科护理方案的实施。[结果]37例病人均顺利通过组合镜上镜并一期完成手术,手术时间55.9 min±19.5 min。9例输尿管狭窄病人中3例行球囊扩张,2例留置双J管术后行ESWL,4例行二期组合镜碎石,1例改为输尿管软镜碎石处理。所有病人梗阻均顺利解除,术中无大出血、输尿管撕脱、输尿管穿孔等并发症发生,无感染中毒性休克病例发生,手术总清石率为97.8%,住院天数为8.4d±3.5d。[结论]组合式硬管镜在治疗无积水上尿路结石中具有手术风险低、碎石时间短,清石率高及术后恢复快的优点,优质细心的围术期专科护理配合同样具有重要的意义,可使手术顺利进行,病人早日康复。 展开更多
关键词 上尿路结石 组合式硬管镜 围术期护理
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脑室置管镜辅助下改良切口行脑室-腹腔分流术 被引量:2
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作者 汤灿 张恒柱 +6 位作者 严正村 王晓东 佘磊 董伦 魏民 李育平 王杏东 《中国微侵袭神经外科杂志》 CAS 2018年第2期71-73,共3页
目的初步探讨脑室置管镜辅助下改良切口行脑室-腹腔分流术治疗脑积水的临床优势。方法回顾性分析10例脑积水病例资料,均应用脑室置管镜辅助下改良切口行脑室-腹腔分流术。结果 10例病人脑积水症状均得到不同程度缓解。改良切口后分流术... 目的初步探讨脑室置管镜辅助下改良切口行脑室-腹腔分流术治疗脑积水的临床优势。方法回顾性分析10例脑积水病例资料,均应用脑室置管镜辅助下改良切口行脑室-腹腔分流术。结果 10例病人脑积水症状均得到不同程度缓解。改良切口后分流术手术时间35~60min,平均(45.0±1.2)min,较传统分流术明显缩短。脑室端置管位置准确,无脑室置管镜相关并发症,无死亡病例。结论脑室置管镜辅助下改良切口行脑室-腹腔分流术安全可靠,定位精确,微创,手术时间明显缩短,相关并发症发生率低,具有临床应用价值。 展开更多
关键词 脑积水 脑室置管镜 脑室-腹腔分流
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纤维支气管镜下大容量肺泡灌洗术在尘肺大咯血患者的应用效果 被引量:7
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作者 李军 《深圳中西医结合杂志》 2017年第10期77-79,共3页
目的:探讨纤支镜下大容量肺泡灌洗术在尘肺大咯血患者中的临床应用效果。方法:选取清远市慢性病防治医院2015年1月至2017年1月收治的尘肺大咯血患者26例作为研究对象,采用乱数表法将患者随机均分为对照组和观察组各13例。对照组常规止血... 目的:探讨纤支镜下大容量肺泡灌洗术在尘肺大咯血患者中的临床应用效果。方法:选取清远市慢性病防治医院2015年1月至2017年1月收治的尘肺大咯血患者26例作为研究对象,采用乱数表法将患者随机均分为对照组和观察组各13例。对照组常规止血;观察组行纤支镜下大容量肺泡灌洗术治疗。结果:对照组患者治疗总有效率为69.2%,观察组患者治疗总有效率为92.3%,观察组治疗总有效率与高于对照组,差异具有统计学意义(P<0.05)。治疗前对照组和观察组患者胸部X线表现相同,治疗后对照组患者胸部X线表现为肺密度无明显变化,两侧光密度不对称,肺部液体残留有所减少;治疗后观察组患者胸部X线表现为肺密度明显降低,与治疗前相比类似白肺,两侧肺光密度对称,肺部无残留液体。结论:尘肺大咯血患者采用纤支镜下大容量肺泡灌洗术治疗临床疗效显著,且胸部X线表现明显改善。 展开更多
关键词 大容量肺泡灌洗术 尘肺 大咯血 纤维运气管镜
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经皮肾输尿管镜取石术治疗肾结石18例效果观察 被引量:6
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作者 赛自和 张思明 《中国社区医师(医学专业)》 2011年第22期106-107,共2页
目的:探讨经皮肾输尿管镜取石术(mPCNL)治疗肾结石的安全性和手术疗效。方法:对18例肾结石患者应用彩超引导经皮肾输尿管镜取石术治疗。结果:手术均获得成功,结石总取净率94%,其中Ⅰ期手术结石取净率89%,手术平均时间90分钟。未发生大出... 目的:探讨经皮肾输尿管镜取石术(mPCNL)治疗肾结石的安全性和手术疗效。方法:对18例肾结石患者应用彩超引导经皮肾输尿管镜取石术治疗。结果:手术均获得成功,结石总取净率94%,其中Ⅰ期手术结石取净率89%,手术平均时间90分钟。未发生大出血,无漏尿及邻近器官损伤等其他并发症。结论:应用彩超引导经皮肾输尿管镜取石术具有简单、安全、创伤小、结石取净率高等优点,适合在基层医院推广。 展开更多
关键词 肾结石 彩超引导经皮肾输尿 管镜取石 微创
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结石捕获取出器在输尿管镜钬激光治疗上段输尿管结石中的应用
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作者 杨泽林 闫立宏 《中国社区医师(医学专业)》 2011年第17期53-53,共1页
目的:探讨NTrap结石捕获取出器在输尿管镜钬激光治疗输尿管上段结石的临床应用价值。方法:24例输尿管上段结石采用NTrap结石捕获取出器配合输尿管镜钬激光碎石治疗。结果:单次成功率87.5%(21/24)。结石退回肾盂3例,2例术后经ESWL治疗,1... 目的:探讨NTrap结石捕获取出器在输尿管镜钬激光治疗输尿管上段结石的临床应用价值。方法:24例输尿管上段结石采用NTrap结石捕获取出器配合输尿管镜钬激光碎石治疗。结果:单次成功率87.5%(21/24)。结石退回肾盂3例,2例术后经ESWL治疗,1例改行PC-NL治疗。术中无输尿管穿孔等并发症,结石排除率100%。无输尿管狭窄发生。结论:NTrap结石捕获取出器配合输尿管镜钬激光碎石术治疗输尿管上段结石,可降低结石回落肾盂的几率,提高了输尿管上段结石的碎石成功率,是一种安全、有效的方法值得推广。 展开更多
关键词 NTrap结石捕获取出器 输尿 管镜 输尿管结石 钬激光 取石术
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右美托咪定在小儿无痛纤维支气管镜检查中的应用
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作者 蒋雪丽 《中文科技期刊数据库(全文版)医药卫生》 2023年第6期68-71,共4页
分析右美托咪定在小儿无痛纤维支气管镜检查中的应用效果。方法 抽取在我院接受无痛纤维支气管镜检查的患儿100例进行分组研究,每组均纳入50例患儿(接受右美托咪定麻醉的患儿以及生理盐水滴鼻的患儿分别记为Ⅰ组、Ⅱ组),分别评估两组患... 分析右美托咪定在小儿无痛纤维支气管镜检查中的应用效果。方法 抽取在我院接受无痛纤维支气管镜检查的患儿100例进行分组研究,每组均纳入50例患儿(接受右美托咪定麻醉的患儿以及生理盐水滴鼻的患儿分别记为Ⅰ组、Ⅱ组),分别评估两组患儿的镇静程度、计算患儿围检查期的不良反应发生率、统计其各自的麻醉诱导时长、总检查时长、术后苏醒时长。结果 对两组患儿围检查期的镇静程度进行评分,可见其均呈现出先降低后升高再降低再升高的规律,t1、t2表现出Ⅰ组低于Ⅱ组的情况,而t3和t4、t5则表现出Ⅱ组低于Ⅰ组的情况,比较有统计学差异。两组患儿围检查期的不良反应发生率比较,Ⅱ组显著低于Ⅰ组,比较有统计学差异。两组患儿围麻醉诱导时长、总检查时长、术后苏醒时长比较有Ⅱ组低于Ⅰ组的情况,但比较差异不明显。结论 小儿患者接受无痛纤维支气管镜检查的过程中,采用右美托咪定进行麻醉的方式麻醉效果值得肯定,同时安全性更好,有利于患儿操作结束后的早期苏醒,是一种相对更加优秀的麻醉方式,可以在儿科临床安全应用。 展开更多
关键词 右美托咪定 小儿无痛纤维支管镜 临床应用
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负压组合式硬管镜联合输尿管软镜钬激光碎石术治疗直径>20 mm无积水上尿路结石的疗效分析 被引量:16
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作者 陈深泉 吴保忠 +4 位作者 杨帝宽 刘明建 刘玉简 张伟健 陈彩眉 《中国激光医学杂志》 CAS 2019年第2期61-66,120,共7页
目的探讨负压组合式硬管镜联合输尿管软镜钬激光碎石治疗直径>20 mm无积水上尿路结石的疗效和安全性。方法回顾性分析2016年1月至2017年12月,应用无积水上尿路结石直径>20 mm患者100例的临床资料,将患者分为两组。实验组(A组),患... 目的探讨负压组合式硬管镜联合输尿管软镜钬激光碎石治疗直径>20 mm无积水上尿路结石的疗效和安全性。方法回顾性分析2016年1月至2017年12月,应用无积水上尿路结石直径>20 mm患者100例的临床资料,将患者分为两组。实验组(A组),患者50例,采用负压组合式硬管镜联合输尿管软镜钬激光碎石治疗,激光治疗功率0. 8~1. 0 W,频率10~15 Hz;对照组(B组),患者50例,同期行微创经皮肾镜碎石治疗。所有患者术后第1天复查血常规及肾功能,第3天及2周后均复查KUB,记录两组患者的血红蛋白下降量、平均碎石时间、一二期清石率、住院时间和并发症等指标,并进行比较分析。结果 A组碎石时间长于B组,一期清石率低于B组,差异均有统计学意义(P<0. 05);A组平均血红蛋白下降量明显少于B组,住院时间短于B组,差异均具有统计学意义(P<0. 05);两组患者二期清石率和术后血肌酐比较,差异无统计学意义(P>0. 05);B组并发症发生率高于A组,差异具有统计学意义(P<0. 05);两组患者无一例出现腹腔脏器损伤和感染性休克。结论负压组合镜联合软镜处理无积水上尿路结石并发症少、恢复快,针对结石直径≤20 mm的上尿路结石治疗,建议优先选用此方法。对于上尿路结石直径>20 mm者,组合镜及软镜钬激光碎石术可作为微创经皮肾镜碎石的一种替代治疗,推荐分期手术。 展开更多
关键词 钬激光碎石术 组合式硬管镜 输尿管软镜 微创经皮肾镜碎石术
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经尿道组合式硬管镜与体外碎石治疗无积水上尿路结石的比较 被引量:5
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作者 陈深泉 吴保忠 +4 位作者 刘明建 杨帝宽 刘玉简 张伟健 胡志雄 《中华腔镜泌尿外科杂志(电子版)》 2017年第6期18-21,共4页
目的初步探讨组合式硬管镜经自然通道治疗无积水上尿路结石的疗效和安全性。方法 2014年6月至2016年9月肇庆第二人民医院泌尿外科收治94例无积水的上尿路结石患者,其中47例接受组合式硬管镜碎石术治疗,47例行体外冲击波碎石术(ESWL)治... 目的初步探讨组合式硬管镜经自然通道治疗无积水上尿路结石的疗效和安全性。方法 2014年6月至2016年9月肇庆第二人民医院泌尿外科收治94例无积水的上尿路结石患者,其中47例接受组合式硬管镜碎石术治疗,47例行体外冲击波碎石术(ESWL)治疗。对患者的资料进行回顾性分析,比较两组的碎石效果。结果 37例患者均顺利通过组合镜上镜并一期完成手术,手术平均时间(56±19)min,其中3例输尿管狭窄患者行球囊扩张后顺利取石,2例留置双J管术后第3天行ESWL,4例留置双J管2周后行二期组合镜碎石,1例患者联合输尿管软镜碎石处理。术中无大出血、输尿管撕脱及输尿管穿孔等并发症发生,拔除双J管后输尿管狭窄1例,术后高热患者1例,术后间歇性血尿2例。组合镜组一次性取尽无残石率65.9%(31/47),平均住院天数为(8.4±3.5)d。ESWL组一次性取尽结石42.5%(20/47),与ESWL组比较,组合镜组清石率高,差异有统计学意义(P<0.05)。结论组合式硬管镜治疗无积水上尿路结石疗效确切,具有损伤少、结石清除率高、并发症少等优点。 展开更多
关键词 组合式硬管镜 无积水 上尿路结石 体外碎石
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Ⅰ期腔道会师治疗尿道损伤42例 被引量:2
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作者 乔着意 孙丹宁 +2 位作者 刘剑 王梅 王兴志 《重庆医学》 CAS CSCD 北大核心 2010年第4期468-469,共2页
目的探讨急诊应用置管镜行腔内尿道会师对尿道损伤的治疗。方法对42例尿道损伤患者使用置管镜通过尿道断端插入膀胱,而后沿镜鞘插入并留置尿管,完成尿道会师。术后3~8周拔尿管,随访3~22个月。结果治愈21例,良好18例,失败3例。结论置... 目的探讨急诊应用置管镜行腔内尿道会师对尿道损伤的治疗。方法对42例尿道损伤患者使用置管镜通过尿道断端插入膀胱,而后沿镜鞘插入并留置尿管,完成尿道会师。术后3~8周拔尿管,随访3~22个月。结果治愈21例,良好18例,失败3例。结论置管镜腔内尿道会师治疗尿道损伤具有创伤小、费用低、操作相对简单等优点,适于急诊尿道创伤患者的治疗。 展开更多
关键词 腔内治疗 尿道会师 管镜
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高危新生儿室管膜下出血/脑室内出血发生率及产科危险因素的分析 被引量:6
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作者 郭小芳 张霞 +2 位作者 张丽范 方文 吴迅 《国际医药卫生导报》 2007年第5期13-18,共6页
目的 探讨高危新生儿室管膜下出血(SHE)/脑室内出血(IVH)发生率与程度及与其相关的产科危险因素的关系。方法 从2001年1月~2006年10月我们对本院收治及留观的4026例高危新生儿,于生后3天均进行前瞻性颅内超声检查,将产科资料完... 目的 探讨高危新生儿室管膜下出血(SHE)/脑室内出血(IVH)发生率与程度及与其相关的产科危险因素的关系。方法 从2001年1月~2006年10月我们对本院收治及留观的4026例高危新生儿,于生后3天均进行前瞻性颅内超声检查,将产科资料完整的3626例高危新生儿作为研究对象,用列联表分析SHE/IVH(SIVH)发生率与产科危险因素的关系。结果 最常见的脑异常是室管膜下囊肿(SEC)9.5%,其次是SIVH5.2%,罕见的有脉胳膜丛囊肿(CPC),脑积水,小脑延髓池增大(ECC),脑室周围白质软化(PVL),脑穿通畸形。胎儿宫内发育迟缓,胎儿宫内窘迫,胎膜早破,孕高征,产程延长时SIVH的发生率增高。SIVH的发生率随着胎龄的减少而逐渐增加,其发生率分别是:38~43周为2.4%,34~36周为6.6%,31~33周为19.5%,27~30周为56.6%。早产儿sIVH的发生率与阿氏评分呈负相关,足月儿阿氏评分0~3分时,SIVH发生率才升高。结论 本研究结果提示SIVH的发生率与胎龄及低阿氏评分密切相关;且受产前产时各种危险因素影响,为了减少高危新生儿SIVH的发生率,应加强围产期保健,预防早产,减少窒息的发生。 展开更多
关键词 颅内超声 管镜下/脑室内出血 高危新生儿 产科危险因素
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结核病国内诊断的进展 被引量:1
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作者 许卓文 郑然冉 《河北医学院学报》 1994年第4期250-253,共4页
结核病国内诊断的进展许卓文,郑然冉河北医学院(050017)关键词结核病;诊断学;最新进展目前,结核已不再是不治之症,但疫情仍十分严重,全世界现有结核病患者2000万人[1],按疫情的排列程度,我国是西太平洋27个国... 结核病国内诊断的进展许卓文,郑然冉河北医学院(050017)关键词结核病;诊断学;最新进展目前,结核已不再是不治之症,但疫情仍十分严重,全世界现有结核病患者2000万人[1],按疫情的排列程度,我国是西太平洋27个国家中的第18位[’‘。据1990年... 展开更多
关键词 结核病 细菌诊断 影像学 免疫诊断 纤维支管镜
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Analysis on Characteristic of Static Induction Transistor Using Mirror Method
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作者 胡冬青 李思渊 王永顺 《Journal of Semiconductors》 EI CAS CSCD 北大核心 2005年第2期258-265,共8页
A cylindrical gates model of the static induction transistor is proposed and mirror method is used to calculate the distribution of electric potential.The results show that:the potential barrier is directly determined... A cylindrical gates model of the static induction transistor is proposed and mirror method is used to calculate the distribution of electric potential.The results show that:the potential barrier is directly determined by channel over pinched-off factor;gate efficiency η decreases as the gate dimension α 2 and shifted gate voltage are minished,and what differs from the first-order theory is that η will tend to zero at the shifted gate voltage tends to zero when V D=0;at low current,the voltage amplification factor μ increases as the drain current rising.When the drain current reaches certain degree,the voltage amplification factor keeps almost constant.In the end,an analytical description of SIT’s characteristic suited to both triode-like and mixed I-V characteristics are obtained.The predicted I-V curves are consistent perfectly with the reported experimental ones. 展开更多
关键词 static induction transistor mirror method I-V characteristic
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High Brightness,High Power Density Fiber Coupling of High Power Laser Diode
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作者 王晓薇 肖建伟 +5 位作者 王仲明 马骁宇 刘宗顺 方高瞻 张敬明 冯小明 《Journal of Semiconductors》 EI CAS CSCD 北大核心 2001年第9期1112-1115,共4页
The output radiation from the 100μm×1μm aperture of a high power Laser Diode (LD) is efficiently coupled into a 50μm multimode optical fiber.The fiber output of the high power LD with high brightness and high ... The output radiation from the 100μm×1μm aperture of a high power Laser Diode (LD) is efficiently coupled into a 50μm multimode optical fiber.The fiber output of the high power LD with high brightness and high power density is achieved.The power density is up to 3 6×104W/cm2 and the coupling efficiency is 70%.The extreme divergence and the astigmatism of high power LDs require the optics with complex lens structures and high performance.A double-curved lens with two crossed cylindrical lenses structured on both sides of the glass substrate is used in the coupling system. 展开更多
关键词 high power LD double-curved lens fiber coupling high brightness high power density
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Intraductal biliary and pancreatic endoscopy: An expanding scope of possibility 被引量:12
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作者 Joel R Judah Peter V Draganov 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第20期3129-3136,共8页
Intraductal endoscopy describes the use of an endoscope to directly visualize the biliary and pancreatic ducts. For many years, technological challenges have made performing these procedures difficult. The "mothe... Intraductal endoscopy describes the use of an endoscope to directly visualize the biliary and pancreatic ducts. For many years, technological challenges have made performing these procedures difficult. The "mother-baby" system and other various miniscopes have been developed, but routine use has been hampered due to complex setup, scope fragility and the time consuming, technically demanding nature of the procedure. Recently, the SpyGlass peroral cholangiopancreatoscopy system has shown early success at providing diagnostic information and therapeutic options. The clinical utility of intraductal endoscopy is broad. It allows better differentiation between benign and malignant processes by allowing direct visualization and targeted sampling of tissue. Therapeutic interventions, such as electrohydraulic lithotripsy (EHL), laser lithotripsy, photodynamic therapy, and argon plasma coagulation (APC), may also be performed as part of intraductal endoscopy. Intraductal endoscopy significantly increases the diagnostic and therapeutic yield of standard endoscopic retrograde cholangiography (ERCP), and as technology progresses, it is likely that its utilization will only increase. In this review of intraductal endoscopy, we describe in detail the various endoscopic platforms and their diagnostic and clinical applications. 展开更多
关键词 Intraductal endoscopy CHOLEDOCHOSCOPY CHOLANGIOSCOPY PANCREATOSCOPY Biliary endoscopy Duodenoscope-assisted cholangiopancreatoscopy Miniscope Percutaneous choledochoscopy Laparoscopiccholedochoscopy Lithotripsy
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Endoscopic management of biliary strictures after liver transplantation 被引量:21
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作者 Emmanuelle D Williams Peter V Draganov 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第30期3725-3733,共9页
Bile duct strictures remain a major source of morbidity after orthotopic liver transplantation (OLT). Biliary strictures are classifi ed as anastomotic or non-anastomotic strictures according to location and are defi ... Bile duct strictures remain a major source of morbidity after orthotopic liver transplantation (OLT). Biliary strictures are classifi ed as anastomotic or non-anastomotic strictures according to location and are defi ned by distinct clinical behaviors. Anastomotic strictures are localized and short. The outcome of endoscopic treatment for anastomotic strictures is excellent. Nonanastomotic strictures often result from ischemic and immunological events, occur earlier and are usually multiple and longer. They are characterized by a far less favorable response to endoscopic management, higher recurrence rates, graft loss and need for retransplantation. Living donor OLT patients present a unique set of challenges arising from technical factors, and stricture risk for both recipients and donors. Endoscopic treatment of living donor OLT patients is less promising. Current endoscopic strategies for biliary strictures after OLT include repeated balloon dilations and placement of multiple side-by-side plastic stents. Lifelong surveillance is required in all types of strictures. Despite improvements in incidence and long term outcomes with endoscopic management, and a reduced need for surgical treatment, the impact of strictures on patients after OLT is signifi cant. Future considerations include new endoscopic technologies and improved stents, which could potentially allow for a decreased number of interventions, increased intervals before retreatment, and decreased reliance on percutaneous and surgical modalities. This review focuses on the role of endoscopy in biliary strictures, one of the most common biliary complications after OLT. 展开更多
关键词 Anastomotic strictures Bile duct diseases Endoscopic retrograde cholangiopancreatography Orthotopic liver transplantation Surgical anastomosis
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Endoscopic retrograde cholangiopancreatography during pregnancy without radiation 被引量:17
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作者 Adem Akcakaya Orhan Veli Ozkan +2 位作者 Ismail Okan Orhan Kocaman Mustafa Sahin 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第29期3649-3652,共4页
AIM: To present our experience with pregnant patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) without using radiation, and to evaluate the acceptability of this alternative therapeutic p... AIM: To present our experience with pregnant patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) without using radiation, and to evaluate the acceptability of this alternative therapeutic pathway for ERCP during pregnancy. METHODS: Between 2000 and 2008, six pregnant women underwent seven ERCP procedures. ERCP was performed under mild sedoanalgesia induced with pethidine HCI and midazolam. The bile duct was cannulated with a guidewire through the papilla. A catheter was slid over the guidewire and bile aspiration and/or visualization of the bile oozing around the guidewire was used to confirm correct cannulation. Following sphincterotomy, the bile duct was cleared by balloon sweeping. When indicated, stents were placed. Confirmation of successful biliary cannulation and stone extraction was made by laboratory, radiological and clinical improvement. Neither fluoroscopy nor spot radiography was used during the procedure. RESULTS: The mean age of the patients was 28 years (range, 21-33 years). The mean gestational age for the fetus was 23 wk (range, 14-34 wk). Five patients underwent ERCP because of choledocholithiasis and/or choledocholithiasis-induced acute cholangitis. In one case, a stone was extracted after precut papillotomy with a needle-knife, since the stone was impacted. One patient had ERCP because of persistent biliary fistula after hepatic hydatid disease surgery. Following sphincterotomy, scoleces were removed from the common bile duct. Two weeks later, because of the absence of fistula closure, repeat ERCP was performed and a stent was placed. The fistula was closed after stent placement. Neither post-ERCP complications nor premature birth or abortion was seen. CONCLUSION: Non-radiation ERCP in experienced hands can be performed during pregnancy. Stent placement should be considered in cases for which complete common bile duct clearance is dubious because of a lack of visualization of the biliary tree. 展开更多
关键词 CHOLANGITIS CHOLEDOCHOLITHIASIS Endoscopic retrograde cholangiopancreatography JAUNDICE PREGNANCY
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Appropriate kidney stone size for ureteroscopic lithotripsy:When to switch to a percutaneous approach 被引量:36
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作者 Ryoji Takazawa Sachi Kitayama Toshihiko Tsujii 《World Journal of Nephrology》 2015年第1期111-117,共7页
Flexible ureteroscopy(f URS) has become a more effective and safer treatment for whole upper urinary tract stones. Percutaneous nephrolithotomy(PNL) is currently the first-line recommended treatment for large kidney s... Flexible ureteroscopy(f URS) has become a more effective and safer treatment for whole upper urinary tract stones. Percutaneous nephrolithotomy(PNL) is currently the first-line recommended treatment for large kidney stones ≥ 20 mm and it has an excellent stone-free rate for large kidney stones. However, its invasiveness is not negligible considering its major complication rates. Staged f URS is a practical treatmentfor such large kidney stones because f URS has a minimal blood transfusion risk, short hospitalization and few restrictions on daily routines. However, as the stone size becomes larger, the stone-free rate decreases, and the number of operations required increases. Therefore, in our opinion, staged f URS is a practical option for kidney stones 20 to 40 mm. Miniaturized PNL combined with f URS should be considered to be a preferred option for stones larger than 40 mm. Moreover, URS is an effective treatment for multiple upper urinary tract stones. Especially for patients with a stone burden < 20 mm, URS is a favorable option that promises a high stone-free rate after a single session either unilaterally or bilaterally. However, for patients with a stone burden ≥ 20 mm, a staged operation should be considered to achieve stone-free status. 展开更多
关键词 URETEROSCOPY LITHOTRIPSY Laser Kidney calculi NEPHROSTOMY PERCUTANEOUS
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A primary intestinal lymphangiectasia patient diagnosed by capsule endoscopy and confirmed at surgery: A case report 被引量:25
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作者 You-Hong Fang Bing-Ling Zhang +1 位作者 Jia-Guo Wu Chun-Xiao Chen 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第15期2263-2265,共3页
Intestinal lymphangiectasia (IL) is a rare disease characterized by dilated lymphatic vessles in the intestinal wall and small bowel mesentery which induce loss of protein and lymphocytes into bowel lumen. Because i... Intestinal lymphangiectasia (IL) is a rare disease characterized by dilated lymphatic vessles in the intestinal wall and small bowel mesentery which induce loss of protein and lymphocytes into bowel lumen. Because it most often occurs in the intestine and cannot be detected by upper gastroendoscopy or colonoscopy, and the value of common image examinations such as X-ray and computerized tomography (CT) are limited, the diagnosis of IL is difficult, usually needing the help of surgery. Capsule endoscopy is useful in diagnosing intestinal diseases, such as IL. We here report a case of IL in a female patient who was admitted for the complaint of recurrent edema accompanied with diarrhea and abdominal pain over the last twenty years, and aggravated ten days ago. She was diagnosed by M2A capsule endoscopy as a primary IL and confirmed by surgical and pathological examination. 展开更多
关键词 Intestinal lymphangiectasia Capsule endoscopy HYPOPROTEINEMIA LYMPHOCYTOPENIA EDEMA SURGERY
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