Radlofrequency Cathter Ablation was performed On 53 patientswith paroxysmal supraventrlcuinr tnchycnrdlm and gained fsfactory results.53 patients:male 32,female 20,aged about 44.4±13.18(21～70)yearn.All thepatien...Radlofrequency Cathter Ablation was performed On 53 patientswith paroxysmal supraventrlcuinr tnchycnrdlm and gained fsfactory results.53 patients:male 32,female 20,aged about 44.4±13.18(21～70)yearn.All thepatients bad suprnventrlcuJar tachyeardla oceurrlng blatorles of more than 1year.Electrophyaiologte tests rhowed:18 with left-alded tecessory pathwayand 12 with concealed pathway,about 30 passways oll together in the left;4casea with right accessory pathway and I with eoncealed pathway,5 passwaysin the right;18 patients with atrioventrlenlar nodal dual pathway.EVA or EAAon A-V ring was the target picture In sceessory passwry sbletion.Middle orInferlor position was taken A-V nodal dual pathway ablation,with imall Alarge V as inrget pteture Includlng breaking up of wave A.The appenranceof slow A-V boarded rhythm daring electric ejection was marked as effectiveablation.Suprtventrlcular tachycardin cin’t be Initiated by various stimulateswas regarded as our final afm.All these patients got suceessful ablation.2cases recurred during foUow-up of 30±12 monthe,but cured after aecondablatlon.One of the recurrers bad right-position heart with atrfoventricularaccessory passway.The trigger site was detacted 3.5cm distance fromcoronary and ablated Juceessfully.展开更多
Pettamna lintta Rfdpraittal Tuhyortk 【fAt) iwdy ion of urtylin* H nut or onij thnpr k X opdml, k am ou* oudbmyopuhy. b iko 【albd ubyculk aritonDopMiy In dfab.IUdlolteqD.ier Ckteto Ablujm (RFCA) i】 one of ...Pettamna lintta Rfdpraittal Tuhyortk 【fAt) iwdy ion of urtylin* H nut or onij thnpr k X opdml, k am ou* oudbmyopuhy. b iko 【albd ubyculk aritonDopMiy In dfab.IUdlolteqD.ier Ckteto Ablujm (RFCA) i】 one of uk bot my to ml USa. A mUl rub* tb PJKT M DM npoiud Ihm Tie me ii lUty-one 】【ui oU nu, Etettophytlolotj Study (EPS) dmoMMri Ital a mlbonlc th u|b iBtemOtaiu Dodd lad UDtonfc duoufh 【tow piUmy 1C iko toned dow pithoy Lotmlbl kft poitaiiqxd, Wbm PJRT lpp【ub| the usnoiy puhwy mi ibkttd by RFCA to fee Id) pMooiqttl bcutoi. no mi pom 20Wx展开更多
目的探讨电话随访对出院患者经外周静脉穿刺中心静脉置管（peripherally inserted central cathter,PICC）的影响。方法将2010年1～12月本院收治的289例PICC患者设为对照组,出院时给予常规置管健康指导;将2011年1～12月本院收治的PICC...目的探讨电话随访对出院患者经外周静脉穿刺中心静脉置管（peripherally inserted central cathter,PICC）的影响。方法将2010年1～12月本院收治的289例PICC患者设为对照组,出院时给予常规置管健康指导;将2011年1～12月本院收治的PICC置管患者305例设为观察组,在对照组基础上实施电话随访。比较两组患者置管期间按时维护导管、导管并发症、意外拔管及满意度情况。结果两组患者按时维护导管、导管并发症、意外拔管及满意度各项指标比较,均P〈0.05,差异具有统计学意义,观察组患者各项指标明显优于对照组。结论电话随访有助于提高出院患者对PICC维护依从性,有效控制PICC置管期间并发症,提高患者生活质量和满意度。展开更多
目的探讨B超在预防经外周静脉置入的中心静脉导管术(peripherally inserted central cathters,PICC)中导管头端异位的应用效果,以期提高置管成功率。方法便利抽样法选取2013年4月1日至2013年9月31日在第二军医大学长海医院静脉输液门诊...目的探讨B超在预防经外周静脉置入的中心静脉导管术(peripherally inserted central cathters,PICC)中导管头端异位的应用效果,以期提高置管成功率。方法便利抽样法选取2013年4月1日至2013年9月31日在第二军医大学长海医院静脉输液门诊进行PICC的患者488例为研究对象,按就诊时间先后分为对照组(n=237)和观察组(n=251)。对照组患者置管时采用转头曲颈法,观察组患者置管时采用B超探头横切按压颈内静脉加以探测定位,比较两组患者置管后发生PICC头端异位的情况。结果对照组237例中5例患者置管后X线摄片示导管尖端异位入颈内静脉;观察组251例中2例患者穿刺置管中发现异位入颈内静脉,立即调整后X线摄片示置管成功。结论 B超不仅有助于提高穿刺成功率,对PICC置管过程中防止导管头端异位入颈内静脉有着较好的定位作用。展开更多
Aim of the work: To evaluate the efficacy and safety of bolus only intra coronary platelet glyco-protein GP IIb/IIIa receptor antagonists combined with thrombus-aspiration during percutaneous coronary intervention (PC...Aim of the work: To evaluate the efficacy and safety of bolus only intra coronary platelet glyco-protein GP IIb/IIIa receptor antagonists combined with thrombus-aspiration during percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI). Patient and Methods: 25 consecutive STEMI patients treated by primary PCI including thrombus aspiration were prospectively enrolled, from a total of 180 PCIs performed at our institution between January 2013 and January 2014. All patients received aspirin (250 mg i.v.) and clopidogrel (600 or 300 mg if already on clopidogrel) plus standard heparin. Glycoprotein IIb/IIIa antagonists were administered at physicians’ discretion before thrombus aspiration. Eptifibatide was used as a slandered Glycoprotein IIb/IIIa antagonists as a dose of the 180-μg/kg eptifibatide bolus only. The bolus was administered for 2 minutes via the thrombus aspiration catheter (STEMI cath of min-vasys) just before thrombus aspiration. Twelve-lead ECGs were recorded at baseline and 60 min (45 - 75 min) after completion of PCI. The primary endpoint was the TIMI 3 patency of the infarct-related coronary artery before PCI. Secondary endpoints were TIMI patency following PCI, ST resolution 60 min after PCI, all-cause death, reinfarction, urgent revascularization, stroke (haemorrhagic, non-haemorrhagic), and severe bleeding complications. Results: The angiography was performed in all 25 patients. The incidence of a TIMI flow grade 3 of the infarct-related coronary artery before PCI was 16% while TIMI grade 2 and I was 24% and 36% respectively. The incidence of a TIMI flow grade 0 (no reflow) of the infarct-related coronary artery before PCI was 24%. Visible thrombus in 52% of patients and 40% of patients have more than one critically disease vessel. Primary PCI was performed in 25 patients. Eptifibatide intracoronary was given through thrombus aspiration catheter before thrombus aspiration. Drug eluting stents were implanted in 60% of patients. Only two patients with acute stent thrombosis did not receive any stents at PCI. One patient died 24 h after the procedure due to severe heart failure and cardiogenic shock. No reinfarction was noted within 30 days after the procedure. Generally heart failure improved significantly after the procedure and at the end of 30 day post operative. Only 3 patients had persistent heart failure class III (12%). 84% of patients had TIMI flow III at the end of procedure with over all significant improvement. Significant TIMI flow improvement after procedure was noticed with P value, 001. Also the results showed significant shows of ST segment resolution after procedure. Conclusions: for patients with STEMI undergoing primary PCI, a routine combination of intracoronary administration of Eptifibatide before transcatheter thrombus aspiration is a safe procedure with low risk of hemorrhage and increases myocardial reperfusion, which ultimately improves outcomes. This therapeutic modality may be recommended for further improving myocardial reperfusion in patients with STEMI.展开更多
本文观察经导管射频消融房室交界区慢、快径区域对大和人心房颤动时心室率的影响.方法 杂种犬4条,体重11±1.2kg.房室结折返性心动过速患者7例,年龄29～65岁.阵发性房颤患者4例,年龄62～70岁,其中2例为短P-R间期综合征.均先采用“...本文观察经导管射频消融房室交界区慢、快径区域对大和人心房颤动时心室率的影响.方法 杂种犬4条,体重11±1.2kg.房室结折返性心动过速患者7例,年龄29～65岁.阵发性房颤患者4例,年龄62～70岁,其中2例为短P-R间期综合征.均先采用“下位法”消融慢径区域后,若房室结有效不应期或房颤时平均R-R间期无明显变化,则加行“快径”区域消融.房颤诱发采用猝发脉冲电刺激(人)或静滴氯化乙酰胆碱后猝发脉冲电刺激(犬).结果 7例房室结折返性心动过速患者中5例经下位法射频消融阻断慢径,房室结前传有效不应期及诱发房颤时平均R-R间期明显延长(222±33ms vs 285±42ms和539±44ms vs 656±53ms P<0.01),无并发症.4条大及4例阵发性房颤患者经心内电生理检查证实均无房室结双径路表现,选择性消融“慢径区域”后,房室结有效不应期和房颤时平均R—R间期无明显变化,加行“快径区域”消融后,房室结有效不应期和房颤时平均R—R间期明显延长(犬145±16ms vs 185±22ms和305±13ms vs 403±17ms P<0.01,人220ms vs 490ms和367ms vs 690msP<0.01),1例房颤患者术后3天出现Ⅲ°AVB,2周后恢复为Ⅰ°AVB.本文还在动物实验中观察到消融快径区域时,房侧靶点(A/V>1)较室侧靶点(A/V<1)更易于造成Ⅲ°AVB.结论 选择性射频消融慢径区域对减?展开更多
文摘Radlofrequency Cathter Ablation was performed On 53 patientswith paroxysmal supraventrlcuinr tnchycnrdlm and gained fsfactory results.53 patients:male 32,female 20,aged about 44.4±13.18(21～70)yearn.All thepatients bad suprnventrlcuJar tachyeardla oceurrlng blatorles of more than 1year.Electrophyaiologte tests rhowed:18 with left-alded tecessory pathwayand 12 with concealed pathway,about 30 passways oll together in the left;4casea with right accessory pathway and I with eoncealed pathway,5 passwaysin the right;18 patients with atrioventrlenlar nodal dual pathway.EVA or EAAon A-V ring was the target picture In sceessory passwry sbletion.Middle orInferlor position was taken A-V nodal dual pathway ablation,with imall Alarge V as inrget pteture Includlng breaking up of wave A.The appenranceof slow A-V boarded rhythm daring electric ejection was marked as effectiveablation.Suprtventrlcular tachycardin cin’t be Initiated by various stimulateswas regarded as our final afm.All these patients got suceessful ablation.2cases recurred during foUow-up of 30±12 monthe,but cured after aecondablatlon.One of the recurrers bad right-position heart with atrfoventricularaccessory passway.The trigger site was detacted 3.5cm distance fromcoronary and ablated Juceessfully.
文摘Pettamna lintta Rfdpraittal Tuhyortk 【fAt) iwdy ion of urtylin* H nut or onij thnpr k X opdml, k am ou* oudbmyopuhy. b iko 【albd ubyculk aritonDopMiy In dfab.IUdlolteqD.ier Ckteto Ablujm (RFCA) i】 one of uk bot my to ml USa. A mUl rub* tb PJKT M DM npoiud Ihm Tie me ii lUty-one 】【ui oU nu, Etettophytlolotj Study (EPS) dmoMMri Ital a mlbonlc th u|b iBtemOtaiu Dodd lad UDtonfc duoufh 【tow piUmy 1C iko toned dow pithoy Lotmlbl kft poitaiiqxd, Wbm PJRT lpp【ub| the usnoiy puhwy mi ibkttd by RFCA to fee Id) pMooiqttl bcutoi. no mi pom 20Wx
文摘目的探讨电话随访对出院患者经外周静脉穿刺中心静脉置管（peripherally inserted central cathter,PICC）的影响。方法将2010年1～12月本院收治的289例PICC患者设为对照组,出院时给予常规置管健康指导;将2011年1～12月本院收治的PICC置管患者305例设为观察组,在对照组基础上实施电话随访。比较两组患者置管期间按时维护导管、导管并发症、意外拔管及满意度情况。结果两组患者按时维护导管、导管并发症、意外拔管及满意度各项指标比较,均P〈0.05,差异具有统计学意义,观察组患者各项指标明显优于对照组。结论电话随访有助于提高出院患者对PICC维护依从性,有效控制PICC置管期间并发症,提高患者生活质量和满意度。
文摘目的探讨B超在预防经外周静脉置入的中心静脉导管术(peripherally inserted central cathters,PICC)中导管头端异位的应用效果,以期提高置管成功率。方法便利抽样法选取2013年4月1日至2013年9月31日在第二军医大学长海医院静脉输液门诊进行PICC的患者488例为研究对象,按就诊时间先后分为对照组(n=237)和观察组(n=251)。对照组患者置管时采用转头曲颈法,观察组患者置管时采用B超探头横切按压颈内静脉加以探测定位,比较两组患者置管后发生PICC头端异位的情况。结果对照组237例中5例患者置管后X线摄片示导管尖端异位入颈内静脉;观察组251例中2例患者穿刺置管中发现异位入颈内静脉,立即调整后X线摄片示置管成功。结论 B超不仅有助于提高穿刺成功率,对PICC置管过程中防止导管头端异位入颈内静脉有着较好的定位作用。
文摘Aim of the work: To evaluate the efficacy and safety of bolus only intra coronary platelet glyco-protein GP IIb/IIIa receptor antagonists combined with thrombus-aspiration during percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI). Patient and Methods: 25 consecutive STEMI patients treated by primary PCI including thrombus aspiration were prospectively enrolled, from a total of 180 PCIs performed at our institution between January 2013 and January 2014. All patients received aspirin (250 mg i.v.) and clopidogrel (600 or 300 mg if already on clopidogrel) plus standard heparin. Glycoprotein IIb/IIIa antagonists were administered at physicians’ discretion before thrombus aspiration. Eptifibatide was used as a slandered Glycoprotein IIb/IIIa antagonists as a dose of the 180-μg/kg eptifibatide bolus only. The bolus was administered for 2 minutes via the thrombus aspiration catheter (STEMI cath of min-vasys) just before thrombus aspiration. Twelve-lead ECGs were recorded at baseline and 60 min (45 - 75 min) after completion of PCI. The primary endpoint was the TIMI 3 patency of the infarct-related coronary artery before PCI. Secondary endpoints were TIMI patency following PCI, ST resolution 60 min after PCI, all-cause death, reinfarction, urgent revascularization, stroke (haemorrhagic, non-haemorrhagic), and severe bleeding complications. Results: The angiography was performed in all 25 patients. The incidence of a TIMI flow grade 3 of the infarct-related coronary artery before PCI was 16% while TIMI grade 2 and I was 24% and 36% respectively. The incidence of a TIMI flow grade 0 (no reflow) of the infarct-related coronary artery before PCI was 24%. Visible thrombus in 52% of patients and 40% of patients have more than one critically disease vessel. Primary PCI was performed in 25 patients. Eptifibatide intracoronary was given through thrombus aspiration catheter before thrombus aspiration. Drug eluting stents were implanted in 60% of patients. Only two patients with acute stent thrombosis did not receive any stents at PCI. One patient died 24 h after the procedure due to severe heart failure and cardiogenic shock. No reinfarction was noted within 30 days after the procedure. Generally heart failure improved significantly after the procedure and at the end of 30 day post operative. Only 3 patients had persistent heart failure class III (12%). 84% of patients had TIMI flow III at the end of procedure with over all significant improvement. Significant TIMI flow improvement after procedure was noticed with P value, 001. Also the results showed significant shows of ST segment resolution after procedure. Conclusions: for patients with STEMI undergoing primary PCI, a routine combination of intracoronary administration of Eptifibatide before transcatheter thrombus aspiration is a safe procedure with low risk of hemorrhage and increases myocardial reperfusion, which ultimately improves outcomes. This therapeutic modality may be recommended for further improving myocardial reperfusion in patients with STEMI.
文摘本文观察经导管射频消融房室交界区慢、快径区域对大和人心房颤动时心室率的影响.方法 杂种犬4条,体重11±1.2kg.房室结折返性心动过速患者7例,年龄29～65岁.阵发性房颤患者4例,年龄62～70岁,其中2例为短P-R间期综合征.均先采用“下位法”消融慢径区域后,若房室结有效不应期或房颤时平均R-R间期无明显变化,则加行“快径”区域消融.房颤诱发采用猝发脉冲电刺激(人)或静滴氯化乙酰胆碱后猝发脉冲电刺激(犬).结果 7例房室结折返性心动过速患者中5例经下位法射频消融阻断慢径,房室结前传有效不应期及诱发房颤时平均R-R间期明显延长(222±33ms vs 285±42ms和539±44ms vs 656±53ms P<0.01),无并发症.4条大及4例阵发性房颤患者经心内电生理检查证实均无房室结双径路表现,选择性消融“慢径区域”后,房室结有效不应期和房颤时平均R—R间期无明显变化,加行“快径区域”消融后,房室结有效不应期和房颤时平均R—R间期明显延长(犬145±16ms vs 185±22ms和305±13ms vs 403±17ms P<0.01,人220ms vs 490ms和367ms vs 690msP<0.01),1例房颤患者术后3天出现Ⅲ°AVB,2周后恢复为Ⅰ°AVB.本文还在动物实验中观察到消融快径区域时,房侧靶点(A/V>1)较室侧靶点(A/V<1)更易于造成Ⅲ°AVB.结论 选择性射频消融慢径区域对减?
