Comparative study for predictability of type 1 gastric variceal rebleeding after endoscopic variceal ligation:High-frequency intraluminal ultrasound study

BACKGROUND The efficacy of endoscopic ultrasonography for the follow-up of gastric varices treated with endoscopic variceal ligation(EVL)has not been established.AIM To evaluate the diagnostic correlation of esophagogastroduodenoscopy(EGD)and high-frequency intraluminal ultrasound(HFIUS)for type 1 gastric varices(GOV1)after EVL and to identify the predictability for rebleeding of EGD and HFIUS.METHODS In liver cirrhosis patients with GOV1,we performed endoscopic follow-up using EGD and HFIUS synchronously after EVL for hemorrhage from GOV1.Endoscopic grading and red color signs were analyzed using EGD,and the largest variceal cross-sectional areas were measured using HFIUS.In addition,1-year follow-up was performed.Variceal rebleeding was defined as the presence of hematemesis,hematochezia,or melena without other evidence of bleeding on endoscopic follow-up.RESULTS In 26 patients with GOV1,variceal cross-sectional areas on HFIUS of GOV1 was poorly correlated with EGD grading of GOV1(r=0.36).In 17 patients who completed the 1-year follow-up,variceal cross-sectional areas on HFIUS was a good predictor of subsequent rebleeding,whereas EGD grading was not a predictor of subsequent rebleeding.CONCLUSION HFIUS measurement is more predictive of GOV1 rebleeding than EGD grading,so HFIUS measurement may be necessary for endoscopic follow-up after EVL in patients with GOV1.

Application Value of High-Frequency Ultrasound and Contrast-Enhanced Ultrasound in Patients with Knee Osteoarthritis with Different TCM Syndromes

Objective: To explore the application value of high-frequency ultrasound and contrast-enhanced ultrasound in different syndrome types of knee osteoarthritis, and to provide more imaging evidence for clinical diagnosis and treatment. Method: Sixty patients with KOA were selected according to TCM classification, which were mainly divided into Qi stagnation and blood stasis type and cold-dampness blockage type. All knee joints were routinely examined by high frequency ultrasound, and those with synovial hyperplasia were examined by contrast-enhanced ultrasound. High frequency ultrasound is the examination of synovium, cartilage and collateral ligament of knee joint based on two-dimensional ultrasound. Contrast-enhanced ultrasound (CEUS) refers to the contrast examination of synovium in knee joint patients with synovial hyperplasia. Result: Among them, the suprapatellar sac effusion and synovial thickening of Qi stagnation and blood stasis type were more obvious than those of cold-dampness arthralgia type (P < 0.05), and the degree of wear of the intercondylar cartilage of cold-dampness arthralgia type was more obvious than that of Qi stagnation. The blood stasis type is heavier and the meniscus bulge is higher (P < 0.05). The radiography of synovial hyperplasia showed that the area under the curve of Qi stagnation and blood stasis type was higher than that of cold dampness arthralgia type (P < 0.05), and the peak time was significantly shorter than that of cold dampness arthralgia type. There was no statistical difference in effective peak gradient and onset time of type (P > 0.05). Conclusion: To a certain extent, the high-frequency ultrasound and contrast-enhanced ultrasound performance of knee osteoarthritis can be used as a dialectical reference for different TCM syndrome types.

Secure Transmission of Compressed Medical Image Sequences on Communication Networks Using Motion Vector Watermarking

Medical imaging plays a key role within modern hospital management systems for diagnostic purposes.Compression methodologies are extensively employed to mitigate storage demands and enhance transmission speed,all while upholding image quality.Moreover,an increasing number of hospitals are embracing cloud computing for patient data storage,necessitating meticulous scrutiny of server security and privacy protocols.Nevertheless,considering the widespread availability of multimedia tools,the preservation of digital data integrity surpasses the significance of compression alone.In response to this concern,we propose a secure storage and transmission solution for compressed medical image sequences,such as ultrasound images,utilizing a motion vector watermarking scheme.The watermark is generated employing an error-correcting code known as Bose-Chaudhuri-Hocquenghem(BCH)and is subsequently embedded into the compressed sequence via block-based motion vectors.In the process of watermark embedding,motion vectors are selected based on their magnitude and phase angle.When embedding watermarks,no specific spatial area,such as a region of interest(ROI),is used in the images.The embedding of watermark bits is dependent on motion vectors.Although reversible watermarking allows the restoration of the original image sequences,we use the irreversible watermarking method.The reason for this is that the use of reversible watermarks may impede the claims of ownership and legal rights.The restoration of original data or images may call into question ownership or other legal claims.The peak signal-to-noise ratio(PSNR)and structural similarity index(SSIM)serve as metrics for evaluating the watermarked image quality.Across all images,the PSNR value exceeds 46 dB,and the SSIM value exceeds 0.92.Experimental results substantiate the efficacy of the proposed technique in preserving data integrity.

Development of a High-frequency Ultrasound System for High-speed Image Scanning

High-frequency image technique has been widely applied in medical diagnosis recently. For high voltage protection, high speed stage and trigger control circuitry are difficult to implement a high-frequency ultrasound imaging system. In this study, we utilized a linear servo with high noise tolerance and a novel multi-depth expression method to overcome those issues in developed high-speed image system. B-mode image of the chicken phantom by 25 MHz transducer shows the resolution of lateral and axial resolutions are up to 123 μm and 59 μm respectively. In addition, the experiment demonstrates that the axial resolution and depth of field (DOF) can be improved by time gain compensation(TGC) and multi-depth method. The results indicate that the proposed system could achieve over 24 fps for 1 mm scan distance and 100 lines per frame. In the future, the developed system is potential for other clinical applications such as ophthalmology and dermatology.

An Adaptive Pulse Compression Filter for Ultrasound Contrast Harmonic Imaging

Coded excitation is useful for ultrasound contrast imaging to increase penetration and SNR, and improve the contrast to tissue ratio (CTR). The waveform of bubble response depends greatly on bubble size, the frequency and bandwidth of the excitation chirp signal. This makes the pulse compression filter based on square-law be wrong for bubbles with changing sizes. In this paper, an adaptive pulse compression (APC) filter for the second harmonic of microbubble with varying size distribution is proposed. The APC filter is designed based on the estimated power spectrum of the received bubble harmonic echoes. Theoretical analysis and simulation studies are presented for evaluating performance of the APC filter. For monodisperse bubble, the power improvement factor of the APC filter can be more than 20 dB.

Efficacy evaluation of high-frequency ultrasound in the treatment of diabetic peripheral neuropathy with α-lipoic acid combined with traditional Chinese medicine package treatment

Objective:To use high-frequency ultrasound to evaluate the efficacy ofα-lipoic acid combined with traditional Chinese medicine in the treatment of diabetic peripheral neuropathy(DPN),so as to provide a basis for clinical medication and evaluation of therapeutic effect.Methods:From December 2018 to December 2019,110 patients with DPN who met the inclusion and exclusion criteria were divided into observation group and control group according to different treatment plans.The control group was treated withα-lipoic acid,and the observation group was treated withα-lipoic acid combined with traditional Chinese medicine encapsulation treatment,and used high-frequency ultrasound,nerve conduction velocity and serological examination to comprehensively evaluate the effectiveness of the two treatment methods.Results:The mean amplitude of glycemic excursions(MAGE)value of the observation group and the control group after treatment was significantly lower than before treatment(P<0.05);After treatment,the SCV of the ulnar nerve,median nerve,and common peroneal nerve in the two groups was significantly faster than before treatment(P<0.05).Similar to SCV,the MCV of the three nerves measured after treatment in the two groups was significantly faster than before treatment(P<0.05).Compared between the groups after treatment,the three kinds of nerve SCV and MCV in the observation group were significantly faster than those in the control group(P<0.05).The cross-sectional area(CSA)value of the ulnar nerve,median nerve and common peroneal nerve in the observation group after treatment was significantly lower than before treatment(P<0.05).Compared with the control group after treatment,the three nerves CSA in the observation group was significantly lower than that in the control group(P<0.05).Abnormal ultrasound performance:The proportion of abnormal ultrasound performances of the ulnar nerve,median nerve,and common peroneal nerve in the observation group after treatment was significantly lower than before treatment(P<0.05).The composition ratio of internal echo reduction and ambiguity in the observation group after three nerve treatments was significantly lower than that in the control group after treatment(P<0.05).In the correlation analysis,the three kinds of nerve CSA before and after treatment were negatively correlated with SCV and amplitude(P<0.05),and positively correlated with latency(P<0.05).Conclusion:The combination ofα-lipoic acid and Chinese medicine encapsulation technology has a good effect on the treatment and repair of DPN nerve damage,and can be routinely applied in clinical treatment.High-frequency ultrasound can intuitively observe changes in peripheral nerves and can be used to evaluate the prognosis of DPN.

Incremental value of compression ultrasound sonography in the emergency department

The quick evaluation of venous thromboembolism is a key point of modern medicine since the delayed diagnosis is associated with a worse prognosis.Venous ultrasound(VU)is a sensitive and rapidly performed test in cases of suspected deep venous thrombosis.Various protocols have been proposed for its execution,such as the study of the whole deep venous circulation of the lower limb or the analysis of the femoral-popliteal area.The aim is to detect a vessel thrombus and the most sensitive element is the non-compressibility with the probe.Initially,the thrombus is hypoechogenic and adherent to the vessel;later,it tends to organize and recanalize.Usually,in the early stages,the risk of embolism is higher.The role of studying the iliac axis and calf veins is still uncertain.VU is not useful for assessing response to anticoagulation therapy and it is unclear whether the persistence of thrombotic abnormalities can guide on a possible prolongation of therapy.

Analysis of High-Frequency Ultrasound in the differential Diagnosis of Lumps in Foot and Hand

Objective:To investigate the ultrasonogram characteristics of common lumps in hand and foot,pursuing for greater understanding of hand and foot lumps.Methods:65 cases of ultrasonographic characteristics of lumps in hand and foot were retrospectively analyzed,including the location,size,shape,boundary,internal echo and posterior echo,surrounding relationship and blood flow.Results:Among 65 cases,there were 26 cases of tendon sheath cyst,16 cases of tenosynovitis giant cell tumor,10 cases of hemangioma,4 cases of tendon sheath fibroma,3 cases of epidermoid cyst,2 cases of Schwannoma,2 cases of fibrolipoma,1 case of angiolipoma and 1 case of neurofibroma.The preoperative and postoperative pathological diagnoses of 45 cases,accounting for 69.23%,were consistent,3 cases(4.62%)were misdiagnosed,which included that 2 cases of tenosynovitis giant cell tumor were misdiagnosed as tendon sheath cyst,1 case of neurofibroma as epidermoid cyst,and the preoperative diagnosis of the rest 17 cases(26.15%)were indefinite.Conclusion:The high-frequency ultrasound can diagnose properties of lumps in foot and hand well,providing diagnosis basis for further treatment in clinic.

Preliminary Application of High-Frequency Ultrasound in the Differentiation of Pemphigus and Bullous Pemphigoid:An Observational Study

Objective:Ultrasonography is a diagnostic imaging technique used to visualize subcutaneous body structures for identification of possible pathologies.In this study,we aimed to explore the clinical significance of high-frequency ultrasound in differentiating the location of blisters between pemphigus and bullous pemphigoid.Methods:Eighteen patients were recruited in Department of Dermatology,Zhongda Hospital from 2020 to 2021 and divided into a pemphigus group(n=8)and a bullous pemphigoid group(n=10)according to the diagnostic criteria for each.Ultrasonographic images were collected using a 50-MHz high-frequency ultrasound system.The indexes of ultrasonic evaluation were the layer(epidermis or dermis),size,shape,internal echo,and boundary of the blister.Categorical variables are expressed as n(%),and differences were compared using Fisher’s exact test.Results:The ultrasonographic images in the pemphigus group showed an intraepidermal semi-arc or irregular anechoic or hypoechoic areas.The inferior borders were situated above the characteristic thin linear hyperechoic bands of the epidermis.A linear hypoechoic band was present at the dermoepidermal junction in some cases.In the ultrasonographic images of the bullous pemphigoid group,the linear hyperechoic bands of the epidermis were continuous and intact.An oval fluid anechoic area(subepidermal blister)was present immediately below the bands.The location of the blisters in the ultrasonographic images was significantly different between the 2 groups(P<0.001).Conclusion:High-frequency ultrasound can be used as an auxiliary means to differentiate the location of blisters between pemphigus and bullous pemphigoid.

Identification of denatured and normal biological tissues based on compressed sensing and refined composite multi-scale fuzzy entropy during high intensity focused ultrasound treatment

In high intensity focused ultrasound(HIFU)treatment,it is crucial to accurately identify denatured and normal biological tissues.In this paper,a novel method based on compressed sensing(CS)and refined composite multi-scale fuzzy entropy(RCMFE)is proposed.First,CS is used to denoise the HIFU echo signals.Then the multi-scale fuzzy entropy(MFE)and RCMFE of the denoised HIFU echo signals are calculated.This study analyzed 90 cases of HIFU echo signals,including 45 cases in normal status and 45 cases in denatured status,and the results show that although both MFE and RCMFE can be used to identify denatured tissues,the intra-class distance of RCMFE on each scale factor is smaller than MFE,and the inter-class distance is larger than MFE.Compared with MFE,RCMFE can calculate the complexity of the signal more accurately and improve the stability,compactness,and separability.When RCMFE is selected as the characteristic parameter,the RCMFE difference between denatured and normal biological tissues is more evident than that of MFE,which helps doctors evaluate the treatment effect more accurately.When the scale factor is selected as 16,the best distinguishing effect can be obtained.

Review of imaging and endovascular intervention of iliocaval venous compression syndrome

Iliocaval venous compression syndrome(ICS)is the extrinsic compression of the common iliac vein by the overlying iliac artery against the vertebra.Chronic compression can lead to venous stenosis and stasis,which manifests as chronic venous disease and treatment resistance.Therefore,early recognition of ICS and prompt treatment are essential.Clinical presentations of ICS can be ambiguous and diagnosis requires a high index of suspicion with the relevant imaging studies.The initial imaging test is typically a Duplex ultrasound for vessel assessment and pelvic ultrasound to exclude a compressive mass,which is followed by computed tomography(CT)or magnetic resonance(MR)venography.CT and MRI can identify the anatomical causes for venous compression.In patients with high clinical suspicion for ICS,negative findings on CT and MR venography would still warrant further investigations.Definitive diagnosis can be established using catheter-based venography complemented with intravascular ultrasonography but the nature of their invasiveness limits its utility as a routine imaging modality.In this review paper,we will discuss the evidence,utility and limitations of the existing imaging modalities and endovascular intervention used in the management of ICS.

CT静脉造影与彩色多普勒超声检查在左髂静脉压迫综合征诊断中的临床价值

目的 研究CT静脉造影(CTV)与彩色多普勒超声(CDS)检查在左髂静脉压迫综合征(IVCS)诊断中的临床价值。方法 选取2022年1月至2023年6月入大庆龙南医院的81例左侧静脉曲张患者作为观察对象,所有患者均接受数字减影血管造影(DSA)检查,参考下肢静脉检查结果有无左IVCS分别作为观察组(n=27)与对照组(n=54)。两组患者均接受CTV或者CDS检查,比较两组患者的CTV左髂静脉前后径、CDS参数(压力梯度、血流速度、前后径),同时比较单一CTV、CDS与CTV联合CDS诊断左IVCS准确性,并采用受试者操作特征(ROC)曲线评估CTV、CDS单独及联合检测对IVCS的诊断价值。结果 观察组患者CTV及CDS左髂静脉前后径分别为(6.09±1.38)、(3.02±0.47) mm,均明显低于对照组[(7.41±1.72)、(5.11±0.58) mm],压力梯度、血流速度分别为(2.69±0.48) mmHg、(40.47±9.25) cm/s,均明显高于对照组[(0.89±0.32) mmHg、(27.53±6.92) cm/s],差异均有统计学意义(P<0.05)。左IVCS诊断中CTV左髂静脉前后径、CDS左髂静脉前后径及联合检查的准确率依次为87.95%、84.34%、91.57%。ROC曲线显示,以10.00 mm为临界值,左IVCS诊断中CTV的ROC曲线下面积(AUC)为0.905,灵敏性为81.47%,特异性为90.38%;CDS的AUC为0.839,灵敏性为74.09%,特异性为88.46%;CTV联合CDS的AUC为0.935,灵敏性为96.28%,特异性为86.49%。结论 左IVCS诊断中IVCS、CDS均具有良好效果,但两种技术联合诊断的准确性、灵敏性更高,早期阶段可为左IVCS诊断提供参考依据。

超声引导下微波消融治疗压迫性甲状腺实性良性结节的临床疗效研究

目的探讨超声引导下微波消融治疗压迫性甲状腺实性良性结节的临床疗效。方法选取2021年1—12月抚州市第一人民医院收治的80例压迫性甲状腺实性良性结节患者作为研究对象,根据不同治疗方式分为对照组与研究组,每组40例。对照组应用常规手术治疗,研究组应用超声引导下微波消融治疗。比较两组治疗前后甲状腺功能及结节体积消融情况。结果治疗前,两组血清游离甲状腺素(free thyroxine,FT4)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、促甲状腺激素(thyroid stimulating hormone,TSH)水平比较差异无统计学意义;治疗后,研究组血清FT4、FT3水平低于对照组,血清TSH水平高于对照组,差异有统计学意义(P<0.05)。研究组结节体积消融总有效率高于对照组,差异有统计学意义(P<0.05)。结论与常规手术治疗相比,超声引导下微波消融治疗压迫性甲状腺实性良性结节对患者甲状腺功能的影响较小,对甲状腺结节体积消融的整体治疗效果较好,应用价值较高。

聚焦超声消融手术治疗子宫腺肌病术后冰敷骶尾部减轻疼痛的疗效分析

目的:探讨聚焦超声消融手术(FUAS)治疗子宫腺肌病术后使用冰袋冰敷患者骶尾部减轻骶尾部疼痛的有效性。方法:选取110例采用FUAS治疗的子宫腺肌病患者为研究对象,根据患者术后是否采用骶尾部冰敷分为两组。冰敷组:术后即刻俯卧位,给予冰袋间断冰敷骶尾部;常规护理组:术后即刻俯卧位,给予常规护理。采用数字评定量表(NRS)比较两组患者术后2、6、24 h骶尾部疼痛的发生率及疼痛程度及术后24 h复查盆腔核磁共振(MRI),比较两组患者术后骶尾部水肿发生率。结果:所有研究对象均顺利完成FUAS治疗,常规护理组1例患者因术后疼痛明显给予盐酸哌替啶止痛,最终冰敷组纳入55例,常规护理组纳入54例。两组患者的一般资料、子宫腺肌病特征及FUAS治疗参数比较,差异均无统计学意义(P>0.05)。术后2、6、24 h,冰敷组骶尾部疼痛发生率及骶尾部疼痛NRS评分均低于常规护理组(P<0.05),术后冰敷组骶尾部水肿的发生率低于常规护理组(P<0.05)。结论:FUAS治疗子宫腺肌病术后即刻冰敷骶尾部可降低骶尾部疼痛和骶尾部水肿的发生率,减轻骶尾部疼痛的程度。

超声引导下自体富血小板血浆注射治疗腓总神经卡压综合征—附1例报告

目的观察1例超声引导下自体富血小板血浆(PRP)注射治疗腓总神经卡压综合征的临床疗效,为周围神经卡压性疾病的治疗提供借鉴。方法对1名腓总神经卡压综合征患者行超声引导下自体PRP神经水分离注射治疗,通过观察患者的症状、电生理及影像学指标,评价PRP注射治疗对腓总神经卡压综合征的疗效。结果经系统注射治疗后,患者的症状、体征及肌电图指标均明显好转,且追踪3个月无明显不良反应。结论超声引导下PRP注射治疗改善了腓总神经卡压综合征中的神经功能障碍。

Foley球囊压迫结合超声下宫腔镜清宫术治疗子宫瘢痕妊娠的临床疗效

目的分析Foley球囊压迫结合超声下宫腔镜清宫术治疗剖宫产术后子宫瘢痕妊娠患者的临床疗效。方法回顾性分析108例I/Ⅱ型子宫瘢痕妊娠患者临床资料,其中44例患者术前给予介入栓塞预处理(对照组),64例患者行超声下宫腔镜清宫术+Foley球囊压迫治疗(观察组)。比较两组患者手术成功率、术中大出血发生率、手术时间及住院时间、术后恢复情况、围术期β人绒毛膜促性腺激素(β-HCG)水平、围术期并发症发生情况及远期瘢痕修复情况。结果两组患者手术成功率、术中大出血发生率、手术时间、围术期并发症发生率、术后阴道流血持续及月经恢复、β-HCG降至正常水平时间均无显著差异(P>0.05)。观察组患者住院时间低于对照组(P<0.01)。两组患者术后β-HCG水平逐渐降低(P<0.05)。两组患者术后6个月瘢痕长度、瘢痕体积、残余肌层厚度及手术前后血清促卵泡刺激素、抗苗勒管激素、抑制素B水平均无显著差异(P>0.05)。结论超声监视下宫腔镜清宫术结合Foley球囊压迫对Ⅰ/Ⅱ型子宫瘢痕妊娠疗效好、安全性高,可缩短住院时间,值得临床推广。

胸椎旁神经阻滞辅助局部麻醉用于老年患者经皮椎体成形术中的应用效果

目的观察胸椎旁神经阻滞辅助局部麻醉在经皮椎体成形术中的应用效果。方法选取2021年6月—2022年8月于江苏省泗阳医院收治的60例经皮椎体成形术患者作为研究对象,按照随机数表法将其分为观察组(胸椎旁神经阻滞辅以局部麻醉)与对照组(局部麻醉),每组30例。观察两组患者于不同时点时数字量表评分(NRS)、平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、Ramsay评分及不良反应发生情况。结果两组患者在手术前(T0)和手术结束(T3)时MAP、HR比较,差异无统计学意义(P>0.05)。在穿刺(T1)和骨水泥注入(T2)时,观察组MAP和HR低于对照组,差异有统计学意义(P<0.05)。两组患者血氧饱和度(SpO2)在T0、T1、T2、T3四个时间点比较,差异均无统计学意义,差异有统计学意义(P>0.05)。两组患者在手术结束(T3)时Ramsay评分、数字量表评分(NRS)比较,差异无统计学意义(P>0.05)。在穿刺(T1)和骨水泥注入(T2)时,观察组Ramsay评分、NRS评分均低于对照组,差异有统计学意义(P<0.05)。两组患者均无严重不良反应发生,差异无统计学意义(P>0.05)。结论经皮椎体成形术患者采用超声引导下胸椎旁神经阻滞辅助局部麻醉治疗,可以有效改善患者术中疼痛,稳定患者生命体征。

超声引导下ESPB在老年经皮椎体成形术中的应用

目的探讨超声引导下竖脊肌平面阻滞(ESPB)在老年经皮椎体成形术中的应用效果。方法选取2023年12月至2024年6月于博罗县人民医院拟接受经皮椎体成形术的80例老年患者作为研究对象,按随机数表法分为观察组和对照组各40例。对照组患者采用局部浸润麻醉,观察组患者采用超声引导下ESPB麻醉。比较两组患者的手术时间及术中舒芬太尼、乌拉地尔使用率,比较两组患者术前(T0)、穿刺定位时(T1)、球囊扩张时(T2)、注入骨水泥时(T3)、手术结束时(T4)各时间点的VAS评分、平均动脉压(MAP)、心率(HR)的变化,同时比较两组患者的不良反应发生率。结果观察组患者的舒芬太尼、乌拉地尔使用率分别为7.50%、5.00%,明显低于对照组的27.50%、22.50%,差异均有统计学意义(P<0.05);观察组患者T2、T3、T4时间点的VAS评分分别为(1.22±0.28)分、(1.52±0.33)分、(1.47±0.31)分,明显低于对照组的(2.35±0.37)分、(2.79±0.41)分、(2.65±0.45)分,差异均有统计学意义(P<0.05);观察组患者T2、T3、T4时间点的MAP分别为(105.97±4.22)mm Hg、(107.98±4.71)mm Hg、(108.34±4.58)mm Hg,明显低于对照组的(110.87±5.17)mm Hg、(115.86±6.32)mm Hg、(117.27±5.14)mm Hg,HR分别为(88.21±4.18)次/min、(89.45±4.66)次/min、(90.32±4.87)次/min,明显低于对照组的(91.58±4.49)次/min、(92.67±4.31)次/min、(93.18±5.22)次/min,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为10.00%,略低于对照组的12.50%,但差异无统计学意义(P>0.05)。结论超声引导下ESPB在老年经皮椎体成形术中的应用效果明显,可缓解术中疼痛、稳定血流动力学,具有临床应用价值。

下肢静脉加压超声联合心脏彩超对肺血栓栓塞症的诊断价值

目的探讨下肢静脉加压超声联合心脏彩超诊断肺血栓栓塞症的价值。方法选取2023年1月—2024年1月赤峰松山医院收治的68例疑似肺血栓栓塞症患者为研究对象,所有患者均实施下肢静脉加压超声、心脏彩超检查。以临床综合诊断作为金标准,比较不同检查的诊断效能。结果临床综合诊断结果显示,68例疑似肺血栓栓塞症患者中阳性40例,阴性28例。下肢静脉加压超声联合心脏彩超诊断的特异度为96.43%(27/28)、灵敏度为95.00%(38/40)、准确度为95.59%(65/68),均高于下肢静脉加压超声诊断的67.86%(19/28)、55.00%(22/40)、60.29%(41/68)以及心脏彩超诊断的64.29%(18/28)、47.50%(19/40)、54.41%(37/68),差异有统计学意义(χ^(2)=9.581、23.192、32.179,P均<0.05)。结论下肢静脉加压超声联合心脏彩超可明显提升肺血栓栓塞症的诊断效能。

超声引导椎板后阻滞在经皮椎体成形术中的应用

目的观察超声引导椎板后阻滞(RLB)在经皮椎体成形术(PVP)中的麻醉效果。方法选取该院2021年7月至2022年12月行PVP的骨质疏松性椎体压缩性骨折(OVCF)患者80例,采用随机数字表法分为观察组(R组)和对照组(L组),各40例。R组采用RLB麻醉,L组采用局部浸润麻醉,对比两组患者阻滞15 min后皮区感觉阻滞效果,术中补救镇痛率及舒芬太尼使用剂量,手术套件椎体穿刺时(T1)及注入骨水泥时(T2)的视觉模拟评分法(VAS)评分;记录患者气胸、血肿、感染及下肢肌力和感觉异常等并发症。结果两组患者麻醉15 min后皮区阻滞效果无明显差异(P>0.05);R组患者在T1[(0.98±0.92)分]及T2[(2.05±0.96)分]的VAS评分低于L组[(1.58±1.20)分和(2.63±1.13)分],差异有统计学意义(P<0.05);R组补救镇痛率(10.0%)及舒芬太尼使用剂量[(5.00±0.00)μg]均低于L组[27.5%和(6.82±2.52)μg],差异有统计学意义(P<0.05);除R组出现3例下腰部及臀部轻度麻木感外,两组患者均未出现气胸、血肿及感染等并发症。结论超声引导下RLB在PVP中的麻醉效果优于局部浸润麻醉,可作为PVP的麻醉方法选择。