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Endoscopic ultrasound-guided diagnosis and treatment of gastric varices 被引量:2
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作者 Jian Yang Yan Zeng Jun-Wen Zhang 《World Journal of Gastrointestinal Endoscopy》 2022年第12期748-758,共11页
Gastric varices(GV)represent a common and severe complication in patients with portal hypertension,commonly seen in patients with cirrhosis and severe pancreatic disease.Endoscopic ultrasonography is a safe and effica... Gastric varices(GV)represent a common and severe complication in patients with portal hypertension,commonly seen in patients with cirrhosis and severe pancreatic disease.Endoscopic ultrasonography is a safe and efficacious approach that can perform real-time ultrasonic scanning and intervention for the gastrointestinal submucosa,portal vein and its tributaries,and collateral circulations during direct endoscopic observation.Recently,various studies have been published about endoscopic ultrasound(EUS)-guided management of GV,mainly including diagnosis,treatment,and prognostic analysis.This article reviews published articles and guidelines to present the development process and current management of EUS-guided GV procedures. 展开更多
关键词 endoscopic ultrasound diagnosis treatment Gastric varices
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Colorectal cancer in geriatric patients: Endoscopic diagnosis and surgical treatment 被引量:1
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作者 Andreas Kirchgatterer Pius Steiner +6 位作者 Dietmar Hubner Eva Fritz Gerhard Aschl Josef Preisinger Maximilian Hinterreiter Bernhard Stadler Peter Knoflach 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第3期315-318,共4页
AIM: To investigate the prevalence of colorectal cancer in geriatrie patients undergoing endoscopy and to analyze their outcome. METHODS: All consecutive patients older than 80 years who underwent lower gastrointestin... AIM: To investigate the prevalence of colorectal cancer in geriatrie patients undergoing endoscopy and to analyze their outcome. METHODS: All consecutive patients older than 80 years who underwent lower gastrointestinal endoscopy between January 1995 and December 2002 at our institution were included. patients with endoscopic diagnosis of colorectal cancer were evaluated with respect to indication, localization and stage of cancer, therapeutic consequences, and survival. RESULTS: Colorectal cancer was diagnosed in 88 patients (6% of all endoscopies, 55 women and 33 men, mean age 85.2 years). Frequent indications were lower gastrointestinal bleeding (25%), anemia (24%) or sonographic suspicion of tumor (10%). Localization of cancer was predominantly the sigmoid colon (27%), the rectum (26%), and the ascending colon (20%). Stage Dukes A was rare (1%), but Dukes D was diagnosed in 22% of cases. Curative surgery was performed in 54 patients (61.4%), in the remaining 34 patients (38.6%) surgical treatment was not feasible due to malnutrition and asthenia or cardiopulmonary comorbidity (15 patients), distant metastases (11 patients) or refusal of operation (8 patients). patients undergoing surgery had a very low in-hospital mortality rate (2%). Operated patients had a one-year and three-year survival rate of 88% and 49%, and the survival rates for non-operated patients amounted to 46% and 13% respectively. CONCLUSION: Nearly two-thirds of 88 geriatrie patiente with endoscopic diagnosis of colorectal cancer underwent successful surgery at a very low perioperative mortality rate, resulting in significantly higher survival rates. Hence, the clinical relevance of lower gastrointestinal endoscopy and oncologic surgery in geriatrie patients is demonstrated. 展开更多
关键词 Colorectal cancer endoscopic diagnosis Surgical treatment
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Goblet cell carcinoid of the appendix:Six case reports
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作者 Toshiaki Toshima Ryo Inada +15 位作者 Shinya Sakamoto Eri Takeda Takahiro Yoshioka Kento Kumon Naoki Mimura Nobuo Takata Motoyasu Tabuchi Kazuyuki Oishi Takuji Sato Kenta Sui Takehiro Okabayashi Kazuhide Ozaki Toshio Nakamura Yuichi Shibuya Manabu Matsumoto Jun Iwata 《World Journal of Clinical Cases》 SCIE 2024年第22期5217-5224,共8页
BACKGROUND Goblet cell carcinoid(GCC)of the appendix is a rare tumor characterized by neuroendocrine and adenocarcinoma features.Accurate preoperative diagnosis is very difficult,with most patients complaining mainly ... BACKGROUND Goblet cell carcinoid(GCC)of the appendix is a rare tumor characterized by neuroendocrine and adenocarcinoma features.Accurate preoperative diagnosis is very difficult,with most patients complaining mainly of abdominal pain.Computed tomography shows swelling of the appendix,so diagnosis is usually made incidentally after appendectomy based on a preoperative diagnosis of appendicitis.Even if a patient undergoes preoperative colonoscopy,accurate endoscopic diagnosis is very difficult because GCC shows a submucosal growth pattern with invasion of the appendiceal wall.CASE SUMMARY Between 2017 and 2022,6 patients with GCC were treated in our hospital.The presenting complaint for 5 of these 6 patients was abdominal pain.All 5 patients underwent appendectomy,including 4 for a preoperative diagnosis of appendicitis and the other for diagnosis and treatment of an appendiceal tumor.The sixth patient presented with vomiting and underwent ileocecal resection for GCC diagnosed from preoperative biopsy.Although 2 patients with GCC underwent colonoscopy,no neoplastic changes were identified.Two of the six patients showed lymph node metastasis on pathological examination.As of the last followup(median:15 mo),all cases remained alive without recurrence.CONCLUSION As preoperative diagnosis of GCC is difficult,this possibility must be considered during surgical treatments for presumptive appendicitis. 展开更多
关键词 Goblet cell carcinoid APPENDIX Preoperative diagnosis endoscopic diagnosis Surgical treatment Case report
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Single balloon enteroscopy for endoscopic retrograde cholangiography in patients with Roux-en-Y hepaticojejuno anastomosis 被引量:2
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作者 Bohuslav Kianika Jan Lata +2 位作者 Ivo Novotny Petr Dítě Jirí Vaníek 《World Journal of Gastroenterology》 SCIE CAS 2013年第44期8047-8055,共9页
AIM:To evaluate single balloon enteroscopy in diagnostic and therapeutic endoscopic retrograde cholangiography(ERC)in patients with Roux-en-Y hepaticojejunoanastomosis(HJA).METHODS:The study took place from January 20... AIM:To evaluate single balloon enteroscopy in diagnostic and therapeutic endoscopic retrograde cholangiography(ERC)in patients with Roux-en-Y hepaticojejunoanastomosis(HJA).METHODS:The study took place from January 2009to December 2011 and we retrospectively assessed 15patients with Roux-en-Y HJA who had signs of biliary obstruction.In total,23 ERC procedures were performed in these patients and a single balloon videoen-teroscope(Olympus SIF Q 180)was used in all of the cases.A transparent overtube was drawn over the videoenteroscope and it freely moved on the working part of the enteroscope.Its distal end was equipped with a silicone balloon that was inflated by air from an external pump at a pressure of≤5.4 kPa.The technical limitations or rather the parameters of the single balloon enteroscope(working length-200 cm,diameter of the working channel-2.8 mm,absence of Albarran bridge)showed the need for special endoscopic instrumentation.RESULTS:Cannulation success was reached in diagnostic ERC in 12 of 15 patients.ERC findings were normal in 1 of 12 patients.ERC in the remaining 11 patients showed some pathological changes.One of these(cystic bile duct dilation)was subsequently resolved surgically.Endoscopic treatment was initialized in the remaining 10 patients(5 with HJA stenosis,2 with choledocholithiasis,and 3 with both).This treatment was successful in 9 of 10 patients.The endoscopic therapeutic procedures included:balloon dilatation of HJA stenosis-11 times(7 patients);choledocholitiasis extraction-five times(5 patients);biliary plastic stent placement-six times(4 patients);and removal of biliary stents placed by us-six times(4 patients).The mean time of performing a single ERC was 72 min.The longest procedure took 110 min and the shortest took34 min.This shows that it is necessary to allow for more time in individual procedures.Furthermore,these procedures require the presence of an anesthesiologist.We did not observe any complications in these 15 patients.CONCLUSION:This method is more demanding than standard endoscopic retrograde cholangiopancreatography due to altered postsurgical anatomy.However,it is effective,safe,and widens the possibilities of resolving biliary pathology. 展开更多
关键词 Single balloon ENTEROSCOPY endoscopic RETROGRADE CHOLANGIOGRAPHY ROUX-Y hepaticojejunoanastomosis endoscopic diagnosis endoscopic treatment
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Esophageal bronchogenic cyst excised by endoscopic submucosal tunnel dissection: A case report 被引量:3
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作者 Fen-Ming Zhang Hong-Tan Chen +2 位作者 Long-Gui Ning Yue Xu Guo-Qiang Xu 《World Journal of Clinical Cases》 SCIE 2020年第2期353-361,共9页
BACKGROUND Esophageal bronchogenic cyst(EBC) is a rare congenital disease that is difficult to diagnose preoperatively, and treatment remains controversial.CASE SUMMARY We report a 53-year-old Chinese woman hospitaliz... BACKGROUND Esophageal bronchogenic cyst(EBC) is a rare congenital disease that is difficult to diagnose preoperatively, and treatment remains controversial.CASE SUMMARY We report a 53-year-old Chinese woman hospitalized in our hospital following the discovery of a submucosal protruding mass of the esophagus by upper endoscopy. A preliminary diagnosis of EBC was made by endoscopic ultrasonography(EUS), and treatment was accomplished by endoscopic submucosal tunnel dissection(ESTD). The pathological results verified the diagnosis. No scar changes or cystic lesion within the original lesion were found under EUS after a 3-mo follow-up.CONCLUSION EUS is valuable for the preliminary diagnosis of EBC and surveillance. ESTD is a safe and effective treatment for EBC. Further evaluation of complications and long-term follow-ups are required. 展开更多
关键词 Esophageal bronchogenic cyst endoscopic ultrasonography endoscopic submucosal tunnel dissection diagnosis and treatment Case report
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Clinical usefulness of single-balloon endoscopy in patients with previously incomplete colonoscopy
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作者 Kiyonori Kobayashi Miyuki Mukae +3 位作者 Taishi Ogawa Kaoru Yokoyama Miwa Sada Wasaburo Koizumi 《World Journal of Gastrointestinal Endoscopy》 CAS 2013年第3期117-121,共5页
AIM:To evaluate the clinical usefulness of singleballoon endoscopy(SBE) in patients in whom a colonoscope was technically difficult to insert previously.METHODS:The study group comprised 15 patients(8 men and 7 women)... AIM:To evaluate the clinical usefulness of singleballoon endoscopy(SBE) in patients in whom a colonoscope was technically difficult to insert previously.METHODS:The study group comprised 15 patients(8 men and 7 women) who underwent SBE for colonoscopy(30 sessions).The number of SBE sessions was 1 in 7 patients,2 in 5 patients,3 in 1 patient,4 in 1 patient,and 6 in 1 patient.In all patients,total colonoscopy was previously unsuccessful.The reasons for difficulty in scope passage were an elongated colon in 6 patients,severe intestinal adhesions after open surgery in 4,an elongated colon and severe intestinal adhesions in 2,a left inguinal hernia in 2,and multiple diverticulosis of the sigmoid colon in 1.Three endoscopists were responsible for SBE.The technique for inserting SBE in the colon was basically similar to that in the small intestine.The effectiveness of SBE was assessed on the basis of the success rate of total colonoscopy and the presence or absence of complications.We also evaluated the diagnostic and treatment outcomes of colonoscopic examinations with SBE.RESULTS:Total colonoscopy was successfully accomplished in all sessions.The mean insertion time to the cecum was 22.9 ± 8.9 min(range 9 to 40).Abnormalities were found during 21 sessions of SBE.The most common abnormality was colorectal polyps(20 sessions),followed by radiation colitis(3 sessions) and diverticular disease of the colon(3 sessions).Colorectal polyps were resected endoscopically in 15 sessions.A total of 42 polyps were resected endoscopically,using snare polypectomy in 32 lesions,hot biopsy in 7 lesions,and endoscopic mucosal resection in 3 lesions.Fifty-six colorectal polyps were newly diagnosed on colonoscopic examination with SBE.Histopathologically,these lesions included 2 intramucosal cancers,42 tubular adenomas,and 2 tubulovillous adenomas.The mean examination time was 48.2 ± 20.0 min(range 25 to 90).Colonoscopic examination or endoscopic treatment with SBE was not associated with any serious complications.CONCLUSION:SBE is a useful and safe procedure in patients in whom a colonoscope is technically difficult to insert. 展开更多
关键词 Single-balloon ENDOSCOPY COLONOSCOPY DIFFICULT to insert diagnosis endoscopic treatment
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Extensively infarcted giant solitary hamartomatous polyp treated with endoscopic full-thickness resection:A case report
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作者 Lu Ye Ji-Hong Zhong +4 位作者 Yong-Pan Liu Dan-Dan Chen Si-Yi Ni Fa-Quan Peng Shuo Zhang 《World Journal of Clinical Cases》 SCIE 2023年第8期1782-1787,共6页
BACKGROUND Solitary hamartomatous polyps(SHPs)are rare lesions.Endoscopic full-thickness resection(EFTR)is a highly efficient and minimally invasive endoscopic procedure that benefits from complete lesion removal and ... BACKGROUND Solitary hamartomatous polyps(SHPs)are rare lesions.Endoscopic full-thickness resection(EFTR)is a highly efficient and minimally invasive endoscopic procedure that benefits from complete lesion removal and high safety.CASE SUMMARY A 47-year-old man was admitted to our hospital after experiencing hypogastric pain and constipation for over fifteen days.Computed tomography and endoscopy revealed a giant pedunculated polyp(approximately 18 cm long)in the descending and sigmoid colon.This is the largest SHP reported to date.Having considered the condition of the patient and mass growth,the polyp was removed using EFTR.CONCLUSION On the basis of clinical and pathological evaluations,the mass was considered an SHP. 展开更多
关键词 Solitary hamartomatous polyp endoscopic full-thickness resection diagnosis treatment Descending colon Case report
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Recent advances in the mechanisms of development and the early diagnosis and treatment of esophageal cancer
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作者 Donghui Jin Yousheng Mao 《Holistic Integrative Oncology》 2023年第1期323-329,共7页
The occurrence and development of esophageal cancer(EC)is a multi-stage process involving from inflammation to invasive cancer.However,this process is very complex,and so far there are few relevant studies to reveal t... The occurrence and development of esophageal cancer(EC)is a multi-stage process involving from inflammation to invasive cancer.However,this process is very complex,and so far there are few relevant studies to reveal this process.Early diagnosis and treatment of EC is the focus of the early diagnosis and treatment of malignant tumors project in China.How to screen EC in a lower cost and more efficient way deserves to be explored.Here,we reviewed the recent advances in the mechanisms of the occurrence and development,and early diagnosis and treatment of EC. 展开更多
关键词 Esophageal premalignant lesion Esophageal cancer Biomarkers PATHOGENESIS Early diagnosis endoscopic treatment
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胆胰结合部疾病的内镜诊疗
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作者 李汛 仲富鹏 岳平 《西部医学》 2024年第9期1256-1259,共4页
胆胰结合部复杂的解剖结构决定了其在人体的重要作用,胆胰结合部解剖异常及功能紊乱都会造成各种疾病的发生发展,包括良性疾病及交界性疾病、恶性疾病。良性疾病如胆管下端狭窄、胆管结石、Oddi括约肌功能紊乱、自身免疫性胆道疾病等;... 胆胰结合部复杂的解剖结构决定了其在人体的重要作用,胆胰结合部解剖异常及功能紊乱都会造成各种疾病的发生发展,包括良性疾病及交界性疾病、恶性疾病。良性疾病如胆管下端狭窄、胆管结石、Oddi括约肌功能紊乱、自身免疫性胆道疾病等;交界性疾病包括胰腺导管内乳头状黏液性肿瘤(IPMN)、胰腺实性假乳头状瘤(SPN)等胰腺囊性肿瘤以及难以界定性质的疾病;恶性疾病主要包括胆道、十二指肠、胰腺来源的恶性肿瘤。随着内镜技术的迅猛发展,胆胰结合部神秘面纱逐渐或正在被人类揭开,人们对胆胰结合部的研究更加深入,胆胰结合部疾病的诊治有了长足的进步。但是,Oddi括约肌功能保护、低度恶性肿瘤的内镜下治疗、功能保留的新术式等方面仍然有许多具有争议的问题等待解决,胆胰结合部仍然是外科医生值得去深入探索的区域。 展开更多
关键词 胆胰结合部 内镜诊疗 外科手术 经内镜逆行胰胆管造影
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基于行为转变理论指导下的健康教育对消化内镜诊疗患者肠道准备质量和心理压力的影响 被引量:1
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作者 杨春丽 张思宇 +1 位作者 卞孝平 王凯 《现代医药卫生》 2024年第6期968-971,共4页
目的探究基于行为转变理论(TTM)指导下的健康教育对消化内镜诊疗患者肠道准备质量、心理压力的影响。方法选取郑州市第二人民医院2021年2月至2022年10月消化内镜诊疗患者134例,依据随机数字表法分为观察组(n=67)、对照组(n=67)。对照组... 目的探究基于行为转变理论(TTM)指导下的健康教育对消化内镜诊疗患者肠道准备质量、心理压力的影响。方法选取郑州市第二人民医院2021年2月至2022年10月消化内镜诊疗患者134例,依据随机数字表法分为观察组(n=67)、对照组(n=67)。对照组实施常规护理干预,观察组实施基于TTM指导下的健康教育干预,统计比较2组肠道准备质量[波士顿肠道准备量表(BBPS)、渥太华肠道准备评分量表(OBPS)]、心理压力[心理弹性量表(CD-RISC)]、并发症(恶心、呛咳、腹痛、腹胀)、生活质量[日常生活能力量表(ADL)]、护理满意度。结果干预后,观察组BBPS、CD-RISC、ADL评分高于对照组,OBPS评分低于对照组,差异有统计学意义(P<0.05);干预后,观察组并发症发生率为1.49%,低于对照组11.94%,差异有统计学意义(P<0.05);干预后,观察组满意度为100.00%,高于对照组的88.06%,差异有统计学意义(P<0.05)。结论基于TTM指导下的健康教育能调节消化内镜诊疗患者心理压力,提高肠道准备质量,减少并发症发生,提高生活质量,提升护理满意度。 展开更多
关键词 基于行为转变理论 6S管理模式 消化内镜诊疗 肠道准备质量 心理压力
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人文关怀的舒适护理对消化内镜诊疗患者舒适度、负性情绪及护理满意度的影响 被引量:2
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作者 杨春丽 张思宇 +1 位作者 卞孝平 王凯 《四川生理科学杂志》 2024年第3期493-496,共4页
目的:探究人文关怀的舒适护理对消化内镜诊疗患者舒适度、负性情绪及护理满意度的影响.方法:选取郑州市第二人民医院2022年2月至2023年2月期间收治的消化内镜诊疗患者83例,随机将其分成对照组(n=41)、干预组(n=42).对照组实施常规护理,... 目的:探究人文关怀的舒适护理对消化内镜诊疗患者舒适度、负性情绪及护理满意度的影响.方法:选取郑州市第二人民医院2022年2月至2023年2月期间收治的消化内镜诊疗患者83例,随机将其分成对照组(n=41)、干预组(n=42).对照组实施常规护理,干预组在对照组基础上实施人文关怀的舒适护理,对比两组不良反应发生情况、舒适度[舒适状况量表(General Comfort Questionnaire,GCQ)]、负性情绪[汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)]、护理效果、护理满意度.结果:干预组不良反应发生率低于对照组(P<0.05);麻醉前10 min,干预组GCQ、HAMA、HAMD评分变化幅度大于对照组(P<0.05);干预组护理有效率及护理满意率均高于对照组(P<0.05).结论:人文关怀的舒适护理可减少不良反应的发生提高患者舒适度,减轻负性情绪,增强护理效果,提高护理满意度. 展开更多
关键词 人文关怀 舒适护理 消化内镜诊疗 舒适度 负性情绪
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内镜诊疗时机对急诊肝硬化食管胃底静脉曲张破裂出血患者救治效果及预后的影响
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作者 陈正彦 刘君颖 +5 位作者 张然 蒋举峰 贺照霞 刘玮 余海洋 张红娟 《河南医学研究》 CAS 2024年第13期2339-2343,共5页
目的探讨内镜诊疗时机对急诊肝硬化食管胃底静脉曲张破裂出血(EGVB)患者救治效果及预后的影响。方法选取2018年10月至2023年2月河南中医药大学第一附属医院收治的高危急诊肝硬化EGVB患者96例进行回顾性分析和随访,根据内镜诊疗时机不同... 目的探讨内镜诊疗时机对急诊肝硬化食管胃底静脉曲张破裂出血(EGVB)患者救治效果及预后的影响。方法选取2018年10月至2023年2月河南中医药大学第一附属医院收治的高危急诊肝硬化EGVB患者96例进行回顾性分析和随访,根据内镜诊疗时机不同分为A组(35例,入院后0~6 h内行内镜诊疗)、B组(29例,入院后6~12 h内行内镜诊疗)和C组(32例,入院后12~24 h内行内镜诊疗),比较3组治疗情况(出血部位检出率、止血成功率、再出血率、死亡率)、输血量、住院时间、住院费用。并根据患者生存情况分为存活组(86例)和死亡组(10例),比较两组临床资料,采用多因素logistic回归分析影响高危急诊肝硬化EGVB患者预后的因素。结果A组和B组出血部位检出率高于C组(P<0.05);A组和B组比较,差异无统计学意义(P>0.05);B组止血成功率高于A组和C组(P<0.05);A组和C组比较,差异无统计学意义(P>0.05);3组再出血率和死亡率比较,差异无统计学意义(P>0.05)。3组输血量、住院时间、住院费用比较,差异无统计学意义(P>0.05)。存活组和死亡组腹水征、血钠、ALT、AST比较,差异有统计学意义(P<0.05);多因素logistic回归分析显示,腹水征、血钠降低是影响高危急诊肝硬化EGVB预后的危险因素(P<0.05)。结论高危急诊肝硬化EGVB患者于入院后6~12 h内行内镜诊疗可提高患者救治效果,但入院后0~6 h内行内镜诊疗需更多临床循证证据,且腹水征、血钠降低是影响患者预后的因素。 展开更多
关键词 急诊 高危 肝硬化 食管胃底静脉曲张破裂出血 内镜诊疗 时机 救治效果 预后
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DR联合内窥镜治疗非洲狮胃内异物
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作者 周攀龙 陈玎玎 +4 位作者 卞庆松 郑应婕 刘龙海 于翔 杨忠兴 《野生动物学报》 北大核心 2024年第4期881-884,共4页
杭州动物园1头成年非洲狮(Panthera leo)出现食欲废绝、呕吐等症状,经临床诊断、呕吐物检测、血常规检测、血清生化检测、DR影像检查和内窥镜检查,确诊为因吞食毛线帽导致的胃内异物,经内窥镜引导取出异物后,通过调整饲喂模式和药物治... 杭州动物园1头成年非洲狮(Panthera leo)出现食欲废绝、呕吐等症状,经临床诊断、呕吐物检测、血常规检测、血清生化检测、DR影像检查和内窥镜检查,确诊为因吞食毛线帽导致的胃内异物,经内窥镜引导取出异物后,通过调整饲喂模式和药物治疗等方式,最终康复。研究结果可为大型猫科(Felidae)动物误食异物的防治提供参考。 展开更多
关键词 大型猫科动物 胃内异物 DR诊断 内窥镜治疗 非洲狮
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消化内镜诊疗后低血糖发生风险及影响因素
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作者 陈连英 梁银霞 +3 位作者 庞雪兰 潘玉升 韦力予 韦薇 《循证护理》 2024年第8期1447-1450,共4页
目的:探讨内镜诊疗后禁食病人低血糖发生风险的现状及其影响因素。方法:选取2019年8月—2021年4月入住我院老年病学消化内科的374例内镜诊疗后须禁食的病人为研究对象,收集其一般资料、内镜下治疗方式、禁食时间以及血糖等信息,采用Logi... 目的:探讨内镜诊疗后禁食病人低血糖发生风险的现状及其影响因素。方法:选取2019年8月—2021年4月入住我院老年病学消化内科的374例内镜诊疗后须禁食的病人为研究对象,收集其一般资料、内镜下治疗方式、禁食时间以及血糖等信息,采用Logistic回归分析进行影响因素分析。结果:47例病人出现低血糖,低血糖发生率为12.6%;其中体质指数(BMI)、合并糖尿病、禁食时间是内镜诊疗后禁食病人发生低血糖的危险因素(P<0.05)。结论:内镜诊疗术后禁食病人若合并糖尿病、低BMI或禁食时间较长时应给予相应护理措施,及时预防并处理低血糖的发生。 展开更多
关键词 内镜诊疗 禁食病人 低血糖 影响因素 护理
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海藻酸钠粘膜下注射粘膜隆起效果的实验研究
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作者 黄颂 韩荣双 +3 位作者 刘明欣 闵丛丛 田字彬 齐兴四 《现代消化及介入诊疗》 2024年第9期1061-1067,共7页
目的本文以粘膜隆起高度及持续时间为指标,以生理盐水(NS)和0.4%的透明质酸钠(SH)分别作为阴性和阳性对照,评估注射不同分子量及浓度的海藻酸钠(SA)溶液的粘膜隆起效果,探讨SA用于内镜粘膜下剥离术(ESD)的可行性和有效性。方法①在新鲜... 目的本文以粘膜隆起高度及持续时间为指标,以生理盐水(NS)和0.4%的透明质酸钠(SH)分别作为阴性和阳性对照,评估注射不同分子量及浓度的海藻酸钠(SA)溶液的粘膜隆起效果,探讨SA用于内镜粘膜下剥离术(ESD)的可行性和有效性。方法①在新鲜离体猪胃的粘膜下,注入相同剂量不同分子量和不同浓度的SA溶液,观察并测量各组注射后所致粘膜隆起的高度及随时间的变化;②在活体猪胃中注射分子量为80 KDa、浓度为0.3%的SA溶液以模拟ESD术,观察和比较完整剥离相同大小的粘膜的过程,并进行病理组织学检查。结果离体实验中,注射分子量80 kDa的低浓度SA溶液时与阴对照组无显著差异,而当浓度≥0.3%时,在观察时间内隆起高度随时间延长逐渐下降,30 min的隆起高度为0.783±0.029 cm,低于0 min的高度1.083±0.104 cm;当SA的分子量为100 kDa、150 KDa和250 KDa,浓度为0.1%~0.5%时,其隆起最佳高度和保持时间与浓度和分子量均无显著依赖性,其隆起最佳高度均在0.7~0.8 cm,保持时间超过30 min,均显著优于NS(P<0.001),与阳性对照无显著差异(P>0.05)。猪体内实验中,分子量为80 kDa浓度为0.3%的SA溶液、SH溶液均可以明显地隆起粘膜、分离组织,且均保持了良好的粘膜隆起高度及隆起维持时间。在粘膜剥离的过程中,两例ESD术均完整剥离粘膜,未发生穿孔、出血等并发症。且根据组织病理学检查,海藻酸钠溶液对粘膜层无损伤作用。结论当SA溶液达到一定分子量及浓度时,粘膜下注射SA溶液可以较好的维持粘膜隆起高度,与SH对照组无明显差异,有望辅助ESD手术过程中粘膜组织的剥离切除。因此,海藻酸钠为临床中潜在的粘膜下注射液。 展开更多
关键词 消化道早癌的内镜下诊治 内镜下粘膜下剥离术 内镜下粘膜切除术 黏膜下注射液 海藻酸钠
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上海市护理学会《消化内镜诊疗前消化道准备》团体标准解读
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作者 陈萃 宋燕 《上海护理》 2024年第6期1-4,共4页
上海市护理学会于2023年11月29日发布了《消化内镜诊疗前消化道准备》团体标准,规范了消化内镜诊疗前消化道准备的护理技术标准,内容包括基本要求、评估要点、护理指导、效果评价及不良反应护理。文章对该团体标准中提出的要求与建议进... 上海市护理学会于2023年11月29日发布了《消化内镜诊疗前消化道准备》团体标准,规范了消化内镜诊疗前消化道准备的护理技术标准,内容包括基本要求、评估要点、护理指导、效果评价及不良反应护理。文章对该团体标准中提出的要求与建议进行解读,以期为临床护士更好地理解及应用标准、规范临床实践提供参考。 展开更多
关键词 消化内镜诊疗 消化道准备 团体标准 解读
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胃小间质瘤的诊断及内镜下治疗研究进展
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作者 陈德玲(综述) 汤丽平(审校) 《现代医药卫生》 2024年第18期3211-3216,共6页
胃肠间质瘤(GIST)是一种好发于消化道的间叶源性肿瘤,出现在胃内部且直径小于2 cm的GIST称为胃小间质瘤(sGST)。此类间质瘤多在体检中偶然发现,其通常为良性或惰性,由于其有恶性潜能,故其治疗标准仍存在争议。目前,较多研究证实多种内... 胃肠间质瘤(GIST)是一种好发于消化道的间叶源性肿瘤,出现在胃内部且直径小于2 cm的GIST称为胃小间质瘤(sGST)。此类间质瘤多在体检中偶然发现,其通常为良性或惰性,由于其有恶性潜能,故其治疗标准仍存在争议。目前,较多研究证实多种内镜下技术均可用于sGST治疗,且与外科手术、腹腔镜相比,具有微创、并发症少、费用低等优点,患者受益更多。该文将针对sGST的诊断及治疗措施等方面进行综述,以期为该病患者及临床医生提供更积极的治疗选择。 展开更多
关键词 胃肠道间质瘤 胃小间质瘤 诊断 内镜治疗 综述
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Single-center retrospective analysis of efficacy and safety of daratumumab plus dexamethasone for light chain amyloidosis nephropathy
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作者 薛韩 《China Medical Abstracts(Internal Medicine)》 2024年第2期112-113,共2页
Objective To analyze the efficacy and safety of daratumumab plus dexamethasone in the treatment of renal injury patients with light chain amyloidosis,and to provide clinical reference.Methods It was a single center re... Objective To analyze the efficacy and safety of daratumumab plus dexamethasone in the treatment of renal injury patients with light chain amyloidosis,and to provide clinical reference.Methods It was a single center retrospective observational study.The clinical data before and after daratumumab treatment of renal injury patients with light chain amyloidosis treated with daratumumab plus dexamethasone from December 2021 to August 2022 were retrospectively collected. 展开更多
关键词 diagnosis endoscopic treatment
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内镜逆行胰胆管造影在胰胆管合流异常诊治中的应用
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作者 吴晨(综述) 王凌云(审校) 《济宁医学院学报》 2024年第2期158-160,共3页
胰胆管合流异常(PBM)是一种胆胰管发育异常的先天性畸形,长期发展会导致胆胰系统肿瘤的发生,因此早发现早诊治是一个重点。内镜逆行胰胆管造影术(ERCP)作为PBM的诊断金标准,不仅能缓解急性临床症状,而且可以作为后期外科手术的桥接手段。
关键词 胰胆管合流异常 内镜下逆行胰胆管造影术 诊断 治疗
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以慢性阻塞性肺疾病入院的复发性化脓性胆管炎1例
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作者 范学娟 王恩允 《中国当代医药》 CAS 2024年第18期151-154,共4页
复发性化脓性胆管炎是一种危重的疾病,起病急骤,病情进展迅速,可导致寒战、高热、腹痛、休克等症状,病情复杂多变,给患者生命健康带来极大的威胁。近年来随着影像学的发展,复发性化脓性胆管炎的确诊率及治疗成功率也逐渐提高。但由于复... 复发性化脓性胆管炎是一种危重的疾病,起病急骤,病情进展迅速,可导致寒战、高热、腹痛、休克等症状,病情复杂多变,给患者生命健康带来极大的威胁。近年来随着影像学的发展,复发性化脓性胆管炎的确诊率及治疗成功率也逐渐提高。但由于复发性化脓性胆管炎初期疾病表现有时不典型,且容易与其他疾病重叠,导致病情加重,甚至危及患者生命。因此如何在短时间内确诊并给予及早干预改善患者预后,对临床医生仍是很大的挑战。本文通过报道潍坊医学院附属医院1例初诊为慢性阻塞性肺疾病急性发作的患者,入院后根据患者病情变化及辅助检查结果确诊为急性梗阻性化脓性胆管炎,经内镜逆行胰胆管造影取石及抗感染治疗病情好转后再次复发后救治成功的案例,为临床医师诊治复发性化脓性胆管炎提供治疗思路。 展开更多
关键词 复发性化脓性胆管炎 慢性阻塞性肺疾病 内镜逆行胰胆管造影取石 诊疗思路
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