obstruction

梗阻
  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    梗阻是晚期结直肠癌的常见并发症。这项研究的目的是调查安全性,功效,经导管动脉灌注化疗联合碘油化疗栓塞治疗晚期结直肠癌合并梗阻的可行性。
    这项回顾性分析是使用在我们中心接受动脉灌注化疗联合碘油化疗栓塞治疗的晚期结直肠癌患者的临床资料进行的。根据无梗阻生存期和总生存期评估治疗效果,监测治疗并发症。
    纳入54例结直肠癌合并梗阻患者。所有患者均成功行经导管动脉灌注联合碘油化疗栓塞治疗。给予的平均碘油剂量为2.62±1.45ml(0.5-5.5ml)。无穿孔、肿瘤播散等严重并发症发生。临床成功率为83.3%(45/54)。治疗后一个月,客观有效率(ORR)和疾病控制率(DCR)分别为66.67%和88.9%,分别。中位无梗阻生存期为5.0个月。无严重不良事件发生。截至最后一次随访,6名患者存活,44死了4人失去了随访。
    我们的研究结果表明,经导管动脉灌注化疗联合碘油化疗栓塞治疗晚期结直肠癌合并梗阻是安全有效的。它可能作为晚期结直肠癌合并梗阻患者的一种新的治疗策略。
    UNASSIGNED: Obstruction is a common complication of advanced colorectal cancer. This study was aimed at investigating the safety, efficacy, and feasibility of transcatheter arterial perfusion chemotherapy combined with lipiodol chemoembolization for treating advanced colorectal cancer complicated by obstruction.
    UNASSIGNED: This retrospective analysis was conducted using clinical data of patients with advanced colorectal cancer who received arterial infusion chemotherapy combined with lipiodol chemoembolization treatment at our center. Treatment efficacy was evaluated in terms of obstruction-free survival and overall survival, and treatment complications were monitored.
    UNASSIGNED: Fifty-four patients with colorectal cancer complicated by obstruction were included. All patients successfully underwent transcatheter arterial infusion combined with lipiodol chemoembolization treatment. The average lipiodol dose administered was 2.62 ± 1.45 ml (0.5-5.5 ml). No serious complications such as perforation or tumor dissemination occurred. The clinical success rate was 83.3% (45/54). One month after treatment, the objective response rate (ORR) and disease control rate (DCR) were 66.67% and 88.9%, respectively. The median obstruction-free survival was 5.0 months. No serious adverse events occurred. As of the last follow-up, 6 patients survived, 44 died, and 4 were lost to follow-up.
    UNASSIGNED: Our findings revealed that transcatheter arterial infusion chemotherapy combined with lipiodol chemoembolization is safe and effective for treating advanced colorectal cancer complicated by obstruction. It may serve as a new treatment strategy for patients with advanced colorectal cancer complicated by obstruction.
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  • 文章类型: Case Reports
    本病例报告描述一名80岁女性患者因腹胀入院急诊,腹痛,呕血持续三天.术后病理检查确诊为腹膜癌。的发生,诊断,治疗,并详细介绍了原发性腹膜癌(PPC)的预后。PPC是一种起源于原发性腹膜间皮组织的癌症,在腹部和骨盆区域引起弥漫性恶性肿瘤。由于本病缺乏特异性的临床表现,因此强调早期诊断和治疗的重要性。文章还提到了这种类型癌症的组织学来源以及术前腹腔化疗在提高PPC治疗疗效方面的优势。最后,强调了综合治疗方法和熟练使用靶向治疗技术对提高PPC治疗结局的重要性.
    This case report describes an 80-year-old female patient admitted to the emergency department due to abdominal distension, abdominal pain, and hematemesis persisting for three days. Subsequent postoperative pathological examination confirmed the diagnosis of peritoneal cancer. The occurrence, diagnosis, treatment, and prognosis of primary peritoneal cancer (PPC) are presented in detail. PPC is a type of cancer originating from the primary peritoneal mesothelium organization, causing diffuse malignant tumors in the abdominal and pelvic regions. Due to the lack of specific clinical manifestations for this disease, the importance of early diagnosis and treatment is hereby emphasized. The article also mentions the histological source of this type of cancer and the advantages of preoperative intraperitoneal chemotherapy in improving the efficacy of PPC treatment. Finally, the importance of a comprehensive treatment approach and proficient use of targeted therapy techniques are highlighted to enhance the treatment outcomes of PPC.
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  • 文章类型: Journal Article
    UNASSIGNED: Left brachiocephalic vein (LBV) obstruction is a common complication in patients undergoing hemodialysis. This study aimed to compare the clinical characteristics and outcomes of patients with LBV obstruction who underwent percutaneous angioplasty or stenting.
    UNASSIGNED: We performed a retrospective study of 67 hemodialysis patients with LBV stenosis or occlusion who underwent percutaneous transluminal angioplasty (PTA; n = 25) or percutaneous transluminal stenting (PTS; n = 42). We compared the clinical characteristics, lesion features, and patency between the two groups of patients.
    UNASSIGNED: The average age, sex, smoking history, body mass index, obstruction period, comorbidities, and clinical manifestations were comparable between the PTA and PTS groups. Prior ipsilateral catheterization was less common in the PTS group than in the PTA group (14.3% vs 36.0%, p < 0.05). Smaller sized balloons were used in the PTS group than in the PTA group (p < 0.05). The overall primary patency rates were similar between the two groups, whereas the secondary patency rate in the PTS group was higher than that in the PTA group (p < 0.05). The average age, sex, smoking history, body mass index, obstruction period, prior ipsilateral catheterization, comorbidities, and types of lesions were comparable between patients with or without restenosis, while patients with restenosis had a higher percentage of high venous pressure than those without restenosis (87.5% vs 60.5%, p < 0.05).
    UNASSIGNED: The primary patency rates were similar in the angioplasty and the stenting groups. Stenting has a significantly higher secondary patency rate than angioplasty alone for treating LBV obstruction and is required more commonly in patients without prior ipsilateral catheterization.
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  • 文章类型: Journal Article
    Budd-Chiari综合征(BCS)和窦阻塞综合征(SOS)是两种主要的肝脏血管疾病,两者均可导致门静脉高压相关并发症,但是他们的阻塞位置不同。BCS是指从肝静脉到下腔静脉与右心房交界处的阻塞,这是窦后门静脉高压症的主要病因;相比之下,SOS的特点是肝窦和末端静脉水平的阻塞,这是窦性门静脉高压症的一个原因.两者都会导致肝充血并危及生命的并发症,尤其是急性肝功能衰竭和慢性门静脉高压症,并在成像和临床表现方面分享一些相似的特征,但是他们有不同的风险因素,管理策略,和预后。在这里,本文回顾了目前的证据,然后总结了原发性BCS和SOS在危险因素方面的差异,临床特征,诊断,和治疗。
    Budd-Chiari syndrome (BCS) and sinusoidal obstruction syndrome (SOS) are two major vascular disorders of the liver, of which both can cause portal hypertension related complications, but their locations of obstruction are different. BCS refers to the obstruction from the hepatic vein to the junction between the inferior vena cava and right atrium, which is the major etiology of post-sinusoidal portal hypertension; by comparison, SOS is characterized as the obstruction at the level of hepatic sinusoids and terminal venulae, which is a cause of sinusoidal portal hypertension. Both of them can cause hepatic congestion with life-threatening complications, especially acute liver failure and chronic portal hypertension, and share some similar features in terms of imaging and clinical presentations, but they have heterogeneous risk factors, management strategy, and prognosis. Herein, this paper reviews the current evidence and then summarizes the difference between primary BCS and SOS in terms of risk factors, clinical features, diagnosis, and treatment.
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  • 文章类型: Journal Article
    与干线上的铁路通信服务要求相比,站、场等热点地区的需求在服务类型和带宽方面更加复杂,其中铁路专用移动通信系统,如5G-R等专用频率支持,无法满足整个通信需求。因此,需要采用其他无线电通信技术作为补充,其中毫米波通信系统是一项很有前途的技术,特别是列车和轨道之间的大带宽通信。然而,对于铁路编组站场景,缺乏对28GHz毫米波信道特性的评估。在本文中,深入分析了铁路编组站毫米波传播场景,并将其分为三类典型,基于此,使用配备有28GHz毫米波相控阵天线的SDR信道探测系统进行测量活动。在LabVIEW平台下自行开发的软件用于推导通道参数。关于MPC数参数之间关系的结论,时间传播,接收到的功率和位置,以及接触网等典型障碍物的影响,相邻的机车,和建筑物被绘制。本文的统计结果和结论有助于促进未来铁路编组站毫米波通信系统的设计和性能评估,也可以进一步扩展和应用于6G毫米波利用和其他未来通信技术的研究。
    Compared with railway communication service requirements on the mainline, requirements in hotspots such as stations and yards are more complicated in terms of service types as well as bandwidth, of which railway-dedicated mobile communication systems such as 5G-R facilitated with dedicated frequency support cannot meet the entire communication requirements. Therefore, other radio-communication technologies need to be adopted as a supplement, among which the mmWave communication system is a promising technology, especially for large bandwidth communication between train and trackside. However, there is a lack of evaluation of the 28 GHz mmWave channel characteristics for the railway marshaling yard scenario. In this paper, the railway marshaling yard mmWave propagation scenario is deeply analyzed and classified into three typical categories, based on which, a measurement campaign is conducted using an SDR channel sounding system equipped with a 28 GHz mmWave phased-array antenna. A self-developed software under the LabVIEW platform is used to derive the channel parameters. Conclusions on the relationship between the parameters of MPC numbers, time-spread, and received power and position, as well as the impact of typical obstructions such as the Catenary, adjacent locomotives, and buildings are drawn. The statistical results and conclusions of this paper are helpful for facilitating the design and performance evaluation of future mmWave communication systems for railway marshaling yards and can also be further extended and applied to the research of mmWave utilization in 6G and other future communication technologies for more scenarios.
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  • 文章类型: Case Reports
    背景:Jackstone是尿路中罕见的结石,具有类似玩具千斤顶的特征外观。据报道,它们几乎总是发生在膀胱中,我们首先报告了一例罕见的位于阻塞的肾萼中的夹风岩。
    方法:我们报告了一名46岁的男性,无痛性肉眼血尿和左侧腹疼痛。泌尿系计算机断层扫描显示鹿角状结石和继发性肾积水。在其中一个扩张的肾萼中发现了一个带有辐射分支的夹心石。术中进行经皮肾镜取石术并记录内镜图像。术后结石成分分析显示其为草酸钙一水合物结石。
    结论:结石可发生在膀胱以外的肾脏集合系统。独特的外观和影像学表现是诊断结石的最重要因素,需要进一步探索形成机制。
    BACKGROUND: Jackstone is a rare entity of calculi in urinary tracts and has the characteristic appearance resembling toy jacks. They are nearly always reported to occur in the urinary bladder, we first report a rare case of jackstone located in the obstructed renal calyx.
    METHODS: We report a 46-year-old man presenting with intermittent, painless gross hematuria and left flank pain. Urinary computed tomography revealed staghorn stones and secondary hydronephrosis. A jackstone with radiating branches was found in one of the dilated renal calyx. Percutaneous nephrolithotomy was performed and endoscopic images were recorded during the operation. Postoperative stone composition analysis revealed it as calcium oxalate monohydrate stones.
    CONCLUSIONS: Jackstones can occur in the renal collecting system besides the bladder. The unique appearance and imaging manifestations are the most important factors in the diagnosis of jackstones, and further exploration of the formation mechanism is required.
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  • 文章类型: Journal Article
    腺样体肥大(AH)是一种由于腺样体增大而导致的阻塞性疾病,导致嘴巴呼吸,鼻塞,打鼾和/或不安的睡眠。虽然可靠的诊断技术,如外侧软组织X射线成像或柔性鼻咽镜检查,在一般实践中被广泛采用,气道阻塞对鼻腔气流和药物气雾剂吸入的实际影响尚不清楚.在这项研究中,通过基于实际的3岁鼻气道和AH的术前和术后模型进行虚拟比较,分析了腺样体肥大对气流和微米颗粒吸入暴露特征的影响.更具体地说,详细的比较集中在解剖形状的变化,整体气流和嗅觉通风,进行了整体和局部区域的相关颗粒沉积。我们的结果表明,腺样体组织的扩大可以显着改变气流场。通过几乎切除扩大的组织并恢复气道,恢复了峰值速度和壁面剪应力,嗅觉通风显著改善(就局部通风速度而言,改善了16~63%)。此外,颗粒沉积结果表明,带有AH的鼻气道表现出更高的颗粒过滤趋势,沿底部区域和腺样体组织区域均观察到密集堆积的沉积热点。而对于术后模型,沉积曲线向右移动。局部沉积效率结果表明,腺样体切除术(腺样体去除)后,可以将更多惯性较大的颗粒输送到目标受影响的区域。研究结果有望为腺样体切除术后的腺样体切除术计划和气雾剂治疗提供科学依据。这可以大大改善目前的临床治疗结果。
    Adenoid hypertrophy (AH) is an obstructive condition due to enlarged adenoids, causing mouth breathing, nasal blockage, snoring and/or restless sleep. While reliable diagnostic techniques, such as lateral soft tissue x-ray imaging or flexible nasopharyngoscopy, have been widely adopted in general practice, the actual impact of airway obstruction on nasal airflow and inhalation exposure to drug aerosols remains largely unknown. In this study, the effects of adenoid hypertrophy on airflow and micron particle inhalation exposure characteristics were analysed by virtually comparing pre- and postoperative models based on a realistic 3-year-old nasal airway with AH. More specifically, detailed comparison focused on anatomical shape variations, overall airflow and olfactory ventilation, associated particle deposition in overall and local regions were conducted. Our results indicate that the enlarged adenoid tissue can significantly alter the airflow fields. By virtually removing the enlarged tissue and restoring the airway, peak velocity and wall shear stress were restored, and olfactory ventilation was considerably improved (with a 16∼63% improvement in terms of local ventilation speed). Furthermore, particle deposition results revealed that nasal airway with AH exhibits higher particle filtration tendency with densely packed deposition hot spots being observed along the floor region and enlarged adenoid tissue area. While for the postoperative model, the deposition curve was shifted to the right. The local deposition efficiency results demonstrated that more particles with larger inertia can be delivered to the targeted affected area following Adenoidectomy (Adenoid Removal). Research findings are expected to provide scientific evidence for adenoidectomy planning and aerosol therapy following Adenoidectomy, which can substantially improve present clinical treatment outcomes.
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  • 文章类型: Case Reports
    食管癌(EC)是最具侵袭性的胃肠道癌症之一。晚期食管癌主要与吞咽困难有关,吞咽困难会降低生活质量,导致患者虚弱,甚至难以耐受手术和放化疗等全身治疗。此外,放化疗(CRT)不能在短时间内缓解吞咽困难,尤其是对于患有合并症的老年患者。这里,我们报道了1例76岁女性患者,诊断为内镜无法通过的严重阻塞性食管鳞状细胞癌(ESCC).她还并发双侧间质性肺炎和中度肺通气功能障碍。患者无法接受手术和根治性CRT。在MDT讨论之后,我们首先给予患者光动力疗法(PDT)治疗。1周内梗阻明显改善,2周后恢复正常饮食。四周后,考虑到双侧间质性肺炎,对食管病变和腹部转移性淋巴结给予同步减量放化疗.到目前为止,食管和腹部淋巴结没有复发和进展,原发性食管病变的活检显示出病理完全缓解。现在,患者仍在定期随访中。
    Esophageal Carcinoma (EC) is one of the most aggressive gastrointestinal cancers. Advanced esophageal carcinoma is associated mainly with dysphagia which reduces the quality of life and leads to frail in patients even difficult to tolerate systemic treatments such as surgery and chemoradiotherapy. Moreover, chemoradiotherapy(CRT)cannot relieve dysphagia in a short time especially for the elderly patient with comorbidities. Here, we report a 76-year-old female patient diagnosed with severe obstructive esophageal squamous cell carcinoma (ESCC) that endoscope could not pass through. She was also complicated with bilateral interstitial pneumonia and moderate pulmonary ventilation dysfunction. The patient was unable to undergo surgery and radical CRT. After multidisciplinary team (MDT) discussion, we gave the patient photodynamic therapy (PDT) treatment firstly. The obstruction was significantly improved within 1 week and normal diet was resumed after 2 weeks. Four weeks later, considering bilateral interstitial pneumonia, concurrent dose-reduction chemoradiotherapy was given for esophageal lesions and abdominal metastatic lymph nodes. There was no recurrence and progression in the esophagus and abdominal lymph nodes until now and the biopsy of the primary esophageal lesion showed pathologic complete response. Now, the patient is still under regular follow-up.
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  • 文章类型: Journal Article
    目的:本研究调查了目前我国梗阻性左半结肠癌(OLCC)的外科治疗实践。
    方法:2020年8月27日至9月2日,邀请中国三级或二级医院的所有结直肠外科科室完成基于网络的问卷调查。
    结果:总体而言,已完成的问卷来自357家医院.急诊手术是OLCC的主要治疗手段,开放式方法占比高达61.62%。急诊手术造口率高达80%,主要是由于肠道准备不足和结肠壁严重水肿。Hartmann的手术(61.62%)是最优选的手术。共有243家医院(68.7%)报告说,他们将考虑使用自膨胀金属支架(SEMS)作为择期手术的桥梁。参与这项研究的医院中有50%以上报告了SEMS放置的成功率,以及80%以上的阻塞解决率,支架相关穿孔率<5%。共有126家医院考虑在择期手术前实施SEMS和新辅助化疗的策略,并认为这可能进一步改善治疗结果。
    结论:除了传统的急诊手术外,SEMS是治疗OLCC的可行选择,其临床效益已得到初步认可。
    OBJECTIVE: This study surveyed the current practice of surgical treatment of obstructive left-sided colon cancer (OLCC) in China.
    METHODS: All colorectal surgery departments at tertiary or secondary hospitals in China were invited to complete a web-based questionnaire between August 27 and September 2, 2020.
    RESULTS: Overall, completed questionnaire were received from 357 hospitals. Emergency surgery was the mainstay of treatment for OLCC, with the open approach accounting for up to 61.62%. The stoma rate of emergency surgery was up to 80%, mainly due to inadequate bowel preparation and severe edema of colon walls. Hartmann\'s procedure (61.62%) was the most preferred operation. A total of 243 hospitals (68.7%) reported that they would consider the use of a self-expanding metallic stent (SEMS) as a bridge for elective surgery. More than 50% of the hospitals participating in this study reported the success rate of SEMS placement, as well as the resolution rate of obstruction more than 80%, and the stent-related perforation rate was < 5%. A total of 126 hospitals considered carrying out a strategy of SEMS followed by neoadjuvant chemotherapy prior to elective surgery and believed that it might further improve treatment outcomes.
    CONCLUSIONS: SEMS is a feasible option for the treatment of OLCC in addition to traditional emergency surgery, and its clinical benefits have been preliminarily recognized.
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