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  • west china medical publishers
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    find Author "方方" 3 results
    • Clinical Application of Pulmonary Artery Banding

      Objective To summarize our clinical experience of pulmonary artery banding (PAB) for the treatment of complex congenital heart diseases as a palliative procedure.?Methods?From January 1997 to November 2010, 138 patients with complex congenital heart diseases underwent PAB in Fu Wai Hospital. There were 87 male patients and 51 female patients with their age of 22.2±26.5 months and average body weight of 7.5±4.6 kg. All the 138 patients were divided into 3 groups according to the purpose of PAB:left ventricular retraining (group 1, n=55), initial procedure for functional single ventricle with unobstructed pulmonary blood flow (group 2, n=32) and initial palliative procedure followed by later biventricular repair (group 3, n=51). The intraoperative and postoperative clinical parameters of all participants were observed, and follow-up was made for these 3 groups of patients.?Results?The in-hospital mortality of PAB was 5.1% (7/138). Three patients underwent re-banding procedure to adjust the size of banding. In group 1, there was 1 postoperative death. Among the 55 patients, 36 patients with dextro-transposition of great arteries received PAB at an average age of 19.6±29.5 months, 29 patients of whom underwent concomitant modified Blalock-Taussig shunt. After an average training interval for 42 days, 83.3% of them(30/36)successfully received arterial switch operation. The other 19 patients in group 1 with isolated corrected transposition of great arteries received PAB at an average age of 45.3±27.2 months. Afteran average training interval for 9 months, 42.1% of them (8/19) successfully received double-switch operation. In group 2, there was 2 postoperative death. Thirty-two patients with functional single ventricle and unobstructed pulmonary blood flow received PAB at an average age of 14.1±14.9 months. Their postoperative mean pulmonary artery pressure decreased significantly from 34.00±10.00 mm Hg to 23.00±7.40 mm Hg, and their oxygen saturation of blood (SpO2) significantly decreased from 92.60%±5.90% to 83.30%±6.30%. After a median interval of 2 years, 18.8% of them (6/32) underwent right heart bypass operation. In group 3, there was 4 postoperative death. Fifty-one patients received PAB at an average age of 20.60±25.60 months. After PAB procedure, the ratio of systolic pulmonary artery pressure and systolic blood pressure significantly decreased from 0.81±0.14 to 0.46±0.15, and their SpO2 significantly decreased from 93.10%±7.60% to 85.00%±10.00%. After a median interval of 6 months, 23.5% of them (12/51) received biventricular repair.?ConclusionAlthough PAB is a palliative procedure with comparatively high risks, it still plays an indispensable role in terms of protecting pulmonary vascular beds, retraining ventricular function and two-stage surgical correction for the treatment of complex congenital heart diseases.

      Release date:2016-08-30 05:50 Export PDF Favorites Scan
    • 《7T-MRI 癲癇特別工作組關于 7T-MRI 臨床應用的專家共識》解讀

      通過磁共振成像(MRI)識別腦結構性病變對癲癇具有重要意義,是藥物難治性局灶性癲癇患者術后癲癇無發作最重要的影響因素。然而,約 1/3 的癲癇患者在常規磁場強度(1.5T 和 3T)MRI 檢查無法發現病變。現有研究已證明 7T- MRI 在 1.5T 和/或 3T-MRI 檢查中有或無已知致癇性病變的患者中有應用價值。然而,將 7T-MRI 用于臨床仍具挑戰性,尤其是在剛開始或準備開始應用的癲癇中心,并且有必要對 7T-MRI 在癲癇患者臨床管理中的應用提出具體推薦意見。7T 癲癇特別工作小組(一個代表有 2 000 例癲癇患者掃描經驗的 21 個 7T-MRI 中心專家組成的國際小組)于 2020 年 12 月在《Neurology》上發表了《7R-MRI 癲癇特別工作組關于 7T-MRI 臨床應用的專家共識》(下文簡稱為“共識”)。該《共識》針對 7T-MRI 在癲癇患者中應用的適應證、患者準備、掃描協議和設置、技術挑戰、圖像分析等進行了指導,并對 7T- MRI 在癲癇患者中未來的分子和功能顯像進行了討論。當然仍有檢查的年齡、如何縮短掃描時間、閱圖規范等問題未得到解決。不過鑒于 7T-MRI 已被批準用于臨床,我國已有部分醫院開始引進 7T-MRI 設備,本文旨在解讀《共識》,希望對推薦轉診、合適的 7T-MRI 掃描方案和圖像分析來指導臨床 7T-MRI 在癲癇管理中應用。

      Release date:2021-04-25 09:50 Export PDF Favorites Scan
    • 應用頭皮腦電高頻振蕩自動檢測方法評估嬰兒痙攣癥經 ACTH 沖擊治療的療效和預后

      Release date:2021-12-30 06:08 Export PDF Favorites Scan
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  • 松坂南