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Objective To evaluate the value of clinical application in chest tumor biopsy by DSA rotating reconstruction technology and CT guided technology.Methods The 63 cases of chest tumors collected,38 cases of lung tumors,25 cases of mediastinal tumors.Applicating of CT and DSA scan and formulating puncture path,according to their respective descending thoracic tumor puncture guide way.DSA and CT guided traditional way from the success rate of puncture,operation time,X-ray exposure and complications were analyzed.Results 45 cases take CT guidance,18 cases take DSA guidance.60 cases,the pathological results achieved and positive rate was 95.2％.CT group success rate of first puncture in 68.9％ (31/45),DSA group 88.9％ (16/18),statistically significant.CT group pneumothorax rate 17.8 ％ (8/45),DSA group pneumothorax rate 11.1％ (2/18),no statistical difference.Operation time CT group (23.111 ± 4.281) minutes,DSA group (12.889 ± 3.693) minutes,with significantly statistical differences.CT group exposure (11.563±3.023) mGy,DSA group exposure (9.956±2.193) mGy,statistically significant.Conclusion The chest tumor puncture biopsy by DSA rotating reconstruction technique guided with flexible,fast and convenient,and superior to traditional CT with real-time monitoring,shorten the operation time,reduce the exposure,the success rate of first puncture aspects.
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Objective To investigate the safety and effectiveness of using covered stent in endovascular isolation treatment of spontaneous peripheral artery dissection.Methods A total of 9 patients with peripheral artery dissection were collected.The dissectionwas located at iliac artery in 6 patients and at subclavian artery in 3 patients.Preoperative CT angiography was performed in all patients to determine the site and degree of the dissection,based on which the corresponding covered stents were prepared.After puncturing the femoral artery with Seldinger technique,angiography was performed to confirm the lesions in all patients,then,according to the angiographic findings the implantation of covered stent was carried out.Results Among the 9 patients,the dissections were located at the right common iliac artery in 3,at the right external iliac artery in one,at the left common iliac artery in 2 and at the left subclavian artery in 3.The length of the dissection was 0.9-3.3 cm with a mean of 1.7 cm.The distance between the initial part of arterial dissection and the target vessel opening was 0.5-5.6 cm with an average of 2.3 cm.The covered stent was successfully implanted in all patients.In one patient,the implanted stent covered the non-dominant left vertebral artery.During the procedure no obvious complications occurred.The patients were followed up for 3-32 months (mean of 18 months).No procedure-related complications were observed in all patients.Color Doppler ultrasound examination showed that all the implanted stents were unobstructed.Conclusion For peripheral artery dissection,endovascular isolation therapy by using covered stent is safe and effective.
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Objective To analyze the clinical effect of tongue traction massage in the improvement of speech deficit in acute stage of ischemic stroke. Methods A total of 60 cases of acute ischemic stroke aphasia patients from June 2015 to June 2016 were selected and divided into experimental group (30 cases)and control group(30 cases)by random digits table method,the control group was treated with drug therapy, experimental group was treated with drug plus tongue traction massage therapy. The curative effect of tongue body massage and traction safety was compared between two groups. Results After 2 courses of treatment, there was no significant change in vital signs in the experimental group, the total effective rate was 90.00%(27/30), and the total effective rate of the control group was 70.00% (21/30), there was significant difference between two groups(Z=-2.05,P<0.05). Conclusions In the treatment of acute ischemic stroke aphasia,the tongue traction massage,good clinical effect,can effectively improve the patient′s speech function,simple operation,safety,compliance is good,worthy of promotion.
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Objective To develop a portable pressure detector to facilitate the battlefield self and buddy aids training for dressing,hemostasis and fixation.Methods The changes of pressure were converted into the ones of electric current with the pneumatic cuff,catheter and membrane pressure sensor,and then transmitted to the panel display by Bluetooth.The efficacy for the training was determined based on the acquired data.Results The detector implemented quantifying of the pressures during dressing,hemostasis and fixation,and non-medical staff obtained the results of battlefield treatment training easily to execute rapid assessment of battlefield self and buddy aids training.Conclusion The device gains advantages in visualized data,portability,easy operation and accurate measurement,and contributes to battlefield self and buddy aids training.
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Objective To evaluate the cause and the treatment of the vagus nerve reflex in patients with hemoptysis during bron-chial artery embolization (BAE).Methods 1 12 patients with much hemoptysis were enrolled,9 of whom represented vagus nerve reflex in the process of interventional embolization.Results In 9 patients with mixed vagal reflex,5 occurred in the process of bron-chial artery embolization,1 in removing of sheath,1 in hemostasis by compression and 2 in returning to the ward.The intraoperative vagus reflex during BAE was related to over tension and unnormolized operation,and it improved by block of vagus nerve,raising blood pressure and fluid expansion without serious complications.Conclusion Vagus nerve reflex during BAE should be noticed, and early detection and timely intervention may improve its prognosis.
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Objective To discuss the value of combining superselective mesenteric angiography (SSMA)with methylene blue in-jection for localization of the Obscure Gastrointestinal Bleeding (OGIB).Methods 12 patients presenting with OGIB had preopera-tive localization of the bleeding site by SSMA.The microcatheter was remained inside the bleeding artery branch after angiography. Then the methylene blue was injected via the microcatheter for localization during exploratory laparotomy and the dyed intestine was then removed.Results The detected rate of bleeding sites by using preoperative SSMA was 100%.The lesions in total 12 patients were found quickly during the exploratory laparotomy.The length of the removed intestine was 9 -12 cm (median,10 cm).After followed up for 10-24 months (median,18 months),all patients with OGIB had no recurrence.Conclusion The method of SSMA combined with the use of methylene blue injection is a safe and effective procedure for the localization of OGIB and could be beneficial for increasing the surgical success rate of hemostasis.