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1.
J Healthc Eng ; 2021: 5522492, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33995982

RESUMO

Severe acute pancreatitis (SAP) is traditionally treated with chemical analysis. Faced with the increasing maturity of CT imaging technology, it is necessary to use more advantageous CT imaging to treat SAP. In this article, 72 SAP patients admitted to the Affiliated Hospital of Southwest Medical University were selected for study, of which 62 were severely ill, 8 were exacerbated, and 2 changed from severe to mild. This article combines the patient's case records and related CT images during treatment from the perspective of nursing and conducts nursing research on the application of CT image changes in severe acute pancreatitis in nursing practice. CT image processing uses CT imaging system workstation (DICOM). The results of the study showed that, in the care of patients, 21 cases had recurrence after internal drainage, and the cure rate was 91.1%. Internal drainage is an effective way to treat SAP. The higher the incidence of pancreatitis, the more likely it is to relapse after SAP internal drainage, which may be related to repeated episodes of pancreatitis and repeated inflammation of the pancreas and pancreatic duct damage. 4 of the relapsed cases in this article are postchronic pancreatitis SAP, and the relapsed cases account for 50% of the chronic pancreatic cases. This may be due to chronic fibrosis of the branched and main pancreatic ducts, continuous abnormal pancreatic juice drainage. Therefore, it is necessary to further explore the prognosis of different causes of SAP. In terms of complication care, the overall complication rate was 16.6%. One patient died of postoperative hemorrhage. Analysis of the causes of cyst recurrence and complications may be closely related to the mechanism of the occurrence and development of SAP. The initiating factor of SAP is that the pancreatic tissue is damaged due to inflammation, trauma, or microcirculation disorder, and then the pancreatic juice leaks out of the pancreas, wrapping the pancreatic juice; it takes a certain time for the capsule of fibrous knot tissue to form and strengthen.


Assuntos
Realidade Aumentada , Pancreatite , Doença Aguda , Eletrônica , Humanos , Pancreatite/diagnóstico por imagem , Tomografia Computadorizada por Raios X
2.
J BUON ; 25(2): 1056-1062, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32521906

RESUMO

PURPOSE: To explore the efficacy and safety of percutaneous transhepatic cholangial drainage (PTCD)-based biliary stent placement combined with iodine-125 (125I) particle intracavitary irradiation versus palliative internal biliary-intestinal drainage in the treatment of pancreatic head cancer-induced obstructive jaundice. METHODS: The clinical data of 110 patients with pancreatic head cancer, who were admitted to and treated in our hospital from July 2013 to July 2016 were registered. Among them, 55 patients underwent PTCD-based biliary metallic stent placement combined with 125I particle intracavitary irradiation (125I group), while the other 55 patients received palliative internal biliary-intestinal drainage (Surgery group). The jaundice index, and liver function parameters before and after treatment, duration of stent patency, tumor growth and incidence of adverse reactions were compared between the two groups of patients, and the patient overall survival (OS) time was followed up and recorded. RESULTS: The two therapies both effectively alleviated jaundice and improved liver function in patients. There were no statistically significant differences in the preoperative liver function parameters albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and direct bilirubin (DBIL) between the two groups of patients, and the liver function was significantly improved at each period of time after operation, showing a statistically significant difference. At 3 months after operation, 125I group had substantially lower levels of ALT, AST, TBIL and DBIL, but a prominently higher level of ALB than Surgery group. The complications of patients mainly included pancreatitis, recurrent biliary infections and stent blockage, which were resolved after symptomatic treatments. After operation, the maximum diameter of tumors was enlarged in both groups, and the tumor size in Surgery group and 125I group was increased from 3 months after operation to 6 months after operation, with a more obvious increase in Surgery group. The total clinical benefit rate (CBR) was 61.8% (34) and 54.5% (30), and the mean survival time of patients was 13.4±4.9 months and 12.7±4.6 months in 125I group and Surgery group, respectively. Moreover, the OS in 125I group was notably superior to that in Surgery group. CONCLUSION: PTCD-based biliary metallic stent placement combined with 125I particle intracavitary irradiation can effectively relieve jaundice, improve liver function, repress tumor growth, prolong survival and produce tolerable adverse reactions in the patients with pancreatic head cancer who lose the opportunity for surgery or are intolerant to surgery.


Assuntos
Braquiterapia/métodos , Radioisótopos do Iodo/administração & dosagem , Neoplasias Pancreáticas/radioterapia , Neoplasias Pancreáticas/cirurgia , Stents , Drenagem/métodos , Feminino , Humanos , Fígado/fisiopatologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/fisiopatologia , Estudos Retrospectivos , Resultado do Tratamento
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