目的评估鼻内镜下翼管神经切断术治疗中一重度持续性变应性鼻炎的临床疗效，探讨其可能的作用机制。方法191例变应性鼻炎患者被分为3组，分别进行鼻内镜下翼管神经切断术（A组，71例）、下鼻甲部分切除和（或）鼻中隔矫正术（B组，39例...目的评估鼻内镜下翼管神经切断术治疗中一重度持续性变应性鼻炎的临床疗效，探讨其可能的作用机制。方法191例变应性鼻炎患者被分为3组，分别进行鼻内镜下翼管神经切断术（A组，71例）、下鼻甲部分切除和（或）鼻中隔矫正术（B组，39例）和保守治疗（C组，81例，对照组）。应用鼻结膜炎生存质量调查问卷（rhinoconjunctivitis quality of life questionnaire，RQLQ）和视觉模拟量表（visual analogue scale，VAS）评估术前、术后6个月、1年和3年的鼻炎相关生活质量。结果通过对145例资料完整的病例进行分析，经鼻内镜下翼管神经切断组（A组）RQLQ平均（面±s，以下同）得分和VAS评分在术后6个月（0．84-4-0．41、2．55±1．57）、1年（0．91±0．43、2．63±1．71）、3年（1．03±0．46、2．81±1．75）都显著低于术前（2．25±0．49、7．34±1．11），F值分别为115．45、133．09，P值均〈0．001，且分别低于B、C组治疗后6个月、1年、3年的RQLQ平均得分和VAS评分（P值均〈0．001）。患者对治疗后3．0～5．5年总体主观评估结果显示，A组显著改善率、改善率、无改善率分别为65．5％（38例）、24．1％（14例）、10．4％（6例），总体有效性显著高于B组（U=237．0，P〈0．001）和C组（U=246．0，P〈0．001）。没有发生严重的手术并发症。结论鼻内镜下翼管神经切断术是一种治疗中．重度持续性变应性鼻炎安全、有效的手段。展开更多
Background Increased renal sympathetic nerve activity can result in diuretic resistance in patients with chronic congestive heart failure. We investigated the effect of regional renal nerve blockade on the patients wi...Background Increased renal sympathetic nerve activity can result in diuretic resistance in patients with chronic congestive heart failure. We investigated the effect of regional renal nerve blockade on the patients with chronic refractory heart failure and diuretic resistance. Methods Eighteen patients with chronic refractory heart failure were enrolled （mean age （64＋11） years）. The patients were randomly divided into two groups （renal nerve blockade group and standard therapy group, n=9 each）. Renal nerve blockade was performed by percutaneous injection of local anaesthetic under computed tomographic guidance. Heart rate, mean arterial blood pressure, plasma and urine electrolytes, neurohormones, factional excretion of sodium （FENa）, 24-hour urine volume were monitored at baseline and the first 24 hours after therapy. Dyspnea and oedema were also evaluated. The major adverse cardiovascular events （MACE）, plasma brain natriuretic peptide （BNP） level and left ventricular ejection fraction （LVEF） were compared between the two groups during the 3-12 months follow-up period. Results No complication was observed during the acute phase of renal nerve blockade. After renal nerve blockade, the 24-hour urine volume and FENa were significantly increased, while the level of plasma rennin, angiotensin II, aldosterone BNP and atrial natriuretic peptide as well as dyspnea and oedema were significantly reduced in renal nerve blockade group compared with baseline and standard therapy group. During three to 12 months of follow-up, the rate of MACE and plasma BNP level were significantly lower, while LVEF was significantly higher in renal nerve blockade group than those in standard therapy group. Conclusion Regional renal nerve blockade may be a safe and effective treatment for patients with chronic refractory heart failure.展开更多
文摘目的评估鼻内镜下翼管神经切断术治疗中一重度持续性变应性鼻炎的临床疗效，探讨其可能的作用机制。方法191例变应性鼻炎患者被分为3组，分别进行鼻内镜下翼管神经切断术（A组，71例）、下鼻甲部分切除和（或）鼻中隔矫正术（B组，39例）和保守治疗（C组，81例，对照组）。应用鼻结膜炎生存质量调查问卷（rhinoconjunctivitis quality of life questionnaire，RQLQ）和视觉模拟量表（visual analogue scale，VAS）评估术前、术后6个月、1年和3年的鼻炎相关生活质量。结果通过对145例资料完整的病例进行分析，经鼻内镜下翼管神经切断组（A组）RQLQ平均（面±s，以下同）得分和VAS评分在术后6个月（0．84-4-0．41、2．55±1．57）、1年（0．91±0．43、2．63±1．71）、3年（1．03±0．46、2．81±1．75）都显著低于术前（2．25±0．49、7．34±1．11），F值分别为115．45、133．09，P值均〈0．001，且分别低于B、C组治疗后6个月、1年、3年的RQLQ平均得分和VAS评分（P值均〈0．001）。患者对治疗后3．0～5．5年总体主观评估结果显示，A组显著改善率、改善率、无改善率分别为65．5％（38例）、24．1％（14例）、10．4％（6例），总体有效性显著高于B组（U=237．0，P〈0．001）和C组（U=246．0，P〈0．001）。没有发生严重的手术并发症。结论鼻内镜下翼管神经切断术是一种治疗中．重度持续性变应性鼻炎安全、有效的手段。
文摘Background Increased renal sympathetic nerve activity can result in diuretic resistance in patients with chronic congestive heart failure. We investigated the effect of regional renal nerve blockade on the patients with chronic refractory heart failure and diuretic resistance. Methods Eighteen patients with chronic refractory heart failure were enrolled （mean age （64＋11） years）. The patients were randomly divided into two groups （renal nerve blockade group and standard therapy group, n=9 each）. Renal nerve blockade was performed by percutaneous injection of local anaesthetic under computed tomographic guidance. Heart rate, mean arterial blood pressure, plasma and urine electrolytes, neurohormones, factional excretion of sodium （FENa）, 24-hour urine volume were monitored at baseline and the first 24 hours after therapy. Dyspnea and oedema were also evaluated. The major adverse cardiovascular events （MACE）, plasma brain natriuretic peptide （BNP） level and left ventricular ejection fraction （LVEF） were compared between the two groups during the 3-12 months follow-up period. Results No complication was observed during the acute phase of renal nerve blockade. After renal nerve blockade, the 24-hour urine volume and FENa were significantly increased, while the level of plasma rennin, angiotensin II, aldosterone BNP and atrial natriuretic peptide as well as dyspnea and oedema were significantly reduced in renal nerve blockade group compared with baseline and standard therapy group. During three to 12 months of follow-up, the rate of MACE and plasma BNP level were significantly lower, while LVEF was significantly higher in renal nerve blockade group than those in standard therapy group. Conclusion Regional renal nerve blockade may be a safe and effective treatment for patients with chronic refractory heart failure.
