目的探讨应用单根4 F多功能导管经右上肢静脉行双侧肾上腺静脉采血(AVS)的可行性。方法对63例确诊为原发性醛固酮增多症且需分型、定侧患者,经右上肢静脉插入4 F MPA1导管行右侧AVS和第1次下腔静脉(IVC)采血,然后拔出导管;接着在体外将...目的探讨应用单根4 F多功能导管经右上肢静脉行双侧肾上腺静脉采血(AVS)的可行性。方法对63例确诊为原发性醛固酮增多症且需分型、定侧患者,经右上肢静脉插入4 F MPA1导管行右侧AVS和第1次下腔静脉(IVC)采血,然后拔出导管;接着在体外将导管头塑形呈直径6~7 cm类圆形,行左侧AVS和第2次IVC采血。每例患者右侧有1个采血点(共63个),左侧有2个采血点(共126个)。在图像上标记对应采血序号,便于与检验值对比。采集完成后立即送检。结果根据肾上腺静脉皮质醇和下腔皮质醇比值>2为标准,左侧123个采血点比值达标,达标率为98%(123/126)。63例左侧2组数据中至少有1组数据有效,成功率达到100%;63例右侧数据中有2例不达标,成功率为97%(61/63)。双侧AVS成功率为97%(61/63)。手术过程顺利,术中无明显严重并发症发生。结论单根4 F多功能导管经右上肢静脉行双侧AVS是简便、安全有效的采血方法。展开更多
Three male patients were diagnosed with new cortical infarctions of the right parietal lobe on the basis of head magnetic resonance imaging; high-intensity signals indicating lesions in the right parietal lobe were no...Three male patients were diagnosed with new cortical infarctions of the right parietal lobe on the basis of head magnetic resonance imaging; high-intensity signals indicating lesions in the right parietal lobe were noted on diffusion-weighted images at admission. Two of them presented with left hand weakness, and one exhibited left upper limb weakness. Treatment for improving blood supply to the brain was administered. One patient died suddenly because of ventricular fibrillation 3 days after admission. The other two patients had increased troponin levels and abnormal electrocardiograms, and were diagnosed with acute myocardial infarction half a month after admission. When lesions exist in field 7 of the parietal cortex （resulting in paralysis of the contralateral hand）, the sympathetic center of the posterior lateral nucleus of the hypothalamus demonstrates compensatory excitement, which easily causes tachyarrhythmia and sudden death. Our experimental findings indicate that close electrocardiograph monitoring and cerebral infarction treatment should be standard procedures to predict and help prevent heart disease in patients with cerebral infarction in the right parietal lobe and left upper limb weakness as the main complaint.展开更多
文摘Three male patients were diagnosed with new cortical infarctions of the right parietal lobe on the basis of head magnetic resonance imaging; high-intensity signals indicating lesions in the right parietal lobe were noted on diffusion-weighted images at admission. Two of them presented with left hand weakness, and one exhibited left upper limb weakness. Treatment for improving blood supply to the brain was administered. One patient died suddenly because of ventricular fibrillation 3 days after admission. The other two patients had increased troponin levels and abnormal electrocardiograms, and were diagnosed with acute myocardial infarction half a month after admission. When lesions exist in field 7 of the parietal cortex （resulting in paralysis of the contralateral hand）, the sympathetic center of the posterior lateral nucleus of the hypothalamus demonstrates compensatory excitement, which easily causes tachyarrhythmia and sudden death. Our experimental findings indicate that close electrocardiograph monitoring and cerebral infarction treatment should be standard procedures to predict and help prevent heart disease in patients with cerebral infarction in the right parietal lobe and left upper limb weakness as the main complaint.
