目的探讨急性缺血性脑卒中介入治疗术中应用替罗非班的疗效。方法方便选择2016年1月—2017年6月在福建医科大学附属第二医院及解放军第180医院行急诊介入手术的急性脑梗塞患者共84例,用随机数字表法分为替罗非班组(41例)及对照组(43例)...目的探讨急性缺血性脑卒中介入治疗术中应用替罗非班的疗效。方法方便选择2016年1月—2017年6月在福建医科大学附属第二医院及解放军第180医院行急诊介入手术的急性脑梗塞患者共84例,用随机数字表法分为替罗非班组(41例)及对照组(43例)。替罗非班组术中靶血管内注射替罗非班10μg/kg,继之以0.075μg/(kg·min)持续静脉滴注24 h;对照组不应用替罗非班。根据全脑血管造影图像观察两组患者靶血管TICI血流分级情况,并观察两组术前,术后24 h、7 d的NIHSS评分,90 d改良Rankin量表(m RS)评分。结果动脉内注射药物后首次及手术结束前末次造影显示:替罗非班组TICI 2b^3级血流比例(63.4%、73.2%)均高于对照组(39.5%、44.2%),两组间差异有统计学意义(χ~2=4.79,P<0.05;χ~2=7.25,P<0.01);替罗非班组术后24 h及7 d NIHSS评分[(6.51±3.67)分、(4.13±1.57)分]均低于对照组[(9.22±4.52)分、(7.98±2.74)分],两组间差异有统计学意义(t=3.01,P<0.01、t=7.85,P<0.01);替罗非班组90 d m RS评分0~2分比例65.9%高于对照组37.2%,两组间差异有统计学意义(χ~2=6.89,P<0.01)。结论急性缺血性脑卒中患者介入治疗中采取替罗非班贯续治疗能有效改善患者血流灌注,改善近期及远期预后,是AIS患者术中出现灌注不良或"无复流"的一种有效的治疗方法。展开更多
Objective: To compare metal versus plastic biliary stent implantation for treatment of malignant biliary obstruction in cost-effectiveness ratio (CER). Methods: Percutaneous transhepatic self-expandable metal stent (M...Objective: To compare metal versus plastic biliary stent implantation for treatment of malignant biliary obstruction in cost-effectiveness ratio (CER). Methods: Percutaneous transhepatic self-expandable metal stent (MS, n=61) or 10F plastic stent (PS, n=34) implantation was performed in 95 patients with malignant biliary obstruction in three hospitals of Guangdong province. All patients were followed up until death or at least one year after the procedure. Kaplan-Meier analysis was used to compare the survival and stent patency rates of the patients in the two groups. CERs of two groups were calculated. The main indexes were CERsurvival period (total cost/median survival period), CERpatency period (total cost/median patency period). Results: The total costs of treatment were 53177±3139 yuan (RMB) in MS group and 42564±4950 yuan (RMB) in PS group respectively (P>0.05). CER in MS group was superior to that in PS group (CERsurvival period was 237.4 yuan /d vs 452.6 yuan /d, respectively; CERpatency period was 231.2 yuan /d vs 472.9 yuan /d, respectively). Conclusion: The metal stent implantation is superior to the plastic stent in the CER for treatment of malignant biliary obstruction.展开更多
文摘目的探讨急性缺血性脑卒中介入治疗术中应用替罗非班的疗效。方法方便选择2016年1月—2017年6月在福建医科大学附属第二医院及解放军第180医院行急诊介入手术的急性脑梗塞患者共84例,用随机数字表法分为替罗非班组(41例)及对照组(43例)。替罗非班组术中靶血管内注射替罗非班10μg/kg,继之以0.075μg/(kg·min)持续静脉滴注24 h;对照组不应用替罗非班。根据全脑血管造影图像观察两组患者靶血管TICI血流分级情况,并观察两组术前,术后24 h、7 d的NIHSS评分,90 d改良Rankin量表(m RS)评分。结果动脉内注射药物后首次及手术结束前末次造影显示:替罗非班组TICI 2b^3级血流比例(63.4%、73.2%)均高于对照组(39.5%、44.2%),两组间差异有统计学意义(χ~2=4.79,P<0.05;χ~2=7.25,P<0.01);替罗非班组术后24 h及7 d NIHSS评分[(6.51±3.67)分、(4.13±1.57)分]均低于对照组[(9.22±4.52)分、(7.98±2.74)分],两组间差异有统计学意义(t=3.01,P<0.01、t=7.85,P<0.01);替罗非班组90 d m RS评分0~2分比例65.9%高于对照组37.2%,两组间差异有统计学意义(χ~2=6.89,P<0.01)。结论急性缺血性脑卒中患者介入治疗中采取替罗非班贯续治疗能有效改善患者血流灌注,改善近期及远期预后,是AIS患者术中出现灌注不良或"无复流"的一种有效的治疗方法。
文摘Objective: To compare metal versus plastic biliary stent implantation for treatment of malignant biliary obstruction in cost-effectiveness ratio (CER). Methods: Percutaneous transhepatic self-expandable metal stent (MS, n=61) or 10F plastic stent (PS, n=34) implantation was performed in 95 patients with malignant biliary obstruction in three hospitals of Guangdong province. All patients were followed up until death or at least one year after the procedure. Kaplan-Meier analysis was used to compare the survival and stent patency rates of the patients in the two groups. CERs of two groups were calculated. The main indexes were CERsurvival period (total cost/median survival period), CERpatency period (total cost/median patency period). Results: The total costs of treatment were 53177±3139 yuan (RMB) in MS group and 42564±4950 yuan (RMB) in PS group respectively (P>0.05). CER in MS group was superior to that in PS group (CERsurvival period was 237.4 yuan /d vs 452.6 yuan /d, respectively; CERpatency period was 231.2 yuan /d vs 472.9 yuan /d, respectively). Conclusion: The metal stent implantation is superior to the plastic stent in the CER for treatment of malignant biliary obstruction.
