AIM: To assess the ability of endoscopic ultrasonography (EUS) to differentiate neoplastic from non- neoplastic polypoid lesions of the gallbladder (PLGs).METHODS: The uses of EUS and transabdominal ultrasonogra...AIM: To assess the ability of endoscopic ultrasonography (EUS) to differentiate neoplastic from non- neoplastic polypoid lesions of the gallbladder (PLGs).METHODS: The uses of EUS and transabdominal ultrasonography (US) were retrospectively analyzed in 94 surgical cases of gallbladder polyps less than 20 mm in diameter.RESULTS: The prevalence of neoplastic lesions with a diameter of 5-20 mm was 27.2% (10/58); 22-15 mm, 25.4% (4/26), and 16-20 mm, 50% (5/20). The overall diagnostic accuracies of EUS and US for small PLGs were 80.9% and 63.9% (P 〈 0.05), respectively. EUS correctly distinguished 12 (63.2%) of 19 neoplastic PLGs but was less accurate for polyps less than 1.0 cm (4/10, 40%) than for polyps greater than 1.0 cm (8/9, 88.9%) (P = 0.02).CONCLUSION: Although EUS was more accurate than US, its accuracy for differentiating neoplastic from non-neoplastic PLGs less than 1.0 cm was low. Thus, EUS alone is not sufficient for determining a treatment strategy for PLGs of less than 1.0 cm.展开更多
目的观察右美托咪定预防腹腔镜下胆囊手术术后恶心、呕吐(postoperation nausea and vomiting,PONV)的效果。方法选择择期行腹腔镜下胆囊手术的患者60例,随机均分为3组:右美托咪定0.05μg·kg^-1组(D1)、右美托咪定0.1μg·...目的观察右美托咪定预防腹腔镜下胆囊手术术后恶心、呕吐(postoperation nausea and vomiting,PONV)的效果。方法选择择期行腹腔镜下胆囊手术的患者60例,随机均分为3组:右美托咪定0.05μg·kg^-1组(D1)、右美托咪定0.1μg·kg^-1组(D2)和生理盐水组(NS),每组20例。麻醉诱导:静脉给予咪达唑仑0.05mg·kg^-1,顺式阿曲库铵0.15mg·kg^-1,芬太尼2μg·kg^-1和依托咪酯0.3 mg·kg^-1,3min后进行气管插管采取机械通气。麻醉诱导插管后各组给予相应药物容积均为5mL。麻醉维持以丙泊酚4~12mg·(kg·h)^-1和瑞芬太尼0.25~2μg·(kg·min)^-1泵注,顺式阿曲库铵间断静注,围术期保持患者的各项生命体征平稳。记录术后24h时内头晕、头痛不良反应及恶心、呕吐的发生情况。结果 D1组、D2组PONV的发生率均明显低于NS组(P〈0.05);而不同剂量药物的D1和D2组PONV的发生率比较差异无统计学意义(P〉0.05)。结论右美托咪定能有效减少腹腔镜下胆囊手术PONV的发生率,0.05μg·kg^-1与1μg·kg^-1剂量的右美托咪定的效果无明显不同。展开更多
文摘AIM: To assess the ability of endoscopic ultrasonography (EUS) to differentiate neoplastic from non- neoplastic polypoid lesions of the gallbladder (PLGs).METHODS: The uses of EUS and transabdominal ultrasonography (US) were retrospectively analyzed in 94 surgical cases of gallbladder polyps less than 20 mm in diameter.RESULTS: The prevalence of neoplastic lesions with a diameter of 5-20 mm was 27.2% (10/58); 22-15 mm, 25.4% (4/26), and 16-20 mm, 50% (5/20). The overall diagnostic accuracies of EUS and US for small PLGs were 80.9% and 63.9% (P 〈 0.05), respectively. EUS correctly distinguished 12 (63.2%) of 19 neoplastic PLGs but was less accurate for polyps less than 1.0 cm (4/10, 40%) than for polyps greater than 1.0 cm (8/9, 88.9%) (P = 0.02).CONCLUSION: Although EUS was more accurate than US, its accuracy for differentiating neoplastic from non-neoplastic PLGs less than 1.0 cm was low. Thus, EUS alone is not sufficient for determining a treatment strategy for PLGs of less than 1.0 cm.