简介:摘要目的探讨评估吲哚菁绿(indocyaninegreen,ICG)排泄试验在肝硬化患者行脾切断流术中的临床应用价值。方法选取2016年~2017年我院收治的拟行脾切断流术肝硬化患者68例,按照Child-Pugh分级进行分组,对比分析各组间ICG血浆清除率(K)和吲哚菁绿15min滞留率(ICGR15)的差异,研究ICG排泄实验与Child-Pugh分级的相关性。按照ICGR15的值进行分组,比较各组间术后1周谷丙转氨酶(ALT)、总胆红素(TBil)、凝血酶原时间(PT)、白蛋白(Alb)及腹水情况,研究各变量与ICGR15之间的相关性。把ChildA级病例分为ICGR15≤15%组、15%<ICGR15<30%组和ICGR15≥30%组,对比患者术后肝功能不全的发生率。结果ChildA组患者的ICGR15值明显低于ChildB组患者,K值明显高于ChildB组患者,差异均具有统计学意义(p<0.05)。ICGR15≥30的患者术后1周TBIL、PT和腹水深度明显升高,Alb水平明显下降,与ICGR15<30患者相比差异具有统计学意义(p<0.05)。ICGR15与术后Tbil、PT和腹水深度存在一定的相关性。ICGR15≥30的患者术后肝功能不全发生率明显高于ICGR15≤15%组。结论在对接受脾切断流术的肝硬化患者实施手术之前,对患者进行ICG排泄实验能够对患者的肝储备功能进行有效评价,吲哚菁绿15min滞留率是对Child-Pugh分级的有效补充,能够帮助临床医生对患者的肝储备功能进行有效评价,为患者的手术选择合适的时机,具有较高的临床应用价值。
简介:摘要目的通过测定ICGR15来辅助诊断临床乙肝肝硬化患者的肝脏损害程度及肝储备功能。方法对我科室2012年2月-8月收治的68例乙肝肝硬化患者所做的ICG检测的结果进行分析,以及对数据与其他肝功能检查进行比较。结果68例乙肝肝硬化患者ICGR15滞留率为3.9%~85%,平均为(31.2±2.5)%,Child-Pugh分级为A级者12例,ICGR15波动于3.9%~31%,B级者33例,ICGR15波动于4.2%~52.4%,C级者23例,ICGR15波动于5.1%~90%,结果数据对于临床治疗方案,手术方式的调整及病情的严重程度的评估及预后效果的判断起到了辅助诊断的效果。结论ICG滞留率可以反映肝脏储备功能。
简介:摘要目的探讨吲哚菁绿排泄试验中的吲哚菁绿15 min滞留率(ICG R15)和肝脏有效血流量(EHBF)能否预测轻微型肝性脑病(MHE)的发生。方法采用便利抽样法,收集2019年6—12月于广州中山大学附属第三医院诊治的确诊为肝硬化或肝衰竭的患者资料153例。用数字连接试验A和数字符号试验筛查出MHE患者,并分析临床资料。通过对R15和EHBF取不同数值作为分界点,分别探究两个因素对预测MHE的意义。结果MHE发生率为38.56%(59/153)。由单因素分析,Child-Pugh分级在MHE组和非MHE组的差异有统计学意义(χ2值7.606,P<0.05),而肝硬化和肝衰竭诊断、空腹血糖、血清肌酐等的组间差异无统计学意义(P>0.05)。当选取0.11~0.61绝大多数点作为R15正常异常分界点时,R15具有统计学意义(P<0.05),并当R15选取0.18时最为显著(Fisher精确检验P值=0.00024);选取0.08~0.76绝大多数点作为EHBF正常异常分界点时,EHBF都具有统计学意义(P<0.05),并当EHBF选取0.25时最为显著(Fisher精确检验P值=0.000 22)。通过Logistic逐步回归分析,得到MHE发生的危险因素为R15和EHBF,并利用ROC曲线说明两个因素对MHE的预测作用。结论MHE在肝硬化和肝衰竭患者的发生率较高。当R15≥0.18或EHBF≤0.25 L/min时,吲哚菁绿排泄试验中的R15和EHBF相较Child-Pugh分级更能预测MHE的发生,有助于及时对患者进行评估与管理。
简介:摘要目的探讨吲哚菁绿排泄试验中的吲哚菁绿15 min滞留率(ICG R15)和肝脏有效血流量(EHBF)能否预测轻微型肝性脑病(MHE)的发生。方法采用便利抽样法,收集2019年6—12月于广州中山大学附属第三医院诊治的确诊为肝硬化或肝衰竭的患者资料153例。用数字连接试验A和数字符号试验筛查出MHE患者,并分析临床资料。通过对R15和EHBF取不同数值作为分界点,分别探究两个因素对预测MHE的意义。结果MHE发生率为38.56%(59/153)。由单因素分析,Child-Pugh分级在MHE组和非MHE组的差异有统计学意义(χ2值7.606,P<0.05),而肝硬化和肝衰竭诊断、空腹血糖、血清肌酐等的组间差异无统计学意义(P>0.05)。当选取0.11~0.61绝大多数点作为R15正常异常分界点时,R15具有统计学意义(P<0.05),并当R15选取0.18时最为显著(Fisher精确检验P值=0.00024);选取0.08~0.76绝大多数点作为EHBF正常异常分界点时,EHBF都具有统计学意义(P<0.05),并当EHBF选取0.25时最为显著(Fisher精确检验P值=0.000 22)。通过Logistic逐步回归分析,得到MHE发生的危险因素为R15和EHBF,并利用ROC曲线说明两个因素对MHE的预测作用。结论MHE在肝硬化和肝衰竭患者的发生率较高。当R15≥0.18或EHBF≤0.25 L/min时,吲哚菁绿排泄试验中的R15和EHBF相较Child-Pugh分级更能预测MHE的发生,有助于及时对患者进行评估与管理。
简介:摘要“ICG”是北滘西海小学的一种教学模式,它取自自主(Independence)、交流(Communication)、引导(Guidance)这三个单词的首个英语大写字母。
简介:AbstractBackground:Arteriovenous malformation(AVM) have long-term "blood stealing" characteristics, which result in complicated hemodynamic features. To analyze the application of intraoperative indocyanine green angiography with FLOW 800 software in AVM surgeries.Methods:Data on 17 patients undergoing surgery with ICG fluorescence were collected in Beijing Tiantan Hospital. To analyze the hemodynamic features of AVM and the influence on the peripheral cortex of AVM resection, we assessed the following hemodynamic parameters: maximum intensity, slope of rise, time to half-maximal fluorescence, and transit time from arteries to veins.Results:In the 17 superficial AVMs studied, the time-delay color mode of the FLOW 800 software was superior to the traditional playback mode for identifying feeding arteries, draining veins, and their relation to normal cortical vessels. The maximum fluorescence intensity and slope of the ICG fluorescence curve of feeder arteries and draining veins were higher than those of normal peripheral vessels (P < 0.05). The transit times in AVMs were significantly shorter than those in normal peripheral vessels (P < 0.05). After AVM resection, cerebral flow increased in the cortex, and local cycle time becomes longer, although the differences were not significant (P > 0.05).Conclusions:Hemodynamic parameter analysis provided quality guidance for the resection of AVMs and could also be used in estimating changes in blood flow in the local cortex to identify abnormal hyperperfusion and residual nidus.
简介:【摘要】自闭症儿童出现无疾病症状的排泄异常行为问题,严重影响其学习与生活。为帮助自闭症儿童及其家庭摆脱困扰,以研究对象之一的小林为个案,教师团队通过“转变家长观念”、“家校紧密配合”、“充分运用代币制”、“运用沟通手段”、“使用绘本及校本教材”等多种手段进行综合干预,取得了一定成效。
简介:AbstractBackground:Indocyanine green video angiography (ICG-VA) is a safe and effective instrument to assess changes in cerebral blood flow during cerebrovascular surgery. After ICG-VA, FLOW 800 provides a color-coded map to directly observe the dynamic distribution of blood flow and to calculate semiquantitative blood flow parameters later. The purpose of our study is to assess whether FLOW 800 is useful for surgery of complex intracranial aneurysms and to provide reliable evidence for intraoperative decision-making.Methods:We retrospectively reviewed patients with complex aneurysms that underwent microsurgical and intraoperative evaluation of ICG-VA and FLOW 800 color-coded maps from February 2019 to May 2020. FLOW 800 data were correlated with patient characteristics, clinical outcomes, and intraoperative decision-making.Results:The study included 32 patients with 42 complex aneurysms. All patients underwent ICG-VA FLOW 800 data provided semiquantitative data regarding localization, flow status in major feeding arteries; color maps confirmed relative adequate flow in parent, branching, and bypass vessels.Conclusions:FLOW 800 is a useful supplement to ICG-VA for intraoperative cerebral blood flow assessment. ICG-VA and FLOW 800 can help to determine the blood flow status of the parent artery after aneurysm clipping and the bypass vessels after aneurysm bypass surgery.