报道24例(32侧)超声联合DSA引导的经皮顺行双J管植入术治疗输尿管梗阻的结果和经验.患者在超声引导下细针穿刺肾盏,然后在DSA引导下采用导丝交换法植入双J管.其技术成功率为90.6%(29/32),临床有效率为84.4%(27/32),无严重并发症发生.

ObjectiveTo investigate the value of alpha-fetoprotein (AFP) combined with des-γ-carboxy-prothrombin (DCP) in predicting the therapeutic effect of transarterial chemoembolization (TACE). MethodsA retrospective analysis was performed for the clinical data of 85 patients with hepatocellular carcinoma (HCC) who underwent TACE in The First Affiliated Hospital of Soochow University from October 2016 to March 2018. The serum levels of AFP and DCP were measured before TACE and after two consecutive sessions of TACE, and modified RECIST (mRECIST) was used to evaluate the therapeutic effect of TACE. The changes in AFP and DCP were compared with imaging findings based on mRECIST. The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test was used for comparison of categorical data between two groups, and the Mann-Whitney U test was used for comparison of ranked data between two groups. A Spearman correlation analysis was used to investigate the correlation of mRECIST category with AFP and DCP. The receiver operating characteristic (ROC) curve was used to investigate the value of each index in the diagnosis of remission. ResultsAccording to the mRECIST criteria, 38 patients achieved remission (remission group) and 31 did not achieve remission (non-remission group). After treatment, the remission group had significantly lower AFP and DCP than the non-remission group (Z=-3.366 and -4.065, both P＜0.05). There were significant differences between the remission group and the non-remission group in ΔAFP, ΔDCP, ΔAFP%, and ΔDCP% (Z=-4.837, -5.597, -4.210, and -5.851, all P＜0.001). The mRECIST category was negatively correlated with ΔAFP and ΔDCP (rs=-0.552 and -0.593, both P＜0.001). In the diagnosis of remission, ΔAFP% had an area under the ROC curve (AUC) of 0.796, while ΔDCP% had an AUC of 0.912 and ΔAFP% combined with ΔDCP% had an AUC of 0921, suggesting that ΔAFP% combined with ΔDCP% had the highest diagnostic value. ConclusionChanges in serum DCP and AFP after TACE can be used to evaluate the outcome of HCC after TACE.

Objective: To investigate the analgestic effect of dezocine in radio frequency ablation (RFA) for the treatment of hepatic carcinoma. Methods: Sixty patients with hepatic carcinoma were enrolled in this study. These patients were randomly divided into two groups: Group A (n=28) and Group B (n=30) . Before operation, the patients in Group A were IM given pethidine (75 mg) while the patients in Group B were treated with dezocine (0.1 mg/kg) . The visual analogue scale (VAS) and patients satisfaction scale were used to evaluate the comfort degree, and the incidence rates of adverse drug reactions were also recorded. Results: In the operation, the VAS score in Group B was lower than that of the Group A (3.3±1.7 vs. 5.9±1.4) and the difference was statistically significant (P<0.05) . After operation, the VAS score in Group B was lower than that of Group A (2.3±1.4 vs. 4.6±1.3) and the difference was statistically significant (P<0.05) . Satisfaction level (1:very good, 2:good, 3:general, 4:bad) in group B (8, 13, 7, 1) was better than that in group A (3, 10, 12, 5) and the difference was statistically significant (P<0.05) . Conclusions: The use of dezocine can ensure the completion of RFA operation for HCC, and the effect is better than that of pethidine. Key words: Dezocine; Pethidine; Analgesia; Hepatic Carcinoma; Radio frequency albation