搜索到98837篇“ LOWER“的相关文章
Foreign Bodies in the Lower Airways: Patient Pathways and Management at the ENT Department of Donka National Hospital, Guinea
2025年
Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.
Ibrahima DialloMamadou Mouctar Ramata DialloIsmaël DaboSayon KouroumaMamadou Aliou DialloAlseny CamaraAlseny CisséRaphan Mady Kaba KeïtaAminata G. DialloMamadou Cellou BahYoussouf Bapaté BarryAlpha Oumar BarryAbdoulaye BayoMohamed Casimir KamanAbdoulaye KeitaAlpha Oumar Diallo
关键词:PATHWAYGUINEA
Open Lower Limb Trauma in Children
2025年
Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age was 8 years with a sex ratio of 2.45. In 68.4% of cases, trauma occurred in road traffic accidents. Average consultation time was 2.4 hours. Trauma mainly affected the leg in 39.5% of cases, and the thigh in 34.2%. Soft tissue wounds occurred in 52.6% of cases, and open fractures in 47.4%. Average response time was one hour. Wound trimming and suturing were performed in 76.3% of cases and combined with bone nailing in 15.8%. The outcome was favorable in 92.1% of cases. Average hospital stay was 4.37 days. Conclusion: Open trauma to the lower limb is a frequent and occurs mainly in road traffic accidents. Management was early, with a favorable outcome for most patients and a short hospital stay.
Abakar Djibrine Mahamat-NourOlivier N’garinguemBembo LamegaAli Haouane NaziraKalki DjiannoneOuchemi Choua
关键词:CHILDRENCHAD
Surgical Management of Varicose Veins of the Lower Limbs: Retrospective Study of 280 Patients
2025年
Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical management of varicose pathology of the IM in Dakar. We enrolled 280 patients, with a mean age of 36 and a sex ratio of 2. Factors favouring venous disease were dominated by prolonged orthostatism and multiparity. The average consultation time was 6 years. The reasons for consultation were functional manifestations, progressive complications and aesthetics. The venous trunks concerned were the great saphenous vein (GSV) in 58.9% of cases, the small saphenous vein (SSV) in 29% of cases, perforating veins and varicose veins were unsystematized in 28.5% of cases. Surgery was performed under spinal anaesthesia. Surgical procedures were dominated by stripping of the GSV, crossectomy of the SSV and staged ligations. One patient developed meningismus immediately after the operation. Average follow-up was 2 years. Mortality was null.
Papa Amath DiagneAbdoul Aziz ThiawMomar Sokhna DiopNdeye Fatou SowAbdoul Ahad MbenguePapa Ousmane BaMory CamaraSoda Mareme MbayeMoussa Seck DiopJean Claude DioneAbdoul Khoudoss DialloMoussa Mareme SambaIbrahima WadeAnta Mbaye SallMagaye GayePapa Adama DiengAmadou Gabriel Ciss
关键词:STRIPPING
Keep式下肢功能锻炼操在宫颈癌术后预防下肢淋巴水肿中的应用
2025年
目的:探讨Keep式下肢功能锻炼操在宫颈癌术后病人下肢淋巴水肿预防中的应用效果。方法:选取2020年4月—2022年10月在无锡市某三级甲等医院行宫颈癌根治性切除联合盆腔淋巴结清扫术的108例病人,采用随机数字表法分为对照组与观察组,每组54例。对照组实施常规健康宣教,观察组实施常规健康宣教结合Keep式下肢功能锻炼操干预,比较两组病人术后6个月下肢周径、下肢淋巴水肿发生率及淋巴水肿相关症状发生率,比较病人住院和出院6个月满意度。结果:术后6个月,观察组大腿、小腿周径均小于对照组,下肢淋巴水肿相关症状总发生率低于对照组,出院6个月满意度高于对照组,差异均有统计学意义(P<0.05)。结论:将Keep式下肢功能锻炼操用于宫颈癌病人术后护理中,有助于减少下肢淋巴水肿相关症状的发生,提高病人生活质量及出院满意度。
朱滢钰陈志芳
关键词:宫颈癌下肢淋巴水肿
下肢静脉常规超声检查联合CT血管造影技术在缺血性脑卒中后下肢深静脉血栓形成评估中的研究
2025年
目的:分析下肢静脉常规超声检查联合CT静脉血管造影(CTV)在缺血性脑卒中后下肢深静脉血栓(DVT)形成评估中的效果。方法:回顾性分析2020年1月至2023年5月西电集团医院进行治疗的132例缺血性脑卒中患者的临床资料,所选患者均疑似下肢DVT形成,故接受数字减影血管造影(DSA)、下肢静脉常规超声和CTV检查,以DSA检查结果为“金标准”,分析下肢静脉常规超声检查联合CTV在脑卒中后下肢DVT形成中的诊断效能。结果:经DSA检查结果证实,132例疑似下肢DVT形成患者中,共计128例患者确诊下肢DVT;下肢静脉常规超声检出下肢DVT形成102例,超声诊断结果与DSA一致性一般(Kappa=0.461,P=0.000);CTV检出111例下肢DVT形成,CTV诊断结果与DSA一致性一般(Kappa=0.605,P=0.000);下肢静脉常规超声联合CTV诊断下肢DVT形成结果与DSA一致性较好(Kappa=0.752,P=0.000);超声联合CTV诊断准确率、灵敏度和阴性预测值分别为93.33%、94.53%和73.08%,均明显高于单项诊断,差异均有统计学意义(x^(2)=10.727、12.463、6.313,P<0.05)。结论:下肢静脉常规超声检查联合CTV诊断缺血性脑卒中后的下肢DVT形成,能够提高临床诊断准确率和诊断效能,有助于患者病情的评估。
刘天鹰段欣张改王文利
关键词:CT血管造影
双下肢气压泵对预防腰椎术后患者下肢深静脉血栓的效果研究
2025年
目的:研究双下肢气压泵辅助踝泵运动对预防腰椎术后卧床患者下肢深静脉血栓的效果。方法:选取2022年7月~2023年7月74例腰椎术后卧床患者为研究对象,随机分为对照组、观察组各37例;对照组进行常规干预,观察组在对照组基础上实施双下肢气压泵辅助的踝泵运动干预;比较两组凝血功能指标、下肢静脉血流速度、下肢周径、下肢深静脉血栓发生率。结果:干预后,观察组各项凝血功能指标均优于对照组,观察组各下肢静脉血流速度均快于对照组,观察组各下肢周径均小于对照组,观察组下肢深静脉血栓发生率远低于对照组,P均<0.05。结论:双下肢气压泵辅助的踝泵运动可改善腰椎术后患者凝血功能,加快下肢静脉血流速度,有效预防下肢深静脉血栓。
王佳宁
关键词:腰椎下肢深静脉血栓
祛痹健腰丸联合骶管神经阻滞对腰椎间盘突出症患者腰痛及下肢窜痛的改善作用分析
2025年
目的分析祛痹健腰丸联合骶管神经阻滞对腰椎间盘突出症患者腰痛及下肢窜痛的改善作用。方法前瞻性选取2024年1月至2024年6月九江市中医医院收治的120例腰椎间盘突出症患者,按随机数字表分为观察组(n=60)和对照组(n=60)。对照组采用骶管神经阻滞治疗;观察组采用祛痹健腰丸联合骶管神经阻滞治疗。比较两组患者疗效、血清指标及不良反应。结果与治疗前相比,治疗后及随访3个月的日本骨科协会腰痛评分表(JOA)评分明显升高,Oswestry功能障碍指数(ODI)评分降低,且与对照组JOA评分[(18.42±3.88)分、(16.45±3.71)分]、ODI评分[(13.41±3.54)分、(14.23±4.26)分]相比,观察组JOA评分[(26.33±2.16)分、(24.33±4.36)分]、ODI评分[(6.42±2.23)分、(8.82±2.26)分]更优(均P<0.05)。两组治疗后肿瘤坏死因子(TNF-α)、白细胞介素(IL-6)、C反应蛋白(CRP)水平低于治疗前,且与对照组TNF-α(1.74±0.48)mg/L、IL-6(126.42±8.77)ng/L、CRP(6.46±1.63)ng/L相比,观察组TNF-α(1.04±0.49)mg/L、IL-6(88.64±8.52)ng/L、CRP(4.75±1.74)ng/L更低(均P<0.05)。两组治疗后环氧化酶(COX-2)、前列腺素(PGE_(2))水平高于治疗前,且与对照组COX-2(27.46±4.68)mg/L、PGE_(2)(74.82±8.12)mg/L相比,观察组COX-2(21.35±4.33)mg/L、PGE_(2)(65.83±8.71)mg/L更低(均P<0.05)。两组治疗后骨特异性碱性磷酸酶(BALP)、骨钙素(OC)水平高于治疗前,且与对照组BALP(42.64±5.68)mg/L、OC(28.76±3.89)mg/L相比,观察组BALP(51.44±6.13)mg/L、OC(36.45±4.51)mg/L更高(均P<0.05)。治疗后两组中医证候积分低于治疗前,且与对照组(10.36±1.21)相比,观察组(8.36±0.92)更低(均P<0.05)。观察组疗效(96.67%)高于对照组(83.33%)(P<0.05)。两组不良反应总发生率的差异无统计学意义(P>0.05)。结论祛痹健腰丸联合骶管神经阻滞对腰椎间盘突出症患者有改善腰痛及下肢窜痛的作用。
毛文晶李昌杰汪洋
关键词:骶管神经阻滞腰椎间盘突出症腰痛
改良无管化经皮肾镜碎石取石术治疗2~3cm肾下盏结石后肾下盏解剖结构的变化及对术后清石率的影响
2025年
目的:探讨改良无管化经皮肾镜碎石取石术(percutaneous nephrolithotomy,PCNL)治疗2~3 cm肾下盏结石后肾下盏解剖结构变化及对术后清石率的影响。方法:选取2020年9月至2023年9月西南医科大学附属医院泌尿外科收治的300例2~3 cm肾下盏结石患者作为研究对象,经改良无管化PCNL治疗术后疗效将患者分为清除组(n=253)和残余组(n=47),对2组患者一般资料进行单因素分析,采用限制性三次样条回归法分析肾下盏解剖结构参数变化与术后结石残余的关系;采用逐步logistic回归分析进行影响因素分析,并基于此构建列线图预测模型,绘制校准曲线、受试者工作特征(receiver operating characteristic,ROC)曲线对模型的诊断效能进行评估。结果:2组患者在肾功能不全史(P=0.017)、肾下盏长度(infundibular length,IL)(P<0.001)、结石数量(P=0.025)、结石CT值(P=0.001)、肾下盏宽度(infundibular width,IW)(P<0.001)、手术时间(P=0.002)、肾盂漏斗部夹角(infundibulopelvic angle,IPA)(P<0.001)、肾盂肾下盏高度(pelvic caliceal height,PCH)(P<0.001)、血尿酸(uric acid,UA)(P<0.001)、尿素氮(blood urea nitrogen,BUN)(P=0.014)方面差异有统计学意义(P<0.05);logistic回归显示调整后IL、PCH、IW、IPA仍是术后结石残余的危险因素;逐步logistic回归分析结果显示结石数量、结石CT值、IL、PCH是影响患者经改良无管化PCNL治疗肾下盏结石残余的独立危险因素,IW、IPA是保护因素(均P<0.05);利用以上影响因素进行列线图预测模型构建,得到回归方程为Logit(P)=-2.567+0.1109×X_(1)+1.170×X_(2)-0.226×X3+0.023×X4-0.442×X5+0.714×X6,其一致性指数0.893(95%CI=0.878~0.901),ROC曲线分析显示,模型AUC为0.888(95%CI=0.869~0.897),灵敏度为0.827,特异度为0.795,区分度较好;校准曲线提示该模型准确度较高。结论:改良无管化PCNL治疗2~3 cm肾下盏结石是一种安全有效的方法,肾下盏结石患者可通过充分考虑解剖结构方面影响因�
吴韬王亮
下肢动脉硬化闭塞症临床误诊分析
2025年
目的分析下肢动脉硬化闭塞症的临床误诊原因,以提高临床医师诊治水平。方法回顾性分析2022年1月至2024年1月收治的曾误诊的2例下肢动脉硬化闭塞症患者的临床资料。结果1例因右小腿麻木、间歇性跛行、右足趾、小腿持续性疼痛、右足趾末端感觉消失,多次就诊于当地医院诊断为血栓闭塞性脉管炎,予相应治疗症状未见缓解反而加重,后经彩色多普勒超声检查确诊为右股动脉硬化性闭塞症。误诊时间3年。确诊后予相应治疗后坏疽停止进展,行人工血管移植转流和右侧前足截除术。术后3个月随访,症状消失,胫后动脉和足背动脉搏动恢复。1例右下肢间歇性跛行,伴下腰部疼痛不适,行腰椎CT检查考虑腰椎间盘突出症,予相应治疗后,间歇性跛行症状进行性加重并出现右膝下皮肤溃烂坏死,行右下肢动脉造影术,术中见右侧髂总动脉及髂外动脉闭塞,诊断为下肢动脉硬化闭塞症。误诊时间1年。确诊后行血管腔内支架成形术,右股动脉及右足背动脉搏动恢复。术后1个月复查无下肢不适症状。结论下肢动脉硬化闭塞症早期表现多样,误诊率较高,医师应提高对该病的认识,认真详细询问病史及查体,重视临床资料的综合分析,早期行特异性检查方法,以降低误诊率。
杨占辉王鹏
关键词:下肢动脉硬化闭塞症误诊血栓闭塞性脉管炎腰椎间盘突出症下肢动脉造影
下肢血栓性静脉炎的临床分析及治疗
2025年
目的探讨下肢血栓性静脉炎(SVT)患者病因、临床特点及治疗效果。方法将南京中医药大学附属医院2022年3月至2023年12月67例急性下肢SVT患者纳入研究,分析其发病原因、临床表现特征;所有患者彩超明确诊断及血栓范围,根据临床特征将其分为轻症组42例,重症组25例。所有患者给予迈之灵口服、中药煎剂熏洗及多磺酸粘多糖外用基础治疗,轻症组给予阿司匹林缓解肿痛症状,而重症组患者给予每日1次利伐沙班10 mg抗凝治疗,治疗28 d后观察症状缓解率、静脉血栓栓塞症(VTE)发生率及出血等并发症情况,治疗后随访30 d,明确VTE发生及SVT复发情况。结果SVT发病因素多样,但以下肢静脉曲张患者居多(轻症34例,重症18例),其临床表现主要为局部红肿疼痛、皮下硬结条索改变、色素沉着等。所有急性期患者D-二聚体均明显升高,治疗后两组D-二聚体水平均明显下降(t=15.667、29.314,P<0.01)。轻症组总体疗效优于重症组(Z=2.281,P=0.023)。轻症组1例出现血栓蔓延转为重症,接受利伐沙班治疗症状缓解,无深静脉血栓/肺栓塞发生;重症组2例出现深静脉血栓形成,按深静脉血栓抗凝治疗血栓消退。轻症组无明显出血事件发生,重症组出现1例鼻出血,停药后恢复。30 d随访两组均无VTE事件发生,无SVT复发。结论SVT病因多样,血栓位置、范围及临床表现不一,根据SVT临床特点进行风险评估,采取个体化综合治疗,可以缓解症状,预防VTE形成及SVT的复发,具有良好疗效。
乔威刘佳莅夏成勇姜伟华邵泽锋
关键词:血栓性静脉炎下肢下肢静脉曲张利伐沙班中药熏洗

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