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Intraluminal versus infiltrating gallbladder carcinoma:Clinical presentation,ultrasound and computed tomography 被引量:7
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作者 Tze-Yu Lee Sheung-Fat Ko +5 位作者 chung-cheng huang Shu-Hang Ng Jiun-Lung Liang Hsuan-Ying huang Min-Chi Chen Shyr-Ming Sheen-Chen 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第45期5662-5668,共7页
AIM: To compare clinical presentation and ultrasound (US) and computed tomography (CT) sensitivity between intraluminal and infiltrating gallbladder carcinoma (GBCA). METHODS: This retrospective study evaluate... AIM: To compare clinical presentation and ultrasound (US) and computed tomography (CT) sensitivity between intraluminal and infiltrating gallbladder carcinoma (GBCA). METHODS: This retrospective study evaluated 65 cases of GBCA that were categorized morphologically into the intraluminaI-GBCA (n = 37) and infiltrating-GBCA (n = 28) groups. The clinical and laboratory findings, presence of gallstones, gallbladder size, T-staging, nodal status, sensitivity of preoperative US and CT studies, and outcome were compared between the two groups. RESULTS: There were no significant differences between the two groups with respect to female predominance, presence of abdominal pain, serum aminotransferases level, T2-T4 staging, and regional metastatic nodes. Compared with the patients with intraluminaI-GBCA, those with infiltrating-GBCA were significantly older (65.49 ± 1.51 years vs 73.07 ± 1.90 years), had a higher frequency of jaundice (3/37 patients vs 13/28 patients) and fever (3/37 patients vs 10/28 patients), higher alkaline phosphatase (119.36 ± 87.80 IU/L vs 220.68 ± 164.84 IU/L) and total bilirubin (1.74 ± 2.87 mg/L vs 3.50 ± 3.51 mg/L) levels, higher frequency of gallstones (12/37 patients vs 22/28 patients), smaller gallbladder size (length, 7.47± 1.70 cm vs 6.47 ± 1.83 cm; width, 4.21 ± 1.43 cm vs 2.67 ± 0.93 cm), and greater proportion of patients with 〈 12 mo survival (16/37 patients vs 18/28 patients). The sensitivity for diagnosing intraluminal- GBCA with and without gallstones was 63.6% and 91.3% by US, and 80% and 100% by CT, respectively. The sensitivity for diagnosing infiltrating-GBCA with and without gallstones was 12.5% and 25% by US, and 71.4% and 75% by c-r, respectively. CONCLUSION: In elderly women exhibiting small gallbladder and gallstones on US, especially those with jaundice, fever, high alkaline phosphatase and bilirubin levels, CT may reveal concurrent infiltrating-GBCA. 展开更多
关键词 Gallbladder neoplasms CARCINOMA ULTRASOUND Computed tomography
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体外冲击波与髓芯减压植骨对股骨头坏死治疗的比较研究
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作者 CHING-JEN WANG FENG-SHENG WANG +4 位作者 chung-cheng huang KUENDER D. YANG LIN-HSIU WENG HSUAN-YING huang 李晓辉(译) 《骨科动态》 2006年第2期74-80,共7页
背景:有关早期症状性股骨头坏死的理想治疗长期以来一直存在着争议。为此,我们对两组随机患者分别进行了体外冲击波的非侵入性治疗和髓芯减压植骨的手术治疗,并将两种不同干预手段的治疗结果做了比较研究。方法:Ⅰ、Ⅱ或Ⅲ期股骨头... 背景:有关早期症状性股骨头坏死的理想治疗长期以来一直存在着争议。为此,我们对两组随机患者分别进行了体外冲击波的非侵入性治疗和髓芯减压植骨的手术治疗,并将两种不同干预手段的治疗结果做了比较研究。方法:Ⅰ、Ⅱ或Ⅲ期股骨头坏死患者随机分为两组:冲击波组和髓芯减压联合不带血管的腓骨移植组。冲击波组23例(29髋);手术组25例(28髋)。两组病例的人口统计学特征、疾病分期和随访时间相似。冲击波组用28kV6000脉冲的冲击波对患髋行一次性治疗,评价参数包括临床上对痛觉的视觉模拟评分、Harris髋关节评分以及日常生活和工作能力评价;影像学评价包括系列X线片和磁共振成像(MRI)观察。结果:两组患者治疗前的疼痛评分和Harris髋关节评分均相似。经过平均25个月的随访,冲击波治疗组,疼痛评分和Harris髋关节评分明显优于治疗前(p〈0.001),患髋79%改善、10%无变化、10%加重;不带血管的腓骨移植手术组,29%改善、36%无变化、36%加重。影像学结果显示:冲击波组治疗前Ⅰ或Ⅱ期的13侧患髋中有5侧病变复原,1例Ⅲ期病未复原,4侧髋(2侧Ⅱ期和2侧Ⅲ期)病变进展;手术组19侧患髋(Ⅰ或Ⅱ期)中有4侧病变复原,15侧病变进展,其余9侧患者病变无变化。结论:体外冲击波对早期股骨头坏死的疗效优于髓芯减压联合不带血管的腓骨移植手术治疗。而这种新的治疗手段对股骨头坏死的远期疗效还有待进一步探索。 展开更多
关键词 早期股骨头坏死 体外冲击波 手术治疗 髓芯减压 减压植骨 视觉模拟评分 病变进展 非侵入性治疗 腓骨移植 随访时间
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