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紫杉醇洗脱支架在冠心病介入治疗中的临床应用

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岭南心血管病杂志 2005年第3期11卷 187-189页

作者：李浪 lim yean teng Tan Huay Cheem 刘唐威广西医科大学第一附属医院心内科南宁530021 新加坡国立大学医院

目的观察紫杉醇洗脱支架(商品名TAXUS)治疗冠心病的疗效及安全性。方法选择77例冠心病患者,包括36例稳定型心绞痛、40例急性冠状动脉综合征、1例急性心肌梗死,对其92处病变(1处A型病变.91处B型和C型病变)植入92枚TAXUS。于术后住院期间... 详细信息

目的观察紫杉醇洗脱支架(商品名TAXUS)治疗冠心病的疗效及安全性。方法选择77例冠心病患者,包括36例稳定型心绞痛、40例急性冠状动脉综合征、1例急性心肌梗死,对其92处病变(1处A型病变.91处B型和C型病变)植入92枚TAXUS。于术后住院期间、术后30日及12个月检查手术部位再狭窄及心脏不良事件。结果全部病例成功植入TAXUS;术前靶病变狭窄程度为(77±10)%,术后残余狭窄程度为(6.2±0.8)%;目标血管的参考直径及长度分别为(3.6±0.4)mm和(15.0±2.0)mm,植入支架的平均直径及长度分别为(3.2±0.4)mm和(24±15)mm。术后30日发生支架内再狭窄1例,术后第4日亚急性血栓形成1例,6个月在观察终点发生支架边缘再狭窄1例。再狭窄发生率2.6%,心脏不良事件发生率3.9%,靶血管血运重建率3.3%。结论TAXUS可有效地预防冠心病介入治疗术后再狭窄,心脏不良事件发生率低。

关键词：血管成形术,经腔,经皮冠状动脉支架药物洗脱紫杉醇

Acute Coronary Syndrome-Conservative vs Invasive Treatment

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South China Journal of Cardiology 2001年第2期2卷 80-80页

作者： lim yean teng Chief Cardiac Department National University Hospital Singapore

Patients with Acute Coronary Syndrome (ACS)are a clinical continuum-with patients presenting with unstable angina on one end, with patients with ST elevation myocardial infarction (STEMI) at the other end of the spect... 详细信息

关键词： NSTEMI In TIMI Acute Coronary Syndrome-Conservative vs Invasive Treatment ACS

急诊经皮冠状动脉介入治疗与远端血栓保护装置PercuSurge Guardwire联合治疗急性心肌梗死(英文)

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中华急诊医学杂志 2004年第9期13卷 581-583页

作者：李浪刘唐威 Tan Huay Cheem lim yean teng 广西心血管病研究所广西医科大学第一附属医院心内科新加坡国立心脏研究所新加坡国立大学医院

目的　评价远端血栓保护装置PercuSurgeGuardwire在急性心肌梗死 (AMI)的高危急诊经皮冠状动脉介入 (PCI)治疗中预防远端血栓栓塞并发症的临床疗效及安全性。方法　 92例AMI患者为研究对象 ,其中 4 7例在急诊PCI过程中联合应用PercuSurg... 详细信息

目的　评价远端血栓保护装置PercuSurgeGuardwire在急性心肌梗死 (AMI)的高危急诊经皮冠状动脉介入 (PCI)治疗中预防远端血栓栓塞并发症的临床疗效及安全性。方法　 92例AMI患者为研究对象 ,其中 4 7例在急诊PCI过程中联合应用PercuSurgeGuardwire装置(PercuSurge组 ) ,平均年龄 (6 1 4± 7 1)岁 ;另 4 5例进行常规无PercuSurgeGuardwire保护的急诊PCI (对照组 ) ,平均年龄 (6 4 9± 8 3)岁。比较两组急诊PCI术后即刻冠状动脉TIMI血流及院内、 30天主要心脏不良事件发生率。结果　全部病例均成功植入血管支架并放置PercuSurgeGuardwire保护装置。平均阻滞球囊直径 (4 5± 0 5 )mm ,平均阻滞时间 (8 7± 5 9)min。PercuSurge组术后TIMI 3级血流率显著高于对照组 (95 74与 86 6 7% ,P <0 0 5 ) ,无血流事件发生率显著降低 (0 %与 6 6 7% ,P <0 0 5 )。并发症包括 :血管夹层 1例 (2 13% ) ,远端小血管血栓栓塞 1例 (2 13% )。随访全部患者 ,PercuSurge组院内及 30天心脏不良事件发生率均显著低于对照组 (分别为 2 13%与13 33% ,2 13%与 8 89% ,P值均小于 0 0 5 )。结论　联合应用PercuSurgeGuarwire远端保护装置在AMI患者的急诊PCI过程中可安全有效地预防远端血栓栓塞并发症的发生。

关键词：并发症血流发生率急诊PCI 患者对照组远端血栓保护装置平均年龄病例预防

比较Cypher^(TM)和Taxus^(TM)支架在冠心病合并糖尿病患者中应用的安全性和有效性

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介入放射学杂志 2005年第6期14卷 569-572页

作者：张俊杰陈淮沁李志恒林延庭陈绍良南京医科大学附属南京第一医院心内科 210006 新加坡国立大学医院心脏中心新加坡国立大学医学院心脏研究所

背景与裸支架相比,药物洗脱支架可以显著降低冠心病合并糖尿病患者PCI术后再狭窄率和靶病变重建率。但目前尚未见关于直接比较雷帕霉素洗脱支架(CypherTM)和紫杉醇洗脱支架(TaxusTM)在治疗冠心病合并糖尿病患者中安全性和有效性的研究... 详细信息

背景与裸支架相比,药物洗脱支架可以显著降低冠心病合并糖尿病患者PCI术后再狭窄率和靶病变重建率。但目前尚未见关于直接比较雷帕霉素洗脱支架(CypherTM)和紫杉醇洗脱支架(TaxusTM)在治疗冠心病合并糖尿病患者中安全性和有效性的研究。目的观察和比较两种药物洗脱支架在冠心病合并糖尿病患者中应用的安全性和有效性。方法自2002年6月~2004年2月新加坡国立大学医院心脏中心所有置入Cypher或Taxus支架冠心病合并糖尿病患者,观察:术后6个月的主要不良心脏事件(包括死亡、心肌梗死、靶病变重建)。结果共计122例患者(Cypher组为31例,Taxus组为91例)。B2和C型病变75%。两组患者基本特征无显著差异。与Taxus组相比Cypher组有更小参照血管直径(2.4±0.6 mm和2.6±0.7 mm,P<0.01),Cypher组和Taxus组术后急性和亚急性支架内血栓发生率(0%和1.1%)、6个月靶病变重建率(3.2%和3.3%)和主要不良心脏事件(6.4%和5.5%)都没有差异。结论两种药物洗脱支架在冠心病合并糖尿病患者中的临床应用安全、有效的,在降低6个月临床再狭窄率、靶病变重建率和主要不良心脏事件上无明显差异。

关键词：药物洗脱支架冠心病糖尿病随访

远端血栓保护装置在冠状动脉介入治疗中的应用

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中国循环杂志 2003年第3期18卷 235-237页

作者：李浪 Huay Cheem Tan yean teng lim 530021 广西壮族自治区南宁市广西心血管病研究所广西医科大学第一附属医院心内科

远端血栓栓塞是冠状动脉介入治疗 (PCI)中严重的并发症 ,尤其在高危病变如急性心肌梗死和大隐静脉 (SVG)桥的介入治疗过程中更常见。远端血栓栓塞可直接导致“慢血流”或“无再流”现象 ,心肌梗死 ,泵衰竭或死亡等严重的临床后果 ,而且... 详细信息

远端血栓栓塞是冠状动脉介入治疗 (PCI)中严重的并发症 ,尤其在高危病变如急性心肌梗死和大隐静脉 (SVG)桥的介入治疗过程中更常见。远端血栓栓塞可直接导致“慢血流”或“无再流”现象 ,心肌梗死 ,泵衰竭或死亡等严重的临床后果 ,而且传统药物疗效不佳。目前认为 ,微血栓在远端血栓栓塞的机制中发挥着十分重要的作用。远端血栓保护装置是迄今为止预防PCI过程中远端血栓栓塞并发症较理想的器械。

关键词：急性心肌梗死大隐静脉桥介入治疗远端血栓保护装置并发症

Future of Percutaneous Coronapy Intervention From an Asian Perspective

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South China Journal of Cardiology 2002年第1期3卷 1-3页

作者： yean-Leng lim Director NationalHeartCenterSingapore

We have come a long-way since Andreas Gruentzig performed the first percutaneous transluminal coronary angioplasty (PTCA) in man in 1977. It is timely to assess what we have actually achieved for patients with coronar... 详细信息

关键词： Future of Percutaneous Coronapy Intervention From an Asian Perspective

Bilateral Sphenopalatine Ganglion Block for the Treatment of Post Dural Puncture Headache: A Case Report

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Open Journal of Anesthesiology 2022年第1期12卷 1-7页

作者： Shivani Manohara yean Chin lim Department of Anaesthesia and Surgical Intensive Care Changi General Hospital Singapore

Background: Post dural puncture headache (PDPH) is a known and potentially debilitating complication of neuraxial anesthesia that can impede patient recovery. The conventional treatment includes hydration and symptomatic treatment like simple analgesics. Those who have unremitting symptoms following conservative measures are offered an epidural blood patch (EBP). However, EBP, an invasive procedure, is associated with complications in itself. Case: We report a 40-year-old man who experienced PDPH after spinal anesthesia. His symptoms recurred after conservative management was instituted. He was then offered a trans-nasal sphenopalatine ganglion (SPG) block. He had excellent pain relief and did not require an EBP. Conclusion: SPG blocks can be considered early in the treatment of PDPH together with general supportive measures. However, if pain relief is not achieved, an epidural blood patch should still be considered.

关键词： Pain Management Postdural Puncture Headache Sphenopalatine Ganglion Block

Pancreatic pseudocystocolonic fistula treated without surgical or endoscopic intervention

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World Journal of Gastroenterology 2014年第7期20卷 1882-1886页

作者： Jae Choon Kwon Bo yean Kim Ah lim Kim Tae Hoon Kim Myung Il Park Ho Jin Jung Jang Hwan lim Jae Kwon Jung Hyun Soo Kim Dong Wook Lee Division of Gastroenterology and Hepatology Department of Internal MedicineDaegu Fatima HospitalDong-gu Daegu701-600South Korea

We report here a case of pancreatic pseudocystocolic fistula that was treated without surgical or endoscopic intervention.A 76-year-old woman,presenting with a fever and epigastric pain,was referred to our *** months prior to this admission,the patient had been admitted to the hospital for acute *** computerized tomography(CT)revealed a 9 cm pseudocyst containing air,and a fistular opening was observed via *** colonoscopy,the abdominal pain was slightly improved,the fever subsided and laboratory results showed decreased C-reactive protein *** observed improvement was likely due to the cleansing of the bowel,which induced spontaneous drainage from the pseudocyst into the *** therapy was administered and daily bowel cleansing was performed using a polyethylene glycol *** three weeks,a follow-up CT revealed that the size of the pseudocyst had decreased significantly from 9 to 5.3 *** addition,laboratory tests were *** patient was able to resume a normal diet and was discharged in good overall health from the hospital,without aggravation of the symptoms.A colonoscopy performed 3 mo later and a follow-up CT performed 6 mo later confirmed that both the fistula and pseudocyst had completely disappeared.

关键词： Acute pancreatitis Pseudocyst Pseudocystocolic fistula

Comparison of the Analgesic Effects of Ultrasound Guided Supra-Inguinal Fascia Iliaca Block with Femoral Nerve Block for Surgical Fixation of Hip Fractures

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Open Journal of Anesthesiology 2021年第11期11卷 325-333页

作者： Shivani Manohara yean Chin lim Qian Jun Tong Department of Anaesthesia and Surgical Intensive Care Changi General Hospital Singapore

Introduction: Regional anaesthesia techniques have been used for perioperative analgesia for hip fractures. The supra-inguinal approach to fascia iliaca block (FIB) can potentially provide superior analgesia compared to femoral nerve block (FNB) by blocking the obturator and lateral femoral cutaneous nerves. We aimed to evaluate the analgesic effect of single shot FIB and FNB for surgical fixation of hip fractures. Methods: After obtaining ethics approval and written, informed consent, 30 patients undergoing surgical fixation of hip fractures were recruited and randomized into 2 groups. Patients received either a single shot FIB or FNB with 0.5% Ropivacaine 30 mls, and a subarachnoid block. Pain scores were assessed pre-operatively, post-block, in recovery and at 24 hours post-operatively. Time to first analgesic, oxynorm consumption, opioid related side effects and block related complications were assessed at 24 hours. Results: There were no statistically significant difference in post-block pain scores, median (IQR) of 0 (0 - 0) versus 0 (0 - 0) at rest and 3 (2 - 6) versus 5 (2 - 6) on positioning for spinal;and 24 hour pain scores were 0 (0 - 0) versus 0 (0 - 0) at rest and 4 (2 - 5) versus 5 (2 - 6) on movement for FIB and FNB groups respectively. 5 patients from each group required post-operative opioids, post-operative opioids requirement were similar. Conclusions: Though ultrasound guided supra-inguinal FIB was more consistent in blocking the lateral femoral cutaneous nerve then a femoral nerve block, this did not translate to any difference in terms of pain scores, opioid consumption and side effects.

关键词： Hip Fracture Regional Anaesthesia Analgesia Femoral Block Fascia Iliaca Block