文章摘要
张楼乾,蒋 峰,李 明,胡江文,许 林.无创三维重建在肺部亚厘米结节定位中应用[J].南京医科大学学报,2019,(10):1491~1493
无创三维重建在肺部亚厘米结节定位中应用
Study of antiplatelet efficacy of ticagrelor and clinical outcomes in patients after off⁃pump coronary artery bypass graft via thrombelastography test
投稿时间:2019-01-01  
DOI:10.7655/NYDXBNS20191018
中文关键词: 肺结节  定位  亚厘米  三维重建  无创
英文关键词: thrombelastography  ticagrelor  clopidogrel  coronary artery bypass graft
基金项目:国家“863”计划 (SQ2015AA0201657);国家自然科学基金(81872378,81572261);江苏省科技厅重点研发计划(BE2016797)
作者单位
张楼乾 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院胸外科江苏 南京 210009 
蒋 峰 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院胸外科江苏 南京 210009 
李 明 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院胸外科江苏 南京 210009 
胡江文 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院胸外科江苏 南京 210009 
许 林 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院胸外科江苏 南京 210009 
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中文摘要:
      目的:探讨影像三维重建技术在亚厘米肺部结节术前规划及术中定位中的应用价值。方法:利用Osirix软件对40例肺部亚厘米结节患者胸部增强CT扫描的DICOM格式数据进行三维重建,通过三维模型来实现术前制定手术方式和术中无创定位肺结节。结果:40例患者共46枚结节,术中均成功定位找到结节,结节手术切除率为100%。行单孔胸腔镜下肺段切除14例,楔形切除26例。CT影像测量结节距胸膜表面深度为(12.1 ± 5.8)mm(0~55 mm)。楔形切除平均术中定位结节时间为(5.2 ± 3.0)min(2~20 min),平均住院时间为(2.4 ± 1.6)d。本组患者术中、术后均未出现相关并发症,术后随访3个月均恢复良好。结论:Osirix重建软件可为肺部亚厘米结节术前制定手术方案提供依据;无肺穿刺定位相关并发症,术中定位准确性高,为肺结节定位提供了一种新方法,具有临床推广价值。
英文摘要:
      Objective:To evaluate the antiplatelet efficacy of ticagrelor in patients after off?pump coronary artery bypass graft(OPCABG)surgery and observe its clinical outcomes. Methods:A total of 90 patients undergoing OPCABG successfully in the First Affiliated Hospital of NMU during May 2015 to June 2016 were enrolled in this study. Patients were randomly divided into three groups. In the first day after surgery,group A was given clopidogrel(75 mg,1/day,oral);group B was given ticagrelor(90 mg,2/day,oral);group C was given half amount ticagrelor(45 mg,2/day,oral). The three groups took aspirin standard dose(100 mg,1/day)at the same time. In 5 to 7 days after OPCABG,platelet inhibition(PI)rate induced by arachidonic acid(AA)and adenosine diphosphate(ADP)(PIADP and PIAA)by TEG was monitored to compare antiplatelet efficacy of the three groups. Major adverse cardiac events(MACE),bleeding events and related adverse reactions were also compared between the groups to evaluate the clinical effect. Results:Compared with group A,PIADP(%)of group B and group C were significantly increased(83.8 ± 17.6 vs. 60.5 ± 25.6,P=0.001;77.9 ± 24.6 vs. 60.5 ± 25.6,P=0.013,respectively). There was no obvious difference of PIADP(%)between group B and group C(77.9 ± 24.6 vs. 83.8 ± 17.6,P > 0.05). The three groups were not seen obvious MACE. Compared with group A,incidence of bleeding events in group B was increased,but there was no statistically significant difference(23.3% vs. 16.6%,P > 0.05). Conclusion:Ticagrelor treatment as antiplatelet therapy in patients after OPCABG was effective and safe,and its antiplatelet efficacy was superior to clopidogrel.
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