Baidu
map

NEJM:磁共振随访检查对坐骨神经痛患者无益

2013-03-21 shumufeng 丁香园

存在已知腰椎间盘突出症和持续存在坐骨神经痛症状的患者在随访期间经常进行磁共振成像(MRI)检查。目前对MRI的表现与临床转归之间的相关性尚存争议。荷兰莱顿大学医学中心神经外科的Abdelilah Barzouhi博士等人进入了深入研究,他们发现,已治疗坐骨神经痛和腰椎间盘突出症的患者随访1年时进行的MRI检查在转归良好的患者与转归欠佳的患者之间无差异。研究结果发表于国际权威杂志NEJM 2013年

存在已知腰椎间盘突出症和持续存在坐骨神经痛症状的患者在随访期间经常进行磁共振成像(MRI)检查。目前对MRI的表现与临床转归之间的相关性尚存争议。荷兰莱顿大学医学中心神经外科的Abdelilah Barzouhi博士等人进入了深入研究,他们发现,已治疗坐骨神经痛和腰椎间盘突出症的患者随访1年时进行的MRI检查在转归良好的患者与转归欠佳的患者之间无差异。研究结果发表于国际权威杂志NEJM 2013年最新一期在线版上。
研究人员在一项比较坐骨神经痛和腰椎间盘突出症手术治疗与长期保守治疗的随机试验中对283例患者进行了研究。患者在基线和1年后进行了MRI检查。我们采用了一个4分的量表(范围从“确定有”的1分到“确定没有”的4分)来评估MRI上的椎间盘突出症(表现)。良好的临床转归定义为1年时症状完全或几乎完全消失。我们比较了确定没有椎间盘突出症的患者和确定、很可能、可能有椎间盘突出症的患者在1年时转归良好的患者比例。我们采用了接受者操作特征(ROC)曲线下的面积来评估该4分量表预测转归良好或欠佳的准确性,1(ROC曲线下的面积)提示有鉴别价值,≤0.5提示无鉴别价值。
试验1年时,84%的患者报告转归良好。椎间盘突出症见于35%转归良好的患者和33%转归欠佳的患者(P=0.70)。85%的椎间盘突出症患者和83%的无椎间盘突出症患者报告转归良好(P=0.70)。转归良好的患者和转归欠佳的患者椎间盘突出症的MRI评估无差异(ROC曲线下的面积0.48)。
研究者由此得出结论,已治疗坐骨神经痛和腰椎间盘突出症的患者随访1年时进行的MRI检查在转归良好的患者与转归欠佳的患者之间无差异。

BACKGROUND
Magnetic resonance imaging (MRI) is frequently performed during follow-up in patients with known lumbar-disk herniation and persistent symptoms of sciatica. The association between findings on MRI and clinical outcome is controversial.
METHODS
We studied 283 patients in a randomized trial comparing surgery and prolonged conservative care for sciatica and lumbar-disk herniation. Patients underwent MRI at baseline and after 1 year. We used a 4-point scale to assess disk herniation on MRI, ranging from 1 for “definitely present” to 4 for “definitely absent.” A favorable clinical outcome was defined as complete or nearly complete disappearance of symptoms at 1 year. We compared proportions of patients with a favorable outcome among those with a definite absence of disk herniation and those with a definite, probable, or possible presence of disk herniation at 1 year. The area under the receiver-operating-characteristic (ROC) curve was used to assess the prognostic accuracy of the 4-point scores regarding a favorable or unfavorable outcome, with 1 indicating perfect discriminatory value and 0.5 or less indicating no discriminatory value.
RESULTS
At 1 year, 84% of the patients reported having a favorable outcome. Disk herniation was visible in 35% with a favorable outcome and in 33% with an unfavorable outcome (P=0.70). A favorable outcome was reported in 85% of patients with disk herniation and 83% without disk herniation (P=0.70). MRI assessment of disk herniation did not distinguish between patients with a favorable outcome and those with an unfavorable outcome (area under ROC curve, 0.48).
CONCLUSIONS
MRI performed at 1-year follow-up in patients who had been treated for sciatica and lumbar-disk herniation did not distinguish between those with a favorable outcome and those with an unfavorable outcome. 

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (6)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1818752, encodeId=30741818e52ef, content=<a href='/topic/show?id=48e4984e332' target=_blank style='color:#2F92EE;'>#随访检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98473, encryptionId=48e4984e332, topicName=随访检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Sun Apr 07 03:56:00 CST 2013, time=2013-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=5561, encodeId=637d55616f, content=这种研究国内极少出现,逆向思维结果, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=, createdTime=Sat Mar 30 14:03:00 CST 2013, time=2013-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341517, encodeId=0cef134151e5e, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519910, encodeId=de7c151991030, content=<a href='/topic/show?id=7835414e572' target=_blank style='color:#2F92EE;'>#坐骨神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41475, encryptionId=7835414e572, topicName=坐骨神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a6a111300563, createdName=lishiwen, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540796, encodeId=0c2c1540e964b, content=<a href='/topic/show?id=ac8de440615' target=_blank style='color:#2F92EE;'>#神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74406, encryptionId=ac8de440615, topicName=神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d8213287489, createdName=贵阳, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571801, encodeId=618d15e1801e9, content=<a href='/topic/show?id=9e40414e44c' target=_blank style='color:#2F92EE;'>#坐骨神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41474, encryptionId=9e40414e44c, topicName=坐骨神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4cdc15767871, createdName=ycmayy, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=)]
    2013-04-07 habb
  2. [GetPortalCommentsPageByObjectIdResponse(id=1818752, encodeId=30741818e52ef, content=<a href='/topic/show?id=48e4984e332' target=_blank style='color:#2F92EE;'>#随访检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98473, encryptionId=48e4984e332, topicName=随访检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Sun Apr 07 03:56:00 CST 2013, time=2013-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=5561, encodeId=637d55616f, content=这种研究国内极少出现,逆向思维结果, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=, createdTime=Sat Mar 30 14:03:00 CST 2013, time=2013-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341517, encodeId=0cef134151e5e, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519910, encodeId=de7c151991030, content=<a href='/topic/show?id=7835414e572' target=_blank style='color:#2F92EE;'>#坐骨神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41475, encryptionId=7835414e572, topicName=坐骨神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a6a111300563, createdName=lishiwen, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540796, encodeId=0c2c1540e964b, content=<a href='/topic/show?id=ac8de440615' target=_blank style='color:#2F92EE;'>#神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74406, encryptionId=ac8de440615, topicName=神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d8213287489, createdName=贵阳, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571801, encodeId=618d15e1801e9, content=<a href='/topic/show?id=9e40414e44c' target=_blank style='color:#2F92EE;'>#坐骨神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41474, encryptionId=9e40414e44c, topicName=坐骨神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4cdc15767871, createdName=ycmayy, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=)]
    2013-03-30 匿名用户

    这种研究国内极少出现,逆向思维结果

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1818752, encodeId=30741818e52ef, content=<a href='/topic/show?id=48e4984e332' target=_blank style='color:#2F92EE;'>#随访检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98473, encryptionId=48e4984e332, topicName=随访检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Sun Apr 07 03:56:00 CST 2013, time=2013-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=5561, encodeId=637d55616f, content=这种研究国内极少出现,逆向思维结果, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=, createdTime=Sat Mar 30 14:03:00 CST 2013, time=2013-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341517, encodeId=0cef134151e5e, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519910, encodeId=de7c151991030, content=<a href='/topic/show?id=7835414e572' target=_blank style='color:#2F92EE;'>#坐骨神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41475, encryptionId=7835414e572, topicName=坐骨神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a6a111300563, createdName=lishiwen, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540796, encodeId=0c2c1540e964b, content=<a href='/topic/show?id=ac8de440615' target=_blank style='color:#2F92EE;'>#神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74406, encryptionId=ac8de440615, topicName=神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d8213287489, createdName=贵阳, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571801, encodeId=618d15e1801e9, content=<a href='/topic/show?id=9e40414e44c' target=_blank style='color:#2F92EE;'>#坐骨神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41474, encryptionId=9e40414e44c, topicName=坐骨神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4cdc15767871, createdName=ycmayy, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1818752, encodeId=30741818e52ef, content=<a href='/topic/show?id=48e4984e332' target=_blank style='color:#2F92EE;'>#随访检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98473, encryptionId=48e4984e332, topicName=随访检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Sun Apr 07 03:56:00 CST 2013, time=2013-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=5561, encodeId=637d55616f, content=这种研究国内极少出现,逆向思维结果, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=, createdTime=Sat Mar 30 14:03:00 CST 2013, time=2013-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341517, encodeId=0cef134151e5e, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519910, encodeId=de7c151991030, content=<a href='/topic/show?id=7835414e572' target=_blank style='color:#2F92EE;'>#坐骨神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41475, encryptionId=7835414e572, topicName=坐骨神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a6a111300563, createdName=lishiwen, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540796, encodeId=0c2c1540e964b, content=<a href='/topic/show?id=ac8de440615' target=_blank style='color:#2F92EE;'>#神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74406, encryptionId=ac8de440615, topicName=神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d8213287489, createdName=贵阳, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571801, encodeId=618d15e1801e9, content=<a href='/topic/show?id=9e40414e44c' target=_blank style='color:#2F92EE;'>#坐骨神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41474, encryptionId=9e40414e44c, topicName=坐骨神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4cdc15767871, createdName=ycmayy, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1818752, encodeId=30741818e52ef, content=<a href='/topic/show?id=48e4984e332' target=_blank style='color:#2F92EE;'>#随访检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98473, encryptionId=48e4984e332, topicName=随访检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Sun Apr 07 03:56:00 CST 2013, time=2013-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=5561, encodeId=637d55616f, content=这种研究国内极少出现,逆向思维结果, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=, createdTime=Sat Mar 30 14:03:00 CST 2013, time=2013-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341517, encodeId=0cef134151e5e, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519910, encodeId=de7c151991030, content=<a href='/topic/show?id=7835414e572' target=_blank style='color:#2F92EE;'>#坐骨神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41475, encryptionId=7835414e572, topicName=坐骨神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a6a111300563, createdName=lishiwen, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540796, encodeId=0c2c1540e964b, content=<a href='/topic/show?id=ac8de440615' target=_blank style='color:#2F92EE;'>#神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74406, encryptionId=ac8de440615, topicName=神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d8213287489, createdName=贵阳, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571801, encodeId=618d15e1801e9, content=<a href='/topic/show?id=9e40414e44c' target=_blank style='color:#2F92EE;'>#坐骨神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41474, encryptionId=9e40414e44c, topicName=坐骨神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4cdc15767871, createdName=ycmayy, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=)]
    2013-03-23 贵阳
  6. [GetPortalCommentsPageByObjectIdResponse(id=1818752, encodeId=30741818e52ef, content=<a href='/topic/show?id=48e4984e332' target=_blank style='color:#2F92EE;'>#随访检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98473, encryptionId=48e4984e332, topicName=随访检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Sun Apr 07 03:56:00 CST 2013, time=2013-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=5561, encodeId=637d55616f, content=这种研究国内极少出现,逆向思维结果, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=, createdTime=Sat Mar 30 14:03:00 CST 2013, time=2013-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341517, encodeId=0cef134151e5e, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519910, encodeId=de7c151991030, content=<a href='/topic/show?id=7835414e572' target=_blank style='color:#2F92EE;'>#坐骨神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41475, encryptionId=7835414e572, topicName=坐骨神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a6a111300563, createdName=lishiwen, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540796, encodeId=0c2c1540e964b, content=<a href='/topic/show?id=ac8de440615' target=_blank style='color:#2F92EE;'>#神经痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74406, encryptionId=ac8de440615, topicName=神经痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0d8213287489, createdName=贵阳, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571801, encodeId=618d15e1801e9, content=<a href='/topic/show?id=9e40414e44c' target=_blank style='color:#2F92EE;'>#坐骨神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41474, encryptionId=9e40414e44c, topicName=坐骨神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4cdc15767871, createdName=ycmayy, createdTime=Sat Mar 23 01:56:00 CST 2013, time=2013-03-23, status=1, ipAttribution=)]

相关资讯

NEJM:中山大学发表一罕见病例

  在最新一期《新英格兰医学杂志》(N Engl J Med 2012;367:e18)上刊登了中山大学附属第三医院耳鼻咽喉-头颈外科医生杨钦泰和李鹏合作撰写的题为“A Laryngeal Fluke”一例罕见病例。   病例报道的患者因进食生鱼片后出现严重的咽痒、咳嗽症状,经多方治疗经久不愈。当患者到三院耳鼻咽喉-头颈外科门诊喉镜检查

NEJM:免疫功能低下患者诺如病毒胃肠炎的防治

传染性胃肠炎是一种常见的急性疾病,虽然有自限性的特征,但可能使免疫功能低下患者更加虚弱并危及生命。诺如病毒是引发免疫功能强健和免疫功能低下患者胃肠炎的主要致病源。在美国,诺如病毒是引发成人急诊室就诊的急性胃肠炎的单一最常见病源微生物,也是引发婴儿和儿童严重腹泻的第二大主要轮状病毒。 在发展中国家,评估认为诺如病毒导致了超过200 000 例5岁以下儿童死亡,预测当轮状病毒经疫苗预防得到控制后,此

NEJM:脐带血与间充质细胞体外共培养可改善脐带血移植结局

限制脐血移植临床应用的主要因素是其有核细胞数量太低。美国德克萨斯州立大学de Lima博士等研究者假设通过间充质细胞与脐带血体外共培养移植或可改善移植应用,他们的研究发现,间充质基质细胞与脐带血细胞共培养移植或是安全有效的。与仅接受未处理脐带血移植相比,扩增脐带血与未处理脐带血共移植可显着性改善移植结局。论文发表于国际权威杂志NEJM 2012年12月19日在线版。 研究者对31例接受2个单位脐

NEJM:阿比特龙可使早期前列腺癌患者有显著获益

一项重要的新临床试验显示,一种已经用于治疗晚期前列腺癌的药物也可使早期前列腺癌患者明显获益。去年5月英国国家卫生与临床优化研究所(NICE)批准将伦敦癌症研究所研制的阿比特龙列为国家健康保险(NHS)的医保用药,其治疗适应症是对标准激素治疗和紫杉醇化疗停止反应的前列腺癌。 癌症研究所(ICR)和皇家马斯登NHS信托基金进行了一项新的III期临床试验,结果显示,化疗前给无症状和轻度症状男性患者进行

NEJM:他汀降低癌症患者死亡率

一项丹麦的大样本研究发现,对癌症患者应用他汀类药物减少疾病相关死亡率可达15%。 研究发现,与没有应用他汀类药物的患者相比,13种癌症患者应用他汀类药物后,癌症特异的死亡率降低了。所有原因死亡的风险比是0.85,死于癌症是0.85。 研究结果发表在2011年11月8日的《新英格兰医学杂志》上。 Neil E Caporaso博士(国家癌症研究所,马里兰州贝塞斯达)在一篇社论指出,先前的研究显

NEJM: 乳腺癌放疗增加缺血性心脏病风险

缺血性心脏病的累积发生率 乳腺癌放疗往往涉及一些偶然的心脏对电离辐射的暴露。这种暴露对以后缺血性心脏病风险的影响尚不确定。英国牛津大学Darby博士及其同事对此进行了深入研究,他们发现在乳腺癌放疗期间心脏电离辐射暴露可导致以后缺血性心脏病的发生率增加。该病发生率的增加与心脏受照平均剂量成比例,于暴露后数年内开始,并持续至少20年。此前存在心脏风险因素的女性因放疗导致的风险绝对增加值大于其他女

Baidu
map
Baidu
map
Baidu
map