浅论肝移植医师的理念和思维

随着医学的进步,在新的医疗形势下,肝移植是对器官移植科医师的巨大挑战,在实际临床工作中,应首先树立正确的器官移植医患关系观,不断提高自己的人文修养和职业素养,进一步完善与肝移植相关的新的知识结构,运用正确的哲学理念和逻辑方式来处理与肝移植相关的临床问题。使肝移植患者得到满意的治疗效果。     

活体肝移植与供体安全

等候移植的病人增多和可用器官短缺,是我们目前所面临的主要问题。为降低等候期间的死亡率,活体肝移植(LDLT)是一种不错的选择,但其前提是要确保供体的安全。尽管活体肝移植术对供体而言是安全可行的,然而供体所发生的严重并发症、甚至死亡则是我们所不应忽视和低估的。     

活体肝移植供者心理社会方面问题的研究进展

活体肝移植供者心理社会方面问题的主要研究进展为：多数供者与受者之间有血缘关系,或者有亲密的情感联系;供者有利他主义动机;供者术后有短期健康相关生存质量下降,但术后1年之内可恢复正常。     

Dieulafoy 病导致上消化道大出血的成功救治体会

一例肾移植术后患者行盆腔磁共振检查后出现剧烈呕吐,引起严重的上消化道大出血,行急诊胃镜后确诊为 Dieu-lafoy 病并给予内镜下钛夹止血治疗,治疗效果满意,随访至今未再复发。消化内镜对于 Dieulafoy 病的诊断及治疗均具有重要的意义：内镜不仅成为 Dieulafoy 病变诊断的首选,也逐渐成为该病治疗及诊断的一线选择方案。本文病例的成功诊治,亦得益于及时的急诊胃镜,故可见胃镜对于 Dieulafoy 病诊治的可行性与重要性。     

关于异种器官移植的问题

随着器官移植的广泛开展,器官短缺的问题日渐突出,８０年代末起异种器官移植的应用引起人们的重视,并形成热潮。但研究表明,克服异种移植排斥非易事,异种器官移植可能引起的病毒性疾病的传播,以及异种器官分子不相容性造成的种属屏障,都使异种器官移植的前景难料。     

移植免疫学的新突破与器官移植

现代器官移植是建立在移植免疫学基础上,移植免疫学基础研究的每一个进展都推动了器官移植的发展。９０年代以来,Ｓｔａｒｚｌ提出了移植排斥的“双向移植排斥理论”,反映了在临床应用免疫抑制药物的情况下,移植排斥的特点,是移植免疫学发展史上的一个重要理论地临床器官移植耐受的诱导具有重要的指导作用。     

老龄活体供肾移植的临床应用

为缓解供体器官的严重短缺,老龄活体供肾移植逐渐成为一种可以接受的对策。老龄活体供肾移植有其特殊性并且更易于引发伦理争论。本文简要介绍此问题的研究现状,并就若干社会伦理学问题展开讨论。     

妊娠合并卵巢良性肿瘤的治疗进展

卵巢肿瘤是妊娠期较常见的并发症之一,以良性多见,其并发症发生率高于非妊娠期,孕妇常因并发症引起急腹症就诊,甚至危及母儿的生命,其治疗方式和处理时机与非妊娠期卵巢良性肿瘤明显不同。     

Religious Coping, Psychological Distress and Disability Among Patients with End-Stage Pulmonary Disease

A growing body of literature suggests that individuals who face life-threatening situations turn to religion to help them cope. Religion has been cited as the most frequently used resource to cope with stressful events (K. I. Pargament, 1997). The present study was the first to investigate the religious coping methods of patients with lung disease who are awaiting transplant and to identify which coping methods are associated with distress and disability. The study was an exploratory, cross-sectional analysis of 90 patients with end-stage pulmonary disease who were being evaluated for transplant. Results indicated that religiosity was highly prevalent. Patients employed a combination of religious coping efforts, but mostly used coping methods considered positive. Patients with late-onset pulmonary diseases used religious coping strategies more frequently than patients with cystic fibrosis. Hierarchical regression analyses identified a subset of religious coping strategies that predicted 27%, 14%, and 34% of the unique variance in depression, overall disability, and psychosocial disability, respectively.     

Current status of psychological research in organ transplantation

Research addressing the psychological concomitants of organ transplantation is reviewed. Specifically, cognitive, behavioral, and psychosocial correlates of kidney, heart, liver, and bone marrow transplantation in both children and adults are discussed. Despite several conceptual and methodological shortcomings of the psychologically-based research in this area, results seem to indicate that organ transplantation is associated with many psychological issues at pretransplantation, posttransplantation, and follow-up periods. Implications of these general findings for the advancing roles of the health psychologist in organ transplantation are discussed.