目的 評估多普勒超聲引導的痔上動脈結扎治療Ⅱ、Ⅲ度內痔的臨床應用價值。方法 對2009 年4～9月期間在我科行多普勒超聲引導的痔上動脈結扎的49 例Ⅱ、Ⅲ度內痔患者從術后肛門括約肌功能、癥狀有效改善情況、疼痛程度及完全恢復正常生活所需時間方面進行評價。結果 術后無患者出現肛門括約肌功能失調；術后1 周、1 個月及3 個月Ⅱ、Ⅲ度內痔分別有77.8%(42/54)、87.0%(47/54)、92.6%(50/54)和59.4%(19/32)、71.9%(23/32)、78.1%(25/32)的患者單項癥狀得到有效改善； 術后6 h及24 h VAS 法疼痛程度評分平均分分別為1.95分和1.63分； 患者完全恢復正常生活所需時間平均為術后2.98 d。結論 多普勒超聲引導的痔上動脈結扎治療Ⅱ、Ⅲ度內痔安全有效，術后疼痛較輕且可以較快地完全恢復正常生活。
Understanding the mass transfer behaviors in hollow fiber membrane module of artificial liver is important for improving toxin removal efficiency. A three-dimensional numerical model was established to study the mass transfer of small molecule bilirubin and macromolecule bovine serum albumin (BSA) in the hollow fiber membrane module. Effects of tube-side flow rate, shell-side flow rate, and hollow fiber length on the mass transfer of bilirubin and BSA were discussed. The simulation results showed that the clearance of bilirubin was significantly affected by both convective and diffusive solute transport, while the clearance of macromolecule BSA was dominated by convective solute transport. The clearance rates of bilirubin and BSA increasd with the increase of tube-side flow rate and hollow fiber length. With the increase of shell-side flow rate, the clearance rate of bilirubin first rose rapidly, then slowly rose to an asymptotic value, while the clearance rate of BSA gradually decreased. The results can provide help for designing structures of hollow fiber membrane module and operation parameters of clinical treatment.