胰腺假性囊肿的内镜治疗进展

胰腺假性囊肿可以由急性胰腺炎、慢性胰腺炎、胰腺创伤、胰管阻塞等引起,对于胰腺假性囊肿的最佳治疗方案尚无确切的一致意见,目前内镜引流假性囊肿已被广泛接受,本文就胰腺假性囊肿的内镜治疗方法及其并发症与预防作一综述。     

急性胰腺炎继发胰腺假性囊肿的护理体会

胰腺假性囊肿是急性胰腺炎的并发症,也可由外伤引起。胰腺假性囊肿的形成是由于胰腺实质或胰管破裂,外漏的胰液、炎性渗液和坏死组织等积聚于胰腺周围间隙,刺激胰周发生炎症反应和肉芽组织增生,形成囊壁内无上皮细胞的囊肿。     

急性胰腺炎后胰腺假性囊肿的影像表现

由急性胰腺炎引发的胰腺假性囊肿是一种常见的胰腺囊性病变,其特点是临床表现多样、影像表现复杂、并发症多见,相关的影像诊断和鉴别诊断仍然是日常临床工作中的难题之一。主要讨论急性胰腺炎后假性囊肿的各种影像表现和诊断原则,以期为临床诊治胰腺假性囊肿提供有价值的信息。     

B超引导下经皮穿刺引流在胰腺假性囊肿治疗中的应用

目的探讨B超引导下经皮穿刺引流在胰腺假性囊肿(胰腺假性囊肿)治疗中的应用。资料与方法将82例胰腺假性囊肿患者随机分为B超引导下囊肿穿刺引流治疗组(n=35)和手术治疗组(n=47)两组,又将手术治疗组47例随机分为外引流组(n=8)和内引流组(囊肿-胃吻合术或囊肿-空肠Roux-en-Y吻合术)(n=39),比较B超引导下囊肿穿刺引流治疗组分别与外引流组和内引流组疗效及治愈率的差异。结果 B超引导下经皮穿刺引流治疗胰腺假性囊肿,术后均无并发症;治愈率比较:①B超引导下囊肿穿刺引流治疗组(62.9)高于外引流组(62.5),但与外引流组之间差异无统计学意义(P>0.05);②B超引导下囊肿穿刺引流治疗组(62.9)低于内引流组(76.9),与内引流组之间差异也无统计学意义(P>0.05)。结论 B超引导下胰腺假性囊肿穿刺引流术值得临床推广,是胰腺假性囊肿外引流术的有效替代治疗方法;在某些情况下也可替代内引流术。但仍有一定比例的胰腺假性囊肿患者需手术治疗,囊肿-空肠Roux-en-Y吻合术仍是比较合理的内引流术式。     

胰腺巨大假性囊肿超声内镜引导下胃内支架引流1例报告——附文献复习

为探讨胰腺假性囊肿内镜治疗的操作技术和临床疗效，在超声内镜引导下对1例巨大胰腺假性囊肿行超声内镜引导下经胃壁穿刺置管引流。术后当天患者症状缓解，1周后囊肿缩小50%，随访6个月，囊肿消失无复发，未发生出血、穿孔等并发症。超声内镜引导下囊肿胃置管引流术安全、可靠，并发症少，是一种有效的微创介入治疗方法。     

重症急性胰腺炎的增强CT及MRI特征

重症急性胰腺炎常引起胰腺实质及胰周组织的损坏，并伴有休克、弥漫性血管内凝血、严重代谢紊乱及多脏器衰竭，还可出现胰腺坏死、脓肿、假性囊肿、瘘管及假性动脉瘤等局部并发症。增强CT及MRI在区别正常胰腺与胰腺坏死、判断胰周炎性病变及液体聚积作用方面相似。MRI的多平面成像，可判断液体聚积、假性囊肿与上腹部结构的关系。MRI发现出血、瘘管、周围脏器炎症较CT敏感，而发现气泡、钙化、假性动脉瘤CT优于MRI。     

重症急性胰腺炎的增强CT及MRI特征

重症急性胰腺炎常引起胰腺实质及胰周组织的损坏，并伴有休克，弥漫性血管内凝血，严重代谢及多脏器衰竭，还可出现胰腺坏死，脓肿，假性囊肿，瘘管及假性动脉瘤等局部并发症，增强CT及MRI在区别正常胰腺与胰腺坏死，判断胰周炎性病变及液体聚积作用方面相似，MRI的多平面成像，可判断液体聚积，假性囊肿与上腹部结构的关系。MRI发现出血，瘘管，周围脏器炎症较CT敏感，而发现气泡，钙化，假性动脉瘤CT优于MRI。     

内镜超声引导下经胃穿刺引流治疗胰腺假性囊肿疗效观察

目的探讨内镜超声引导下经胃穿刺引流治疗胰腺假性囊肿的临床疗效。方法回顾性分析自2011年1月至2018年1月因胰腺假性囊肿在襄阳市中心医院行内镜超声引导下穿刺引流术的42例患者的临床资料。分析患者的临床疗效及术后并发症情况。结果 41例患者穿刺成功,36例囊肿消失或缩小,仅行一次性穿刺引流。将41例患者分为单纯置入支架组(n=21)与加鼻囊肿引流管组(n=20)。两组患者在囊肿消失或缩小方面比较,差异无统计学意义(P>0.05)。加鼻囊肿引流管组患者感染指标低于单纯置入支架组,差异有统计学意义(P<0.05)。12例患者发生术后并发症,其中,支架移位9例,术后化脓性感染2例,穿孔1例,均经保守治疗痊愈。结论内镜超声引导下经上消化道穿刺引流治疗胰腺假性囊肿安全可靠。     

胰腺假性囊肿超声引导介入治疗的应用价值

胰腺假性囊肿是胰腺炎和胰腺外伤常见的并发症之一，以往多采用手术治疗。我们从1996—09～2004—06共收治13例。现报道如下。     

善德定治疗胰腺假性囊肿胰瘘l例报告

胰腺假性囊肿和胰瘘是慢性胰腺炎常见并发症,而临床上要解除其疼痛和预防其它并发症的发生,外科手术是最常用的方法,但又存在更大的危险性.胰液是假性囊肿内的主要成分.胰瘘经常造成感染出血、营养和电解质失调.在使用善德定(Sandostatin)前病人常先     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

人体中的镭-226、镭-228、钋-210、铅-210

本文报道了广东阳江高本底地区6名、对照地区8名人尸体的骨²²⁶Ra、²²⁶Ra的浓度以及部分居民内脏器官中。²¹⁰Po、²¹⁰Pb的浓度。结果轰明阳江高本底地区和对照地区居民骨镭-226、镭-228的浓度分别为29.9pCi/kg, 26.9pCi/kgl 8.7pCi/kg, 8.2pCi/kg.由此估算出阳江高本底地区屠民骨中²²⁶Ra、²²⁸Ra的负薄璧及对骨衬、骨髓所产生的剂量当量分别为对照地区民民的3.4倍, 3.3倍。两地区居民内脏器官中^{210Po、210Pb的测定分析铡数较少但仍看出, 高本底地区均明显高于对照地区.}     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).