口服等渗洗肠液临床X线应用研究

目的:通过X线检查观察自制口服等渗洗肠液的实用性和有效性。方法:对406例X线检查者详细记录服药时间、首次排便时间及排便次数,进行服药前、服药后临床及X线对比分析。结果:从X线影像分析肠道清洁程度,Ⅰ级(理想)372例(61.93%),Ⅱ级(较理想)24例(5.91%),Ⅲ级(不理想)10例(2.46%)。有效清洁率97.54%。结论:此种肠道清洁方法较既往方法简单易行,安全有效,快速无痛苦,无不良反应,清洁效果理想。     

不透X线标记物检测胃肠道

目的探讨不透X线标记物法(radiopaquemarker's,Rom's)对胃肠动力学检测的临床应用价值.方法自制marker's为浸渍医用硫酸钡的聚乙烯,制成2mm×2mm的钡粒,20个装入一个胶囊内消毒备用.受检者为42例功能性消化不良(FD),50例慢性功能性便秘(CFC)以及20例健康对照,空腹随标准餐吞服含20个钡粒胶囊1个,于餐后4h、48h及72h拍腹部平片,计算4h胃排空率、48h、72h全胃肠排空率以及72h排空指数,评估FD及CFC病人的胃肠动力异常.结果66.6%(28/42)FD病人胃排空较正常延迟;CFC病人48h、72h全胃肠排空率均低于正常(Ρ＜0.01),其中根据排空指数测算64%(32/50)CFC为慢传型便秘.结论Rom's法检测胃肠动力,方法简单,符合生理条件并能定量评估胃肠排空,可为指导临床诊治胃肠运动障碍提供依据.     

米非司酮配伍米索前列醇在高原地区中孕引产中的应用效果观察

目的分析米非司酮配伍米索前列醇(MS)在中孕引产中的应用价值。方法 133例中孕患者(藏族119例)平均妊娠时间(4.08±1.14)月,采用米非司酮150mg分别按1次/12h,1次/24h或顿服方法口服,结合MS阴道上药进行引产。结果所有患者均引产成功,使用MS后胚胎排出时间平均为(8.40±5.68)h,1次/12 h组与1次/24 h组间比较,差异无统计学意义。妊娠3月组胚胎排出时间最短为(6.70±3.07)h,清宫率最高达94.9%,初孕患者胚胎排出时间最长;患者平均住院时间为(3.74±0.84)d。结论米非司酮配伍MS作为一种简便安全的引产方法,适宜在高原地区应用。     

慢性胃痛辨证与消化道X线征象的关系研究

目的:探索慢性胃痛证候与消化道X线征象的关系,为慢性胃痛的辨证提供客观指标。方法:符合中医辨证标准即本研究纳入标准的病人160例,正常人22例为对照组,均按一定程序行X线钡餐检查全消化道。中医内科医师的辨证与放射科医师的观察用双盲法进行。结果:气滞证以长型、低位胃、低张力胃及胃排空减慢多见;郁热证以胃分泌增多、张力改变及器质性疾病多见;虚寒证以肠道动力减慢多见。结论:慢性胃痛各证候与消化道X线征象如胃型、胃的位置、胃分泌功能、胃张力、胃排空、肠道动力、器质性病变等表现有显著或极显著差异,可作为中医慢性胃痛辨证的客观指标。     

脂肪肝患者血清总胆汁酸测定及其临床意义

目的　观察脂肪肝患者空腹、餐后 2h血清总胆汁酸的变化及其临床意义。方法　晨空腹、餐后 2h抽静脉血测定总胆汁酸。结果　脂肪肝组总胆汁酸空腹时 (2 2 .4± 14 .9) μmol/L、餐后 2h(36 .8± 2 2 .5 ) μmol/L明显高于正常对照组(P <0 .0 1)。餐后脂肪肝组总胆汁酸为 18～ 70 μmol/L ,其中 37例超出高 ,异常率为 80 4 % ,而正常对照组的异常率仅为 15 %。结论　检测空腹总胆汁酸及餐后 2h总胆汁酸 ,尤其是后者 ,可作为判断脂肪肝病人肝功能的指标之一     

硝酸异山梨酯在药物流产中的作用

目的探讨阴道内应用硝酸异山梨酯在药物流产中的作用。方法选择行药物流产的患者630名,孕期在35~49 d,因各种原因需人工终止妊娠。所有患者均口服米非司酮50 mg/d,连服3 d后,随机分为两组:一组(310例)米索前列醇600μg晨起空腹顿服(M组);另一组(320例)同样给予米索前列醇口服,之前1 h,阴道内置硝酸异山梨酯5mg(M I组);观察绒毛排出情况。结果M组绒毛排出平均所需时间(6.3±2.9)h,M I组所需时间(3.1±1.9)h,差别有统计学意义(P<0.05);3 h之内绒毛排出率M组及M I组分别为38.0%(119/310)和77.0%(247/320),差别有统计学意义(P<0.05);8 h内绒毛排出率没有区别;具有相同副反应。结论药物流产过程中,硝酸异山梨酯与米索前列醇有协同作用,且不增加其副作用。     

婴儿髋关节X线测量

目的 :通过测量婴儿髋关节X线平片 ,为婴幼儿先天性髋关节脱位 (CDH)的早期诊断提供依据。方法 :测量67例婴儿髋关节正位片 ,指标包括双侧髋臼角、h值、f值、耻颈线 (Shenton线 )、髋颈线 (Calve线 )。结果 :5 0例健康婴儿右侧髋臼角 :男 2 1.88°± 3 .72°、女 2 5 .0 8°± 3 .49° ;左侧髋臼角 :男 2 1.92°± 3 .2 0°、女 2 4.96°± 3 .5 0° ,随月龄增加而减小。右侧h值 :男 ( 0 .89± 0 .14 )cm、女 ( 0 .82± 0 .12 )cm ;左侧h值 :男 ( 0 .91± 0 .11)cm、女 ( 0 .83± 0 .12 )cm ,左右两侧差异无统计学意义。右侧f值 :男 ( 0 .2 9± 0 .2 0 )cm、女 ( 0 .3 0± 0 .16)cm ;左侧f值 :男 ( 0 .2 8± 0 .18)cm、女 ( 0 .3 1± 0 .15 )cm ,左右两侧差异无统计学意义 ,h >f。Shenton线、Calve线均连续。 17例 2 4个髋关节诊断为CDH之髋臼角 2 9.5 4°± 4.43° ,h值 ( 0 .3 8± 0 .3 2 )cm ,f值( 0 .61± 0 .2 5 )cm ,h 相似文献   

兔肝动脉化疗栓塞术实验方法学的对比性研究

目的　探讨兔肝动脉化疗栓塞的实验方法。材料与方法　大耳白兔 168只 ,随机分为股动脉插管组(n =2 0 )及剖腹下直视穿刺组 (n =148) ,比较两种实验方法的手术及X线下操作时间、手术成功率、动物存活率。结果　股动脉插管组平均手术操作时间 145 .4± 2 4.6min ,X线透视时间 44 .3± 10 .7min ,手术成功率为 2 0 % ( 4/ 2 0 ) ,动物在术后 3天内均死亡。剖腹直视下穿刺组平均手术操作时间为 49.8± 12 .7min ,X线透视时间 7.9± 4.3min ,手术成功率为 97.3 % ( 144 / 148) ,长期存活率为 91.2 % ( 13 5 / 148)。经统计学检验 ,两者间有极显著性差异 (P <0 .0 1)。结论　直视下兔肝动脉细针穿刺行化疗栓塞术是一种简便、有效的实验方法     

CARTO电解剖标测系统指导下射频消融房室结折返性心动过速

目的评价CARTO电解剖标测系统对射频消融房室结折返性心动过速(AVNRT)的指导作用。方法将20例阵发性室上性心动过速患者分为CARTO组(在ARTO指导下行射频消融)和对照组(在常规X线下行射频消融)。比较两组标测与消融过程的X线曝光时间、手术时间、放电次数、放电时间及并发症发生情况。结果20例均即时消融成功。CARTO组与对照组比较,手术时间无显著性差异(105.8±23.8minvs117.1±21.6min,P>0.05),X线曝光时间明显缩短(6.3±2.6minvs16.2±7.0min,P<0.05),放电次数显著减少(2.7±1.5vs5.8±2.4,P<0.05),放电时间显著缩短(173.2±80.5svs355.8±96.4s,P<0.05);术中及术后无一例出现房室传导阻滞,随访6～9个月无心动过速复发病例。结论在CARTO电解剖标测系统指导下射频消融AVNRT安全有效,较常规X线透视下标测定位准确可靠,可减少放电次数,缩短X线曝光时间。     

坦索罗辛治疗输尿管下段结石80例报告

目的评价坦索罗辛在输尿管下段结石辅助排石中的临床效果。方法将80例确诊为单纯输尿管下段结石的患者,随机分为两组:对照组及坦索罗辛(0.2 mg,1次/d)治疗组。两组间患者的年龄、性别、结石直径等差异均无统计学意义。随访2周,观察结石排出率、结石排出时间、肾绞痛发生、镇痛剂使用情况和药物不良反应。结果坦索罗辛治疗组的结石完全排出率为72.5%,显著高于对照组的37.5%(P<0.05);结石排出时间(5±3)d、因肾绞痛的发作而需镇痛剂的使用率为2.5%、也显著低于对照组的(10±3)d及17.5%(P<0.05)。2周内两组患者未观察到明显的药物不良反应,无因不能耐受而退出者。结论坦索罗辛可明显促进输尿管下段结石排出,缓解肾绞痛发生,可作为一种有效的输尿管下段结石辅助药物疗法。     

Evaluation of small-bowel transit for solid and liquid test meal in healthy men and women

Evaluation of severe functional gastrointestinal motility disorders requires an investigation of the entire gastrointestinal tract. This should be possible with a single radionuclide imaging study. The purpose of this study was (1) to define normal values of small-bowel transit in men and women and (2) to assess a possible difference between gender or test meal, since it has been shown that women have slower gastric emptying than men, and gastric emptying of solids is slower than liquids. A standard gastric-emptying test for a solid (technetium-99m sulphur colloid, 230 Kcal) and liquid (indium-111 DTPA water) test meal was performed in 12 healthy male and 12 healthy female volunteers. After 135 min, the volunteer was placed in the supine position for static imaging of the abdomen every 15 min for 6 h. Decay and crossover-corrected geometric mean gastric-emptying data were fit to a modified power exponential function to determine the 10% stomach emptying time for solids and liquids separately. An ROI was drawn around the caecum and ascending colon to determine the arrival time of at least 10% of the solid and liquid test meal. Ten percent small-bowel transit time (10%SBTT) and orocaecal transit time (OCTT) were calculated.The OCTT for males and females, respectively for solids and liquids, are 294.6±18.8; 301.3±24.5; 294.6±18.8 and 301.3±24.5 min. The 10%SBTT for males and females, respectively for solids and liquids, are 280.3±18.4; 280.6±24.0; 288.2±18.9 and 297.4±24.4 (mean±SEM) min. We observed a simultaneous transfer of solids and liquids from the terminal ileum to caecum (correlation coefficient 0.90). There is no statistically significant difference in SBTT between gender or solids and liquids. In contrast to the gastric-emptying time, the SBTT of solids and liquids were not significantly different nor was a gender difference found. Determination of the OCTT seems to be the simplest and most accurate approach to measure SBTT. Since ileocaecal transfer occurs as a bolus phenomenon, a ¹¹¹In-labelled test meal can also be used for the determination of colon transit in a single imaging study protocol. Received: 24 May and in revised from 1 July 1999     

Use of Technegas as a radiopharmaceutical for the measurement of gastric emptying

Many radiopharmaceuticals and test meals that are used to measure gastric emptying are less than optimal. A vegetable-based solid meal, such as rice, labelled with a radiopharmaceutical that also has the capacity to measure gastric emptying of liquids, is likely to be ideal. The role of Technegas as a radioisotopic marker to measure gastric emptying of rice and liquids was evaluated. Technegas-labelled rice was incubated in 0.9% saline, 1 M HCl and simulated gastric fluid (3.2 g/l pepsinogen, pH 2–3) to assess stability of the label. In eight healthy volunteers gastric emptying of two meals – 200 g rice (370 kcal) and 75 g dextrose dissolved in 300 ml water (300 kcal), both labelled with 20 MBq of Technegas – was measured scintigraphically. Over 4 h, the average label stability was 93.7%±0.5% in 0.9% saline, 91.0%±0.4% in 1 M HCl and 93.6%±0.7% in simulated gastric juice. The lag phase was longer for rice than dextrose (25±7 min vs 4±2 min; P<0.05), but there was no difference in the post-lag emptying rate (2.1±0.3 kcal/min vs 1.7±0.2 kcal/min; P=0.2) between the two meals. We conclude that Technegas is a suitable radiopharmaceutical for measurement of gastric emptying of rice and nutrient-containing liquids. Received 8 March and in revised form 19 April 1999     

Daily variation in gastric emptying when using the double sampling technique.

The purpose of this study was to establish the intra-individual variation in the rate of gastric emptying (GE) by using the double sampling technique of George. Eight healthy male volunteers, all familiar with gastric intubation and testing, participated in four GE tests, using an isotonic fluid as a test meal. Conditions were kept constant during all four tests, and each test was separated by at least 48 h. The within-subjects coefficient of variation proved to be 29%. The findings demonstrate that, given standard conditions, GE is reproducible from day to day.     

Comparison of total and compartmental gastric emptying and antral motility between healthy men and women

There is increasing evidence of gender-related differences in gastric emptying. The purpose of this study was first, to confirm the difference in gastric emptying for both solid and liquid test meals between healthy men and women, and secondly, to investigate the origin of this difference by studying regional gastric emptying and antral motility. A standard gastric emptying test with additional compartmental (proximal and distal) evaluation and dynamic imaging of the antrum was performed in 20 healthy women studied during the first 10 days of the menstrual cycle, and in 31 healthy age-matched men. In concordance with previous reports, women had a longer half-emptying time for solids as compared to men (86.2±5.1 vs 52.2±2.9 min, P<0.05). In our observations this seemed to be related to a significantly prolonged lag phase and a significant decrease in terminal slope. Dynamical antral scintigraphy did not show a significant difference. The distribution of the test meal within the stomach (proximal vs distal) showed more early proximal retention in women as compared to men. The terminal slope of the distal somach was significantly lower in women. We did not observe a significant difference in gastric emptying of the liquid test meal between men and women. Gastric emptying of solids is significantly slower in healthy women as compared to men. These findings emphasise the importance of using different normal values for clinical and research purposes in gastric emptying scintigraphy in men and women. The difference could not be explained by antral motility alone. Increased proximal retention and a lower terminal emptying rate in women are observations to be further investigated. Received 2 February and in revised form 17 April 1998     

腹腔镜修补术治疗消化性溃疡急性穿孔40例临床分析

目的探讨腹腔镜胃十二指肠溃疡修补术在消化性溃疡急性穿孔患者的临床应用价值。方法回顾分析我科2010年3月—2011年5月使用腹腔镜行胃十二指肠溃疡修补手术治疗40例消化性溃疡穿孔患者的临床资料。结果 40例患者病理结果均为良性溃疡,手术时间为28～80 min,平均(40.1±17.8)min;术后下床活动时间为14～24 h,平均(16.8±4.7)h;去除胃肠减压时间为14～48 h,平均(19.7±3.5)h;术后镇痛药的使用率为12.5%(5/40);住院时间为4～7 d,平均(5.1±1.4)d;术后均辅以内科抗溃疡药物治疗4～6周,随访6月,无溃疡复发。结论应用腹腔镜胃十二指肠溃疡修补术治疗消化性溃疡穿孔具有安全可靠、疗效好、并发症少、恢复快等优点。     

99Tcm-硫胶体显像测定小肠通过时间的临床研究

目的 建立＾９９Ｔｃ＾ｍ－硫胶体（ＳＣ）显像法，测定小肠通过时间（ＳＢＩＴ），并与加服乳果糖法比较其通过时间及应用价值。方法 用＾９９Ｔｃ－ＳＣ固体试餐对２０例健康志愿者及２６例胃肠道疾患患者进行显像，以测定ＳＢＩＴ；１周后，同一受试者进食素加乳果糖试餐后以同样方法再次显像，并进行乳果糖氢呼气试验，或用反卷积分析法计算ＳＢＩＴ“谱”，或用５０％结肠填充时间减５０％胃排空时间计算平均ＳＢＩＴ。结果：     

Technetium-99m carboxymethylcellulose: a newly developed fibre marker for gastric emptying studies

We report a study of technetium-99m-labelled carboxymethyl-cellulose (99mTc-CMC) as a newly developed non-digestible marker of the solid phase of gastric contents. The radiosynthesis is simple and shows a high labelling efficiency. In vitro and in vivo experiments demonstrated stability of the marker in the gastrointestinal tract during the process of gastric emptying. The gastric half-emptying time in ten healthy volunteers of both sexes was 105 +/- 17 min (mean +/- SD). This rate of gastric emptying is similar to that of non-digestible solid-phase markers such as in vivo labelled 99mTc-chicken liver or radio-iodinated cellulose. In comparison with digestible solid-phase markers such as 99mTc-labelled pancake or 99mTc-cooked egg, gastric emptying of 99mTc-CMC occurred more slowly, confirming the expected behaviour of a non-digestible solid-phase marker. We conclude that 99mTc-CMC has the advantage of a simple and rapid labelling procedure and may be useful for clinical studies of gastric emptying.     

A modified sonographic technique for assessment of gastric emptying of liquid

PURPOSE: Ultrasound scanning is replacing scintigraphy in studies of gastric emptying of liquid, but both have considerable day-to-day variability. This study describes a modified ultrasound technique for assessing gastric emptying of liquid, and evaluates the inter- and intraindividual variation in emptying time. MATERIAL AND METHODS: On different days, each of 12 healthy volunteers had meals of 350 ml broth. The antral area was measured at sonography 5 times before the meal as a baseline, and every 1-4 min after the meal. The time until the antral area had decreased to 150% of baseline (T150) was determined and used as surrogate expression of gastric emptying time. RESULTS: The mean T150 for a broth meal was 12.6 min (range 5-21) and 13.5 min (6-23) (first and second meal, respectively). The standard deviation of the differences between the 12 pairs of repeated measurements was 3.1 min and the coefficient of variation was 24%. CONCLUSION: Ultrasound monitoring of antral size after a liquid meal is a well suited method for assessing gastric emptying of liquid.     

头孢拉定胶囊人体药代动力学和生物等效性

目的研究头孢拉定胶囊在健康人体内的相对生物利用度和生物等效性,为新药报批及其临床应用提供依据。方法20名健康受试者随机双交叉试验方法,单剂量口服受试及参比制剂500 mg,用HPLC法测定给药后不同时间的血药浓度,计算主要药代动力学参数。结果口服头孢拉定胶囊受试制剂和参比制剂后的主要药动学参数:T1/2分别为0.841±0.165和0.842±0.213 h;Cm ax分别为(15.922±2.584)和(15.922±2.584)mg/L;Tm ax分别为(1.225±0.197)和(1.225±0.242)h;AUC0-t分别为(25.399±5.806)和(26.159±5.989)mg/(L.h)。以AUC0-t计算,与参比制剂相比受试制剂中头孢拉定的平均相对生物利用度为(97.4±7.0)%。结论两制剂生物等效。     

Gastrointestinal transit of technetium-99m-labeled cellulose fiber and indium-111-labeled plastic particles

We introduce two new nondigestible solid markers for gastrointestinal transit measurements. One is technetium-99m-labeled cellulose fiber [99mTc]CF, the other is indium-111-labeled plastic particles [111In]PP of 2- to 3-mm diameter. In six healthy male volunteers gastric emptying and small intestinal transit of the two markers were obtained simultaneously. Large intestinal transit of [111In]PP was also obtained. Technetium-99m CF had acceptable stability properties in the proximal gastrointestinal segments. Indium-111 PP was almost completely stable in all segments. Mean gastric emptying time was 1.13 +/- 0.24 hr (mean +/- s.d.) for [99mTc]CF and 1.94 +/- 0.78 hr for [111In]PP. The difference was significant (p less than 0.05). Mean small intestinal transit time was 3.85 +/- 0.61 hr (mean +/- s.d.) for [99mTc]CF and 4.03 +/- 0.34 hr for [111In]PP. The difference was not significant (p less than 0.5). Mean large intestinal transit time of [111In]PP was 23 +/- 11 hr (mean +/- s.d.). We also suggest a simple deconvolution principle for the interpretation of the small intestinal and the large intestinal transit data.