磁共振弥散加权成像在脑脓肿与坏死囊变性脑肿瘤鉴别诊断中的价值

目的　评价磁共振弥散加权成像 (diffusiionwieghtedimaging ,DWI) ,在脑脓肿与坏死囊变性脑肿瘤鉴别诊断中的价值。方法　 12例经手术病理 ( 10例 )或临床随访 ( 2例 )证实的脑脓肿和 5 0例经手术病理证实的坏死囊变性脑脓肿 (其中星形细胞瘤 2 8例、脑转移瘤 10例、血管母细胞瘤 6例、听神经瘤 6例 ) ,在术前或治疗前接受了常规MRI检查及DWI。结果　脑脓肿 (脓腔 )在DWI上表现为明显的高信号 ,而脑肿瘤坏死囊变区表现为低信号。结论　DWI对脑脓肿与坏死囊变性脑肿瘤的鉴别诊断具有重价值 ,应与常规MRI序列一起列为基本序列。     

先天性心脏病并发脑脓肿的影像学诊断

目的探讨影像学对儿童先天性心脏病合并脑脓肿的诊断价值。方法回顾性分析13例先天性心脏病合并脑脓肿患儿的临床资料和影像学表现，其中男性10例，女性3例；最小年龄19个月，最大年龄14岁，平均8岁8个月。10例行CT检查，3例行MRI检查。结果13例全部为青紫型先心，其中法洛四联症（tetralogy of Fallot，TOF）9例，大血管转位（transposition of great arteries，D-TGA）2例，伴有肺动脉狭窄的单心室（single ventricle with pulmonary stenosis，SV／PS）1例，室隔完整的肺动脉闭锁伴动脉导管未闭（pulmonary atersia with intact venticle septum and patem duct artery，PA／IVS／PDA）1例。发生部位有额叶、额顶、枕顶、颞顶、枕叶、丘脑和一侧额颞顶叶。单房10例，多房3例，增强后呈环行强化。结论先心病尤其是青紫型先心，极易并发脑脓肿。影像学方法对本病能作出诊断，有利于及时治疗，减少死亡率。     

耳源性脑疝25例临床分析

耳源性脑疝25例,抢救成功者19例。采用单纯脑脓肿穿刺抽脓抢救脑疝6例,仅1例成功;开颅减压术抢救脑疝20例,18例抢救成功。本组临床实践和文献报道都说明耳源性脑疝一旦发生应即刻行开颅减压术,能卓有成效地抢救生命     

腹膜后脓肿的诊断和治疗

目的探讨腹膜后脓肿的病因,诊断和治疗。方法回顾性分析了1990-2004年诊断和治疗腹膜后脓肿33例的临床资料。结果急性坏死性胰腺炎后20例,胆囊切除胆总管探查术后4例,十二指肠损伤2例,阑尾穿孔3例,肾结石4例。超声检查确诊80%(20/25),CT检查确诊100%(22/22)。经腹部腹膜后脓肿切开置管引流25例,手术1~4次不等,后腰部切开引流8例。手术后并发应激性胃粘膜损伤致消化道出血7例,成人呼吸窘迫综合征(ARDS)5例,急性肾功能衰竭3例,死亡4例。治愈时间1~6个月,平均3.5个月。结论及时明确诊断,进行有效引流并加强营养支持是治疗成功的关键。     

Betropharyngeal abscesses: Revisited

Retropharyngeal abscesses were fairly common in preantibiotic era but the advent of antibiotics has reduced the overall incidence of these abscesses. They still continue to occur specially in developing world and carry significant morbidity and even mortality if not managed properly. The prevalence of this abscess in the young children pose a bigger challenge, as the examination of oral cavity is difficult. Emphasis is placed on the age, sex, type, and duration of symptoms, bacteriology, methodology of diagnosis, therapy and complications. With proper antibiotic cover and surgical management, majority of patients today survive without major residual squeal. Hereby we present a series of 15 cases of retropharyngeal abscess.     

一期切开挂线术治疗肛周脓肿305例

采用一期切开挂线术治疗肛周脓肿３０５例，全瓿期治愈，无发生肛瘘及并发症者。作者认为手术成功的关键是正确处理内口及原发灶，良好通畅的切口引流以及合理的术后处理，对提高疗效，防止复发有重要意义。     

Streptococcus sanguis bacteremia and colorectal cancer: A case report

Streptococcus sanguis, usually considered a nonpathogen of the oral cavity, was isolated from blood cultures from a patient who was subsequently found to have a cecal adenocarcinoma. Further studies are needed to determine if Streptococcus sanguis infections have diagnostic implications similar to those of Streptococcus bovis. © 1995 Wiley-Liss, Inc.     

垂体脓肿的诊断和治疗(14例报告和文献复习)

目的:探讨垂体脓肿的临床特征和治疗。方法:回顾性分析14例垂体脓肿患者的临床表现、影像学特征、诊断和治疗,并结合文献进行分析。结果:14例患者中头痛13例,垂体功能低下6例,视力视野影响6例,多饮多尿3例,发热3例。MRI增强病灶均呈环状强化。11例经蝶手术治疗,3例经开颅手术。术后随访头痛缓解者10例,视力、视野改善者4例,尿崩者2例恢复正常,垂体功能低下者中4例恢复正常,3例开颅手术者中2例复发,再经蝶手术治愈。结论:应用常规CT和MR术前诊断垂体脓肿困难,对鞍区囊性病变应考虑到垂体脓肿的可能。及早手术、正确选择手术入路、围手术期合理应用抗生素和适当的对症治疗是治疗垂体脓肿的关键。     

An epidural abscess due to resistant Staphylococcus aureus following epidural catheterisation

We report a case of abscess formation after epidural analgesia, a rare complication that developed in our patient 13 days after placement of a thoracic epidural catheter for patient controlled analgesia. Culture of the pus grew methicillin-resistant Staphylococcus aureus . Although early diagnosis and rapid management have been reported to yield a satisfactory outcome, the case we describe ended in severe sequelae.     

穿刺置管引流术在口腔颌面部间隙感染中的应用

目的探索硬膜外导管置入脓腔引流对口腔颌面部脓肿的疗效。方法采用既往常规切开引流的患者作为对照组。治疗组为经面部皮肤用18号硬膜外穿刺针穿刺入脓腔,置入硬膜外导管,在口内做切口旋转引流条,或经颌下作小切口,置入负压引流管,经硬膜外导管滴注抗生素盐水冲洗脓腔,比较两者拔出引流物的时间,并行U检验。结果治疗组与对照组比较,差异具有统计学意义(P<0.01)。结论经硬膜外穿刺针置管引流术,具有创伤小、炎症消失快、有效缩短病程、愈后不留瘢痕的特点。