20例缺血性脑梗塞早期CT影像分析

脑梗塞是急性脑血管闭塞引起脑缺血所造成的脑组织坏死，一般认为在起病后12～24小时内不可能发现缺血性脑梗塞。近几年，基层医院在应用CT以来，对病后24～48小时的脑梗塞CT影像已有较深刻的认识，但是由于起病24小时内的早期脑梗塞CT影像尚缺乏明显的，特异性的征象，致使部分患者漏诊、漏治，笔者经过近几年对本院经CT复查及脑血管造影证实的早期缺血性脑梗塞20例CT影像回顾性分析，认为早期的表现：(1)岛带(脑岛，最外囊和屏状核)灰白质界面丧失；(2)豆状核轮廓模糊或密度减低；(3)皮质脑沟，脑池的缩小或消失；(4)大脑中动脉或颈内动脉等主干及其分支的致密影；对缺血性脑梗早期诊断有重要意义。     

老年高血压病患者心脏结构改变与心律失常的关系

目的探讨老年期高血压病患者心脏结构的改变与心律失常的关系.方法 100例老年期高血压病患者和100例正常血压老年人,分别作超声心动图检查和24 h动态心电图.结果老年高血压病组中各超声指标包括室壁厚度、左房内径、左室重量、左房容积等均明显高于对照组;老年高血压病组短阵房速、复杂性室性心律失常、总室性心律失常发生率均明显高于对照组;老年高血压病左室肥厚组短阵房速、复杂性室性心律失常、心房颤动发生率均极明显高于非左室肥厚组;与正常构型组相比较,向心性肥厚组、离心性肥厚组患者短阵房速、复杂性室性心律失常、总室性心律失常发生率均明显增高,向心性重构组总室性心律失常发生率明显增高.结论老年高血压病患者较正常血压老年人存在明显的室壁增厚,左室重量增加,左房增大,在此结构改变的基础上,各种心律失常包括短阵房速、房颤、复杂性室性心律失常的发生率也随之增高.     

超声诊断输尿管结石的价值

目的 评价超声对输尿管结石的诊断价值。方法 由超声诊断并经临床证实的输尿管结石共382例，其中小于或等于10mm的265例。结果 超声检出输尿管结石的敏感性为91．17％，彩超显示输尿管喷尿异常，部分输尿管结石可产生彩色信号。结论 超声是诊断输尿管结石的快速、有效方法。     

右侧背痛、双下肢无力伴尿潴留

患，男37岁。因右侧背痛1周余，双下肢无力伴尿潴留1d，于2001年11月11日入院，入院前1周因劳累后出现右侧背部持续性疼痛并放射至右侧上肢内侧。X线胸片及胸、腰椎正侧位片均无异常发现，服用止痛剂无效。疼痛呈进行性加重夜间不能平卧，入院前1d出现双下肢无力，行走困难，入院当日晨起双下肢麻木，不能站立，恶心、呕吐2次且伴尿     

马克尼MX-8000D双层螺旋CT不能启动故障检修

故障现象 早上打开CT机电源开关，计算机正常启动，双击MX8000图标，初始化不能通过，报告错误“Time out”时间超出，屏幕不能出现已准备扫描，死机在初始化界面，观察扫描机架无电源，不能扫描病人。     

肺切除术影响围手术期右心功能

Objective To investigate the changes of perioperative right ventricular function after pulmonary resction. Methods 45 cases of pulmonary resection were divided into four groups.Group Ⅰwas wedge resection(n = 10), GroupⅡ was lobectomy(n = 19), Group Ⅲ was double lobectomy(n=7)and Group Ⅳ was pneumonectomy(n=9). The changes of CVP, PAMP, PEP/ET, Sa, VTIs, RVSP, Ea/Aa, and Tel were evaluated by traditional ultrasonic and tissue Doppler ultrasonic techniques at different time inter- vals (pre-operation, 5-7 days orland 1 month post-operation), Results Compared with the pre-operation CVP, the indexes of all groups have no significant changes post-operatively. Wedge resection didn' t obviously influence right cardiac after load and systolic function/diastolic function. No evidet changes detected in Tei pre-and post-operatively. However, the indexes (PAMP, RVSP and PEP/ET ratio) reflecting right cardiac afterload evidently increased at post-pneumonectomy or lobectomy group5- 7 days post-opera- tive. All these reflect the decrease of Tei, which was more obvious in pneumonectomy than in lobectomy group. Right cardiac after- load, systolic/diastolic function and Tel index recovered to pre-operative level 1 month post-operation in single lobectomy group. But the above indicators, especially the Tel, were still high in double lobectomy and pmeunonectomy groups 1 morth post-operation.Tei index is positively correlated with PAMP and is weakly correlated with PET/ET ratio and Ea/Aa ratio. Conclusion Pulmonary wedge resection doesn't evidently influence right cardiac function. However, right cardiac diastolic function evidently decreases temporarily at lobectomy group. The systolic function and diastolic funetions decrease after double-lobectomy and pneumonectomy and it's more evident in pneumonectomy group. Though the right cardiac afterloads of lobectomy, double lobectomy and pneumonectomy groupa all increase significantly post-operativlye, only the former recover to pre-operative level 1 month after surgery.     

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胃癌是我国常见的恶性肿瘤，根治术后仍有部分复发和死亡病例，淋巴结转移是主要的原因之一，是影响胃癌病人预后的重要因素。胃癌现代外科治疗的进步，提高了手术切除率、根治切除率及5年生存率，降低了手术死亡率及术后并发症发生率。胃癌现代外科治疗从一般的胃大部切除术进入以清除淋巴结为目的的根治术；从解剖学为基础     

半球脑出血微创清除术后脑水肿的观察

目的 探讨半球脑出血微创清除术后脑水肿的CT和临床的变化。方法 对75例患者术后临床和CT进行不同时间观察。结果 术后一周内86.6％的患者意识障碍和瘫痪减轻，第二周、第三周病情进一步好转，有部分病人因脱水剂减量致头痛、呕吐、瘫痪和意识障碍加重，经脱水调整等治疗后好转，病情的完全稳定需4周后。CT检查：中线结构移位术后第一周平均6mm，第二周9mm，第三周6mm，第四周2mm，4周后大部分中线恢复正常。结论 微创血肿清除术可缓解局部压力，但脑水肿过程不可避免，大多持续2周～3周后好转、需积极治疗。