颈动脉粥样斑块与冠状动脉病变

目的 研究颈动脉粥样斑与冠状动脉病变的关系。方法 将82例冠心病待排和冠心病患者按冠状动脉造影结果分成正常组和冠脉粥样病变组,同期超声检测颈动脉粥样硬化程度。结果 颈动脉粥样斑块与冠脉弱粥样硬化之间有较密切的关系。颈动脉粥样斑块对狭窄性冠状动脉病变预测的敏感性为71.7%,特异性为91.9%,阳性和阴性预测值分别为91.7%和73.9%,其准确性为81.7%。结论 颈动脉超声检测可作为预测冠状动脉粥样硬化有价值的指标。     

经直肠超声实时引导在精囊镜手术中的应用研究

目的探讨经直肠超声实时引导在射精管梗阻性无精子症或少弱精子症患者精囊镜手术中的应用价值。方法回顾性分析2011年9月至2015年12月北京大学第三医院经直肠超声实时引导行精囊镜手术治疗的25例射精管梗阻性无精子症或少弱精子症患者的临床资料。患者年龄(29.4±4.5)岁;精液量0.4(0~2.8)ml,精液pH值6.5(5~7.5),精子总数0(0~580)百万个,精子密度0(0~90.7)百万个/ml,精子活率0(0~24.1%),结合MRI、经直肠超声检查等初步诊断为梗阻性无精子症或少弱精子症。其中13例为前期常规精囊镜手术失败患者(无法找到通道进入射精管和精囊)。均行经直肠超声实时引导下精囊镜射精管梗阻疏通术,分析手术成功率、并发症及随访结果。手术成功的定义为精囊镜疏通射精管后顺利进入精囊。结果25例中21例(84%)精囊镜成功进入精囊腺,手术时间75(31,148)min,术后所有患者均无严重并发症。4例(16%)手术失败患者中,1例术中探查考虑为先天发育不良,2例双侧均未见明确射精管开口,1例术中诊断为Müllerian管囊肿,未见明确精阜小凹及双侧射精管开口。21例精囊镜手术成功者术后3~6个月复查,精液量2.0(0~5.2)ml,精子总数28(0~832)百万个,精子密度5.6(0~110.3)百万个/ml,精子活率5.4%(0~63.6%),与术前精液量[0.4(0~2.8)ml]、精子总数[0(0~342)百万个]、精子密度[0(0~90.7)百万个/ml]、精子活率[0(0~24.1%)]比较,差异均有统计学意义(P<0.05)。在17例电话随访5~9年的患者中,3例配偶自然妊娠受孕;9例精液质量改善但患者配偶未自然受孕,行体外受精-胚胎移植技术受孕。结论术中经直肠超声引导可以增加精囊镜手术的成功率和安全性,对常规精囊镜手术困难的射精管梗阻性无精子症或少弱精子症效果良好。     

腹腔镜超声引导微波消融治疗原发性肝癌的疗效分析

目的:探讨腹腔镜超声引导微波消融术治疗原发性肝癌的临床疗效。方法:选取124例原发性肝癌患者,根据手术方式分为观察组(行腹腔镜超声引导微波消融术,n=62)与对照组(行经皮超声引导微波消融术,n=62),对比分析两组术中新发现病灶、术后并发症、肿瘤完全消融率、局部复发率、肿瘤再发率、相关肿瘤标志物、生存率等相关指标。结果:观察组术中新发现肿瘤病灶18处(10例),对照组术中无新发现病灶,差异有统计学意义(P<0.05);观察组术后并发症发生率(9.7%vs.24.2%)、肿瘤完全消融率(97.1%vs.90.2%)优于对照组,差异有统计学意义(P<0.05);两组局部复发率、肿瘤再发率、相关肿瘤标志物、生存率等差异无统计学意义(P>0.05)。结论:与传统经皮微波消融术相比,腹腔镜超声引导微波消融术治疗原发性肝癌可更好地避免微小病灶的遗漏,具有术后并发症少、肿瘤完全消融率高等优势,值得在临床广泛开展。     

Ultrasound‐Assisted Precise In Situ Decompression for Cubital Tunnel Syndrome

ObjectiveTo explore the effect of locating the ulnar nerve compression sites and guiding the small incision so as to decompress the ulnar nerve in situ on the elbow by high‐frequency ultrasound before operation.MethodsA retrospective analysis was conducted on 56 patients who underwent ultrasound‐assisted in situ decompression for cubital tunnel syndrome from May 2018 to August 2019. The patients'' average age was 51.13 ± 7.35 years, mean duration of symptoms was 6.51 ± 1.96 months, and mean postoperative follow‐up was 6.07 ± 0.82 months. Nine patients had Dellon''s stage mild, 39 had stage moderate, and eight had stage severe. Ultrasound and electromyography were completed in all patients before operation. The presence of ulnar nerve compressive lesion, the specific location, and the reason and extent of compression were determined by ultrasound. A small incision in situ surgery was given to decompress the ulnar nerve according to the pre‐defined compressive sites.ResultsAll patients underwent in situ decompression. The compression sites around the elbow were as follows: two in the arcade of Struthers, one in the medial intermuscular septum, four in the anconeus epitrochlearis muscle, five beside the cyst of the proximal flexor carpi ulnaris (FCU), and the remaining 44 cases were all from the compression between Osborne''s ligament to the two heads of the FCU. The compression localizations diagnosed by ultrasound were confirmed by operations. Preoperative ultrasound confirmed no ulnar nerve subluxation in all cases. The postoperative outcomes were satisfactory. There was no recurrence or aggravation of symptoms in this group of patients according to the modified Bishop scoring system; results showed that 43 cases were excellent, 10 were good, and three were fair.ConclusionsHigh‐frequency ultrasound can accurately and comprehensively evaluate the ulnar nerve compression and the surrounding tissues, thus providing significant guidance for the precise minimally invasive treatment of ulnar nerve compression.     

超声引导下行输卵管通液术在原发性不孕中的应用

通过57例原发性不孕症病人在B超引导下行输卵管通液术,术后随访观察,输卵管不通畅治愈率达89．5％(51／57);妊娠率达63。2％(36／57)。因此,B超引导下行输卵管通液术不仅是诊断和治疗输卵管不通所致原发性不孕症的一条好途径,而且是对传统输卵管通液术的进一步发展。     

孕中晚期取脐血制作染色体的临床应用

目的研究染色体病的产前诊断。方法对不同原因产前咨询的278例孕妇于孕中期B超监测下采取脐血,其中68例制作染色体行核型分析。结果68例中7例为异常核型,分别为46,XY,21P+,46,XX,t(1;4)(q44;q25);47,XX,+21及4例46,X,Yq+。结论于孕中晚期采取脐血制作染色体,具有周期短、染色体形态好及成功率高等优点,可获取供临床诊断有价值的结果,对于有遗传病家族史、畸形胎儿分娩史、异常孕产史等的诊断有其特异性。     

B超测量胎儿腹径在巨大儿预测中的应用--附168例分析

目的 探讨一种Ｂ超预测巨大儿物简便、实用的方法。方法 回顾性分析１９９４年１月 １９９８年１２月间出生的巨大儿共１６８例。结果 胎儿腹径「ＡＤ＝（ＴＡＤ＋ＡＰＡＤ）／２」≥１１０ｍｍ者１４５例,预测巨在儿符合率为８６．３１％。与ＡＣ、ＡＤ＋ＢＰＤ、ＡＤ＋ＦＬ、ＡＤ＋ＢＰＤ＋ＰＬ相似,优于ＢＰＤ、ＦＬ、ＢＰＤ＋ＦＬ及宫高＋腹围。结论 Ｂ超测量胎儿腹径预测巨大儿简便、实用、准确,值得临床推广应用。     

超声评价低频脉冲中药导入治疗乳腺囊性增生病临床疗效

目的：超声观察低频脉冲中药导入治疗乳腺囊性增生病的临床疗效。方法：将１５０例患者随机分为治疗组（１００例）和口服乳增宁片对照组（５０例）,超声观察治疗前后乳腺病变组织的变化情况。结果：经２个疗程治疗后,治疗组治愈率６２％,总显效率８３％,总有效率９８％;对照组治愈率３６％,总显效率６６％,总有效率９０％。治疗组的治愈率和总显效率均显著优于对照组（Ｐ〈０．０１,Ｐ〈０．０５）。结论：低频脉冲中药导入     

彩色多普勒超声对甲状腺肿块的诊断价值

目的 探讨彩色多普勒超声（ＣＤＦＩ）对甲状腺肿块的诊断价值。方法 采用彩色多普勒超声观察４５例患者５９个甲状腺肿块周边部及内部的彩色血流和异常高速的血流信号。结果 ①良性甲状腺肿块周边部及内部常显示稀少的彩色血流信号（７７．４％）,而恶性甲状腺肿块周边部及中央部多显示丰富的彩色血流流信号（８２．１％）。②恶性甲状腺肿块的异常高速血流（〉７０ｃｍ／ｓ）检出率与良性甲状腺肿块差异无显著性（Ｐ〈０．０５     

Tubular ectasia of the rete testis: a potential pitfall in scrotal imaging

Tubular ectasia of the rete testis (TERT) is a benign entity due to dilation of the tubules of the rete testis. Most of the time it is discovered incidentally on scrotal sonograms and may be misinterpreted as malignant. This article outlines the diagnostic criteria of TERT, its possible causes, its incidence and its potential evolution. Recognizing this entity owing to its characteristic clinical, sonographic and, if necessary, MRI features is important to avoid unnecessary surgery or biopsies. Received: 4 August 1998; Revised: 15 April 1999; Accepted: 19 April 1999