正常人肺静脉管径及其血流频谱的研究

肺静脉血流和肺静脉管径的变化与左房压力及左心室舒张功能密切相关 [1 ,4 ] 。超声心动图可以直接、动态观察肺静脉内径及血流频谱变化 ,但是目前超声尚无健康人肺静脉内径正常值。我们应用彩色超声多普勒技术对正常人及孕周 2 4周以上的妊娠妇女进行肺静脉内径及血流频谱研究 ,以探索正常人肺静脉的显示率、内径正常值、血流频谱特点。观察高动力状态及呼吸对肺静脉管径和血流频谱的影响。1　材料与方法1.1　研究对象　 16 9例排除心肺疾患的健康人分组进行研究。其中成年男性组 4 4例、成年女性组 4 6例、儿童组 14例、中期妊娠组 (中妊 …     

Transcranial doppler ultrasonography for the evaluation of shunt malfunction in pediatric patients

Previous studies have demonstrated a high correlation between hydrocephalus and the resistive index (RI), as determined by transcranial Doppler ultrasonography. Measurements of RI, calculated by dividing the difference between the peak systolic velocity and the enddiastolic velocity by the peak systolic velocity, were attempted in 55 pediatric patients during evaluations for ventriculoperitoneal shunt malfunctions; values were obtained in 52. Indications of shunt malfunction included both clinical and radiographic evidence of increased intracranial pressure. Eleven patients, determined to have functional shunts both by clincal criteria and subsequent outcome, had RIs of 47±5 (average±1 standard deviation). Shunt malfunctions were confirmed in 41 patients. Prior to shunt revisions, these 41 patients has RIs of 71±10%; following revision, the RIs fell to 53±12%. Nine patients had had pre-malfunction RIs of 48±11% obtained during routine follow-ups; when they subsequently had shunt malfunctions, their RIs had significantly increased. Four of the 41 patients with shunt malfunctions had essentially normal RIs (52±7%), but had fluid tracking along the shunt; in these, RIs were essentially unaffected by shunt revision. For comparison, 119 pediatric patients with clinically functional ventriculoperitoneal shunts had RIs of 50±9%. The data, statistically significant with a P value of <0.001, showed a correlation between elevated RIs and shunt malfunction; thus, transcranial Doppler ultrasonography is a practical, non-invasive technique useful in the diagnosis of ventriculoperitoneal shunt malfunction.Presented at the Annual Meeting of the Pediatric Section of the American Association of Neurological Surgeons, Washington D.C., November 1989     

大脑中动脉狭窄的TCD与DSA检查比较研究

目的 :通过大脑中动脉狭窄的TCD检查与DSA检查方法比较 ,为临床提供方便可靠的检查方法。方法 :对经TCD检查确诊为大脑中动脉狭窄 6 0例做DSA检查 ,对两种检查结果进行比较分析。结果 :经TCD确诊为大脑中动脉狭窄病例 ,病变侧狭窄处的血流速度(Vm)均明显高于健侧一倍以上 ,在动脉硬化性狭窄中多伴有“海鸥鸣”或“铁锅炒沙”样杂音 ,且频谱形态呈圆钝或脉动指数值增高的阻力波形。该 6 0例在DSA的检查中均出现不同部位的不同狭窄。结论 :TCD检查具有快速方便、安全、经济、确诊率高的优点 ,可作为脑血管病首选检查手段     

Effect of prostaglandin E1 on graft function of kidneys from living related donors

Prostaglandin E₁ (PGE₁) was used in renal transplant recipients with living related donors. The drug was given intravenously from day 1 to day 7 after transplantation at a dose of 40 µg/kg twice a day. A total of 45 patients were studied divided into two groups: 25 patients were treated with PGE₁ (group B) and the remaining 20 patients did not receive the drug (group A). In group B, 24-h creatinine clearance (Ccr) was 66 ± 12.8 ml/min compared with 40.3 ± 13.4 ml/min in group A on the fifth postoperative day (P < 0.05). Urinary levels of N-acetyl-β-d -glucosaminidase (NAG) and serum levels of platelet factor 4 (PF4) in group B were significantly lower than in group A. On the fourth postoperative day, the urinary excretion of thromboxan B₂ (TxB₂) in group A was higher than in group B, but not significantly (5.1 ± 3.0 ng/day and 2.8 ± 1.1 ng/day, respectively). Acute rejection occurred in four patients in group B and in 10 patients (40%) in group A. The percentage of Leu2a-positive lymphocytes in group B was higher than in group A. We conclude that postoperative administration of PGE₁ improves graft function in kidneys from living related donors.     

彩色多普勒超声诊断先天性心脏病

彩色多普勒超声和二维超声心动图并用,不仅可观察和了解心脏解剖、形态及腔室大小,又能观察血流动力学改变。我们从1991年11月至1992年11月间应用上述方法诊断先天性心脏病共18例,均经我院和外院手术证实:室间隔缺损7例;房间隔缺损6例;动脉导管未闭5例,其中1例误诊为肺动脉瓣狭窄,诊断准确率达94.4％。我们认为彩色多普勒诊断先天性心脏病方法安全,准确无损伤,为临床及术前提供了较可靠的诊断依据,但检查者必须了解心脏及大血管的解剖关系,结合临床才能提高诊断准确率,减少漏、误诊的发生。     

右美沙芬对兔急性脑外伤后脑血流速度的影响

目的 :应用经颅多普勒超声 (TCD)技术研究右美沙芬治疗兔颅脑急性损伤后脑血流速度的变化及其意义。方法 :健康雄性白家兔 2 0只 ,随机分为 2组。A组 (n =1 0 )为脑外伤组 ,B组 (n =1 0 )为脑外伤后右美沙芬治疗组。应用TCD分别测定外伤前、伤后 5min、6h、72h、1 6 8h兔大脑中动脉 (MCA)脑血流速度。观察指标为收缩期血流速度 (vS) ,舒张期血流速度 (vD)和脉动指数 (PI)。结果 :A组伤前、后 5min、1 6 8hvS 与B组比较 ,差异无统计学意义 ;A组伤后 6h、72hvS((39.4 5± 7.5 )cm/s,(4 1 .2 0± 5 .94 )cm/s)与B组 ((5 1 .6 8± 1 0 .32 )cm/s,(5 2 .4 1± 8.5 6 )cm/s)比较差异有统计学意义 (P <0 .0 5 ) ;A组伤前、后 5min、1 6 8hvD 与B组比较 ,差异无统计学意义 ;A组伤后 6h、72hvD((2 6 .33± 3.4 6 )cm/s,(2 5 .84± 5 .6 9)cm/s)与B组 ((33.6 4± 4 .2 7)cm/s ,(34.86± 7.4 8)cm/s)比较差异有统计学意义 (P <0 .0 5 ) ;A组伤前、后 5minPI值与B组比较差异无统计学意义 ,A组伤后 6h、72h、1 6 8hPI(2 .0 6±0 .5 8,2 .2 5± 0 .36 ,1 .5 3± 0 .39)与B组 (1 .2 6± 0 .2 9,1 .38± 0 .2 9,0 .96± 0 .1 7)比较差异有统计学意义 (P <0 .0 5 )。结论 :提示右美沙芬可通过改善脑血流速度、降低脉动指     

120例门静脉病变的彩色多普勒超声诊部的临床价值

目的:探讨门静脉临床病变类型及超声诊断价值,指导临床治疗及预防。方法:通过120例超声诊断门静脉病变分析总结,对门静脉病变进行归纳分类,指导临床治疗及预防。结果:按门脉节段分类门脉病变分为:①门脉属支病变,②门脉主干病变,③门脉分支病变。每一病变又分门脉血流异常,门脉本身病变,门脉外异常影响门脉。并分析部分异常出现的原因及后果,指导预防及治疗。结论:应用彩超可以评价门脉病变性质、部位,部分指导临床治疗。     

Skin reactions to irritants assessed by non-invasive bioengineering methods

Pathophysiological components of irritant contact dermatitis caused by 3 chemically-different irritants were investigated. 20 healthy volunteers were patch tested with sodium lauryl sulphate, nonanoic acid and hydrochloric acid on the flexor side of the upper arm. The skin response was evaluated after 24, 48 and 96 h by visual scoring and measured by the following bioengineering methods: transepidermal water loss measurement, electrical conductance for measurement of skin hydration, laser Doppler flowmetry for measurement of cutaneous blood flow and 20 MHz ultrasound A-scan for measurement of skin thickness. In spite of homogeneous inflammatory responses, significant differences in the severity of the injury to the skin barrier function caused by the different irritants were found. Also significant differences between irritants were found in the time course of development of maximum irritant reactions. Bioengineering methods indicating inflammatory responses (measurement of blood flow and skin thickness) were helpful in quantifying the irritant response in general, while bioengineering methods indicating epidermal damage (measurement of TEWL and electrical conductance) were helpful in classifying the individual irritants.     

经阴道彩色多普勒诊断未破裂型输卵管妊娠

本文介绍经阴道彩色多普勒诊断未破裂型输卵管妊娠２６例，１３例经手术及病理检查证实，１３例经临床确诊，符合２５例，诊断符合率９６．１５％；误诊１例，误诊率３．８５％。经阴道彩色多普勒检查其二维图像清晰，彩色血流灵敏，能更早发现输卵管妊娠包块内特异的滋养层周围血流及同侧卵巢的黄体血流，使输卵管妊娠在破裂前就能作出诊断，具有较高的临床应用价值。     

Blood Flow Increase by Cervical Spinal Cord Stimulation in Middle Cerebral and Common Carotid Arteries

The effect of spinal cord stimulation (SCS) on cerebral blood flow (CBF) has, in the past, been evaluated by semiquantitative techniques, but has not been used to treat CBF diseases. The aim of this study was to assess the effect of cervical SCS on regional blood flow by both semiquantitative and quantitative methods. Thirty‐five patients with cervical SCS‐implanted devices were enrolled. The following parameters were measured before and after cervical SCS: systolic and diastolic velocity (cm/s) in the middle cerebral artery (MCA) by transcranial Doppler (TCD) and volume blood flow quantification (ml/min) in the common carotid artery (CCA) by color Doppler. During cervical SCS there was a significant and bilateral increase in systolic (21%) and diastolic (26%) velocity in the MCA and in CCA blood flow (50%). We conclude that cervical SCS increases blood flow in the middle cerebral artery and common carotid artery. The consistent increase supports the potential usefulness of cervical SCS as an adjuvant treatment for cerebral blood flow diseases.