先天性肥厚性幽门狭窄20例临床分析

[背景 ]总结分析先天性肥厚性幽门狭窄临床诊断、治疗经验及影响治疗的相关因素 .[病例报告 ]回顾 1990～ 1999年收治的先天性肥厚性幽门狭窄 2 0例 ,对其临床表现、诊断以及治疗进行分析 .2 0例中手术治疗 18例 ,其中 3例幽门十二指肠交界处粘膜在术中破裂 ,修补后覆盖大网膜 ,术后无 1例消化道瘘 .[讨论 ]先天性肥厚性幽门狭窄患儿在生后 3～ 4周出现呕吐症状 .根据典型的临床表现和X线钡餐透视可确定诊断 ,及时发现并修补破裂的粘膜可防止消化道瘘 .术后少量多次输血对患儿早日康复大有益处     

早期口服祛黄汤防治新生儿黄疸的临床研究

目的 为降低新生儿黄疸减少高胆红素血症发生,我们采用早期口服祛黄汤的方法,观察其对新生儿黄疸的影响,将出生后新生儿随机分为实验组１００例,常规处理后于６小时内口服祛黄汤,连服３日。对照组１００例,不服用任何药物。结果 新生儿生后６小时内第一次排便例数实验组明显高于对照组;新生儿第一次大便变黄时间,实验组较对照组明显缩短;４日龄新生儿黄染的例数、程度实验组明显低于对照组;血胆红素浓度实验组明显低于对     

新生儿缺氧缺血性脑病血浆及脑脊液一氧化氮水平的变化

目的 :了解新生儿缺氧缺血性脑病 (HIE)时血浆和脑脊液 (CSF)中 NO水平的动态变化。方法 :采用硝酸根还原酶法 ,对 35例 HIE患儿 (轻度 10例、中度 13例、重度 12例 )分别于急性期、恢复期进行了血浆和 CSF NO水平测定。结果 :HIE急性期血浆 NO水平除轻度组外 ,中、重度组明显高于对照组 ,重度组又明显高于轻、中度组 ;恢复期轻、中、重度组血浆 NO水平均降至正常 ,与对照组比较差异无显著性。CSF中 NO水平增加的幅度与血浆成正比。结论 :血浆和 CSF中 NO水平与 HIE的脑损伤程度密切相关     

山东省首例体外受精、胚胎移植成功报告

１９９４年初我校妇产科学教研室引进了体外受精－胚胎移植（ＩＶＦ－ＥＴ）术,１９９５年１月５日山东省首例“试管婴儿”在山东省立医院出生。作者详述了实施ＩＶＦ－ＥＴ的经过。此项技术的应用成功为开展生殖生理学、遗传学和优生学研究及临床应用奠定了基础。     

新生儿严重脑室内出血连续腰穿的疗效

目的为了治疗和预防脑室内出血后脑积水的发生和发展,改善新生儿严重脑室内出血的不良预后。方法1989年以来,对19例在出生后早期经头颅B超诊断为严重脑室内出血（IVH）患儿进行了连续腰穿（LP）治疗。结果有效16例,自动出院1例,失败2例。有效率为84．2％。有效16例初次LP日龄为14．6±5．7d,疗程23．4±12d,平均LP次数9．3±4．7次,平均LP间隔期3．1±1．6d,平均每次放液量6．7±2ml,LP治疗后起效天数为10．1±7．8d。2例在连续LP的同时联用乙酰唑胺治疗亦取得显著疗效。16例平均随访月龄为3．2±1月,体格发育均正常,B超显示12例脑室形态正常,4例脑室呈稳定的轻度增大。失败的2例初次LP迟,初期LP间隔期延长为7－9d,放液量＜5ml。同期另有17例严重IVH患儿未予LP治疗。其中4例并发脑积水,5例自动出院,4例早期死亡,余4例其后脑室形态稳定。结论连续LP不失为治疗新生儿严重IVH实用安全有效的方法,LP疗效欠佳时可联用乙酰唑胺治疗。     

新生儿通气相关性肺炎

目的：探讨新生儿通气相关性肺炎病因、病原菌、耐药情况、相关防治措施。方法：分析１０３ 例新生儿通气相关性肺炎患儿痰培养结果、诊治情况。结果：醋酸不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌是三种主要致病菌,耐药率高,对泰能、环丙沙星最为敏感。结论：革兰阴性杆菌是新生儿通气相关性肺炎重要病原菌,耐药率高,治疗较为困难,应积极预防。     

Vanishing Psammoma Bodies in the Anterior Pituitary of the Human Newborn: An Immunohistochemical and Histometric Study

Adenohypophyses of human newborns contain characteristic psammoma bodies. Their numbers are maximal within 2 weeks of the neonatal period and diminish thereafter. They are very rare in infant pituitaries, seeming to disappear by shrinkage in that there is a significant direct correlation between their number and size. The bodies were found to contain a high concentration of endogenous peroxidase, thus suggesting that the enzyme may be responsible for their disappearance. A statistical majority of psammoma bodies were located within follicular lumens. By immunohistochemistry, the follicular epithelium surrounding psammoma bodies showed immunoreactivity for various pituitary hormones. Light microscopy demonstrated that adenohypophysial cells surrounding psammoma bodies contain randomly, scattered granules or globules exhibiting peroxidase activity. Extrusion of such granules into follicular lumens may play a role in the genesis of the concretions. The conspicuous lamellar nature of the calcified psammoma bodies suggests that waves of calcium deposition occur during their morphogenesis. Despite histologic similarities, the histochemical characteristics of this type of psammoma body differ from those in other organs as well as from the calcification encountered in prolactin (PRL)-producing pituitary adenomas.     

Increased whole blood chemiluminescence in patients with Shwachman syndrome: therapy trial with thiamine and α-tocopherol

Neutrophils purified from peripheral blood of patients with the Shwachman syndrome show enhanced chemiluminescence (CL) and depressed chemotaxis. Here we present data showing that the increased CL response can be demonstrated by using a whole blood CL assay. This assay is well-suited for studies in infants, because the blood sample volumes needed are small. Increase in CL was most distinct in the initial (1 min) activation induced by N-formyl-methionyl-leucyl-phenylalanine. The 1-min response is considered to derive from extracellular production of oxygen radicals. Such an extracellular oxygen radical production may render the patients susceptible to undue oxidant stress. We therefore treated the patients with two antioxidants, thiamine and -tocopherol, for 3 months. This supplementation, however, failed to exert any significant effect on either whole blood CL or migration of the patients' neutrophils under agarose.     

新生儿高胆红素血症的临床研究

目的　探讨新生儿高胆红素血症的临床表现、发病因素和防止并发症 ,降低致残率。方法　对 99例新生儿高胆红血症患儿临床及实验室资料进行回顾性分析。结果　 99例新生儿黄疸经光疗等综合治疗除 4例放弃治疗和死亡外 ,其余均痊愈出院。结论　新生儿高胆红素血症病因复杂 ,致残率高 ,应重视予防 ,加强围产保健 ,防止感染和核黄疸发生 ,措施可行。     

凝血酶治疗新生儿上消化道出血的研究

目的　探讨凝血酶治疗新生儿上消化道出血的临床效果。方法　对 2 0 0 0年至今收住院的新生儿上消化道出血患儿 17例 ,除常规综合疗法外 ,静脉滴注维生素K1 10mg/d ,连用 4～ 7d。结果　治疗组 17例 ,显效 16例 ,显效率 97% ,对照组 15例 ,显效 7例 ,显效率 40 % ,两组比较有明显差异性 (P <0 0 0 1)。治疗组止血时间 1 3 5± 0 6d ,对照组平均止血时间 3 2±0 5d ,两组比较有明显差异性 (P <0 0 0 1)。结论　凝血酶治疗新生儿上消化道出血为一种安全、方便 ,无副作用的首选止血药物