阴茎折断临床分析

目的 探讨阴茎折断伤的病因和诊治。方法 对2l例阴茎折断伤的临床资料进行回顾性分析。结果 致伤原因以粗暴性交13例，手淫5例，跌伤、撞击伤各l例，拒绝说明原因l例。B超确诊12例，阴茎海绵体造影确诊l例。12h内手术13例，超过12h手术3例，保守治疗5例。12h内手术组有2例发生阴茎白膜硬结，术后性功能正常；超过12h手术组和保守治疗组各有l例和2例并发阴茎硬结、阴茎成角畸形和勃起功能障碍。结论 阴茎折断致伤原因以粗暴性交和手淫为主；B超检查是诊断阴茎折断首选方法；早期手术能减少其并发症的发生；术中采用纵行小切口容易准确找到白膜破裂位置，且创伤小，适于临床应用。     

AN EPIDEMIOLOGICAL SURVEY OF CHOLELITHIASIS IN SHANGHAI

Objective To obtain a general overview of gallstone disease in Shanghai. Methods 3415citizens aged >20 in the community of Shanghai were randomly selected to undergo a clinical epidemiological study and an ultrasound examination to screen for cholelithiasis. Results Overall prevalence rate of gallstones was 6.5% (8.6% in women and 5.1% in men). Among the 3415 persons investigated, 65 had already undergone cholecystectomy. The percentage of asymptomatic gallstone was 70 .5% . Prevalence of gallstone diseases (gallstones plus cholecystectomy) increased with age significantly. Conclusion Compared to the research in Shanghai ten years ago, especially for the persons older than 50 years, the gallstone disease has become more frequent. The proportion of asymptomatic gallstones and the awareness is increasing.     

彩色多普勒超声检查对卵巢肿瘤的诊断价值

①目的 探讨彩色多普勒超声检查对卵巢肿瘤的诊断价值。②方法 对67例疑诊为卵巢肿瘤的病人术前行彩色多普勒超声检查及血流动力学分析，测其动脉血流收缩期峰值流速(PSV)和阻力指数(RI)，并与手术及病理结果对照。③结果 67例卵巢肿瘤经手术及病理证实良性49例，恶性18例，经彩色多普勒超声诊断为良性41例，恶性15例，超声诊断符合率分别为83．7％和83．3％。④结论 彩色多普勒超声对卵巢肿瘤的良恶性判断具有较高价值。     

阴道超声对行激素替代疗法的绝经后妇女子宫内膜形态变化的研究

目的 :探讨阴道超声观察绝经后行激素替代疗法 (HRT)妇女子宫内膜形态变化中的价值。方法 :对 1 0 2例绝经后行HRT妇女进行定期 (每年 3次 )经阴道超声检查 ,观察其子宫内膜厚度与形态并加以分析。结果 :HRT治疗后 1a内子宫内膜≤ 5mm的 71人 (占 6 9.6 %) ,6mm～ 8mm的 2 0人 (占 1 9.6 %) ,>8mm的 1 1人 (占 1 0 .8%) ,其中 4例伴阴道少量出血 ,诊刮结果 2例为萎缩性内膜 ,2例为内膜部分腺体上皮增生 ;第二年子宫内膜≤ 5mm的 89人 (占 87.3%) ,6mm～ 8mm的 1 3人 (占 1 2 .7%)。结论 :阴道超声对了解绝经后行激素替代疗法妇女子宫内膜形态变化有重要临床价值。当子宫内膜厚度 >8mm时 ,需进行进一步检查。     

经颅多普勒频谱参数与急性颅脑损伤患者颅内压的关系

目的探讨急性颅脑损伤患者的经颅多普勒频谱参数与颅内压的关系。方法应用TCD检测20例急性中、重型颅脑损伤患者双侧大脑中动脉,同时行颅内压监测。结果经颅多普勒频谱参数cf、PI、af、RI、ae均和ICP正相关,Vd、ac和ICP负相关,其中cf与ICP的相关系数最大。建立TCD相关参数与ICP的多元线性回归方程:ICP=0.312MAP-1.531Vd+21.437PI-15.059ac+38.722cf(P<0.001,R2=0.920估计值的标准差=4.0972mmHg)。结论经颅多谱勒频谱参数可以反应颅脑损伤患者的颅内压的改变。综合研究经颅多谱勒频谱参数、血压与颅内压的关系是应用经颅多普勒无创监测颅内压的方向。     

Incidence and growth pattern of simple cysts of the kidney in patients with asymptomatic microscopic hematuria

BACKGROUND: We examined the incidence and natural history of simple renal cysts found by ultrasonography (US) in patients referred for asymptomatic microscopic hematuria. METHODS: Among the 906 patients aged 18-78 years, 743 patients who had undergone US were included in the present study. The natural history of simple renal cysts was investigated in 55 patients who underwent periodical US examinations for more than 3 years. RESULTS: The incidence of simple renal cysts was 4.3% for ages 29 years or younger, 15.3% for ages 30-39, 21.8% for ages 40-49, 23.3% for ages 50-59 and 32.6% for ages 60 years or older; thus the incidence increased in older age groups (P = 0.0005 for men, P = 0.0020 for women). Men tended to have a higher incidence than women. The degree of hematuria did not influence the incidence of renal cysts (P = 0.9044). The annual growth rate of the mean maximum diameter was 4.2% during a 3-year follow-up period in 55 patients and 5.1% during a 6-year follow-up in 31 patients. CONCLUSION: Since the diameter of a renal cyst may increase by 5% annually, the diameter of the cyst may increase by 1.6 times in 10 years. The scheduling of follow-up examinations depends on the size at the time of disclosure, the effects on calyceal systems, or the suspicion of a concurrent malignant disease. However, the most simple renal cysts may be followed-up at an interval of more than 10 years, once a diagnosis has been established.     

Incidence of the retroaortic left renal vein in patients with varicocele.

OBJECTIVE: The purpose of this study was to investigate the incidence of the retroaortic left renal vein (RLRV) in patients with varicocele. METHODS: The left renal vein was ultrasonographically investigated for the presence of the RLRV in 140 patients with varicocele and a control group of 137 age-matched patients. The main diagnostic criteria for varicocele were the presence of a varicose vein with a diameter of 3 mm or larger at rest and with a reflux lasting more than 2 seconds during the Valsalva maneuver. The RLRV was defined as a posterior course of the left renal vein to the aorta at the level of the origin of the superior mesenteric artery. RESULTS: The RLRV was observed in 13 (9.3%) of the 140 patients with varicocele and 3 (2.2%) of the control patients. The incidence of the RLRV was found to be significantly higher in patients with varicocele compared with the control patients (P = .018, Fisher exact test). In 13 patients with the RLRV, left varicocele and bilateral varicocele were detected in 10 and 3 cases, respectively. CONCLUSIONS: In this study, the incidence of the RLRV was found to be significantly higher in patients with varicocele compared with control patients. Thus, we suggest that the presence of the RLRV may be considered one of the etiologic factors in the development of varicocele.     

急性胰腺炎CT、B超、手术及临床对照研究

笔者分析了２４例急性胰腺炎的ＣＴ所见，并同Ｂ超、临床化验和剖腹探查结果进行了对照研究。表明：（１）急性胰腺炎的ＣＴ诊断优于Ｂ超，对胆源性胰腺炎Ｂ超对诊断有明确帮助。（２）急性胰腺炎时，ＣＴ表现与血淀粉酶浓度不一定成正比。（３）急性胰腺炎可累及门脉系统引起血管并发症。     

超声导向肝组织微波固化的实验研究

目的：探讨不同穿刺方案形成的肝组织微波凝固区的大小、形态，为临床治疗，特别是大肝癌的治疗，提供实践基础。方法：利用离体新鲜牛肝，比较ＵＭＣ－Ｉ型微波仪单针、两针及多针组合所形成凝固区的大小、形态。结果：单针穿刺可形成３．０ｃｍ×４．０ｃｍ头宽尾窄的滴水状凝固区。两针组合，距离在２．５～３．０ｃｍ之间造成的完全凝固区最大。不同穿刺方案，可形成８ｃｍ以下不同直径的球形凝固区。结论：适当的穿刺方案可使８ｃｍ以下的球形区域完全凝固     

TCD结合TCCD与DSA对脑动脉狭窄的一致性分析及对治疗方案的指导价值

目的 探究经颅多普勒超声(transcranial Doppler sonography, TCD)结合经颅彩色多普勒超声(transcranial color-coded duplex, TCCD)与数字减影血管造影(digital subtraction angiography, DSA)对脑动脉狭窄的一致性分析及对治疗方案的指导价值。方法 选取缺血性脑血管病患者100例,均行TCD、TCCD及DSA检查,以DSA检查结果作为“金标准”,分析脑动脉狭窄程度,观察不同狭窄程度患者TCD、TCCD超声表现,采用Kappa检验分析TCD结合TCCD诊断脑动脉狭窄程度与DSA检查结果的一致性,比较不同狭窄程度患者收缩期峰流速(systolic velocity, Vs)、平均峰流速(mean velocity, Vm)、搏动指数(pulsatility index, PI),采用Spearman相关系数模型分析Vm、PI与脑动脉狭窄程度的相关性,所有患者均行药物或手术治疗,比较不同治疗方法患者入院时、治疗后6个月Vs、Vm、PI。结果 100例缺血性脑血管病患者,轻度狭窄42例,中度狭窄3...