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1.
目的 探讨颅脑术后创腔张力性积液的临床特点、治疗方法及预后。方法 回顾性分析2019年8月至2021年10月收治的10例颅脑术后创腔张力性积液的临床资料。结果 10例中,星形细胞瘤5例,胶质母细胞瘤2例,中枢神经细胞瘤1例,转移性肺癌1例,脑脓肿1例。3例行开颅积液清除术,7例行钻孔引流术。10例术后症状明显改善。出院时GOS评分5分6例,4分2例,3分2例。术后随访3个月,创腔完全消失3例,缩小失去张力7例。结论 创腔张力性积液是颅脑术后少见的并发症,以脑肿瘤术后多见;一旦发现创腔张力性积液,及时行钻孔引流术,可取得较好的预后。  相似文献   
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Ovarian cysts are common in pregnancy, more so with the increase in routine antenatal use of ultrasonography. The majority of ovarian cysts in pregnancy are benign and resolve spontaneously. It is rare to diagnose malignant ovarian tumours during pregnancy. Imaging with ultrasonography is the first line investigation of choice and the use of International Ovarian Tumor Analysis (IOTA) group rules of ultrasonographic appearances of ovarian lesions can help identify benign and malignant lesions more accurately. MRI is also safe to use in pregnancy to better delineate ovarian lesions. Simple cysts <6 cm can be safely managed conservatively, with surgery reserved for larger, symptomatic cysts or those suspicious of malignancy. Ovarian cysts can be managed laparoscopically between 14 and 16 weeks gestation but require advanced laparoscopic skills. Image guided aspiration of benign ovarian cysts remains an option but is associated with high recurrence rates and risk of spillage, a disadvantageous outcome in cases subsequently shown to be malignant.  相似文献   
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Rationale:Tarlov or perineurial cysts are nerve root lesions often found in the sacral region. Most perineural cysts (PCs) remain asymptomatic throughout a patient''s life. While their pathogenesis is still unclear, trauma resulting in hemorrhaging into subarachnoid space has been put forward as a possible cause of these cysts. Recently, we worked with a patient experiencing symptomatic PCs after spontaneous subarachnoid hemorrhage.Patient concerns:A 45-year-old man had a coil embolization procedure performed after being diagnosed with a subarachnoid hemorrhage from a ruptured anterior communicating artery. His symptoms were relieved after the procedure, but 7 days later he reported worsening pain in the left perineal area. The pain was intermittent at its onset and exacerbated by sitting, walking, and coughing.Diagnoses:Two weeks after the embolization procedure, a lumbar spine MRI revealed 2 PCs at the S1 and S2 level affecting the left S2 root with high signal intensity in T2 and T1 images, suggestive of bleeding within the cyst.Interventions:We operated using a posterior approach. Cyst fenestration was done after S1 laminectomy. We aspirated approximately 1 cc of old blood.Outcomes:His pain was relieved immediately after cyst removal and no neurologic deterioration occurred during the postoperative period.Lessons:Subarachnoid hemorrhage can be the source of the development of pain from asymptomatic PCs, making them symptomatic. Surgical extirpation is 1 treatment option for these symptomatic PCs.  相似文献   
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The epithelial remnants of tooth development give rise to an impressive range of cystic lesions, termed odontogenic cysts. They are classified based on their distinct clinical, radiological and histological features, a process that has not been without controversy. We will attempt to explain the basis of the debate behind the changing classification of odontogenic cysts, describing their aetiology, clinical and histological features, along with common pitfalls that can confuse the diagnostic process. More common diagnostic challenges, such as the effects of inflammation and mucous change, will be explored in detail. An attempt will be made to distil the diagnostic process into simple algorithmic steps to narrow down the differential diagnoses of this fascinating group of lesions. We will demonstrate the importance of careful consideration of the clinical and radiological features that can help prevent misclassification, ensuring appropriate management and follow-up for this diverse group of lesions.  相似文献   
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目的对比经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic surgery, vNOTES)和传统腹腔镜下卵巢囊肿手术治疗的可行性及安全性。 方法回顾性分析2017年11月至2018年4月,于四川大学华西第二医院同期进行手术治疗的18例卵巢囊肿患者的相关信息,按照手术途经分为vNOTES组及传统腹腔镜组,每组9例。统计并分析患者基线情况、手术相关数据。 结果18例患者手术均顺利完成,均未改变手术方式,无围手术期并发症的发生。基线情况中的盆腹腔手术史部分,vNOTES组较传统腹腔镜组少,差异有统计学意义(P<0.05)。手术相关数据中vNOTES组与传统腹腔镜组的平均手术时间分别为115 min和108.89 min,术前与术后血红蛋白下降分别为16.22 g/L和16.33 g/L,住院时间分别为2.78 d和3.33 d,疼痛视觉模拟评分(visual analogue scale,VAS)分别为1.89分和2.78分,术后1周美容评分分别为22.67分和17.78分,组间差异均无统计学意义。但在术后4周、术后24周美容评分上vNOTES组满意度较高,vNOTES组与传统腹腔镜组分别为(23.44分vs 18.56分)和(23.89分vs 19.11分),与传统腹腔镜组存在统计学差异(P<0.05)。 结论vNOTES较传统腹腔镜手术治疗卵巢囊肿有着独到的美容优势,充分的病情评估及病例选择后vNOTES途经是安全可行的。  相似文献   
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Background/Objectives

Due to its rarity, epidermoid cyst in intrapancreatic accessory spleen (ECIPAS) is still a diagnostic dilemma during clinical practice. The aim of this review was to summarize the epidemiologic features and management of ECIPAS.

Methods

MEDLINE and EMBASE were searched for English articles reporting on ECIPAS up to April 30th, 2018 following the methodology suggested by the PRISMA guidelines. Categorical variables were reported as frequency and percentage. Continuous variables were reported as median (range).

Results

A total of 56 patients from 47 full articles were included for the final data synthesis. More than half of the ECIPASs (59%) were found incidentally. The female/male ratio was 1.33. ECIPAS is typically a single mono-/multi-lobular cystic lesions in the pancreatic tail with thickened cystic wall or various amount of solid component which had identical density/signal to the spleen on imaging examinations. The cyst is filled with serous or non-serous fluid. Recognition of the surrounding ectopic splenic tissue is the key point to diagnose ECIPAS. However, no preoperative examination was able to make a definite diagnosis. Almost all the patients (96%) received surgical treatment, due to the suspicion of pancreatic malignant or potentially malignant cystic tumor, especially mucinous cystic neoplasm (MCN).

Conclusions

Although seldom encountered, ECIPAS should be considered as a differential diagnosis for pancreatic cystic lesions, especially when solid component was detected. As a benign disease, unnecessary surgery should be avoided. Because it is difficult to make a definite diagnosis preoperatively by one single examination, multiple modalities may be required.  相似文献   
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手术是颌骨囊肿的主要治疗方法。囊肿刮除术、开窗减压术(袋形术)在临床上广泛应用。术后采用影像学方法观察骨腔的愈合或囊腔的缩小,是术后疗效评估及开窗减压术后选择二期囊肿刮除术时机的必要措施。由于不同的手术方式,上、下颌骨结构的差别,病变类型、大小以及患者年龄等差异,可能影响囊肿术后骨沉积的速率与结果。文章结合文献和笔者的经验,就颌骨囊肿术后骨形成的影像特点与相关因素做一概述。  相似文献   
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