经阴道彩色多普勒超声诊断异位妊娠的价值

目的 探讨经阴道彩色多普勒超声对诊断异位妊娠的重要性.方法 51例临床怀疑异位妊娠的育龄妇女均接受了经阴道彩色多普勒超声检查,并对妊囊包块的血流成像与血流频谱进行了分析.结果 51例异位妊娠患者中,经阴道彩色多普勒超声正确诊断49例,包括输卵管妊娠47例,子宫角妊娠与卵巢妊娠各1例,诊断准确性为95%.2例输卵管妊娠患者由于妊娠包块不明显及腹胀肠气的干扰而漏诊.在声像图上,妊囊包块表现为胎囊型22例,流产破裂型27例,以及类实性光团型2例.在彩色多普勒血流显像上,妊囊包块表现为滋养层血流频谱或怪异频谱.结论 经阴道彩色多普勒超声对异位妊娠有很高的诊断准确性,而且其操作简单、无创,可作为诊断早期异位妊娠的首选方法.     

经阴道彩色多普勒超声对早期异位妊娠和妊娠黄体的鉴别诊断

目的 :探讨早期异位妊娠与妊娠黄体的经阴道彩色多普勒超声声像图特点,以提高诊断符合率。方法 :回顾性分析48例异位妊娠与50例早孕卵巢黄体的二维声像图及彩色多普勒超声表现。结果 :异位妊娠声像图表现为宫旁不均质包块,周围均无小卵泡样回声,妊娠黄体中31例(62.00%)周围可见小卵泡回声;45例(93.75%)异位妊娠患者血流呈点状血流及带状血流,2例(4.17%)呈环状血流,1例(2.08%)无明显血流信号,48例(96.00%)妊娠黄体呈环状及半环状血流,2例(4.00%)呈点线状血流;异位妊娠患者较宫内早孕妊娠黄体收缩期峰值流速(PVS)低,而RI、搏动指数(PI)、收缩期与舒张期比值(S/D)高。结论:经阴道超声在早期异位妊娠与妊娠黄体的鉴别诊断中有较高的价值。     

阴道彩色多普勒超声对早期异位妊娠和妊娠黄体的鉴别诊断

目的：探讨早期异位妊娠与妊娠黄体的经阴道彩色多普勒超声声像图特点,以提高诊断符合率。方法：回顾性分析48例异位妊娠与50例早孕卵巢黄体的二维声像图及彩色多普勒超声表现。结果：异位妊娠声像图表现为宫旁不均质包块,周围均无小卵泡样回声,妊娠黄体中31例（62.00%）周围可见小卵泡回声;45例（93.75%）异位妊娠患者血流呈点状血流及带状血流,2例（4.17%）呈环状血流,1例（2.08%）无明显血流信号,48例（96.00%）妊娠黄体呈环状及半环状血流,2例（4.00%）呈点线状血流;异位妊娠患者较宫内早孕妊娠黄体收缩期峰值流速（PVS）低,而RI、搏动指数（PI）、收缩期与舒张期比值（S/D）高。结论：经阴道超声在早期异位妊娠与妊娠黄体的鉴别诊断中有较高的价值。     

经阴道彩色多普勒超声评价药物治疗输卵管妊娠的价值

目的:探讨经阴道彩色多普勒超声(TVCDFI)评价药物保守治疗输卵管妊娠的价值。方法:应用TVCDFI观察中西医结合保守治疗输卵管妊娠30例,患者治疗前及治疗后1周、2周、1月行阴道超声检查,并记录输卵管妊娠包块的二维声像图特征及多普勒血流动力学参数。结果:输卵管妊娠包块治疗前血流信号丰富,治疗后血流信号逐渐减少,差异具有显著性意义(P<0.005)。治疗1月后附件区包块收缩期峰值流速及舒张末期流速较治疗前明显减慢,P<0.001。治疗2周及1月后附件区包块阻力指数较治疗前明显升高,P<0.001。结论:输卵管妊娠包块大小、血流信号的丰富程度、血流流速的降低及阻力指数的增高以及盆腔积液量的多少是疗效评价客观的、有价值的指标。TVCDFI评价输卵管妊娠疗效有临床推广价值。     

经阴道彩超对输卵管间质部妊娠的诊断(附28例分析)

目的 探讨经阴道彩超(TVCDU)对输卵管间质部妊娠诊断的临床价值.方法 对经手术和病理证实的28例输卵管间质部妊娠二维图像、血流分布情况及频谱特征进行回顾性分析.结果 术前超声诊断为间质部妊娠17例,超声检出率为61%(17/28),其图像特征为子宫不对称性增大,一侧宫角部较对侧官角膨隆,在膨隆处的宫角处探及妊娠囊或包块,包块与宫内膜不延续,包块围绕着肌层厚薄不一.超声图像可分为3种类型:孕囊型(7例)、不均质包块(16例)和破裂型(5例).结论 TVCDU对输卵管问质部妊娠的早期诊断与鉴别诊断具有重要的临床价值.     

输卵管妊娠的MRI诊断

目的探讨输卵管妊娠的MRI表现特点和诊断价值。方法对临床诊断为异位妊娠的19例患者进行超声和MRI检查,仅1例行MRI增强扫描。17例经手术病理证实为输卵管妊娠,2例经保守治疗证实。结果MRI均明确显示孕囊包块、周围血凝块和游离血性液体。孕囊T1WI以等信号和等高信号多见,T2WI信号复杂。包膜在T2WI和抑脂序列显示清晰,呈低信号。包膜破裂处低信号环消失。1例增强者示孕囊呈多个环状、团块状强化。超声发现孕囊包块14例,2例不确定,3例未见明确孕囊包块。结论输卵管妊娠MRI表现有一定的特点,对超声检查可疑或不确定者,行无创性MRI检查对鉴别诊断和临床诊治有重要作用。     

经阴道超声联合磁共振对剖宫产术后子宫瘢痕妊娠的诊断价值分析

目的探究经阴道超声联合磁共振成像（MRI）对剖宫产术后子宫瘢痕妊娠诊断价值。方法选取我院2020年1月至2021年8月期间80例剖宫产术后子宫瘢痕妊娠患者为研究对象,均接受经阴道超声、MRI诊断,以手术病理活检结果为金标准,分析两种诊断方法单独、联合诊断价值。结果经阴道超声：共检出72例瘢痕妊娠,包括孕囊型54例、包块型18例;孕囊型中,胚芽、心管搏动检出率分别为46.2%(37/54)、41.2%(33/54);周围血流情况中,孕囊型环状或半环状血流检出率为51.2%(41/54),包块型局部肌层血流紊乱检出率为6.2%(5/18);MRI共检出79例瘢痕妊娠,包括孕囊型57例、包块型22例;胚芽检出率为51.2%(41/54);平扫见38例（47.5%）孕囊型信号均匀增大,T1WI低信号,T2WI高信号,增强扫描见22例（27.5%）包块型包块型病灶均见囊壁明显强化,囊内容物无明显强化;经阴道超声+MRI对瘢痕、胚芽、心管搏动检出率分别为100.0%、55.0%、41.2%,其中瘢痕、胚芽检出率较经阴道超声高,心管搏动诊断检出率较MRI高（P<0.05）;以手术病理组织检验为...     

经阴道超声对子宫瘢痕妊娠的早期诊断

目的分析剖宫产术后子宫瘢痕妊娠(CSP)的超声图像特征,探讨经阴道超声对CSP的早期诊断价值。资料与方法回顾性分析经病理证实的32例CSP患者的经阴道超声图像特征,观察包块的位置及其与子宫切口的关系、包块与切口的回声及血流情况。结果 32例经阴道超声检查均提示妊娠异常,其中27例(84.38%)明确提示CSP。早期CSP的超声图像特征为:①宫腔正常部位未见孕囊;②子宫下段切口可见囊性或混合性包块;③包块部位子宫肌层连续性中断,呈楔形凹陷或变薄;④包块位于宫颈内口上方,宫颈回声正常、内外口闭合;⑤彩色多普勒血流显像示包块内及其周边可见少许点状或丰富血流信号。结论①②的超声图像特征是妊娠异常的诊断前提,③④的图像特征是早期超声诊断CSP的关键。彩色多普勒血流显像对CSP的鉴别诊断有帮助。     

宫角妊娠的超声特征与误诊分析

目的 分析宫角妊娠的声像学特征及误诊原因,以提高超声诊断符合率.方法 对经病理证实的15例宫角妊娠患者的术前超声检查资料,进行分析.结果 宫角妊娠的超声声像图特征:(1)子宫增大,两侧宫角不对称,向外隆起侧宫角部可见妊娠囊或包块回声;(2)妊娠囊或包块与子宫内膜向连;(3)妊娠囊或包块周围均有较完整的子宫肌层包绕;(4)彩超显示来自宫角部的血流供应妊娠囊或包块.15例宫角妊娠中,超声宫角妊娠诊断符合率约为66.7%(10/15),误诊率约为33.3%(5/15),误诊5例,其中2例误诊为输卵管间质部妊娠,2例误诊为宫腔偏宫角部妊娠,1例误诊为子宫肌瘤1例.结论 超声对宫角妊娠有较高诊断价值,检查者应提高对该病的认识及鉴别诊断避免误诊.     

经阴道超声对未破裂未流产型异位妊娠合并厚壁型妊娠黄体的临床观察

目的:分析未破裂未流产型异位妊娠合并厚壁型妊娠黄体的经阴道超声表现,以提高其诊断符合率。方法:回顾性分析104例未破裂未流产异位妊娠合并86例一侧或同侧妊娠黄体的经阴道超声表现。结果:未破裂未流产型异位妊娠超声表现为宫旁、输卵管"双环征"包块,厚壁型妊娠黄体声像图表现与之类似;未破裂未流产型异位妊娠104例中血流呈环状者4例、半环状27例、点线状59例,无流产者14例(14/104);妊娠黄体血流呈环状79例(79/86)、半环状6例(6/86)、点线状1例(1/86)。未破裂未流产型异位妊娠患者较妊娠黄体收缩期峰值流速低,RI值高。结论:经阴道超声是未破裂未流产型异位妊娠及妊娠黄体特别是厚壁型妊娠黄体的重要鉴别手段,可减少误诊。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.