双侧髂内动静脉瘘并左髂总静脉闭塞一例

患者女,62岁。主诉左下肢截肢术后残端肿胀,伴溃疡7个月余。2009年1月16日因左大隐静脉抽剥术后左下肢静脉曲张伴溃疡出血不止和感染、左股静脉血栓形成行左下肢截肢术。体格检查:贫血貌。会阴部、左下肢残端、左侧腹部腰背部明显橡皮样肿胀,皮温较对侧高,残肢伤口2处溃疡面有脓性分泌物,可见肌肉组织。     

主动脉缩窄伴右锁骨下动脉闭塞一例

患者女,13岁.因发现心脏杂音10余年,伴右下肢活动障碍6年余入院.查体:左上肢BP 210/101 mmHg,右上肢BP 191/83 mmHg,左下肢BP 125/80 mmHg,右下肢BP119/78 mmHg.一般情况尚可,心尖搏动增强,胸骨左缘2～3肋间闻及Ⅲ级连续性机械样杂音,主动脉听诊区闻及Ⅲ级收缩期杂音,心率84次/min,率齐.周围血管征(-),右侧桡动脉搏动弱.脊柱侧弯畸形,右足高弓马蹄内翻,右下肢较左下肢缩短3 cm,跛行.双侧股动脉、足背动脉未触及,双下肢无浮肿,巴彬斯基征( ),右踝阵挛( ),双侧膝反射轻度亢进.下肢血气检查示:PO2 50.4 mmHg,SaO2 85.8%,右上肢SaO289.4%,左上肢PO2 81.4 mmHg,SaO2 96.2%.心脏超声检查诊断为先天性心脏病,主动脉弓离断,动脉导管未闭.     

左髂外动静脉瘘合并巨大瘤样扩张一例报告

1 一般资料男性,32岁,自述左下腹及左下肢隐痛不适1年,左下肢逐渐增粗并有酸胀感,行走时加重.1.1 查体:左下腹部压痛,可触及一不明显包块,质韧不活动,边缘不清.听诊闻及吹风样杂音.左下肢     

髂静脉支架置入术治疗深静脉血栓后遗症1例

患者男性，52岁，主因左下肢肿胀、酸痛、浅静脉迂曲2年，加重1年，于2008年6月30日入院。患者于2年前无明显诱因，出现左下肢肿胀，逐渐出现小腿浅静脉显露、迂曲，感左下肢肢体胀痛，近1年来症状加重，为进一步治疗，到我院就诊。入院后查体：左下肢大小腿肿胀，踝关节有色素沉着，以髌骨上、下缘各15cm测量双侧肢体周径，大腿相差3．5cm，小腿相差5cm。     

彩色多普勒超声诊断下腔静脉、右髂总静脉闭塞1例

1病历简介患者,男,35岁。因双下肢肿胀、静脉曲张、伴右侧精索静脉曲张6年,加重1年余入院。13年前因右侧腰部刀刺伤在当地医院行血管修补术,6年前无明显诱因出现双下肢肿胀,伴胀痛,以活动后明显,于当地医院诊断为双侧下肢静脉曲张、右侧精索静脉曲张,并行双下肢浅静脉“带戒”治疗,术后病情无明显改善。近1年来,患者双下肢静脉、脐以下平面腹部浅表静脉曲张逐渐加重,伴双下肢明显水肿、胀痛,活动后双下肢乏力、疼痛、心悸、头晕。超声扫描所见:下腔静脉于肾静脉汇入处远心端约4.0cm处呈盲袋状中断(图1)。肾静脉汇入处近心端下腔静脉血流充盈…     

盆腔神经鞘瘤伴单侧下肢静脉曲张1例

患者,男,46岁,因腰痛检查发现盆腔占位,于2012-01-03入院。患者腰痛10余年,为双侧腰骶部钝痛,劳累后明显,无会阴部及下肢放射痛,无发热、血尿,按"腰肌劳损"治疗,病情时轻时重。于3个月前行超声检查发现盆腔占位,为进一步诊治入院。近5年来出现进行性加重左下肢静脉曲张症状,右下肢无明显异常。既往史、家族史无特殊。入院查体:一般情况可,心肺未见异常,腹平软,左下腹深压痛、按压左下腹时出现左下肢跳痛感,未触及明显包块。左踝、左小腿内侧可见多处蚯蚓状团块,皮肤可见多处片状色素沉着区,局部苔癣化,右下肢未见异常,双下肢无明显肿胀,运     

球囊锚定技术辅助开通锁骨下静脉闭塞1例北大核心CSCD

1临床资料患者男,75岁,慢性肾脏病5期,7年前因慢性肾脏病终末期接受左上肢桡动脉头静脉低位内瘘术,术后一直规律接受血液透析治疗,近半年内瘘侧左上肢肿胀,透析时更明显,遂来院就诊。查体:左上肢肿胀,动静脉内瘘处震颤明显;心脏彩色超声示:左心室射血分数为62%;胸部CT平扫示:肺部和纵隔未见明显异常;实验室检查:脑钠肽453.9 pg/mL。     

应用Frontrunner导管开通慢性闭塞性病变2例

1 临床资料 1.1 病例1 患者,男性,84岁,主因反复发作的心前区疼痛15年入院.患者于15年前出现劳累时心前区疼痛,持续3～5 min,休息后缓解,口服药物治疗,症状缓解,此后上述症状仍有发作,于1995年行冠状动脉搭桥术,术后继续口服药物治疗,具体不祥;体力活动明显增加,轻微活动无心前区疼痛发作.患者是于2003年12月左右再次发作劳累性胸痛,2004年2月26日行冠状动脉造影示左主干完全闭塞.     

风心病栓子脱落致双侧髂总动脉闭塞一例

患者男 ,5 6岁。因心悸、气短月余 ,突发双下肢剧痛 4ｈ入院。既往有风心病、联合瓣膜病、高血压病史 2 0年 ,糖尿病史 3年。体检 :血压 19/2 4ｋＰａ、心率 12 0次 /ｍｉｎ ,颈软 ,双肺呼吸音清 ,心尖区可闻及 2级舒张期杂音。腹软 ,无压痛 ,未触及双侧股动脉、足背动脉搏动。心电图示 :房性心动过速、ＳＴ段压低、左室肥厚劳损。心脏超声示 :风心病、联合瓣膜病、二尖瓣狭窄 (中度 )、主动脉瓣狭窄 (轻度 )伴关闭不全(轻～中度 )。下肢彩超示 :双下肢动脉血流充盈缺损。初步诊断为 :风心病、双侧髂总动脉闭塞。于急诊行介入治疗。腹主动脉…     

左下肢淋巴管瘤一例

病例资料 患者,女,15岁.14年前无意中发现左大腿肿块,约花生米大小,质软,无红肿.之后肿块逐渐变大,一个月前肿块突然变大,行走不适. 查体:左下肢明显增粗,左大腿内侧可见一大小约20 cm× 15 cm肿物,皮肤无破溃及色素沉着,无静脉扩张,肿物质软,无压痛,与周围组织无明显粘连,下肢活动可,足背动脉搏动可扪及.     

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.