系统性红斑狼疮胸部表现误诊病例的分析

系统性红斑狼疮可侵犯胸部,国内文献有关X线表现尤其是误诊报道不多。1979年以来,我院先后发现34例,10例有胸部X线改变,其中8例误诊。现选择X线表现不同临床资料完整的4例分析如下。 病例报告 例1:女,23岁。发烧,牙龈出血、无红肿性双膝痛半月并月经不规则5个月,尿频尿急,于1984-06-17入院。患者过去曾因类似症状于1982     

高压氧综合治疗急性氨中毒三例

20 0 0年 5月 ,我院收治急性氨中毒患者 3例 ,在内科治疗的基础上 ,均行高压氧 (HBO)治疗 ,结果全部康复 ,现报告如下。一、临床资料1.一般资料 :3例患者均为男性 ,年龄分别为 2 2岁、4 3岁、34岁。均为同一工厂的工人。在工作时吸入同一氨管阀门损坏所漏出的高浓度氨气而昏倒 ,口吐白沫 ,意识不清。立即被救离现场 ,急送我院就诊。检查 :例 1和例 2双眼球结膜充血、咽部充血、双肺呼吸音粗糙 ,可闻及干湿性哨罗音 ,心率均快。心电图均呈窦性心动过速 ;例 3体征较轻。例 1WBC15 .3× 10 9/L,中性粒细胞 0 .90 ;例 2 WBC16× 10 9/L,中…     

氨中毒的胸部X线表现

目的回顾性分析急性氨中毒致肺部损伤的X线表现。方法对37例急性氨中毒致肺部损伤病例的胸部X线表现进行分析,并进行1年随访观察。结果35例早期损伤表现为肺纹理增多,小叶性肺炎,间质性肺气肿,肺水肿等改变;15例晚期出现慢性支气管炎、肺间质纤维化及肺大泡等改变。结论急性氨中毒的肺部损伤是不可逆转的损伤。     

急性氨中毒咽喉部的临床表现

急性氨中毒在临床上比较少见,1976年12月23日我院驻地附近氮肥厂发生一次液氨槽超压爆炸,喷出大量高浓度氨气,高达20m,向周围扩散氨气雾的面积,方圆900m,造成40人急性中毒。其中当场死亡1名,32名住院治疗。急性氨中毒病人的咽喉部症状突出,现将有关情况整理报告如下。     

眼睑癌的放射治疗

日本癌研中心收治原发性眼睑癌30例,男性12例,女性18例。年龄42～82岁。鳞癌21例,基底细胞癌6例,腺癌3例。肿瘤小于2cm者25例,2～5cm4例,5cm以上1例。开始使用软X线(40kV,滤过板Al1mm,SSD1cm),深X线160～250kV,滤过板Cu0.5mm。后改为高能X线(4、10MV)及β线(8、10MeV)。组织内~(252)cf照射。治疗后随访2个月～15年。作者见到,首次治疗的病例,鳞癌有3例(23％)局部复发,5例(38％)有淋巴结转移。基底细胞癌1例因糖尿病恶化,仅放疗9Gy而中断。其他医院治疗后复发的病例,鳞癌2例局部复发,5例淋巴结转移,且3例有远位转移。原发肿瘤不到2cm者17例,4例(20％)有局部复发及淋巴结转移。其他医院治疗后复发病例,不到2cm者8例,再放疗均未复发,但2～5cm的2例都复发。观察2年以上的鳞癌14例,13例照射野直径在3cm以上,2例复发;1例照射野直径在3cm以下,局部复发。总剂量     

~(99m)Tc-MDP 的恶性过敏反应

1982年以来,已有两篇综合报道描述了放射性药物的相互作用或它们所引起的不良反应。Cordova 等人列举了USP、SNM 以及FDA 自1976年以来已报告的药物反应数量。此文中,所有的反应由~(99m)Tc 标记的放射性药物引起的仅3例,其中1例由~(99m)Tc-MDP 引起。本文对该病例加以报道,作者认为该病例可能是患者对MDP 的典型反应。病例报告:患者女性,60岁,1980年因患乳腺癌,做了左侧乳房切除术。1983年4月,在X 线片上出现多处肺转移。同年4月用MDP 做骨扫描,显示在胸骨、腰椎及左侧坐骨有多处转移。扫描后48小时,感到咽     

抢救氨气中毒36例

2000年12月16日晚,某食品公司制作冷冻食品的氨气灌泄露,致使值班职工及前来救援的某部官兵共发生急性氨气中毒36例,经积极抢救全部康复出院. 　　1 临床资料 　　1.1 一般情况男24例,女12例;年龄21～50岁.中毒前有慢性支气管炎史8年1例,年1例;有消化道溃疡史1例,余33例均健康.均为呼吸道吸入中毒,吸入至中毒时间为10～20 min,中毒至就诊时间为30～60 min. 　　……     

一氧化碳中毒迟发性脑病40例

急性一氧化碳(CO)中毒是一种常见病,部分中毒患者在意识障碍恢复后数天至数周正常的间歇期后,出现迟发的CO中毒性脑病(Delayed encephalopathy after acute carbon monox-ide poisoning,DEACMP),主要表现为意识障碍和锥体外系、锥体系功能障碍。我院于1994年~2004年收治DEACMP患者40例,现报告如下。1临床资料1.1一般资料本组40例,其中男30例,女10例,年龄13~74岁,平均45.3岁。否认有冠心病及脑血管病史,高血压病史1例。因失火中毒1例,煤气泄漏中毒5例,煤炉取暖中毒34例。中毒昏迷后苏醒时间1~72h不等,其中16例1~6h,11例7~12h,7例13~24…     

复张性肺水肿的X线诊断(附9例报告)

自发性气胸在日常诊疗中较为常见,但经排气、萎陷肺组织复张后发生的复张性肺水肿(RPE)尚不多见。为探讨复张性肺水肿的X线表现及其形成机制,本文收集了9例胸部X线资料较为完整的复张性肺水肿病例。现回顾性分析总结如下。1材料与方法9例中男7例,女2例,年龄最大45岁,最小16岁,平均29岁。本文病例都以突发性胸痛、胸闷、气促来门诊就医。自诉就医前患病已有1 d者1例,2~3 d者6例,4 d以上者2例。X线立位胸片患侧肺组织被压缩都在85%~95%之间。其中右侧2例,左侧6例,双侧1例(此例左肺被压缩90%,右肺被压缩10%~20%),经排气+闭式引流后24 h内摄…     

微小早期骨肉瘤

本文报告了7例微小早期骨肉瘤。全部病例均经皮穿刺或外科活检,并通过切除标本的检查得到证实. 7例病人。4男3女。年龄13岁-34岁,平均20岁。病人经对症治疗后,局部症状不消失。首次X线诊断。除2例可疑外,其余均诊断为正常。 7例病人的常规X线片分析:1例显示可疑异     

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.