经阴道超声在症状不典型输卵管妊娠早期诊断和保守治疗中的价值

目的探讨经阴道超声对症状不典型输卵管妊娠的早期诊断及保守治疗的价值。方法经阴道超声早期诊断症状不典型输卵管妊娠,确诊患者1周1次肌内注射氨甲喋呤50mg,疗程为1周或2周,并在其保守治疗时进行超声动态监测。结果38例输卵管妊娠患者,经阴道超声早期诊断率为100％;其中妊娠囊型8例,治疗成功7例,失败1例;混合性包块型30例,治疗成功21例,失败9例。结论经阴道超声检查是一种早期诊断症状不典型输卵管妊娠及观察其保守治疗效果转准确的监测手段。     

彩色多普勒超声对输卵管间质部妊娠的诊断价值

目的：探讨彩色多普勒超声对输卵管间质部妊娠的诊断价值。方法：分析输卵管间质部妊娠的彩色多普勒超声图像特点。结果：33例患者术前行彩色多普勒超声检查诊断为输卵管间质部妊娠,其中27例与手术及病理组织学符合,超声诊断符合率为81.8%,其中1例合并宫内早孕;误诊6例,位于宫角处妊娠2例、输卵管峡部妊娠1例、输卵管残端妊娠1例、卵巢妊娠1例、腹腔妊娠1例。结论：彩色多普勒超声检查对输卵管间质部妊娠具有较高的诊断价值。     

经阴道超声诊断输卵管卵巢脓肿的价值

目的:用经阴道超声诊断输卵管卵巢脓肿,以提高其诊断率并指导治疗方案的选择。方法:用经阴道超声观察186例输卵管卵巢脓肿患者病灶形态并检测血流分布情况。结果:186例中用经阴道超声探及包块而正确诊断了158例,准确率为85%。其中58例于病灶内探及血流而72例于包块周边探及血流。根据包块大小对治疗方案进行选择。结论:经阴道超声是诊断输卵管卵巢脓肿的一种简便、有效的无创检查方法,是临床诊断的首选方法之一。     

输卵管妊娠两种介入方法治疗观察

目的：评价经血管介入治疗输卵管妊娠与经阴道插管输卵管灌注治疗输卵管妊娠的临床价值。方法：21例输卵管妊娠患者,两种介入方法治疗：12例子宫动脉造影灌注＋栓塞;9例经阴道输卵管灌注,其中2例在治疗后引起出血改为血管介入治疗。结果：本资料病例总治愈率100%,表现为血β—HCG转阴,超声检查附件区包块缩小甚至消失。结论：经血管介入治疗输卵管妊娠更为安全,且为非血管介入治疗失败后的补救方法。     

四维超声子宫输卵管造影对宫外孕保守治疗后输卵管通畅性评价的价值

目的：探讨四维超声子宫输卵管造影（4D-HyCoSy）在评价宫外孕保守治疗后输卵管通畅性中的诊断价值,为患者再次妊娠方式的选择提供临床指导及降低宫外孕再次发生率.方法：对49例输卵管妊娠经保守治疗血β-HCG恢复正常3月后患者采用4D-HyCoSy评估输卵管通畅性,其中18例行腹腔镜下通液检查.结果：49例患者98条输卵管四维超声造影显示96条,显示率98.0％,其中患侧输卵管通畅18条（37.5％）,患侧输卵管通而不畅24条（50.0％）,患侧输卵管梗阻6条（12.5％）.18条患侧输卵管行腹腔镜下通液检查,输卵管通畅6条（33.3％）,通而不畅10条（55.6％）,阻塞2条（11.1％）.四维超声造影与腹腔镜检查对比,阳性预测值为66.7％,阴性预测值为100％.结论：4D-HyCoSy超声造影检查能实时、快速、动态评价输卵管通畅性,对输卵管妊娠保守治疗后输卵管通畅性的评价具有重要的临床价值.     

经阴道超声声像图特征对输卵管妊娠药物治疗结局的预测价值

目的：探讨输卵管妊娠超声表现对保守治疗结局的预测价值。方法：回顾性分析103例经氨甲蝶呤（Methotrexate,MTX）药物治疗的输卵管妊娠患者经阴道超声（Transvaginal sonograph,TVS）的声像图表现,分析其与治疗结局的关系。结果：包块周围滋养层血流少,滋养血管血流阻力高者,治疗成功率高;反之,治疗成功率低。有胎囊或胎心者,治疗成功率仅55.3%。治疗成功组和失败组在包块大小、治疗前血β-hCG值及盆腔积液的存在等方面的差异无显著性意义。结论：TVS提供的各项超声表现中,包块的类型、CDFI血流分布类型及包块血流频谱类型对MTX治疗结局有预测价值。     

彩色多普勒超声诊断输卵管间质部妊娠24例分析

目的 探头彩色多普勒超声在输卵管间质部妊娠诊断中的应用价值.方法 回顾分析24例经手术病例证实的输卵管间质部妊娠的彩色多普勒超声影像学特征.结果 正确定位诊断21例,漏诊3例,误诊3例.结论 彩色多普勒超声技术是诊断输卵管间质部妊娠良好方法.     

经阴道彩色多普勒超声对输卵管妊娠的诊断价值

【目的】探讨经阴道彩色多谱勒超声对输卵管妊娠的诊断价值。【方法】经阴道超声对86例均经手术及病理证实的输卵管妊娠患者的二维图像及彩色多普勒血流显像（CDFI）进行回顾性分析。【结果】186例经阴道彩色多谱勒超声诊断为输卵管妊娠84例,准确率为97．6％;误诊1例,误诊率1．2％;漏诊1例,漏诊率1．2％。【结论】经阴道彩色多谱勒超声对输卵管妊娠的诊断具有重要的价值。     

经阴道彩超对诊断早期未破裂型输卵管妊娠的体会

目的:探讨经阴道彩超诊断早期未破裂型输卵管妊娠的价值.方法:回顾分析我院2002年12月～2008年5月行阴道超声检查并经术后病理检查证实的68例早期未破裂型输卵管妊娠的超声声像资料.结果:68例中右侧输卵管妊娠36例,左侧输卵管妊娠32例;根据超声声像图特点分为输卵管环型34例(50.0%),非特异性肿块型 27例(39.7%),胎心、胎囊型7例(10.3%).结论:经阴道彩超分辨率高,能较清楚显示子宫、卵巢及宫内假妊娠囊,区分未破裂输卵管妊娠囊与妊娠黄体,且能较准确地提示输卵管妊娠肿块的大小、部位以及胚芽是否存活,是提高输卵管妊娠检出率的最佳方法.     

经阴道超声合并推挤法对卵巢与输卵管妊娠的鉴别

目的 探讨卵巢妊娠与输卵管妊娠的超声声像图特点与鉴别.方法 在经阴道超声检测下,于附件区显示妊娠囊样结构或类圆形不均质囊实性包块时,用推挤法以判定和鉴别为卵巢妊娠还是输卵管妊娠.结果 本组共计390 例均为住院择期手术患者,其中超声诊断为卵巢妊娠5 例,手术符合率为92.5%,超声诊断输卵管妊娠287 例,手术符合率为90.6%.结论 本文从超声检查角度在卵巢妊娠与输卵管妊娠的鉴别方面,总结出一行之有效的方法,经实际应用证实,该方法确有其明确的实用价值.     

Use of crystepin in combination with obsidan in patients with diabetes mellitus with arterial hypertension

Examination included 70 patients with diabetes mellitus in combination with arterial hypertension of different origin (II stage essential hypertension and symptomatic renal arterial hypertension). Crystepin (2-3 tablets per 24 h) in combination with beta-adrenoblocker obsidan (40-80 mg/24 h) was used for treatment. Basic hemodynamic parameters and the state of the renin-aldosterone system were determined. The hemodynamic hypotensive effects in these patients due to the influence of the above therapy are uniform and depend on the form of attendant arterial hypertension. The hypotensive effect of crystepin used in combination with obsidan was more pronounced in patients with diabetes and II stage essential hypertension than that in those with diabetes and renal hypertension. The concentration of aldosterone and renin activity of blood plasma in patients with diabetes and arterial hypertension during treatment with crystepin and obsidan had no regular connection with the hemodynamic parameters.     

高血压病人高尿酸血症与冠心病发生的关系

目的　探讨原发性高血压病人高尿酸血症与冠心病发生的关系。方法　经临床诊断的病人 6 8例 ,6 2例献血员及健康查体者设为对照。测定以上两组人员血中尿酸、肌酐、总胆固醇、低密度脂蛋白胆固醇。结果　冠心病组与高血压组比较血清尿酸、肌酐间有非常显著性差异 (P <0 0 1) ,低密度脂蛋白胆固醇亦有显著差异 (P <0 0 5 )。高血压患者血尿酸低密度脂蛋白胆固醇水平显著高于对照组 (P <0 0 5 )。结论　合并冠心病高血压患者血尿酸显著增高 ,高尿酸血症的高血压病人与冠心病的发生有很直接的关系 ,可能是致冠心病的危险因素之一。     

氨溴索联合人免疫球蛋白静脉滴注治疗小儿重症肺炎的疗效观察

目的：观察氨溴索联合人免疫球蛋白静脉滴注治疗小儿重症肺炎的疗效。方法选择153例重症肺炎患儿,随机分为对照组、单用组、联用组各51例,对照组予利巴韦林治疗,单用组在对照组基础上行氨溴索雾化吸入治疗,联用组在单用组基础上行静脉滴注人免疫球蛋白治疗。记录并比较3组患儿的疗效、症状缓解时间、住院时间、并发症发生情况。结果单用组和联用组的总有效率分别为84％、86％,均明显高于对照组的66％（P＜0.017）。单用组和联用组的音消失、止咳、退热、平喘等症状缓解时间及住院时间均比对照组明显缩短（P＜0.05）。联用组的并发症发生率明显低于对照组（P＜0.017）。结论氨溴索联合人免疫球蛋白静脉滴注治疗小儿重症肺炎疗效良好,且安全性高。     

Effectiveness of long-term treatment with pantethine in patients with dyslipidemia

A one-year clinical trial with pantethine was conducted in 24 patients with established dyslipidemia of Fredrickson's types II A, II B, and IV, alone or associated with diabetes mellitus. The treatment was well tolerated by all patients with no subjective complaints or detectable side effects. Blood lipid assays repeated after 1, 3, 6, 9, and 12 months of treatment revealed consistent and statistically significant reductions of all atherogenic lipid fractions (total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B) with parallel increases of high-density lipoprotein cholesterol and apolipoprotein A. The results were equally good in patients with uncomplicated dyslipidemia and in those with associated diabetes mellitus. The authors conclude that pantethine (a drug entity related to the natural compound, pantetheine) represents a valid therapeutic support for patients with dyslipidemia not amenable to satisfactory correction of blood lipids by diet alone.     

Association of fluconazole pharmacodynamics with mortality in patients with candidemia

Recent studies of nonneutropenic patients with candidemia or candidiasis suggest that fluconazole pharmacodynamic parameters correlate with clinical outcomes; however, additional data of correlation to mortality in patients with candidemia would be valuable. We assessed the impact of MICs for Candida, fluconazole pharmacodynamics, and patient characteristics on all-cause mortality with use of a prospective cohort of 96 hospitalized patients with candidemia. Among 84 patients for whom Candida isolates were available for testing, the most frequent Candida species isolated were Candida albicans (44%), followed by Candida parapsilosis (20.2%), and Candida glabrata (20.2%). Fluconazole resistance (MIC of ≥64 μg/ml) was present in 7 (8.3%) to 10 (11.9%) of 84 isolates, depending on the MIC endpoint determination method (50% or 80% inhibition read at 24 or 48 h). Overall mortality occurred in 27 (28.1%) of 96 patients, and nonsurvivors were more likely to have fluconazole-resistant isolates (25% versus 6.7%; P = 0.02). Multivariable analysis demonstrated an association between fluconazole resistance and mortality, but it did not reach statistical significance (odds ratio, 5.3; 95% confidence interval, 0.8 to 33.4; P = 0.08). By pharmacodynamic analysis, a fluconazole area under the concentration-time curve/MIC of <11.5 or MIC of ≥64 was associated with increased patient mortality (P ≤ 0.09). These data support previous findings of an antifungal exposure-response relationship to mortality in patients with candidemia. In addition, similar MICs were obtained using a 24- or 48-h MIC endpoint determination, thus providing the opportunity to assess earlier the impact of isolate susceptibility on therapy.     

肝硬化患者肝移植前后心电图改变的分析

目的研究肝硬化患者肝移植术前及术后心电图改变,从而探讨肝移植对心电生理的影响。方法选取2007～2010年住院行肝移植术的患者37例,对其心电图结果进行分析;另设健康体检者60例为对照组。结果肝移植患者术前组与对照组心电图异常率比较,差异有统计学意义(P<0.01);肝移植术后围手术期组与术后其他组比较,差异有统计学意义(P<0.01);术前组与术后≤6个月组比较差异有统计学意义(P<0.05);术前组与术后>6个月组比较差异有统计学意义(P<0.01);肝功能A级、B级、C级术后组QTc间期分别与对照组比较,差异有统计学意义(P<0.01)。结论肝硬化患者心电图异常率明显升高,主要表现为QTc间期延长,且随肝损害严重程度加重而延长;肝移植术后,心电图异常率下降,QTc间期较术前缩短,心电生理得到改善;围手术期心电图异常率增高,临床医师应密切注意肝移植患者围手术期心电图的变化,及时治疗心脏并发症。