高位结扎悬吊术治疗小儿腹股沟斜疝78例

高位结扎悬吊术治疗小儿腹股沟斜疝７８例杨波，石洪身，盛国辉，王爱光一、临床资料：本组共７８例，其中男性６７例，占８５．９％；年龄１～１５岁，平均年龄４．５岁；右侧２５例，左侧３８例，双侧４例。女性１１例，占１４．１％，年龄２～１０岁，平均年龄３．８岁...     

婴幼儿肺炎病毒病原与流行病学观察：附52例报告

本文应用ＥＬＩＳＡ法对５２例肺炎患儿进行ＲＳＶ，ＰＦＶ（１，２，３型）和ＡＤＶ（３，７型）特异型抗体检测，阳性２４例（阳性率４６．２％），以ＰＦＶ居首（占２７％），其中ＰＦＶ３和ＰＦＶ１分别占１３．５％和９．６％；ＲＳＶ次之占（占１１．５％）。三种病毒感染主要发生在３岁以内小儿，以１岁以下婴儿发病率最高（占６６．７％）。１２月－１月为流行高峰（占７０．８％）。     

彩色多普勒超声心动图顺序分段探查新生儿青紫型先天性心脏病106例分析

目的　探讨彩色多普勒超声心动图（ＣＦＭ）诊断新生儿青紫型先心病的可行性和优越性。方法　应用ＣＦＭ 探查新生儿青紫型先心病１０６ 例,按超声顺序分段探查法确定先心病的类型。结果　完全性大动脉转位４４ 例（４１－５ ％）居本组首位;肺动脉闭锁２３ 例（２１－７％ ）居第２ 位;危重型法乐四联症１６ 例（１５－１％ ）居第３ 位;完全性肺静脉异位引流８ 例（７－５％） 居第４ 位;极重型肺动脉瓣狭窄５ 例（４－７ ％）居第５ 位;左心发育不良综合征４ 例（３－８ ％） 居第６ 位;其他包括三尖瓣闭锁２ 例（１－８ ％）;三尖瓣下移畸形、永存动脉干、左心室双出口、纠正型大动脉换位各１ 例,均占０－９％ 。结论　ＣＦＭ 不仅安全无创且诊断准确率高,是临床评价新生儿青紫型先心病的首选无创性检查手段。     

2085例小儿先天性室间隔损手术纠治的临床分析

分析影响小儿先心病缺纠治术的因素，以提高手术成功率，回顾性分析２０８５例小儿先心室缺纠治术，手术死亡４８例，病死率２．３％，手术死亡与患儿的年龄，体重有关，年龄小于６个月，体重低６ｋｇ者手术病死率为３５．７％和３０．０％，而年龄大于３岁，体重超过１６ｋｇ者手术病死率低于１．０％，先心室缺的手术时间取决于室缺的位置，大小和心内分流量，室缺伴肺动脉高压患儿必须在２岁前手术，对肺动脉瓣下型室缺患儿应早期     

中枢神经系统感染2234例临床流行病学分析

我院近６年来共收治小儿中枢神经系统感染２２３４例。其中细菌性脑膜炎２１９例（９．８％），以脑膜炎双球菌和肺炎双球菌为主要病原，１岁以内患者最多（４０．２％），治愈率和病死率分别为６７．１％和４．７％，病毒性中枢神经系统感染２０１５例（９０．２％），以腮腺炎病毒和肠道病毒感染为多，３～７岁患者最多（６８．８％），治愈率和病死率分别为７８．２％和０．６％。     

嘉兴市20436例新生儿先天性心脏病流行病学调查

为取得嘉兴地区代表性的新生儿先天性心脏病（简称先心病）发病情况，对１９９２年１月１日～１９９５年１２月３１日嘉兴市市区产科出生的全部活产婴儿２０４３６例进行前瞻性调查。检出先心病２９４例，其中彩色多普勒超声心动图诊断２８４例，尸检确诊１０例。患病率１４．３９‰。以单纯性房间隔缺损（ＡＳＤ）２９．６％和单纯性室间隔缺损（ＶＳＤ）１９．４％居多，其中又以Ⅱ孔型ＡＳＤ和膜部ＶＳＤ最多。复合畸形占３７．１％，以动脉导管未闭（ＰＤＡ）＋ＡＳＤ（１１．９％）居多。出生～７天发生心力衰竭３６例，新生儿期死亡２４例，死亡率１．１７‰。以青紫型复杂畸形为主。提示：先心病的发生与母妊娠早期呼吸道感染有关（χ２＝２１．８４，Ｐ＜０．０１），ＰＤＡ与围产期窒息密切相关（χ２＝２８．００，Ｐ＜０．０１）。     

2085例小儿先天性室间隔缺损手术纠治的临床分析

分析影响小儿先心病室缺纠治术的因素，以提高手术成功率。回顾性分析２０８５例小儿先心室缺纠治术，手术死亡４８例，病死率２．３％。手术死亡与患儿的年龄、体重有关。年龄小于６个月，体重低于６ｋｇ者手术病死率为３５．７％和３０．０％，而年龄大于３岁，体重超过１６ｋｇ者手术病死率低于１．０％。先心室缺的手术时间取决于室缺的位置、大小和心内分流量。室缺伴肺动脉高压患儿必须在２岁前手术，对肺动脉瓣下型室缺患儿应早期手术，防止主动脉瓣脱垂导致主动脉瓣关闭不全．术中避免右室切口，保护术后右心室功能和术后肺动脉高压的处理是手术成功的关键。     

小儿肺血减少性青紫型先天性心脏病呼吸衰竭时的机械通气分析

目的 探讨小儿肺血减少性青紫型先天性心脏病（ＣＨＤ）呼吸衰竭机械通气策略。方法 回顾性总结我院１９９２－１９９８年间１２例小儿肺血减少性青紫型ＣＨＤ合并呼吸衰竭患儿机械通气治疗效果，分析通气时机、方法、参数调节及药物治疗发的影响。结果 机械通气后ＳａＯ２〉７％９例（占７５％）；〈７０％３例，其中２例表现通气不足。在ＳａＯ２〉８５％的５例中，２例表现通气过度或气压伤，通过时间１．５ｈ～５ｄ。结果１例     

小儿心导管,心血管造检查中心律失常相关因素及防治

目的 探讨小儿先天性心脏病（先心病）心导管和／或心血管造影检查中心律失常的发生率、相关因素以及防治措施。方法 ５１２例小儿先心病，常规心导管／或心血管造影检查，对术中４８９例不同程度心律失常发生的相关因素及严重心律失常的防治进行分析。结果心律失常发生率为９７．３％，其中严重心律失常占６．２％。导管位于右室流出道及三尖瓣口处心律失常发生率最高，分别为３０．７％，２６．１％。     

小儿外伤性支气管断裂的诊断与治疗

目的：分析小儿支气管断裂的原因，分型，临床特点及治疗。方法：全组１１例小儿外伤性支气管断裂分别占同期入院小儿胸外伤外伤性支气管断裂的１．１％和３．２％，小儿外伤性支气管断裂以Ⅱ型多见，占６３．６％，其主要临床症状为咳嗽，咯血，皮下气肿，有１／３患儿伤后Ｘ线胸片无气胸改变，极易误诊，结果：１１例皆采用手术治疗，８例行支气管成形术，２例行支气管成形并气管下端侧壁肋间肌瓣修补，１例成形一个月后因吻合口狭     

SOCIAL ADJUSTMENT AND FUNCTIONING OF CHRONICALLY ILL AND IMPARED CHILDREN AND ADOLESCENTS

A cluster sample of 532 children aged 8 to 19 years with certain impairments were compared to a matched sample of 316 healthy children of the same age. Almost half (46 %) of the impaired had a disability, which was mostly in the domain of body disposition ability (in 88 %), behaviour (63 %) and situational functioning (54 %). In the controls, where 12 % had some kind of disability, the corresponding figures were 13 %, 11 % and 15 %. The most disabling conditions were CP (67 % handicapped), MBD (52 %) and epilepsy (42 %). The most frequent non-compènsated handicaps were those of occupation (44 % of impaired), mobility (31 %) and social integration (22 %). More than one handicap was associated most frequently with CP (76 %) and with epilepsy (36 %). Neurological impairments are more disabling and handicapping than non-neurological ones, with the exception of mobility and occupation handicaps in asthmatics.     

HEIGHT AND WEIGHT OF SCHOOL CHILDREN AND ADOLESCENT GIRLS AND BOYS IN OSLO 1970

ABSTRACT: Brundtland, G. H., Liestö1, K. and Wallöe, L. (Oslo City Health Department and Departments of Physics and Physiology, University of Oslo). Height and weight of school children and adolescent girls and boys in Oslo 1970. Acta Paediatr Scand, 64:565, 1975.–Height and weight measurements of the school children of Oslo in 1970 (aged 7 to 19 years) are reported. Weights show considerably skewed distributions with long tails towards higher weights. Weight percentiles are calculated by interpolation in the empirical distributions. Percentiles and tables for both sexes, showing height for age, weight for height and weight for age, are presented. A comparison with existing Norwegian data from Sundal, 1956, Bergen shows that the application of statistics based on normal distribution for weight, has introduced considerable error in these percentiles. Oslo children in 1970 are taller by 5–6 cm at age eighteen, than USA (Iowa) standards and 4–5 cm taller compared to Tanner's English percentiles. Oslo children are also taller than Swedish children, and have reached a stature higher than found in any other comparable study.     

PHYSICAL EXERCISE AND JUVENILE DIABETES—SUMMARY AND CONCLUSIONS

Abstract. Larsson, Y. (Department of Pediatrics, University Hospital, Linköping, Sweden). Physical exercise and juvenile diabetes.—Summary and conclusions. Acta Paediatr Scand, Suppl. 283: 120, 1980.—The various metabolic effects of physical exercise in ketotic diabetics, non-ketotic diabetics and non-diabetics are summarized. A favorable metabolic effect is only observed during optimal insulin administration, while in ketotic diabetics exercise may aggravate the metabolic situation. The use of exercise as a tool in the routine treatment of young diabetics is described. Activity-produced hypoglycemia should be prevented through an adequate food intake and through patient education. Regular exercise may postpone the appearance of diabetic microangiopathy.     

ABETALIPOPROTEINEMIA TREATED WITH PARENTERAL AND ORAL VITAMINS A AND E, AND WITH MEDIUM CHAIN TRIGLYCERIDES

ABSTRACT. An 11-year-old girl with abetalipoproteinemia was treated with parenteral vitamin A and vitamin E for two and a half years. Some improvement in neurological and visual deficits was noted. On changing to oral vitamin E and later with addition of medium chain triglycerides (MCT) to the diet, a considerable improvement in her general wellbeing, neuromuscular lesions and ophthalmological symptoms was noted. This regimen is being adhered to for five and a half years. The condition is stable with no further improvement.     

MECONIUM ILEUS AND INTESTINAL ATRESIA IN FETUSES AND NEONATES

A collaborative study was performed to determine the different types and mechanisms of intestinal abnormalities during gestation. Cases had to fulfill one or more of the following three criteria: (1) meconium ileus, (2) intestinal stenosis or atresia, and (3) meconium peritonitis. Esophageal atresia, anorectal atresia, and abdominal wall defects were excluded. One hundred two cases were reviewed from the autopsies of 42 induced abortions, 22 stillborns, and the surgical findings in 38 neonates. Meconium ileus was detected mainly during the second trimester (28/38), and was associated with cystic fibrosis (15), fetal blood deglutition (4), infection (6), or multiple abnormalities (10), in which three chromosomal aberrations were found. Intestinal stenosis or atresia was more commonly detected during the third trimester of gestation (46/56). Sixteen of the 30 duodenal malformations were associated with trisomy 21, whereas in the 26 small intestinal atresias, signs of distress or ischemia were most frequently detected. Only 8 of 25 meconium peritonitis cases were isolated. A total of 20 cystic fibrosis cases could be proved. In this series, functional abnormalities were observed predominantly in the second trimester and associated mainly with cystic fibrosis or amniotic fluid abnormalities. Anatomic lesions were commonly detected later on and associated with ischemic conditions, chromosomal aberrations, and even cystic fibrosis.     

MATERNAL CARETAKING AND PLAY WITH FULL-TERM AND PREMATURE INFANTS

The contribution of past psychological experiences of the mother and medical complications of the infant to differences in caretaking of pre- and full-term infants are examined. Twenty full- and 20 pre-term matched mother-infant dyads were studied during a feed and play 1, 2 and 3 months after the expected date of birth. Full-term infants were more active than pre-terms at 4 weeks only. Mother of pre-terms showed differences in their interactions at all times. Interactions were related to maternal experiences in full-term infants only. Degree of neonatal illness was correlated with behavioral disorganization of premature infants, leading to differences in caretaking style.