超声显像对胆管扩张的诊断价值探讨

近年来,我们采用B型超声诊断胆管扩张病人160例,均经CT、ERCP或手术证实。现将超声显像对胆管扩张的诊断价值分析如下。1 资料与方法 本组男90例,女70例。年龄6个月至87岁,平均52岁。采用Aloka-SSD630及Tos-hiba-SAL38A型线阵超声仪,探头频率为3.5及3MHz。病人空腹12小时后,常规扫查肝胆区,观察胆囊、总胆管和肝内胆管情     

电子支气管镜检查对肺不张的诊断价值

目的探讨不明原因肺不张电子支气管镜(电镜)检查的诊断价值。方法X线、CT诊断肺不张116例,经电镜观察、活检、刷检及细菌学等明确诊断。结果116例确定病因的肺不张中,肺癌占74例(63.8%),炎症次之30例,(25.9%),结核10例(8.6%),异物2例(1.7%)。结论电镜检查对确定肺不张病因有重要的价值。     

纤维支气管镜检查对118例肺不张的诊断

肺不张是由多种病因引起的临床 X线综合征。急性起病者 ,病因不难确定 ,关键在于治疗 ;慢性起病者 ,则应积极探索其发生原因 ,以便得到及时而正确的治疗。本文就 118例肺不张的纤维支气管镜 (下简称纤支镜 )检查结果进行分析 ,并探讨肺不张的病因及其鉴别。118例中肺癌占 5 8.6 % ,炎症 35 .9% ,结核、良性肿瘤等占5 .5 %。 5 0岁以上的肺不张多属恶性病变 ,约占 3/ 5 ;4 0岁以下的肺不张和良性病变较多 ,约占 2 / 3。炎性肺不张 90 %为充血 ,水肿。少数呈息肉状 ,外观者活检证实为肉芽组织。右中叶肺不张的病因多属炎症 (占 6 8.2 % ) ,其…     

老年人中叶肺不张85例病因诊断

老年人中叶肺不张８５例病因诊断薛立福，姚秀云，高鲁芳我们对１９８４～１９９４年老年人中叶肺不张８５例进行分析，探讨病因及纤维支气管镜的诊断价值。一、临床资料８５例均经胸部Ｘ线正侧位摄片，４２例经胸部体层摄片，２６例经胸部ＣＴ检查，均证实为中叶肺不张。...     

420例肺不张病因诊断分析

目的对1996~2004年间发现的420例肺不张的病因诊断进行回溯性分析。方法经手术病理证实和随访证实。结果420例肺不张中支气管结核120例,中心型肺癌140例,肺炎球菌肺炎160例。结论支气管结核、中心型肺癌、肺炎球菌肺炎经临床、PPD试验、痰检、CT扫描等可予鉴别,必要时行纤支镜检查或手术病理证实。     

纤支镜检查在阻塞性肺不张病因诊断中的价值

本文就我院1999年5月～2003年8月50例经X线检查为肺不张，并行CT及纤支镜检查明确病因的病例分析报告如下。     

电子支气管镜诊断肺不张的临床研究

目的 探讨电子支气管镜(EBS)在肺不张诊断中的作用.方法对经EBS确诊的105例肺不张患者进行分析总结.结果 肺不张病因以肺癌最常见,其次是炎症、结核;上肺肺不张以肺癌及结核多见,下肺肺不张以炎症居多;青年组以炎症最多见,中年组及老年组以肺癌较多;肺癌患者镜下表现以管腔新生物多见,炎症以管腔狭窄、充血水肿多见,结核以管壁浸润及管腔狭窄、充血水肿多见.结论 EBS检查在肺不张患者病因诊断中具有重要意义,为肺不张确定病因,明确诊断提供了重要的依据.     

超声检查对颈动脉疾病的诊断价值

文章对常用的超声检查在颈动脉疾病中的诊断价值作了评价，并重点介绍了超声对颈动脉硬度、斑声性质、溃疡外形、狭窄程度以及血流障碍的敏感性，特异性和精确性，进一步强调联合检查的重要性。     

内镜超声检查对胆总管扩张的诊断价值

目的 探讨内镜超超检查（ｅｎｄｏｓｃｏｐｉｃ ｕｌｔｒａｓｏｎｏｇｒａｐｈｙ,ＥＵＳ）对不明原因的胆总管扩张的诊断和鉴别诊断价值。方法 对４３例经多次腹部Ｂ超检查未能明确病因诊断的胆总管扩张患者行ＥＵＳ,并与手术和病理结果进行比较。结果 ＥＵＳ诊断为胆总管结石３４例,胰头占位性病变５例,胆道系统肿瘤２例,先天性胆道扩张１例。ＥＵＳ检查阳性率９７．７％,与手术和病理对照正确率为８８．４％。结论 ＥＵ     

肺不张的病因探讨

目的探讨肺不张的病因,提高肺不张的诊断率。方法对272例经胸部X线片诊断为肺不张的患者进行纤维支气管镜检查,根据镜下所处的部位及形态不同,分别采用活检、刷检,有关细菌学、抗酸杆菌、细胞学、病理学的检查。结果272例肺不张患者病因为肺癌138例(50．7%),病理检查结果鳞癌54例(39．1%),小细胞未分化癌30例(21．7%),腺癌44例(31．9%),大细胞未分化癌10例(7．3%)；炎症居第2位,检出74例(27．2%),经病原学检查：急性细茵学炎症26例(35．1%),慢性细菌学炎症16例(21．6%),肺炎支原体感染20例(27．0%),肺炎衣原体感染8例(10．8%),病茵感染4例(5．4%)；结核居第3位,检出50例(18．4%),其中肺结核14例(28．0%),气管内膜结核10例(20．0%),支气管内膜结核26例(52．0%)。结论肺不张临床表现无特异性,其病因复杂,纤维支气管镜检查是诊断肺不张病因的一项重要技术。     

纤维支气管镜治疗胸腹部手术后肺不张

目的 探讨纤支镜治疗胸及上腹部手术后肺不张的效果。方法 术后肺不张患28例，均做纤支镜检查，吸出痰液或支气管冲洗。结果 发现23例患粘稠痰液阻塞一侧主支气管或叶支气管，为阻塞性肺不张；5例在气管腔内只有少许粘液，为非阻塞性肺不张。27例经治疗后肺完全复张，1例纤支镜术后不久死亡。结论 对胸及上腹部术后肺不张的患，用纤支镜检查和治疗是较为安全有效的方法，但仍应做好抢救准备。     

老年肺不张患者的纤维支气管镜检查

报告91例老年人肺不张纤维支气管镜检查结果，88例获得病因诊断。诊断率96．7％。其中53例肺癌取得病理证据。发病原因中，肺癌56例，占61．5％，居病因首位。其他依次是：炎症，占34．1％，肺结核，占3．3％，支气管结石，占1．1％。本组资料表明，老年人右肺中叶不张的原因以炎症最多，占64.5％。在53例肺癌病理分型中，鳞癌39例，占73.6％，小细胞癌少见，有6例，占11.3％。认为纤维支气管镜检查对于老年肺不张患者的病因诊断具有重要价值。     

Recombinant Human Deoxyribonuclease Improves Atelectasis in Mechanically Ventilated Children with Cardiac Disease

Objective. To investigate whether a mucolytic agent, recombinant human deoxyribonuclease (rhDNase), improves atelectasis in children with cardiac illness requiring mechanical ventilation. Design. A retrospective cohort study on consecutive patients receiving short‐term (≤14 days) rhDNase therapy for atelectasis in the cardiac intensive care unit from January 2005 through February 2007 was carried out. Data relating to patient characteristics, gas exchange, ventilatory parameters, and chest radiographs were collected and analyzed. The effectiveness of rhDNase therapy in the presence of neutrophils and/or bacteria in the pre‐rhDNase therapy tracheal aspirates was also investigated. Results. rhDNase was effective in significantly improving established atelectasis without any major changes in gas exchange and ventilatory parameters. Therapeutic effect of rhDNase is most effective in ameliorating atelectasis in the lungs within 10 doses. rhDNase was more effective in improving chest radiographic atelectasis score in patients who had > moderate amounts of polymophonuclear neutrophils (P value = 0.0008), or bacteria (P value = 0.007) or both (P value = 0.004) present in their pre‐rhDNase therapy trachea aspirate. No adverse effects were seen with rhDNase administration in the study cohort. Conclusions. rhDNase can be safely and effectively used to improve atelectasis in mechanically ventilated children with cardiac disease especially in the presence of bacteria and/or moderate amounts of polymophonuclear neutrophils in the pre‐rhDNase therapy tracheal aspirate.     

Aspergillus Bronchitis Causing Atelectasis and Acute Respiratory Failure in an Immunocompromised Patient

Aspergillus tracheobronchitis is an uncommon clinical form of invasive aspergillosis with fungal infection limited entirely or predominately to the tracheobronchial tree. We report a case of Aspergillus fumigatus bronchitis, diagnosed by fiberoptic bronchoscopy, with fungal growth completely occluding the left main bronchus leading to lung collapse and acute respiratory failure in a 60-year-old male with erythroleukemia and profound granulocytopenia. Received: October 9, 2000 · Revision accepted: March 27, 2001     

脑实质室管膜瘤的MRI诊断价值

目的 探讨脑实质室管膜瘤的磁共振成像表现.方法 回顾性分析我院2009年1月-2011年6月经病理证实的50例脑实质室管膜瘤的临床资料.结果 50例患者位于幕上的病灶有40例,位于幕下的病灶有10例,脑实质病灶合并脑室病灶的有6例,患者均有轻中度水肿.结论 磁共振成像能清楚显示室管膜瘤病灶,对诊断及鉴别诊断脑实质室管膜瘤具有重要价值.     

双水平无创正压通气联合纤支镜肺段冲洗在严重肺挫伤合并急性肺不张中的临床应用

目的 探讨双水平无创正压通气联合纤支镜肺段冲洗在严重肺挫伤合并急性肺不张患者中的临床应用价值.方法 回顾性分析45例严重肺挫伤合并急性肺不张患者的临床资料,比较患者在双水平无创正压通气联合纤支镜肺段冲洗前后的心率、呼吸频率和动脉血气分析指标、胸部影像学表现等方面的差异.结果 双水平无创正压通气联合纤支镜肺段冲洗后心率、呼吸频率和动脉血气分析指标、胸部影像学表现均较治疗前明显好转(P＜0.05).结论 在常规治疗基础上加用双水平无创正压通气联合纤支镜肺段冲洗是治疗严重肺挫伤合并急性肺不张的有效方法.     

多普勒超声对肾动脉狭窄的筛查诊断价值

目的：评价彩色多普勒和频谱多普勒超声对肾动脉狭窄的筛查诊断价值。方法：应用彩色多普勒和频谱多普勒超声分别测量17例肾动脉狭窄患者的33支肾动脉（其中21支肾动脉狭窄）和18例无肾动脉狭窄的高血压病患者的36支肾动脉的主干峰值流速（Vmax）、肾动脉与腹主动脉峰值流速比值（RAR）和肾脏大小,并与肾动脉造影或CTA结果进行对比分析。结果：17例肾动脉狭窄患者的21支肾动脉Vmax≥180cm／s,RAR≥1．5,并且Vmax、RAR与肾动脉狭窄程度呈正相关;以Vmax≥210cm／s诊断狭窄率≥50％的肾动脉狭窄,敏感性为88％,特异性为75％,诊断准确性为86％。结论：多普勒超声可以准确诊断肾动脉狭窄,并可判断狭窄程度,可以作为高血压病患者有无肾动脉狭窄的筛查诊断方法。     

Diagnostic implications and treatment of massive spontaneous atelectasis in childhood

During a 5-month period five children were treated for spontaneously occurring massive lung atelectasis. In three patients the underlying disease was bronchial asthma; in one patient idiopathic plastic bronchitis; and in another patient, infection with anaerobic Corynebacteria may have been a contributing factor. Types I and III hypersensitivity reactions were not considered to be likely causal factors. The clinical manifestations and management of this relatively rare event are described.     

Endoscopic Removal of Gastric Lipoma: Diagnostic Value of Endoscopic Ultrasonography

A 47-yr-old male with gastric lipoma is presented. X-ray and endoscopic examinations revealed a submucosal tumor on the posterior wall of the gastric antrum. Endoscopic ultrasonography demonstrated the hyperechoic mass in the submucosa without continuity to the muscularis propria, by which the lesion was diagnosed as lipoma. The lesion was successfully removed by endoscopic polypectomy without complications. The cross-sections of the removed specimens were quite consistent with the ultrasonographic findings. Endoscopic ultrasonography is valuable in assessing the exact extent of the tumor and in determining whether or not endoscopic polypectomy is called for.