首发症状为消化系统表现的甲状腺功能亢进症28例分析

目的探讨首发症状为腹痛、腹泻、呕吐等消化系统症状的甲状腺功能亢进症的特点,提高对不典型甲亢的认识。方法对28例病人的临床资料进行回顾性分析。结果以腹痛、腹泻、呕吐等消化系统症状为首发症状的甲亢患者大部分无甲状腺肿大,突眼,高代谢症状不突出。结论甲状腺功能亢进症可以腹痛、腹泻、呕吐等消化系统症状为首发症状。     

急性阑尾炎的CT诊断

临床常见急腹症之一阑尾炎,因大部分急性阑尾炎临床症状典型,结合患者体征及血常规检查等结果,术前可明确诊断.不排除部分患者因临床表现不典型或与其他急腹症临床症状表现相似而较难诊断,为此延误治疗甚至产生严重并发症.回顾性分析我院收治的46例经临床诊断为急性阑尾炎行CT检查的患者资料,就CT扫描在急性阑尾炎诊断方面的价值做进一步探讨.     

急性白血病少见的首发临床表现25例分析

目的探讨急性白血病(AL)少见的首发临床表现及其原因。方法回顾性分析251例初诊AL患者的临床资料。结果251例AL患者中有25例是以少见的首发临床症状而就诊,其中以特殊部位感染者3例、以特殊器官出血者6例、以浸润为首发症状者16例。结论有少数AL患者早期临床表现不典型,可能以特殊部位的感染、器官的出血或突出的浸润症状为首发临床表现,容易引起误诊、误治。     

急性阑尾炎相关疾病延诊误诊56例分析

目的总结分析急性阑尾炎相关疾病延诊、误诊的原因，避免临床误诊，提高疗效。方法回顾分析387例急性阑尾炎患者的临床资料，将相关延诊、误诊病例进行统计及病种分类。结果急性阑尾炎延诊、误诊为其他疾病共计29例，占7．5％；其他疾病误诊为急性阑尾炎共计27例，占6．9％。结论．急性阑尾炎相关疾病延诊、误诊的原因有：病史询问不详，临床症状被医患双方忽视；部分患者临床表现不典型；忽视阑尾异位多变的临床表现及相关检查；临床医生思路狭窄，患者高龄体弱，医生不愿意承担医疗风险等。     

急性阑尾炎的超声诊断介值

急性阑尾炎的发病率居急腹症首位,是一种临床常见的急腹症.既往仅凭症状、体征、实验室检查进行诊断,但有的患者临床症状不典型,体征不明显,常会造成误诊、漏诊.超声检查是诊断阑尾炎最简便的方法,深入探讨急性阑尾炎的超声诊断.以降低临床的误诊及病死率显得尤为重要.现将我院2005年10月～2007年8月期间B超诊断为急性阑尾炎(经手术证实为急性阑尾炎)270例的患者进行分析,并探讨其声像图特征,以便更好地提高急性阑尾炎的诊断准确率,减少其误诊率.     

急性白血病少见的首发临床表现25例分析

目的 探讨急性白血病（AL）少见的首发临床表现及其原因。方法回顾性分析251例初诊AL患者的临床资料。结果251例AL患者中有25例是以少见的首发临床症状而就诊，其中以特殊部位感染者3例、以特殊器官出血者6例、以浸润为首发症状者16例。结论有少数AL患者早期临床表现不典型，可能以特殊部位的感染、器官的出血或突出的浸润症状为首发临床表现，容易引起误诊、误治。     

普外科临床中急性阑尾炎临床诊治探究

目的:对普外科临床中急诊阑尾炎的临床诊治情况进行探究分析;方法:以我院2016年7月至2017年6月诊治的45例急性阑尾炎患者为研究对象,回顾分析患者的临床资料,总结分析患者的临床诊治情况;结果:对45例患者进行影像学检查,确诊41例急性阑尾炎患者,临床确诊率为91.6％;另外4例患者采用手术方式确诊;40例患者通过手术方式治疗,5例患者采用保守方式治疗;4例患者术后发生不良反应,1例为术后出血,3例为切口感染,不良反应率为8.89％;结论:可综合运用多种手段对急性阑尾炎进行临床诊断,以提升诊断准确率,临床治疗以手术治疗为主,术后加强对患者护理,以免出现并发症状.     

急性阑尾炎的超声诊断价值

急性阑尾炎的发病率居急腹症首位、是一种临床常见的急腹症。既往仅凭症状、体征、实验室检查进行诊断，但有的患者临床癖状不典型，体征不明显，常会造成误诊、漏诊。超声检查是诊断阑尾炎最简便的方法，深入探讨急性阑尾炎的超声诊断．以降低临床的误诊及病死率显得尤为重要。现将我院2005年10月～2007年8月期间B超诊断为急性阑尾炎（经手术证实为急性阑尾炎）270例的患者进行分析，     

急性心肌梗死26例误诊原因分析

急性心肌梗死是常见的心血管系统急症,其临床表现有持久的胸骨后剧烈疼痛、心肌酶谱增高以及心电图进行性改变[1]。但缺乏典型症状者易漏诊、误诊。现报告26例,并简要分析误诊原因。1临床资料26例病人中,男19例、女7例;年龄60～75岁,平均年龄67岁。全部病例均符合世界卫生组织关于急性心肌梗死的诊断标准。2首发表现及误诊疾病①以腹痛为首发症状4例,其中1例伴腹泻。3例初诊腹痛待查,可疑胆囊炎;1例拟诊急性胃肠炎。行腹部超声及便常规检查未见异常,行心电图检查诊断为急性心肌梗死(均为下壁)。②以头晕为首发症状4例,均有高血压病史。初诊:…     

14例不典型甲亢患者首诊误诊分析

随着碘盐的普及 ,甲亢患者的典型体征较以往明显减少 ,易误诊。现将我院 2 0 0 0 - 2 0 0 3年首诊误诊的 14例不典型甲亢患者的首发症状与误诊原因做一分析。1　临床资料1.1　一般资料　 14例患者中 ,男 3例 ,女 11例 ,年龄 2 1～ 6 5岁。本地患者 4例 ,年龄 34～ 6 5岁 ,外来务工人员 10例 ,年龄 2 1～ 39岁。1.2　首发症状表现　 14例患者中上腹不适、纳差为首发症状 2例 ,顽固性腹泻为首发症状 3例 ,恶心、呕吐、乏力、血三系减少 1例 ,反复心悸、胸闷、心电图示频发室性早搏 2例 ,反复发作的阵发性心房纤颤 2例 ,失眠多梦 1例 ,四肢无力…     

Dengue fever mimicking acute appendicitis

We report 12 patients [5 males, mean age 28 years (SD 4.6)] presenting with clinical features suggestive of acute appendicitis who were later diagnosed as having dengue fever (DF). Seven were admitted to hospital by surgeons and then referred to physicians due to thrombocytopenia (one of them following appendicectomy). Five were admitted to medical wards and then referred to surgeons due to abdominal pain. The mean time from onset of fever to abdominal pain was 2.2 d (SD 0.9). Clinical features included: right iliac fossa tenderness in 12 patients, rebound tenderness in nine, vomiting in nine, erythematous rash in eight, arthralgia/myalgia in eight, headache in six, diarrhea in three and palatal petechiae in three. All patients had C-reactive protein <12mg/l, and DF was confirmed serologically. Leucocytopenia and thrombocytopenia occurred by the third or fourth day of illness in all patients. Seven had free fluid around the appendix on abdominal ultrasound. The mean duration of abdominal symptoms and signs was 1.8 d (SD 1.3). DF may present with features suggestive of acute appendicitis in dengue-endemic areas. A carefully obtained history, clinical examination and a full blood count done on the third or fourth day of illness may help to differentiate DF from acute bacterial appendicitis.     

Pysical examination--rebound tenderness

Rebound tenderness is generally practiced in the diagnosis of acute abdominal pain. It is a test that inflicts much discomfort to the patient. Literature data derived from reports assessing the reliability of the diagnosis of acute appendicitis indicate a sensitivity of 0.78-0.91 (pooled: 0.91) and a specificity of 0.48-0.60 (pooled: 0.60) of rebound tenderness. It would appear that rebound tenderness is a test of little specificity (leading to many false positive results) and that it has very little additional value, particularly in the presence of local tenderness and/or rigidity in patients with acute abdominal pain.     

Endometriosis of the Appendix Presenting as Acute Appendicitis: A Case Report and Literature Review

Endometriosis is a common disease generally, but appendiceal endometriosis causing acute appendicitis is a very uncommon clinical phenomenon and a few cases have been reported. The authors aim to highlight the rarity of such clinical entity in Nigeria. A 29 year old nulliparous woman presented with severe right iliac fossa pains, tenderness and rebound tenderness on her second day of menstruation. She subsequently had appendicectomy and a histopathological diagnosis of appendiceal endometriosis causing acute appendicitis. Appendiceal endometriosis causing acute appendicitis is rare, and definitive diagnosis is performed through histopathological evaluation. Post-operative gynaecological follow-up is highly recommended.     

MSCT及后处理技术对急性阑尾炎的诊断价值

目的 探讨MSCT及后处理技术诊断急性阑尾炎的价值.方法 搜集经手术及病理证实的16例急性阑尾炎,回顾分析其MSCT表现.所有患者均仅行CT平扫,扫描完成后在图像工作站上对原始扫描数据进行薄层重建及多方位重建等后处理.结果 急性阑尾炎MSCT的主要征象有阑尾管腔直径增粗、管壁增厚10例,阑尾脓肿6例,阑尾结石4例,阑尾炎性包块2例,阑尾周围炎12例.结论 MSCT及后处理能快速、准确地判断有无急性阑尾炎,而且还能发现除阑尾炎以外的其他病变.     

The role of real-time sonography in the differential diagnosis of acute appendicitis and in the detection of post-appendectomy complications

110 urgent sonography were performed on 101 patients with suspected acute appendicitis and on subsequent 26 patients 33 echography with suspected postappendectomy abscess. Although according to a few publications in connection with acute appendicitis there are characteristic sonographic signs, the authors didn't find any typical structures at patients having non-complicated appendicitis. But at perforated appendicitis and periappendicular abscesses the fluid collection was frequently very well visualizable and the periappendicular infiltration was detectable as well. The differentation between infiltration and abscess is difficult, often unsuccessfull. The authors confirm the high sensitivity of sonography in the detection of postappendectomy intraabdominal abscesses, similarly to other abscesses of unrelated origin. They emphasize the differentialdiagnostic aid of sonography, if the clinical symptoms are atypical or the signs of acute appendicitis are imitated by other disease.     

急性病毒性心肌炎100例临床探析

目的：分析探讨急性病毒性心肌炎患者的治疗效果及临床表现。方法：收集2004年1月至2011年12月我院临床收治的急性病毒性心肌炎患者100例,对其临床表现、发病情况、治疗预后进行分析。结果：急性病毒性心肌炎患者临床表现胸闷者居多,病程轻重不等,心电图表现形式多样。结论：急性病毒性心肌炎临床表现多样,需提高重视度,及时诊治。     

利福昔明治疗成人急性感染性腹泻的临床研究

目的比较利福昔明与环丙沙星治疗成人感染性腹泻的疗效及安全性。方法用双盲随机的方法将50例急性腹泻患者分入利福昔明组200 mg 2次/d或环丙沙星组200 mg 2次/d,用药3 d,观察药物的止泻天数、止泻率、大便常规复常率以及临床症状的缓解,进行疗效评价。结果利福昔明的止泻率、止泻时间及疗效评价,大便常规复常率,对腹痛、恶心、腹胀等临床症状的缓解率与环丙沙星组比较差异无统计学意义(P>0.05)。结论利福昔明是一种安全有效的成人急性感染性腹泻口服治疗药,其疗效与全身作用的环丙沙星相同。     

细菌性痢疾与其他感染性腹泻的早期临床对比分析 FREE

目的 对比研究细菌性痢疾(简称菌痢)和其他感染性腹泻的流行病学及临床症候特点,以提高临床医生对二者的非细菌学简易鉴别能力。方法 对140例临床菌痢与349例其他感染性腹泻患者的流行病学和临床资料进行对比研究,同时再通过多因素分析筛选鉴别两者的相关因素。结果菌痢与其他感染性腹泻好发季节有所不同（P＜0.05）,前者夏季多发,后者秋季更为多见。菌痢患者发热、里急后重、黏液便、脓血便及左下腹压痛较其他感染性腹泻多见,而后者以恶心呕吐、水样便及稀便较多见,差异均有显著性（均P＜0.05）。二分类Logistic回归分析发现,发病季节、里急后重、发热、大便性状及左下腹压痛5个因素与菌痢的诊断密切相关。结论发热、里急后重、黏液便及左下腹压痛是临床诊断菌痢和其他感染性腹泻的主要鉴别点。     

急性阑尾炎的腹部B超分析

目的 探讨B超对阑尾炎临床诊断价值及显像分析.方法 选取我院于2010年5月至2011年5月收治的阑尾炎患者共计160例,对其B超显像与临床结果进行对照分析.结果 临床证实本组患者中单纯性阑尾炎92例,急性化脓性阑尾炎42例,坏疽性阑尾炎性11例,阑尾周围脓肿7例,慢性阑尾炎8例,超声诊断符合率为95.2％.结论 超声对阑尾炎诊断确切,有快捷、方便、无创、经济、能反复应用等优点,此外结合临床病史、症状、体征等可明显提高正确诊断率.     

Stump appendicitis after previous appendicectomy

Two patients, a 25-year-old male and a 57-year-old female, were treated for stump appendicitis. Both patients had undergone appendicectomy 6 months previously and again presented with pain in the right lower abdominal region. On physical examination, the first patient had tenderness as well as rebound tenderness over the entire abdomen, indicative of a general peritonitis. The second patient had tenderness and rebound tenderness in the right iliac fossa alone. Both patients underwent a laparotomy. In the first patient a perforated appendiceal stump was found and removed. In the second patient an acutely inflamed appendiceal stump was found and removed. Appendicitis of a residual appendiceal stump following incomplete appendicectomy is a rare cause of abdominal pain. A lack of familiarity with this condition frequently causes a delay in diagnosis, which increases the chance of perforation and intra-abdominal sepsis. Therefore, all clinicians need to be aware of the possibility of stump appendicitis and to take appropriate measures to prevent serious complications should they suspect this.