新生儿休克和DIC的早期诊断

新生儿休克是由多种病因引起的重危临床综合征 ,是新生儿最常见的急症。与其它年龄相比 ,不论是病因、病理生理或是临床表现等方面都有其特殊性 ,它具有病情重、变化迅速、病死率高、早期临床表现常不典型 ,等到血压下降 ,症状明显 ,发生弥散性血管内凝血 (DIC)时 ,使病情加剧     

固尔苏治疗新生儿肺透明膜病（附36例疗效观察）

目的：观察固尔苏治疗新生儿肺透明膜病（HMD）的疗效和探讨其相应的护理措施。方法：对36例生后确诊为新生儿肺透明膜病的患儿使用固尔苏，观察治疗前后患儿临床症状及血气，肺氧合指标和呼吸机参数的变化，并采取相应的护理措施。结果：患儿用药后缺氧症状明显改善，氧合指标均较用药前明显改善。结论：固尔苏能快速、有效地改善新生儿肺透明膜病患儿的肺功能及临床症状，用药过程中严格无菌操作，注意呼吸道管理及体位护理，适时调整呼吸机参数是减少感染及并发症的重要措施。     

不同时长光疗治疗新生儿高胆红素血症疗效比较

新生儿高胆红素血症是新生儿期常见临床症状之一，治疗不及时会导致核黄疸，造成患儿智力、听力、神经系统的损害，因此，给予积极合理的治疗，是降低新生儿致死率、致残率的关键。蓝光治疗法简单易行，是目前治疗新生儿高胆红素血症安全有效的方法。     

限制性液体复苏对治疗失血性休克的研究进展

创伤、手术、严重感染等是外科危重患者最常见的问题,很多会引起有效循环血容量不足或休克,在外科休克中,失血性休克已被公认为是效循环血量不足的典型代表,而且失血性休克又是临床上最为常见的极危重症之一,严重者可导致死亡。液体复苏已经成为失血性休克在临床中的重要治疗措施之一。     

失血性休克的病理生理及治疗研究进展

失血性休克是临床上常见的危重症之一 ,多经补液、输血治疗而好转 ,但如果患者的失血量过大或救治不及时 ,可发展至不可逆损害以至死亡。失血性休克的主要发病机制是由于各脏器有效血流灌注不足 ,导致缺血性损害 ,缺血又使机体产生了一系列连锁反应 ,如肠道细菌、内毒素移位 ,大量炎性因子、一氧化氮 (ｎｉｔｒｉｃｏｘｉｄｅ ,ＮＯ)的合成、释放等 ,这些反应促使休克向不可逆发展。彻底弄清这些反应在休克发展中的作用 ,对休克的治疗将有重要的意义。一、肠道细菌、内毒素移位许多研究证明 ,失血性休克发生后出现了明显的内毒素血症 ,休克…     

急性心肌梗塞时肌钙蛋白T检测的临床研究

ＡＭＩ早期诊断对指导临床医师及时选择正确的治疗方法，降低病死率十分重要。ＡＭＩ的传统诊断一直依据临床症状、心电图和酶学检查，而早期临床症状常不典型，心电图确诊率也仅６０％～７０％［１］，酶学检查中ＣＫ－ＭＢ常被认为是诊断ＡＭＩ的“金指标”，但其活性很...     

新生儿败血症的实验室检查评价

新生儿败血症是造成新生儿死亡的主要原因之一,早期诊断,及时治疗可降低新生儿死亡率。由于新生儿败血症临床症状不典型性和多样性,一些实验室检测方法存在某些不足,给早期诊断带来一定困难,目前趋向于采集多项检查后的综合分析。     

新生儿锁骨骨折的临床与X线分析

新生儿锁骨骨折是产妇在分娩过程中，由于胎位不正或胎儿过大强行牵拉造成的。常因临床表现不明显或合并其它症状时才偶尔发现。现就近年发现的6例新生儿锁骨骨折的临床及X线表现加以分析，以提高其感性认识。     

固尔苏治疗新生儿肺透明膜病(附36例疗效观察)

目的:观察固尔苏治疗新生儿肺透明膜病(HMD)的疗效和探讨其相应的护理措施.方法:对36例生后确诊为新生儿肺透明膜病的患儿使用固尔苏,观察治疗前后患儿临床症状及血气,肺氧合指标和呼吸机参数的变化,并采取相应的护理措施.结果:患儿用药后缺氧症状明显改善,氧合指标均较用药前明显改善.结论:固尔苏能快速、有效地改善新生儿肺透明膜病患儿的肺功能及临床症状,用药过程中严格无菌操作,注意呼吸道管理及体位护理,适时调整呼吸机参数是减少感染及并发症的重要措施.     

新生儿肾上腺囊性占位性病变的影像学观察

新生儿肾上腺囊性占位性病变极为罕见，多元症状和偶然发现，少数楞因囊内出血破裂，休克而表现为内外科急症。笔者结合文献及所见症例资料，着重讨论囊性神经母细胞瘤及肾上腺出血的临床及影像学表现。     

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.