儿童CT和MRI扫描时的镇静措施

作者对CT和MRI检查中儿童应用镇静剂的可靠性和安全性进行了研究。350例儿童,年龄1个月至18岁。检查前3—4小时禁食、禁水,家长尽量让孩子疲劳。1岁以下的患儿口服水合氯醛50(45-75)mg/kg;1—5岁的儿童肌肉注射戊巴比妥5(4-6)mg/kg。给药后30—45分钟假若     

儿童MRI检查中大剂量水合氯醛的镇静:安全性和效果与年龄的关系

作者对MRI检查中不同年龄儿童应用大剂量水合氯醛的安全性和效果进行了研究。共300例,年龄1个月～11岁(平均3岁)。检查前30分钟分别口服水合氯醛100mg/kg,总量不超过2.5g。给药后监测动脉血氧饱和度和心率,记录MRI检查时间和并发症。镇静有效标准是能完成检查全过程,95％以上MRI图象无运动伪影;反之为镇静无效。将有效率和并发症发生率与年龄作统计学分     

儿童腹部的MRI

一、总的考虑(一)病儿的镇静与固定为获得良好检查,7岁以下儿童及有恐惧的较大儿童需用镇静剂。3岁以下口服水合氯醛50～100mg/kg, 较大儿童经直肠给硫喷妥钠25mg/kg。效果不好者推迟检查,由儿科监护医师给更强的药如Versed或fentanyl并行督护。给予镇静的病儿与—窒息监视器相连,此监视器能测出病儿鼻管呼出的相对CO_2量。完成检查病儿清醒后再去除监视器。由主管放射医师解     

CT检查时安定与水合氯醛对学龄前儿童镇静效果分析

CT扫描对病人基本要求是身体保持不动,但大多数患儿则难以做到,往往需要镇静催眠后方能完成检查,保持图像清晰[1]。我们于2000年1月~2004年10月对409例不合作儿童给予静脉注射安定或口服水合氯醛镇静。通过观察对比,认为安定和水合氯醛对婴儿组具有相似的效果,安定对幼儿及学龄前儿童的镇静效果优于水合氯醛。现将观察结果分析如下。1材料与方法1.1临床资料本组3个月~7岁的患儿409例,其中男277例,女132例。按年龄分为婴儿组、幼儿组、学龄前组。其中婴儿81例,幼儿组95例,学龄前组233例。221例静脉注射安定、188例口服水合氯醛。1.2给药方法…     

肾盂积水患儿控制利尿期间肾动态显像的价值

肾动态显像(DRS)是当今评价尿道狭窄有无动力学影响的重要方法,然而究竟哪一种指标所获得结果能清楚指出尿道狭窄受累肾需要外科手术的认识还有争议。此项研究拟观察示踪剂随利尿清除(WO)对尿道狭窄患儿的临床价值。方法:86例(年龄为1～24个月)经超声检查发现肾盂扩大1.2cm的肾盂积水患儿,经静脉注射(8MBq/kg,至少注射20MBq)99m　Tc-疏基乙酰基三甘氨酸(MAG-3)后即刻行DRS。显像前4小时,受检者静滴(30～40ml/kg)葡萄糖水和电解质(Ionos-terilPED),必要时给予水合氯醛(0.56～1.0mg/kg)镇静剂。对显像15分钟时怀疑有流出道狭窄者,在显…     

婴幼儿CT检查制动方法与评价

随着现代影像医学科学的发展，CT检查已广泛用于临床。但对于婴幼儿来说，要做好CT检查，是一件不容易的事，关键是制动。临床中患儿制动大多应用10％的水合氯醛，给药方式口服及灌肠两种，因此，本文通过对1299例1个月-3岁患儿采用10％的水合氯醛制动效果的分析，探讨婴幼儿CT检查的制动方法，以便进一步提高婴幼儿CT诊断质量。     

水合氯醛给药途径对视网膜母细胞瘤患儿镇静效果的观察

 目的 探讨口服法和灌肠法应用水合氯醛对视网膜母细胞瘤患儿进行检查时的镇静效果.方法 将203例需应用水合氯醛镇静的视网膜母细胞瘤患儿随机分为2组:口服法给药102例,灌肠法给药101例,观察2组患儿的镇静效果.结果 口服组显效92例,有效8例,无效2例.灌肠组显效75例,有效12例,无效14例.两组之间比较差异非常显著(P<0.01).结论 对于视网膜母细胞瘤患儿做辅助检查时,口服法使用水合氯醛的镇静效果优于灌肠法.     

苯巴比妥联合地西泮治疗小儿热性惊厥37例分析

目的：探讨苯巴比妥联合地西泮治疗小儿热性惊厥的临床治疗效果。方法：选择我院2007-10～2009-10,热性惊厥患儿73例,随机将上述患者分为两组,观察组和对照组。对照组给予地西泮0.3～0.5mg/kg,静脉注射,注射速度为1mg/min,最大剂量〈10mg。观察组应用地西泮0.3～0.5mg/kg,静脉注射,注射速度为1mg/min,最大剂量〈10mg。同时给予苯巴比妥,10mg/kg,肌内注射。根据两组患者情况,如果复发,可行10%水合氯醛0.5mL/kg灌肠治疗。结果：两组患者在用药后30min内、30～60min内有效率比较,差异无统计学意义,P〉0.05;两组患者复发率比较,差异有统计学意义（P〈0.05）。结论：地西泮与苯巴比妥联合应用治疗小儿热性惊厥,具有起效快、复发率低等特点,并且易于操作,值得借鉴。     

运用心理疗法使患儿积极配合磁共振检查

磁共振成像检查患儿必须保持镇静，稍有躁动便引起伪影，影响成像质量。目前对患儿心理学方面的研究尚未引起重视，患儿由于躯体疾病、环境改变和对医疗器械的恐惧心理，常出现胆怯、害怕、执拗甚至拒绝反应和硬性反抗等心理反应，以往常需佐以镇静、催眠药物。１９９７年１０月以来，我们对１２５例行磁共振检查的患儿应用心理疗法，克服患儿的心理障碍，减轻和消除其对检查的恐惧和紧张，使患儿积极配合检查，取得了满意效果，减少了镇静剂的使用。１临床资料 本组１２５例患儿，男８１例，女４４例，按年龄分为三组，其中幼儿组（ １～＜…     

水合氯醛给药途径在64排CT气管成像中的临床应用

目的探讨口服法和灌肠法应用水合氯醛对支气管异物患儿进行CT检查时的镇静效果。方法将425例应用水合氯醛镇静的支气管异物患儿随机分为两组：口服法给药212例,灌肠法给药213例,观察两组患者镇静效果。结果口服组显效160例,有效29例,无效23例。灌肠组显效193例,有效12例,无效8例。两组之间比较差异非常显著（P〈0.01）。结论对于支气管异物患儿做辅助检查时,灌肠法使用水合氯醛的镇静效果优于口服法。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.