高原新兵集训致阑尾炎高发临床分析

目的：分析高原新兵集训期间高发阑尾炎的特点、发病原因、治疗及预后，并提出预防新兵集训期阑尾炎的可行性建议。方法：采集2004～2007年新兵训练期间收治的新兵急性阑尾炎病189例，进行回顾性分析。结果：本组189例新兵集训期阑尾炎，均经急诊手术或择期手术治愈，有并发症者经保守治疗或再次手术的治疗而痊愈。结论：集训新兵在高原缺氧环境下，由于高强度训练及训练时间安排不合理，导致胃肠道功能紊乱，加上饮食习惯改变、诊治不及时，使集训新兵急性阑尾炎呈现高发及病情急、病情重的特点。可通过高原科学适应性训练、逐步改变饮食习惯，及时诊治等措施，减少集训新兵急性阑尾炎的发病。     

高原新兵集训致阑尾炎189例分析

2005年12月~2007年3月,我们共收治高原新兵集训致急性阑尾炎189例,经手术治疗,疗效满意。现分析报告如下。1临床资料1.1一般情况189例中,男175例,女14例;年龄16~20岁,平均18.8岁。1.2治疗方法本组病例均采取手术治疗,其中急性化脓穿孔性阑尾炎8例和阑尾周围脓肿2例,采用甲硝唑局部冲洗腹腔,并于右髂窝放置引流管,于3~5天拔管。术后主要对症治疗。1.3结果189例全部治愈,其中急性单纯性阑尾炎97例和急性化脓性阑尾炎82例,于7~9天拆线出院,均未发生其他并发症;急性化脓穿孔性阑尾炎8例及阑尾周围脓肿2例,行急诊手术或择期手术,其中并发肠梗阻8例,经保守治疗或再次手术治疗后全部治愈。2讨论我们认为,高原地区新兵集训期间急性阑尾炎高发的主要原因:(1)在海拔3000m高原缺氧环境下,从内地进藏的新兵短期内机体对环境、气候不适应,睡眠不佳,抵抗力降低,细菌易侵入引发急性炎症。(2)新兵集训期间训练运动量大、时间长,运动后通常缺乏恢复性训练,分配至运动肌肉的血液不能及时回至胃肠道。另外,运动与进餐间隔时间短,容易引起胃肠道功能紊乱,阑尾反射性痉挛收缩,加之高原缺氧,阑尾组织缺血缺氧更为严重...     

高原地区小儿急性阑尾炎54例诊治体会

目的:总结高原地区小儿急性阑尾炎的诊治经验。方法:对高原地区54例经手术确诊的小儿急性阑尾炎进行回顾性分析。结果:单纯性阑尾炎5例,化脓性阑尾炎20例,坏疽性阑尾炎12例,阑尾穿孔17例。术后并发症:切口感染4例,腹腔脓肿3例,不完全性肠梗阻2例,均经治疗痊愈出院。结论:高原地区环境缺氧,小儿急性阑尾炎进展快,为降低并发症及改善预后,早期诊断、尽早手术及正确的围手术期处理非常重要;对诊断不甚明确者应密切观察,随时做好手术准备;对酷似阑尾炎的病例,应注意诊断和鉴别诊断,尽量减少误诊。     

高原急性阑尾炎32例

急性阑尾炎是最多见的急腹症,一般经手术治疗后可获良好预后。然而,高原阑尾炎却有其自身特点,如病情危重,合并症、并发症多,预后相对较差,甚至危及患者生命。我部在执行任务期间,驻守海拔3100m以上的高原地区,20个月中共收治急性阑尾炎患者32例。笔者对这32例急性阑尾炎的特点回顾性分析如下。     

47例阑尾切除术同时胆囊切除术治疗体会

目的 探讨阑尾炎合并结石性胆囊炎或胆囊息肉手术治疗体会.方法 对手术治疗的47例急慢性阑尾炎合并结石性胆囊炎或胆囊息肉患者进行回顾性分析.结果 阑尾炎合并结石性胆囊炎35例,合并胆囊息肉12例,其中急性阑尾炎37例,慢性阑尾炎10例 开腹手术31例,腹腔镜手术16例.开腹手术后切口感染2例 腹腔镜手术后发生胆漏1例,发生阑尾残端瘘1例.结论 单纯急慢性阑尾炎合并结石性胆囊炎或胆囊息肉患者可以选择性同时进行胆囊切除术和阑尾切除术.     

妊娠合并急性阑尾炎24例手术时机的探讨

妊娠合并急性阑尾炎易误诊误治 ,是否手术及手术时机如何掌握是较为棘手的问题。现将我科收治 2 4例的手术时机及治疗体会介绍如下。1　临床资料1 1　一般情况　本组 2 4例 ,年龄 2 2～ 35岁 ,平均2 7岁。阑尾炎发病在妊娠早期 6例 ,中期 8例 ,晚期 10例。术后病理诊断 :单纯性阑尾炎 11例 ,化脓性阑尾炎 9例 ,坏疽及穿孔性阑尾炎 4例。1 2　治疗和结果　术后发生先兆流产 4例 ,经保胎治疗痊愈出院 ;完全性流产 1例 ;早产 2例 ;足月临产 2例。全部病例均行阑尾切除 ,无切口感染 ,随访出生儿 1～ 3年无明显发育异常。2　讨　论2 1　诊断　除…     

彩色多普勒超声诊断急性阑尾炎124例分析

目的:分析急性阑尾炎的超声声像图特征及漏诊原因,以进一步提高急性阑尾炎的超声诊断水平。方法:总结分析2009-02～2012-04的124例经手术及病理证实为急性阑尾炎的超声检查结果,着重讨论各型阑尾炎的超声特征及漏诊原因。结果:124例急性阑尾炎的患者,均经手术及病理证实。急性化脓性阑尾炎62例,急性坏疽性阑尾炎并穿孔30例,急性单纯性阑尾炎26例,阑尾周围脓肿4例,误诊2例。超声诊断符合率83.1%。结论:了解急性阑尾炎的声像图特征及漏诊原因,全面仔细的超声检查,对提高急性阑尾炎的超声诊断率有重要意义。     

儿内科急性阑尾炎诊治探讨

目的 探讨儿内科小儿急性阑尾炎的诊治特点。方法 对儿内科就诊的79例急性阑尾炎病例进行回顾性分析。结果 首次于儿内科就诊的79例急性阑尾炎病儿，均于就诊后24h内转入儿外科治疗，临床以腹痛、发热、末梢血白细胞及中性粒细胞增高为主要表现。74例经手术治疗后证实为急性阑尾炎，其中化脓性阑尾炎45例，坏疽性阑尾炎12例，蛔虫性阑尾炎1例，单纯性阑尾炎16例。36例发生阑尾穿孔，21例并发弥漫性腹膜炎。5例未手术治疗。结论 首次于儿科内科就诊的腹痛患儿，伴有发热、周围血白细胞或／和中性粒细胞增高，尤其有右下腹固定压痛者，鉴别除外儿内科常见腹痛性疾病，应考虑阑尾炎，并及时与儿外科医生联系，早期诊断，及时处理，减少并发症。     

急性阑尾炎的CT漏诊及误诊分析

目的:探讨急性阑尾炎CT诊断漏诊、误诊的原因.材料和方法:对23例经手术及病理证实的急性阑尾炎病例的术前CT资料进行回顾性分析,重点对CT漏诊、误诊原因进行分析.结果:23例急性阑尾炎中,14例(60.9%)CT于术前确定急性阑尾炎诊断,8例(34.8%)漏诊,1例(4.3%)误诊.8例漏诊中,5例诊断时对急性阑尾炎CT表现认识不足或完全忽略;2例分别为单纯性阑尾炎及慢性阑尾炎急性发作,CT表现轻微;3例右下腹缺乏脂肪比衬,影像学诊断困难;2例CT扫描范围不足,未完全覆盖病变区域.1例阑尾脓肿因忽略脓腔中粪石征而误诊.结论:熟悉急性阑尾炎的各种CT表现、改善扫描方法并密切结合临床应可帮助提高术前诊断率.     

21例老年人阑尾炎临床与病理分析

２１例老年人阑尾炎临床与病理分析胡奎１对２１例老年人阑尾炎手术病理与临床我院１９８９年一１９９３年以急性阑尾炎行阑尾切除术７６１例，其中６０岁以上２１例，占２．８％，本人就老年人阑尾炎临床及病理分析如下：１１６床资料ＺＩ例老年人阑尾炎经手术治疗，病理...     

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.