输尿管狭窄介入治疗一例

球囊扩张术的临床应用日趋广泛,本文报道用球囊扩张术治疗输尿管狭窄１例。患者男性,４５岁。２年前因左输尿管结石伴肾盂积水行开放性取石术,术后情况良好。近２周感左肾区酸胀、坠沉感。ＩＶＰ示左输尿管中上１／３交界处狭窄伴肾积水,狭窄段长约３ｍｍ,宽径仅１ｍｍ。我们在连硬麻醉下经膀胱镜导引下,将７Ｆ超滑加硬导丝从膀胱入口处插入左侧输尿管。在Ｘ线电透监视下,经导丝插入球囊导管并通过狭窄段,然后逐渐向下牵移,对狭窄处由近及远地间断扩张（球囊规格为０．８ｃｍ×４ｃｍ,以５０％泛影葡胺充盈球囊）,使之稳定均匀地…     

球囊扩张术治疗儿童食管良性狭窄的疗效北大核心CSCD

目的 探讨透视下球囊扩张术治疗不同原因的儿童食管良性狭窄的疗效及安全性。方法 回顾性分析2018年3月至2021年5月天津市儿童医院收治的17例食管良性狭窄患儿的临床资料。患儿中,食管闭锁术后吻合口狭窄组(Ⅰ组)8例,腐蚀性食管狭窄组(Ⅱ组)5例,食道裂孔疝加贲门成形术后贲门狭窄1例,贲门失迟缓症1例,先天性食管狭窄1例。患儿存在吞咽困难,经X线钡餐造影确诊食管狭窄后,在放射线引导下进行食管狭窄的球囊扩张治疗,术后随访6~18个月,观察疗效。结果 17例患儿共进行49次球囊扩张术,每例患儿平均扩张2.88次(1~9次),球囊直径为6~25 mm。Ⅰ组患儿扩张成功7例;Ⅱ组患儿成功扩张4例,其余患儿均扩张成功。术后随访6~18个月,长期有效13例,Ⅰ组长期有效6例,Ⅱ组长期有效4例,余患儿均长期有效。术中术后均无严重并发症出现。结论 透视下食管球囊扩张术治疗不同原因儿童食管良性狭窄安全有效。     

带囊导管扩张术治疗贲门失弛缓症95例经验总结

本文报告带囊导管扩张术治疗贲门失弛缓症９５例，近期效果显著，远期有效者为９５．７６％。作者强调对贲门失弛缓症实施扩张球囊的直径不得小于４．０ｃｍ（儿童患者酌减），提出影响疗效的因素与患者的病程、年龄以及贲门狭窄的程度有关。对本病大球囊扩张的原理、疗效及并发症进行了探讨，认为可将扩张法作为贲门失弛缓症的首选疗法。     

应用球囊导管治疗食管狭窄25例

1991年10月～1996年12月;我们采用球囊导管扩张食管狭窄25例,获得满意效果。1　临床资料1.1　一般情况　本组25例,男21例,女4例,年龄7～79岁。食管胃吻合术后吻合口狭窄15例,贲门失弛缓症术后狭窄1例。因强酸或强碱化学烧伤9例,其中狭窄3处1例,2处2例,1处狭窄6例;钡餐显示狭窄长度2～4cm;狭窄口直径<0.2cm6例,0.2～0.3cm3例。扩张前只能进食流质饮食16例,勉强食少渣半流质3例,不能进水6例。1.2　方法　扩张前行X线钡餐检查,确定狭窄部位、长度和程度。术前30min肌注山莨菪碱10mg。经鼻孔插入中心孔内带金属导丝的扩张导管(COOK公司生产),…     

X线监控下直肠狭窄的球囊扩张术

直肠狭窄通常发生于术后的吻合口,传统的治疗方法是用金属扩张器或再次手术。作者自1989年3月～1990年5月对8例术后直肠狭窄病人采用了球囊导管扩张治疗。术前清洁灌肠后,静脉给予必要的镇静或止痛药,病人左侧卧位于导管检查床上,经肛门插入乙状结肠镜抵达狭窄段下端,并造影观察狭窄情况。电视监控下经乙状结肠镜将0.87mm“J”型导丝通过狭窄段,再沿导丝插入19F聚氯乙烯球囊扩张导管于狭窄部,球囊内用50%Conray280持续充胀10分钟,最大囊径为22mm。8例病人中有4例一次扩张成功,另4例需扩张3～4次,所有病人术后随访平均11.5个月,狭窄由扩前平均的7.2mm扩至17.0mm,均获良好效果,     

球囊扩张术治疗贲门失弛缓症(附24例报告)

自 8 0年代对食管狭窄的治疗开始采用球囊导管扩张术并取得成功经验以来 ,关于贲门失弛缓症应用球囊导管扩张术进行治疗的评价很多 ,其疗效不同、褒贬不一。本文通过对 4年来收治的 2 4例经球囊导管扩张术治疗的贲门失弛缓症 (achala sia ,以下简称AC)病人的资料进行回顾观察 ,对其疗效进行评价和总结。1　材料与方法本组 2 4例病人 ,男 14例 ,女 10例 ;年龄 16～ 68岁 ,平均 5 0岁。所有病人均经临床症状及上胃肠道钡餐造影检查证实为AC。所有病人均首次行球囊导管扩张术治疗。术前常规行出凝血时间、心电图检查。术日禁食水 ,术前肌注安…     

食管-胃吻合口严重瘢痕性狭窄大球囊过度扩张治疗

目的探讨大球囊扩张成形治疗食管-胃吻合口严重瘢痕性狭窄的疗效和价值。方法透视下应用直径27～30mm的大球囊导管对36例食管-胃吻合口瘢痕性狭窄患者进行扩张治疗。结果26例(72．2％)一次性扩张治愈,8例(22．2％)扩张2次,2例(5．6％)扩张3次。术后随访6～40个月,吞咽困难缓解率100％,均无严重并发症和复发。结论利用大球囊扩张成形治疗食管一胃吻合口瘢痕性狭窄安全、有效,可取代内支架置入达到根治目的,值得大力推广。     

Boston专用球囊扩张治疗贲门失弛缓症107例报告

目的总结Boston专用扩张球囊治疗贲门失弛缓症105例的方法与疗效。方法在电视监视下经口腔置入加强导丝,并经导丝引入球囊于贲门狭窄部,狭窄严重者需用20～25 mm球囊预扩张。手推法球囊内注入15%造影剂,将球囊循序渐进与间断性扩张至球囊存在小切迹为止。持续5 m in后松解,3～5 m in后再扩张,连续2~3次。结果 105例球囊扩张成功率100%,13例2次扩张,1例无效和1例破裂手术,术后随访2周~6年,总有效率98%。结论采用直径40 mm专用球囊治疗贲门失弛缓症,方法简单、疗效可靠,可以取代外科手术。     

应用金属内支架治疗食管及贲门部恶性狭窄

目的：评价金属内支架治疗食管及贲门部恶性狭窄的效果。材料和方法：１４例食管，贲门部恶性狭窄患者，１例合并有食管气管瘘。经口操作，先行球囊导管对狭窄段进行扩张，后置入金属内支架，其中１３例置入国产被覆涤纶膜Ｚ型内支架（共１５枚）。另１例应用Ｓｔｒｅｃｋｅｒ ｓｔｅｎｔ。结果：内皮架置入全部成功，术后患者狭窄得到改善，食管气管瘘孔安全封闭。术后患者平均生存时间为５．５个月。结论：金属内支架是治疗食管及     

儿童食管化学性灼伤致疤痕狭窄的介入治疗

目的 探讨儿童食管化学性灼伤致疤痕狭窄的介入球囊扩张治疗的疗效。方法 8例化学性灼伤致食管疤痕患儿在出现临床症状如咽下困难，反流，及呕吐后1-3月内接受了球囊扩张治疗，全部患儿经随访6个月-2年。结果 8例患儿经球囊扩张治疗4-12次。其中7例临床症状明显改善，基本上能进普食，随访6个月-2年无狭窄症状；1例碱性物质灼伤共经12次扩张治疗效果不佳。行外科手术治疗。结论 球囊扩张术治疗儿童食管化学性灼伤致疤痕狭窄是一种安全可靠有效的治疗方法，但食管狭窄严重经多次球囊扩张术无效，需手术治疗。     

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.