保留肾单位手术治疗肾血管平滑肌脂肪瘤的疗效观察

目的探讨保留肾单位手术（NSS）治疗肾血管平滑肌脂肪瘤（RAML）的安全性及有效性。方法对56例采用NSS治疗的RAML患者的临床资料回顾性分析,其中肿瘤剜除术35例,肾部分切除21例,4例患者术前行选择性肾动脉栓塞术。结果术中切除肿瘤平均直径（5．6±2．7）cm,术中平均失血量（140±75）ml,术后无大出血、尿瘘。51例患者获得随访,平均随访36月（6-120月）,术后肾功能相对稳定,未见肿瘤复发。结论保留肾单位手术是治疗RAML的较好方法,有效地控制出血和保护肾脏功能是手术成功的关键。     

手术对甲亢突眼的影响

通过外科手术治疗甲状腺功能亢进,至今仍是治疗甲亢很有效的方法。但手术对突眼的影响,值得探讨。本文就突眼的特征,手术后的变化及应对措施进行讨论。 一、原发甲亢可致二种特殊的眼征 1. 非浸润性突眼征,又称良性突眼,占本病中大多数。一般属双侧对称性,有时一侧突眼先于另一侧,是因交感神经兴奋眼外肌群和睑肌张力增高所致,主要为眼睑及眼外部的改变表现,球后组织改变不大。眼征有以下几种:(1)眼睑裂隙增     

围手术期应用心得安对甲亢患者甲状腺功能影响的观察

对于甲亢病人围手术期应用心得安是否可以减少术后甲状腺危象的发生 ,至今仍有争议。本文用放射免疫分析法观察了 4 7例甲亢病人手术前后甲状腺内分泌的变化。旨在探讨甲亢病人手术前后应用心得安观察对甲亢患者甲状腺功能的影响。资料和方法一、对象 :中、重度甲亢病人 4 7例 (男 2 4 ,女 2 3) ,年龄 2 3～ 6 2岁。其中原发性甲亢 2 5例 ,高功能腺瘤伴甲亢 11例 ,巨结节性甲状腺肿合并甲亢 11例。术前均无明显心、肺、肝及其他内分泌疾病 ,心电图均有不同程度的心率增快 ,无其他特异性改变。二、方法 :各组术前均常规口服 1%卢戈氏液 (10～…     

甲亢病人的围手术期处理

甲状腺机能亢进症(甲亢)的外科治疗虽属常见手术,但引起医疗纠纷或疗效不好的仍不少见。今就有关问题谈些看法。 一、术前准备:甲亢的诊断比较容易,如果一经确诊,一定要做好门诊的术前准备工作,卢戈氏碘液是     

甲亢术后复发再手术2例体会

甲状腺机能亢进症手术后复发的原因较多,一般认为术后一年内复发者多与“残留量”过多有关;二年以上复发者常与甲状腺刺激免疫球蛋白(TSI)或缺碘有关。根据国内统计,手术后复发率一般为5.4％。对术后复发的处理意见不一。再次手术值得采用。~(131)I治疗也值得考虑。本文报告我院在1990年～1991年对2例术后复发再手术的体会如下:     

甲状腺癌保留功能手术探讨

我院于1983年采用保留功能甲状腺癌根治术为15例病人做了手术。术式为Ⅰ式(保留胸锁乳突肌、颈内静脉及副神经),取得了满意疗效。现报道如下: 临床资料 一、本组15例病人全部为女性。年龄:16～60岁,以30～45岁最多;病程3个月～1年;部位:左侧5     

保留胃短动脉的保脾手术3例

近年许多文献强调对外伤性脾破裂应尽量采用保留全睥或部分脾组织的保守手术．以保留脾功能。我科自1990年4月～1996年8月共收治外伤性脾破裂102例．采用单纯缝合或部分切除保留脾手术18例。其中采用保留胃短动脉的保留脾手术3例，效果较好现报道如下：     

保留括约肌手术治疗肛瘘的临床进展

肛瘘是肛管直肠与肛门周围皮肤之间的异常通道。由于本病的治愈率和肛门失禁率之间的矛盾仍然未能解决,在一味追求治愈率的同时,我们发现了较高的肛门失禁率,而为了减少失禁率,则治愈率偏低。肛瘘不能自愈,必须手术治疗。而肛瘘的手术治疗,特别是复杂性肛瘘更易导致肛门功能的损伤。保留括约肌手术因能在最大限度保护肛门功能的前提下治愈肛瘘,从而成为目前治疗肛瘘的主流术式。以下就目前肛瘘的保留括约肌主要手术治疗方式的临床进展做一综述。1松弛挂线术     

早期乳腺癌保留乳腺手术治疗的临床效果

目的 探究早期乳腺癌保留乳腺手术治疗的临床效果及其不良反应发生情况。方法 选取2014年6月~2018年6月我院收治的50例早期乳腺癌患者作为研究对象,随机分为研究组和对照组,每组25例。对照组患者采用传统的切除乳腺手术方法进行治疗,研究组患者采用保留乳腺手术方法进行治疗。比较两组患者的临床效果、半年存活率及并发症发生率。结果 研究组患者的复发率（12.00%）和转移率（12.00%）均低于对照组的36.00%和32.00%,差异有统计学意义（P＜0.05）,研究组患者的半年存活率为96.00%,高于对照组的76.00%,术后并发症发生率为12.00%,低于对照组的40.00%,差异有统计学意义（P＜0.05）。结论 早期乳腺癌患者采用保留乳腺的手术治疗临床治疗效果优于传统的切除乳腺的手术方法,有助于提高患者半年存活率升高,减少并发症,值得在临床借鉴应用。     

越来越多乳腺癌患者做乳头保留全乳切除术

乳头保留全乳切除术就像传统手术一样安全。据美国WebMD医学新闻网(2011-11-07)报道,越来越多女性在面对乳房切除术时会去除乳房组织,保留皮肤、乳头及乳晕。之前,因为乳头保留全乳切除术可能会增加癌症复发的风险,没有很多人接受,但现在有越来越多医院提供这种手术。     

甲状腺过氧化物酶抗体在甲亢、甲状腺占位性病变诊治中的临床意义

目的观察不同临床治疗阶段甲亢、甲状腺占位性病变患者血清甲状腺过氧化物酶抗体(TPOAb)浓度的变化,探讨其临床指导价值。方法采用固相化学发光酶免疫分析法观察血清TPOAb浓度变化与甲状腺功能减退(化验室检查结果)的关系。结果89例患者中,有50例患者治疗前TPOAb正常或仅轻度增高,治疗后呈现阳性者31例,其中19例发生了甲减或亚临床型;39例治疗前TPOAb阳性,治疗后转阴2例,26例浓度降低,发生甲减3例,29例患者服用不同剂量的甲状腺片而未出现甲减或亚临床型。结论甲亢和甲状腺占位性病变患者在治疗过程可伴有TPOAb浓度的变化,TPOAb的明显增高,预示出现甲减的可能性大,TPOAb阳性的患者应被关注,高滴度TPOAb的甲亢患者治疗方案的选择要慎重。     

Histologic changes in Graves' thyroid gland after 131I therapy for hyperthyroidism.

The effect of 131I therapy was examined in 13 thyroid glands affected by Graves' disease 3 to 29 years after irradiation for hyperthyroidism. All of the patients had clinically palpable thyroid nodules. Two patients were in a latent hypothyroid, 6 in a euthyroid and 5 in a hyperthyroid state. The microscopic changes in the thyroids showed a pattern of multiple adenomatous nodules with cystic changes, marked oxyphilic cell changes with nuclear atypism and various degrees of chronic thyroiditis. Immunohistochemical staining for TG and T4 was negative to mildly positive in these oxyphilic cells and entirely negative for EGF and CEA. The DNA ploidy pattern was diploid pattern in 6 cases. One papillary-type microcarcinoma occurred, but there was no evidence of a relationship between the tumor and the irradiation. The pathologic findings in Graves' thyroid gland after 131I therapy are not specific, but pathologists should differentiate this lesion from adenomatous goiter, which occurs with no apparent cause, or from thyroid carcinoma because of the marked nuclear atypism of this lesion.     

Disorders of the thyroid gland in neonates and youth: latent hypothyroidism and hyperthyroidism

Etiology and clinical manifestation of subclinical hypothyroidism is different in neonates and in young. In the neonatal period babies present with jaundice and/or constipation due to thyroid hypoplasia, thyroid ectopia or transient hypothyroidism. The main reason for subclinical hypothyroidism in the youth is Hashimoto thyroiditis. Indication for thyroxin therapy in subclinical hypothyroidism is discussed controversial in the literature. For best growing and maturation in childhood thyroxin therapy should be given. Subclinical hyperthyroidism is rare in childhood. The main reasons are Graves' disease or Hashimoto thyroiditis (initial period). The therapy of subclinical hyperthyroidism is the same as in overt hyperthyroidism.     

Bromine metabolism in the thyroid gland of guinea pigs during experimental hyperthyroidism and in rats fed on methylthiouracil

Summary A significant increase in the weight of the thyroid glands and of the bromine content was noted in experimental hyperthyroidism of ginea pigs. The relative quantity of the protein-combined bromine does not change. Preliminary administration of bromine greatly decreases the entrance of bromine into the protein fraction of the thyroid gland tissue.The percentage of bromine in the protein fraction of the thyroid gland tissue is considerably diminished in rats fed methylthiouracil, whereas the total amount of bromine entering the thyroid gland of experimental animals rises.Presented by Active Member of the AMN SSSR V. N. Chernigovskii     

Enzymohistochemical and immunomorphological study of experimental thyroid gland carcinoma]

A total of 8 medullary carcinimas, 134 adenomas of C-cells, 32 solid focal over-growths of C-cells, and 124 normal thyroid glands of rats were investigated by histochemical, immunomorphological and histological methods. Modullary carcinomas were characterized by a high enzymes of hydrolysis of ethers of carboxylic acids, tissue respiration, and by a moderate or low activity of enzymes of the initial link of glycolysis, oxidative deamination, synthesis of amino acids, hydrolysis of monoethers of orthophosphoric acid, pentose and citric acid cycles. In medullary carcinomas, as well as in normal C-cells and adenomas of C-cells, there was revealed the phenomenon of occult metachromasia with the absence of a microsomal tissue-specific antigen and direct reaction to amyloid. The authors consider medullary carcinomas to be analogues of solid carcinoma with amyloidosis of the stroma of the human thyroid gland, differing from the latter by specific metabolic reactions, and therefore, they may serve as an experimental model in studies of these diseases.     

56例甲状腺乳头状增生性病变的回顾性研究

收集５６例甲状腺乳头状增生性病变的临床病理资料，试图进一步探讨此病变形态各个方面与患者预后的关系。常规ＨＥ染色，光镜观察，根据近期共认的标准讨论重新诊断，２提示：（１）甲状腺乳头状癌具有乳头分枝多，密集，核染色淡，６０％有泡状核，８０％有核沟，７５％有核内假包涵体，３５％的砂粒体，综合组织学特征，泡状核，核沟，假包涵体，砂粒体，可做为诊断头乳头状癌的依据。（２）甲状腺乳头状囊腺瘤可能是结节性甲状腺     

全同步肾阻抗血流图临床应用研究

目的：探讨全同步肾阻抗血流图（RNG）对慢性肾炎（CGN）分型诊断与鉴别诊断及肾功能不全判定的价值；方法：在200例正常人研究的基础上，检测85例CGN及高血压病人的全同步RNG，并与临床诊断，肾功能及肾B超作对照分析。结果：CGN普通型仅见Q-B轻度延长，CGN高血压型Hd/Hs增大，慢性肾功能衰竭（CRF）Hs及C波显著降低而Hd/Hs正常，高血压肾硬化Hs及C波降低伴Hd/Hs增大，上述各组Q-B/B-X均见增大，但组间无显著差异性，而高血压病Ⅰ期均为正常，肾功能不全代偿期各参数的正常，氮质血症期Hs及C波降低伴Hd/Hs增大，而CRF仅Hs及C波显著降低。且各组均见有显著差异。结论：全同步RNG对CGN分型诊断与鉴别诊断及肾功能不全的分期判定均有重要价值。其波幅参数较之时间参数更具诊断意义。