中晚期高血压性脑出血手术治疗体会

１　资料和方法１．１　一般资料　１９９１年３月～１９９８年１月共收治中晚期高血压性脑出血病人８例,男６例,女２例。年龄４７～７１岁,其中４７～５７岁５例,５８～７１岁３例。全部病例均有不同程度的高血压病史。按１９８７年国内３级分类法,本组病例均为２级以上。按ＧＣＳ计分：４～５分５例,３分３例。术前均经头颅ＣＴ扫描。发病至手术时间：１２～２４ｈ６例,２４～４８ｈ２例。出血部位：壳核出血７例,丘脑出血１例,血肿破入脑室３例。１．２　手术方法　８例均以耳廓上１．０ｃｍ向前１．０ｃｍ为穿刺点,切开头皮,…     

急诊肺切除治疗大咯血18例

大咯血症状急重，并发症多，严重威胁病人生命。因此，我们对大咯血１８例内科治疗无效者行急诊肺切除，效果满意。１临床资料１．１一般情况男１５例，女３例；年龄１８～５２岁，平均３６岁。病史１～１０年，平均３．５年。原发病：空洞型肺结核１３例，结核性毁损肺２例，支气管扩张２例，结核性支气管扩张１例。既往均有少量或大咯血史，其中有窒息史 ２例。术前一次性咯血＞３００ ｍｌ者 ６例，２４ ｈ咯血量 ６００～１０００ ｍｌ者 １０例，＞１０００ ｍｌ者 ２例。均经内科治疗１或２ｄ，仍咯血不止而手术。一侧肺有病变者１２…     

联合应用脑室冲洗和腰穿引流治疗脑室出血28例

１　临床资料１－１　一般资料　男２２例，女６例，年龄１６～６８岁，平均４８－６岁。其病因为外伤引起者９例，脑血管畸形破裂６例，高血压脑出血引起１２例，白血病引起１例。临床表现为头痛、头晕、恶心、呕吐、血压升高、脑膜刺激征。意识障碍：其中嗜睡４例，浅昏迷６例，中度昏迷８例，深度昏迷１０例。一侧瞳孔散大６例，双侧瞳孔散大４例，去大脑强直１例，单侧或双侧病理征阳性２０例。头颅ＣＴ表现，所有病例均在２４ｈ内行头颅ＣＴ检查，一侧半球内出血破入者８例，丘脑出血破入者３例，壳核出血破入者２例，两者混合型３例，…     

颅脑外伤并发尿崩症11例

颅脑外伤并发尿崩症临床较少见。我院从１９８２年１月一１９９８年６月共收治１１例，占同期颅脑外伤病人的１．０８％。现报告如下。临床资料１．一般资料：本组男８例，女３例；年龄１６－４５岁，平均２７．６岁。致伤原因：车祸伤７例，坠落伤３例，打击伤１例。临床诊断：脑挫伤５例，急性硬膜下血肿３例，急性硬膜外血肿３例，其中台并颅底骨折９例。术前ＧＣＳ评分：５分２例，６－８分４例，９一门分５例。开颅清除血肿６例，保守治疗５例。伤后至出现尿崩症时间：最短７天．最长１６天，平均１１天。：临床表现：除昏迷者外均有烦…     

6例小儿手部严重爆炸伤的救治

自１９８８年２月～１９９２年２月收治小儿手部严重爆炸伤６例，报告如下．临床资料本组６例，均为男性，年龄６～１２岁，平均８．８岁．左、右手各３例．鞭炮炸伤５例，敲击子弹炸伤１例（此例并右膝炸伤）．入院时伤手均有多处开放性创口，创面多严重污染．３例有早期...     

外伤性支气管断裂的诊断与治疗

我院共收治外伤性支气管断裂６例，均为闭合性，全部手术治愈．临床资料男５例，女１例；年龄２０～５１岁．重载马车碾压伤３例，机动车撞伤３例．伤后４８小时内就诊５例，８个月１例．左侧５例，右侧１例．合并多发性肋骨骨折伴血气胸４例，张力性血气胸２例．主要症状...     

109HH人发腱治疗手伸屈肌腱缺损12例

笔者自１９９６年２月采用１０９ＨＨ人发腱（人发角蛋白即人发经特殊促健化处理称人发腱）重建手伸屈肌腱缺损１２例，临床效果满意。临床资料（１）一般资料：本组男１１例，女１例；年龄８～３８岁（平均２４．５岁）。左手４例６条，右手８例９条，伸指肌腱３例４条，...     

14例肛管直肠损伤的诊治

临床资料本组男１０例，女４例；年龄６～４９岁。受伤至手术时间＜６小时８例，６～１２小时３例，＞２４小时３例。损伤原因：坠落跌倒于尖锐物上戳伤３例，车祸伤２例，刀刺伤２例，枪伤、牛角挑伤各１例，医源性损伤５例。损伤部位：盆底腹膜返折上直肠伤６例，返折下...     

胰腺损伤24例

胰腺损伤，尤其是闭合性损伤，其诊治难度大，并发症也多。笔者自１９７０年１月～１９９５年１２月共收治２４例。临床资料１．一般情况：男１９例，女５例；年龄６～５０岁，平均２６．８岁。腹部开放性损伤３例，其中刀刺伤１例，子弹穿通伤２例；闭合性钝器伤２１例，...     

高血压病脑出血破入脑室60例早期手术体会

１９８５～１９９８年，我们对高血压病脑出血破入脑室６０例，采用早期手术的方法，取得较好疗效。１临床资料１．１一般情况男４１例，女１９例；平均年龄５４．３岁。本组均有高血压病史，舒张压 １６ ｋＰａ以上４５例。１．２ＣＴ检查（１）出血部位：基底节２４例，丘脑１５例，脑叶１５例，混合型出血６例；（２）破入脑室部位：从侧脑室前角破入３３例，后角破入７例，体部破入２０例；（３）血肿量：２５～６０ ｍｌ，平均４７．３ ｍｌ；（４）血肿波及脑室情况：一侧脑室２８例，双侧１５例，侧脑室及第３脑室１２例，侧脑室及第…     

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.