腹腔镜治疗小儿腹股沟斜疝42例

目的探讨腹腔镜下小儿腹股沟斜疝疝囊高位结扎术治疗小儿腹股沟斜疝的临床应用价值。方法采用腹腔镜手术治疗小儿腹股沟斜疝42例,男37例,女5例。年龄1～10岁,平均5．3岁。疝囊位于右侧23例,左侧14例,双侧3例,对侧隐性疝2例。其中嵌顿性疝4例。均在腹腔镜下行小儿腹股沟斜疝疝囊高位结扎术。结果手术时间10～20min,平均13min,术后平均住院2d,全部治愈出院,无并发症发生。随访1—12个月,未见复发病例。结论腹腔镜下小儿腹股沟斜疝疝囊高位结扎术安全高效,创伤小,恢复快,并发症少,复发率低,值得临床推广应用。     

微型腹腔镜治疗小儿腹股沟斜疝20例报告

目的：探讨微型腹腔镜治疗小儿腹股沟斜疝的安全性、有效性。方法：分析2010-10～2011-02我院应用微型腹腔镜行小儿疝囊高位结扎术20例的临床资料,患儿年龄2.5岁～13岁。平均5岁。结果：手术过程顺利,手术时间8～13 min。术中发现对侧内环口未闭1例,占5%。所有患儿术后1～2 d出院。结论：经腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝损伤小,痛苦轻,恢复快。操作简单,安全、疗效可靠,可以同时发现和处理对侧的隐匿性疝,值得临床推广。     

腹腔镜治疗小儿腹股沟疝227例的临床观察

目的探讨腹腔镜疝囊高位结扎术在治疗小儿腹股沟疝中的优点。方法分析2009年10月-2010年9月腹腔镜小儿腹股沟疝疝囊高位结扎术227例的临床资料。结果全组病例均治愈，随访1年无复发及并发症。结论腹腔镜治疗小儿腹股沟疝，创伤小，康复快，手术时间及住院时间短，复发率低，并发症少，可同时发现及处理对侧腹股沟隐性疝和双侧腹股沟疝。     

腹腔镜和传统手术治疗小儿嵌顿性腹股沟斜疝的对比分析

目的：对比分析小儿嵌顿性腹股沟斜疝腹腔镜手术与传统开放手术的优劣。方法分析应用腹腔镜手术治疗例嵌顿性腹股沟斜疝106例（腹腔镜组）,及同期行下腹部腹横纹小切口手术的嵌顿性腹股沟斜疝92例患儿（对照组）的临床资料进行对比分析,对两组患儿的手术时间、出血量、住院时间、术后并发症、复发率等进行统计分析。结果腹腔镜组平均手术时间、出血量、住院时间、术后并发症、复发率等均显著优于对照组,并且能在手术中检查对侧鞘状突闭合情况,未闭合的一并行鞘状突高位结扎术治疗。结论腹腔镜手术治疗小儿嵌顿性腹股沟斜疝与下腹部腹横纹小切口手术治疗嵌顿性腹股沟斜疝比较,具有切口美观,创伤小,恢复快,可同时探查对侧及术后并发症及复发率少等优点。     

经脐部单孔腹腔镜治疗小儿腹股沟斜疝的临床应用

目的探讨经脐部自然通路单孔腹腔镜手术治疗小儿腹股沟斜疝的可行性与安全性。方法使用微型腹腔镜,配合自制的针形缝合器,施行荷包缝合内环口与疝囊高位结扎术,治疗小儿腹股沟斜疝。对我科采用此方法收治的63例腹股沟斜疝患儿（年龄10个月～14岁）的相关临床资料进行分析,分别是单侧疝47例,双侧疝16例,其中有隐形疝10例。结果 63例均成功治愈,无中转开腹;单侧疝手术时间9～15 min,平均约13 min,双侧疝手术时间26～31 min、平均约28 min;术后未发生严重阴囊水肿、感染、睾丸萎缩、明显疼痛等并发症;住院2～4 d,平均3.5 d;术后随访3～12个月,未见疝复发等。结论经脐部自然通路单孔腹腔镜治疗小儿腹股沟斜疝可行、安全、有效,且微创美观、手术操作简便,值得推广。     

腹腔镜二孔法治疗小儿腹股沟疝临床疗效观察

目的探讨腹腔镜二孔法治疗小儿腹股沟疝临床疗效。方法采用腹腔镜二孔法技术治疗小儿腹股疝167例,年龄1.2~12岁,平均4.7岁,其中男141例,女26例;腹股沟斜疝136例,直疝31例;右侧疝93例,左侧疝55例,双侧疝19例;术中发现对侧隐性疝12例,嵌顿疝9例。均用腹腔镜二孔法行小儿腹股沟疝疝囊高位结扎术。结果手术时间8~15m in,平均12 m in,术后平均住院2.5 d,全部治愈出院,无并发症发生。随访6~24个月,未见复发病例。结论腹腔镜二孔法治疗小儿腹股沟疝安全可靠、创伤小、恢复快、并发症少、无复发病例,值得临床推广应用。     

一孔法腹腔镜行小儿腹股沟斜疝高位结扎术48例

小儿腹股沟斜疝传统的治疗方法为高位结扎术 ,虽然有效但切口长、创伤大。近几年我院在学习和借鉴国内外腹腔镜手术方法实践的基础上 ,不断改进小儿腹股沟斜疝的手术方法 ,自 2 0 0 1年 1月首例成功以来 ,现开展此类手术 48例 ,现报告如下。1　资料和方法1.1　一般资料　本组 48例 ,年龄 1.5～ 12岁 ,平均 3.5岁 ,男 37例 ,女 11例。右侧 31例 ,左侧 13例 ,双侧 4例 ;单侧斜疝中有 5例对侧存在隐性疝 ;2例为传统的外科高位结扎术后复发。1 2　方法1 2 1　主要器械　腹腔镜直径 5ｍｍ/ 10ｍｍ ;改制的Ｅｎｄｏ ｃｌｏｓｅ缝合钩针 1支 ,直径…     

小切口疝囊高位结扎术治疗小儿斜疝118例临床分析

目的 探讨治疗小儿腹股沟斜疝的微创手术方法。方法 回顾性分析我院2001年1月至2004年3月期间对118例小儿腹股沟斜疝经外环横形小切口疝囊高位结扎术治疗的临床资料。结果 118例全部治愈，无并发症，随访6个月至3年无复发。结论 经外环横形小切口疝囊高位结扎术具有损伤小、并发症少、复发率低、疤痕小等优点，是一种安全有效的治疗小儿腹股沟斜疝的微创手术方法。     

腹腔镜在治疗小儿双侧腹股沟疝的临床研究

目的探讨腹腔镜治疗小儿双侧腹股沟疝相对于传统手术方式的优越性。方法回顾性分析2010年1月～2011年9月我科在全麻下实行的双侧小儿疝手术102例,腹腔镜下双侧小儿疝囊高位结扎术58例(腔镜组)和传统疝囊高位结扎术44例(对照组)的临床资料,对比两组手术时间、术中出血量、术后自主活动时间、住院时间、复发率及有关并发症的情况。结果腔镜组在手术时间(26.29±8.76)min、术中出血量(4.22±2.14)ml、术后自主活动时间(14.24±5.12)h、复发率(0%)和术后并发症发生率(0.9%)方面明显优于对照组,差异有统计学意义(P<0.05)。结论腹腔镜小儿疝囊颈高位结扎术是一种操作方便、手术时间短、创伤小、安全有效的手术方式,术后患儿康复快,并发症少,复发率低等优点,尤其在双侧疝的治疗中更体现出它的优越性,值得临床推广和应用。     

经脐单孔腹腔镜治疗小儿腹股沟直疝临床特征及诊疗方法分析

目的探讨经脐单孔腹腔镜治疗的小儿腹股沟直疝临床特征及诊疗方法。方法回顾性分析大连医科大学附属儿童医院自2013年1月至2018年5月收治的经脐单孔腹腔镜下鞘状突高位缝扎术2 000例腹股沟疝患儿的临床资料。结果 2 000例腹股沟疝患儿中,仅有14例患儿(0.7%)术中被诊断为直疝。其中,右侧12例(85.7%),左侧2例(14.3%)。术前能够诊断为直疝的仅有2例(14.3%),9例患儿诊断为腹股沟斜疝(64.3%),3例患儿诊断为复发疝(21.4%)。平均手术时间(20.6±5.9)min,平均住院时间(1.8±0.5)d,随访6个月,无并发症发生。结论经脐单孔腹腔镜具备与传统手术相同安全性与可行性,同时具有美容效果佳、住院时间短、创伤小等优点,可有效诊断、治疗小儿腹股沟直疝。     

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.