内镜下微波切开结合记忆合金支架置入术治疗贲门失弛缓症13例

目的:探讨微波切开结合记忆合金支架置入术在治疗贲门失弛缓症中的应用价值。方法:在胃镜直视下微波切开部分食管下扩约肌并将记忆合金支架置入病变部位。结果:13例患者均获得良好疗效,治疗后进食通畅,未再出现阻塞和呕吐,近期有效率达100%。结论:内镜下微波切开结合记忆合金支架植入术是治疗贲门失弛缓症行之有效的方法。     

国产金属支架置入合并动脉化疗治疗食管恶性狭窄的效果

目的评价国产镍钛记忆合金带膜支架置入及其合并动脉化疗治疗食管恶性狭窄的疗效。方法52例经临床或病理证实的食管狭窄患者，均在透视下经口将导丝安全通过狭窄段行球囊扩张后置入支架。其中，22例支架置入2周后行动脉化疗。结果全部病例置入支架一次完成，支架置入成功率100％，吞咽困难缓解率100％，明显提高了患者生存质量。1a生存率，单纯支架组6．7％；支架＋动脉化疗组31．8％。两组比较，差异显著（P〈0．01）。结论食管支架置入是姑息治疗食管恶性狭窄的最佳方法之一，而支架＋动脉化疗明显优于单纯支架的治疗效果。     

食管狭窄金属支架置入后的食管再狭窄

我院胸外科自 1992 -0 3～ 1999-12用食管金属支架治疗14 4例食管狭窄 ,置入金属支架 15 0例次 ,发生食管再狭窄 10例 ,其中 3例从外院转入。现报告如下。1　临床资料1.1　一般情况　本组 10例患者 ,男 8例 ,女 2例 ;年龄 :最小 4岁 ,最大 67岁 ,平均 5 0 .6岁。疾病分类 :晚期食管癌 5例 ,食管、贲门癌术后吻合口狭窄 3例 ,贲门失弛症 1例 ,食管烧伤后狭窄 1例。支架种类 :网格型不带膜镍钛记忆合金支架 7枚 ,带膜不锈钢支架 3枚。食管再狭窄发生时间 :最短在放置金属支架过程中发生 ,大部分在金属支架置入后 3～ 5个月后 ,最长发生置入后 …     

记忆合金支架置入治疗食管癌性狭窄36例

目的探讨采用记忆合金食道加膜支架治疗晚期食管癌所致食管狭窄的结果。方法在胃镜及X线协助下将支架置入狭窄处。结果36例支架均一次置入成功，术后进食通畅，无呕吐、腹胀，近期有效率100％。结论支架置入治疗晚期食管癌所致食管狭窄，具有操作简便、创伤小等优点。     

食管内支架置入新定位法介绍及应用

自应用食管内支架治疗食管良、恶性狭窄以来,国内外均采用术前造影片骨性解剖病灶定位法和术中体表金属标记物病灶定位法,行X线下内支架置入术,我们经多年观察和实践总结出一种在食管内行病灶上缘或下缘定位的新方法,应用此法可行非X线下食管内支架置入术,现介绍如下。1材料与方法1.1采用器材牙托、咽部喷雾器、导丝、定位导管(长约55cm,直径5mm左右为佳,外表光滑且有15~50cm刻度标计,内孔可通过导引钢丝,能在X线下清晰显影),萨氏扩张器、支架置入器、镍钛记忆合金带膜食管支架37枚。1.2方法假设置入器内镍钛记忆合金食管支架在正常食管内…     

镍钛记忆合金食管内支架治疗食管疾病的临床研究

作者应用镍钛记忆合金食管内支架治疗各类食管疾病共９例，置入支加前吞咽困难Ｃｗｉｋｉｅｌ分级均达２－３组，置入后立即缓解，Ｃｗｉｋｉｅｌ０－１级者为１００％。全组病例除有异物感及轻微胸背疼痛外，无严重并发症发生。     

食管支架在食管良恶性狭窄中的应用(附30例分析)

目的 :分析食管支架在食管良恶性狭窄中应用的临床资料 ,充分了解其适应证 ,避免支架在临床中的滥用。方法 :30例食管狭窄病人行镍钛合金记忆支架或不锈钢合金记忆支架治疗。男 2 1例 ,女 9例 ,年龄 4～ 70岁。良性狭窄 2 1例 ,恶性狭窄 9例。结果 :30例食管狭窄病人置入 32根记忆合金支架 ,吞咽困难明显改善 ,总有效率 96 .6 7%。结论 :食管—胃吻合口狭窄是食管内支架治疗最适宜的适应证 ;对于病变范围大于 8cm者应放置多根支架 ;对食管气管、食管纵隔瘘病人放置带膜支架疗效不好。     

食管恶性狭窄内支架治疗和食性狭窄球囊扩张后的随访评价

目的 评价食管恶性狭窄内支架治疗和良性狭窄球囊扩张后的长期随访疗效。方法 ９２例食管狭窄做了内支架或球囊扩张，有较完善的随访资料。５９例恶性食管狭窄均置入了内支架，其中置入支架前后行放射治疗（简称放疗）和（或）化学药物治疗（简称化疗）３７例，占６３％，３３例良性食管狭窄做了单纯球囊扩张治疗。内支架置入类型：国产镍钛记忆合金网孔支架２４例，带膜支架２２例，国产ＧｉａｎｔｕｒｃｏＺ形支架７例。带膜支架     

记忆合金支架治疗食管疾病24例

1999年 8月～ 2 0 0 2年 12月 ,我们对晚期食管癌、贲门癌及贲门失弛缓症、食管 气管瘘 2 4例经胃镜置入镍钛记忆合金支架进行治疗 ,取得了满意效果。1　临床资料1 1　一般情况　 2 4例均为男性 ,食管癌 10例 ,贲门癌 6例 ,贲门失弛缓症 6例 ,食管 气管瘘 2例 ;年龄 2 8～ 72岁 ,平均 5 2 4岁 ;所有病人均有吞咽困难、咽下和胸骨后疼痛及进食后呕吐。食管 气管瘘2例有进食呛咳的症状。1 2　材料、术前准备　 (1)选用材料 :南京微创公司生产的镍钛记忆合金覆膜支架、覆膜可回收支架和置入器。 (2 )术前准备 :术前 4～ 6h禁食 ,术前 30…     

食管恶性狭窄内支架治疗和良性狭窄球囊扩张后的随访评价

目的　评价食管恶性狭窄内支架治疗和良性狭窄球囊扩张后的长期随访疗效。方法92例食管狭窄做了内支架或球囊扩张 ,有较完整的随访资料。 5 9例恶性食管狭窄均置入了内支架 ,其中置入支架前后行放射治疗 (简称放疗 )和 (或 )化学药物治疗 (简称化疗 ) 3 7例 ,占 63 % ;3 3例良性食管狭窄做了单纯球囊扩张治疗。内支架置入类型 :国产镍钛记忆合金网孔支架 2 4例 ,带膜支架2 2例 ;国产GianturcoZ形支架 7例 ,带膜支架 4例 ;Ultreflex支架 2例。门诊行食管造影和内窥镜检查随访 78例 ,14例通过电话或信件随访。结果　本组病例经过 1～ 4 1个月的随访观察 ,仅 1例支架发生轻度移位 ,但仍能覆盖病变全长。食管恶性狭窄 17例死亡 ,术后生存时间 2～ 3 0个月 ,平均 8 2个月。死亡原因 :肿瘤多脏器转移 15例 ,心肌梗死 1例 ,其他原因引起死亡 1例。恶性食管狭窄内支架置入后再狭窄 11例 ,因食物在支架内阻塞 1例 ,发生食管 气管瘘 1例 ,因肿瘤组织生长发生狭窄 8例 ,因支架上端组织增生发生狭窄 1例。发生再狭窄的 11例均再次做了内支架置入或球囊扩张治疗。结论　中晚期食管癌内支架置入是解除吞咽困难有效的姑息治疗方法 ,应用带膜支架和同时行放疗、化疗可防止因肿瘤生长而发生再狭窄 ,延缓患者生命。球囊扩     

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.