多层螺旋CT平扫在急腹症中的应用

急腹症是以急性腹痛为主要临床表现并需要紧急处理的腹部疼痛。因腹腔脏器较多，病因复杂，给临床诊治带来困难。多层螺旋CT因简便、快速、断层及高分辨率的特点，加上后处理软件及显示器阅片的广泛使用，为急腹症的准确诊断提供了条件，对于减少患者的痛苦，争取救助时间有着重要的意义。笔者通过分析因急腹症而行腹部CT平扫的71例患者的初诊结果，并与临床诊治结果进行比较，探讨多层螺旋CT平扫在急腹症中的应用，总结常见疾病的CT表现及诊断过程中的注意事项。     

6层螺旋CT在肠道急腹症诊断中的临床价值

目的 探讨6层螺旋CT在肠道急腹症病因临床诊断中的应用价值方法选择2010年12月～2012年12月间我院诊治的肠道急腹症患者59例.方法 分析6层螺旋CT对肠道急腹症诊断符合率,观察其影像学特征.结果 本组包括肠道肿瘤患者32例、肠梗阻17例、急性肠道穿孔患者3例、阑尾炎患者5例、肠坏死2例.6层螺旋CT明确诊断52例,诊断符合率为89.83％（52/59）.6层螺旋CT对肠道急腹症定位及定性诊断准确率分别为93.22％和89.83％,均显著高于X线平片,差异具有显著性（P＜0.01）.结论 肠道急腹症的诊断中,6层螺旋CT对其定位及定性诊断均具有很高的准确性.     

多层螺旋CT重建技术诊断急腹症临床价值分析

目的探讨多层螺旋CT重建技术在急腹症诊断与鉴别中的应用价值。方法对急腹症患者采用多层螺旋CT重建技术进行诊断的效果,采用多平面重建(multi-plan reconstruction,MPR)、最大密度投影法(MIP)、容积成像法(volume rendering,VR)等进行图像后处理技术进行处理,并分析其表现。结果 64例患者中经临床确诊为梗阻性病变18例,炎性病变33例,出血性病变11例,缺血性病变2例。经多层螺旋CT检查后,其诊断总符合率为95.31%,其中梗阻性病变18例,炎性病变32例,出血性病变10例,缺血性病变1例;经统计学分析其中梗阻性病变的腹部多层螺旋CT检查诊断符合率最高达100.00%,明显高于缺血性病变(50.00%),且差异具有统计学意义(2=4.87,P0.05)。结论多层螺旋CT重建技术对急腹症进行诊断具有快速、准确等诸多优势,为临床制定合理的治疗方案提供客观依据。     

超声与多层螺旋CT在急腹症诊断中的临床价值分析

目的 探讨急诊超声在急腹症中的应用价值.方法 选择2011年1月～2012年12月间我院急诊科诊治的急腹症患者100例,进行超声检查及螺旋CT检查.结果 超声定性准确92例,定位准确90例,准确率分别为92％和90％,多层螺旋CT定性准确94例,定位准确96例,准确率分别为94％和96％,两者间差异不具有显著性(P＞0.05).结论 在急腹症的诊断中,多普勒超声对其定位及定性诊断均具有很高的准确性.     

64层螺旋CT在肠道急腹症病因诊断中的价值

目的：探讨64层螺旋CT在肠道急腹症病因诊断中价值。方法：对46例经手术或临床证实的肠道急腹症病例资料行64层螺旋CT平扫加增强扫描,并进行回顾性分析。主要重组方法为多平面重组（MPR）、最大密度投影（MIP）及容积再现（VR）。结果：46例病例中,肠道肿瘤22例、肠道炎性病变11例、憩室5例、淋巴瘤2例、肠系膜上静脉血栓1例、肠坏死1例、麻痹性肠梗阻伴全内脏转位1例、单纯性肠扭转1例、腹壁疝及闭孔疝各1例;其中64层螺旋CT准确诊断（定位定性）40例,诊断符合率87.0%,4例结肠癌误诊为炎性病变,漏诊脂肪瘤及肠穿孔各1例。结论：64层螺旋CT扫描及重组图像对肠道病变显示直观、准确,对肠道急腹症的病因诊断具有重要的诊断价值。     

多层螺旋CT在肺结核诊断和鉴别诊断中的临床应用价值

目的探讨多层螺旋CT在肺结核诊断和鉴别诊断中的临床应用价值。方法收集选取2009年7月～2012年7月收治的68例经多层螺旋CT诊断为肺结核,后经痰检、活检及临床治愈明确证实为肺结核的患者。所有患者均行胸片、多层螺旋CT扫描,其中39例患者做了增强CT扫描。分析研究多层螺旋CT在肺结核诊断和鉴别诊断中的临床应用价值。结果多层螺旋CT能够发现常规CT和胸片无法发现的肺结核征象。结论多层螺旋CT在肺结核的诊断和鉴别诊断中,能够显示处肺结核的各种重要CT征象,并做出正确的诊断,具有重要的临床意义。     

多层螺旋CT诊断急性胰腺炎的临床价值分析

目的探讨CT诊断急性胰腺炎患者的临床应用价值。方法对在我院接受诊断与治疗的急性胰腺炎患者采用多层螺旋CT进行检查,并与临床病理确诊结果进行对比分析,为临床诊断与治疗提供准确直观的依据。结果对急性胰腺炎患者的多层螺旋CT影像学检查结果进行分析发现,72例患者中急性水肿型52例,占72.22%(52/72);出血坏死型20例,占27.78%(20/72)。对手术病理分析结果及保守治疗穿刺检查结果进行分析发现经临床确诊为急性水肿型患者52例,出血坏死性20例,多层螺旋CT检查结果与病理确诊结果一致,多层螺旋CT诊断准确率达100.00%(72/72)。结论多层螺旋CT检查急性胰腺炎简便、有效能够做出准确的诊断。     

螺旋CT对急腹症病因诊断的价值

目的：探讨螺旋CT对急腹症病因诊断的价值。方法：对363例临床怀疑为急腹症的患者行螺旋CT扫描,将术前CT诊断结果与手术、病理或临床随访结果进行对照。结果：CT发现287例真阳性,56例真阴性,18例假阴性和2例假阳性。CT对急腹症诊断的敏感性94.1%,特异性96.6%,准确性94.5%,病因诊断的准确性92.5%。结论：CT有助于诊断或排除急腹症,可快速显示急腹症的病变部位、程度和病因,为临床及时诊断和选择治疗方案提供准确的参考依据。     

大动脉炎的多层螺旋CT诊断

目的 :探讨大动脉炎的多层螺旋CT表现。方法 :回顾性分析 7例大动脉炎患者的CT表现 ,所有病例均经临床及多层螺旋CT血管成像 (MSCTA)确诊。结果 :7例大动脉炎患者多层螺旋CT血管成像主要表现为主动脉及其分支血管管腔的狭窄、闭塞、扩张及血管壁增厚与钙化。结论 :多层螺旋CT血管成像能准确诊断大动脉炎患者主动脉及其主要分支的管腔与管壁的变化。     

多层螺旋CT在诊断老年急腹症中的临床应用价值

目的探讨多层螺旋CT(MSCT)在诊断老年急腹症中的临床应用价值。方法对我院152例急性腹痛而进行腹部CT检查的患者进行多层螺旋CT平扫、增强及三维重建。结果本文152例急性腹痛患者在经临床确诊其中急性胰腺炎7例,占4.61%,急性阑尾炎15例,占9.87%,急性胆囊炎12例,占7.89%,肠梗阻36例,占23.68%,间位结肠5例,占3.29%,泌尿系统结石51例,占33.55%,腹部肿瘤8例,占5.26%,消化道溃疡穿孔15例,占9.87%,腹部异物3例,占1.97%。多层螺旋CT对老年急腹症诊断的总体符合率(96.05%)明显高于CR(57.89%),且差异具有统计学意义。结论 MSCT由于扫描速度快,对病变的原因、部位、性质均有较直观的显示,可显著提高老年急腹症的诊断率。     

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.