会阴部鳞状上皮癌1例

患者女性 ,4 4岁 ,因“会阴部外伤后感染”1月余而入院。入院前骑摩托车从车上摔下 ,致使会阴部裂伤。当时在村卫生所包扎 ,换药 ,静滴庆大霉素 ,伤口不愈。后又在创面涂湿润烧伤膏 ,仍不愈。且在住院前出现伤口周围肿胀 ,疼痛加重。体格检查 :会阴部纵形外伤裂口长约 6cm ,深达肌层。表面附有白色脓性分泌物 ,无出血 ,周围皮肤略红肿。未发现溃疡及白斑 ,无肿块 ,无波动 ,有轻压痛。化验 :血白细胞14 .6× 10 9/L ,中性粒细胞 0 .75 ,淋巴细胞 0 .2 5。入院诊断 :会阴裂伤合并感染 ,给予抗生素控制感染治疗。入院 5天后 ,伤口及周围组织肿…     

超声诊断胆总管结石并鳞状上皮癌1例

1病例报告患者,女,63岁。上腹间歇性痛2年,加重9天伴发热及全身黄染7天。外院曾诊断为胆总管结石。超声检查:肝内胆管轻度扩张,肝外胆管明显扩张,胆总管内径为2.1 cm,胆总管下段见1.2 cm×1.1 cm强回声团,后方伴声影,胸膝位可见其移动。于该强回声团上方另见约2.8 cm×1.8 cm范围的高回声区,与胆总管壁分界不清,形态不规则,后方无声影,胸膝位未见其移动。胆囊轮廓清,大小8.6 cm×4.3 cm,壁光滑,腔内未见异常回声。超声提示:(1)肝内胆管轻度扩张;(2)胆囊肿大;(3)胆总管扩张,胆总管下段结石;(4)胆总管中段高回声区(胆总管癌可能性大)。术中:胆…     

阴囊损伤42例诊治分析

我院自１９９４年１月～１９９８年１２月共收治阴囊外伤５１例,其中４２例获得随访,随访时间６个月至５年。现将４２例的处理和预后分析报告如下。临床资料４２例均有明显外伤史,除２例为刀刺伤外,余４０例为踢伤和车祸伤。４例开放性损伤,３８例闭合性损伤。年龄３～５８岁,平均３１．５岁。就诊时间伤后１小时～７天。除４例开放伤外,３４例来院时予Ｂ超检查,其中２０例当时即发现阴囊内有不同程度的血肿。手术３３例(包括４例开放伤),非手术９例。４例开放伤者除１例行左侧睾丸切除外,余３例行睾丸修补清创,睾丸还纳及阴囊成形术。双侧…     

绒毛膜上皮癌肺转移的X线特点(附一例报告)

绒毛膜上皮癌(绒癌)为一种高度恶性的肿瘤,早期即可通过血行转移至全身,常见的转移部位依次为肺、阴道、脑及肝,但以其他系统症状为首发表现时,易引起误诊。本文报告1例以血性胸水为首发症状的绒癌,并分析绒癌肺转移的x线特点。1 病例资料女,28岁。因左侧胸闷、气喘、发热及左侧乳腺包块2个月,于2001年5月24日入院。在当地医院x线胸片及CT检查提示左侧大量胸腔积液,给予胸腔穿刺抽液,结果为血性。纤维支气管镜及胸水脱落细胞检查均阴性,结核菌素纯蛋白衍生物(PPD)试验(-),仍考     

糖尿病继发阴囊坏疽的诊治

目的：探讨糖尿病继发阴囊坏疽的病因和诊治，提高该病的诊治水平。方法：回顾分析7例糖尿病继发阴囊坏疽并复习相关文献。结果：5例经全身综合治疗和局部彻底的清创后治愈出院。2例因病情延误，死于感染性休克、急性肾功能衰竭、多器官功能衰竭。结论：熟悉该病的病因和演变，早期诊断，及时彻底的切除坏死组织。早期联合应用广谱抗生素，控制血糖，是抢救病人生命的关键。     

阴囊肛缘窦道1例

患者男,23岁.主因间断肛旁肿痛2年余,阴囊肿痛2月余住院.2年前曾患肛旁脓肿,排脓治疗后,反复发作,2个月前阴囊出现肿痛,并于阴囊正中处破溃,流出少量脓液.遂行造影检查,自阴囊破口处注入60%泛影葡胺约10 ml,透视下点片,可见不规则窦道形成,壁不光滑(图1).即刻行CT薄层扫描并多平面重建(MPR),可见造影剂自阴囊后下正中瘘口经后尿道下方达肛管右前下缘,与肛管未见相通,瘘管壁不光滑,最宽径约2.2 cm,长约12.4 cm.瘘管周围组织不均匀增厚,密度增高(图2).诊断为阴囊后下正中至肛缘窦道形成伴感染.     

腰椎间盘退行性变30例放射影像分析

通过对３０例腰椎间盘退行变的影像分析,认为常规Ｌ１－Ｌ５正侧位拍片为腰椎间盘退行性变射影像检查的首选方法,但腰椎片未见异常,而腰椎变临床体征明确者仍需ＣＴ检查来确诊断。     

阴囊Paget病35例报告

目的探讨阴囊Paget病的诊治。方法对35例Paget病患者的临床资料进行回顾性分析。35例患者均接受手术治疗,6例同时行单侧或双侧腹股沟浅组淋巴结清扫术。结果术后I期愈合27例,Ⅱ期愈合8例。随访2个月-3年,平均2年。1例因其他疾病死亡。8例出现局部复发,复发者均接受再次手术治疗。结论阴囊Paget病极易误诊为阴囊皮肤慢性湿疹等疾病,病理学检查可对该病作出正确诊断,对阴囊湿疹治疗6-8周无效时应作组织病理学检查。该病的首选治疗方法为手术切除,行根治性切除术可获满意疗效。     

阴囊疾病的超声图像分析及体会

本文收集了自 1997年以来治疗的33例阴囊疾患病人的临床资料 ,旨在讨论各种阴囊疾患的Ｂ超表现特点 ,33例病人的诊断均经临床或手术所证实。1　资料与方法1 1　一般资料　本组 33例病人均为男性 ,年龄 3～ 70岁不等。其中 15例经手术证实 ,18例经临床治疗随访所证实。1 2　探查     

子宫内膜异位症恶变的临床研究

目的分析由子宫内膜异位症恶变发展的卵巢恶性肿瘤的临床特点,明确内膜异位恶变的规律。方法天津市中心妇产科医院2011年1月至2012年6月收治新发卵巢恶性肿瘤患者74例,其中7例为子宫内膜异位症恶变发展的卵巢恶性肿瘤患者,总结这7例患者的临床特点。结果 7例患者中有异位病史4例。7例患者中由子宫内膜异位症发展为透明细胞癌4例,发展为黏液性囊腺癌2例,发展为卵巢未分化肉瘤1例。结论由子宫内膜异位症恶变发展的卵巢恶性肿瘤临床表现不典型,所以临床医师应加强本病的诊断和鉴别诊断,以便对本病早发现、早治疗,改善患者预后。     

The acute scrotum

In boys and adolescents, the acute scrotum usually results from one of three diseases: torsion of the spermatic cord, torsion of the appendix testis, or epididymitis. A rapid diagnosis of torsion of the cord, if present, is essential, and as soon as this diagnosis is made, arrangements must be made for timely surgical correction. Although a diagnosis for the acute scrotum in this age group can sometimes be made on the basis of the history, pathognomonic signs, and basic laboratory analysis of the urine and a urethral discharge, in the usual case diagnosis requires a Doppler ultrasound examination (which if positive for torsion makes the diagnosis), a radionuclide scan (for cases negative or indeterminate for torsion on the Doppler examination), or, as a last resort, scrotal exploration. In men, by far the most common cause of the acute scrotum is epididymitis, with the torsions being much less common. In heterosexual young men with epididymitis, N. gonorrhoeae and C. trachomatis are the most likely etiologic organisms; in homosexual men and older men (and boys), E. coli, Pseudomonas sp., and the gram-positive cocci are the most common pathogens. Ceftriaxone plus tetracycline is the initial antimicrobial regimen of choice in heterosexual young men; in the absence of evidence of a sexually transmitted pathogen, one of the antimicrobials effective against common urinary tract pathogens is the initial antimicrobial of choice in all other patients. When torsion of the cord is suspected in adult male patients, the Doppler examination and the radionuclide scan (if the Doppler is negative or indeterminate) can again make the diagnosis or rule it out.     

Ultrasound of the scrotum

Ultrasound plays an important role in the diagnostic workup of scrotal diseases. It can differentiate a testicular mass from an extratesticular mass and determine whether the mass is cystic, solid, or complex. Using this information a likely diagnosis can be ascertained. In the acute scrotum, acute epididymitis/epididymo-orchitis can in most cases be distinguished from testicular torsion. Following scrotal trauma, surgery is needed to salvage the testis if there is testicular disruption and ultrasound can help with this diagnostic dilemma. When a large hydrocele is present, ultrasound allows evaluation of the underlying testis and epididymis and it can detect varicoceles, especially in the infertile male. In patients at risk for a testicular tumor (cryptorchid testis, testicular microlithiasis), ultrasound is the best imaging modality for follow-up. CT, MRI, and nuclear medicine scanning may be necessary for further evaluation of scrotal diseases and this will be briefly addressed.     

英夫利昔单抗治疗银屑病性关节炎患者的护理

目的探讨银屑病性关节炎患者在使用英夫利昔单抗（infliximab）治疗时的护理方法。方法 2008年5月至2009年10月于我院门诊就诊或住院治疗的银屑病性关节炎患者15例,在治疗的第1、2、6、8、16和24周,采用5mg/kg的英夫利昔单抗进行治疗,1次/周,疗效评价采用ACR-20和银屑病面积与严重性指数（psoriasis area and severity index,PASI）评分;并针对该药物的特点,制定相应的护理措施、健康教育与随访措施。结果治疗24周后,有13例（86.7%）患者达到了ACR-20改善;有9例（60%）患者获得PASI改善率大于75%。结论熟悉药物的使用特点、治疗期间密切观察、治疗后长期随访,是英夫利昔单抗治疗银屑病性关节炎的护理重点。     

Psoriasis

Psoriasis affects patients to varying degrees, and may seriously impair their quality of life. Treatments minimise symptoms but cannot cure the condition.     

Psoriasis

Psoriasis is a common affliction that family practitioners and other primary care physicians are certain to encounter in their daily practice. This disease presents in many manifestations and in a diffuse patient population. The therapeutic tools available to combat this disease are numerous, as are their untoward effects. This article, directed at the primary care physician, is a review of the spectrum of psoriasis and its manifestations, diagnosis, and management.