胆心综合征58例临床及心电图分析

胆心综合征是指胆囊疾患引起类似心血管疾病临床表现的一个征侯群。在临床上并非少见,现将我院从1989年至1994年收治58例胆心综合征患者结合有关资料,分析如下。 1 临床资料 1.1 一般资料:58例中男26例,女32例。年龄29～73岁,其中29～39岁6人,40～60岁34人,60岁以上18人。原发病中胆囊炎、胆石症34例,单纯性     

B超和心电图在胆-心综合征诊断中的应用

目的 探讨胆－心综合征时Ｂ超成像和心电图的变化。方法 对４９例患者进行观察分析,结果发现胆道疾患确会波及心脏并引起其变化。结论 认为临床工作中应仔细观察和分析二者的变化以防严重并发症的发生。     

胆心综合征30例分析

对我院胆心综合征30例分析如下. 1临床资料 本组男9例,女21例,年龄22～75岁,平均(51士13)岁.其中胆囊结石25例,胆囊炎3例,胆总管结石2例.其临床表现在胆石症、胆囊炎的症状如腹疼、腹胀、恶心、呕吐、肩背疼、厌油腻食物的基础上均有不同程度的胸闷、心前区疼痛不适、心悸、气短等,疼痛为闷痛、钻痛,持续时间均超过0.5 h以上.ECG有异常表现28例,分别为窦性心动过速19例,房早8例,ST-T压低20例,T波低平5例,ECG正常2例.     

胆心综合征23例分析

目的：通过对胆心综合征发病机制及特征的研究,提高对胆心综合征的认识,减少误诊率。方法：对23例胆心综合征患者临床资料进行回顾性分析。结果：23例均治愈。结论：胆心综合征一经确诊,应以治疗胆系疾病为主,原发病得到理想控制治疗,心脏症状即可消除。     

胆心综合征

１引言近年来，随着人们膳食结构的改变，胆道疾病的发生率逐年提高，胆心综合征亦随之增多，并且有低龄化的倾向。因此，加强对本病的理论及临床研究，显得极为重要。１９８１年Schwartz等报道，在１０９例胆囊炎胆石症患者中，６３％有冠状动脉粥样硬化性心脏病（冠心病）症状，而同期无胆囊炎的对照组中仅４１％的病例出现冠心病症状，两组病例的冠心病发生率有显著性差异，提示胆囊炎可诱发冠心病的症状。胆心综合征的主要特点是伴随胆道疾病（包括急、慢性胆囊炎，肝内胆管、胆道或胆囊结石等）产生酷似器质性心脏病的征象，其严重程…     

胆心综合征45例分析

胆心综合征是指胆道疾病患者，由于胆道反射和其他因素对心肌代谢的影响而产生各种心脏临床症状的一组综合征。随着人们膳食结构的改变，胆道疾病的发生逐年提高，为进一步了解胆心综合征的临床特点，现将我院近年收治的45例胆心综合征分析如下。     

31例胆心综合征误诊分析

急、慢性胆囊炎,胆石症等消化系统疾病,常可出现类似心绞痛的表现而被误诊为冠心病.现将31例合并有心脏方面表现的急、慢性胆囊炎,胆石症患者误诊情况进行分析.     

胆心综合征21例的临床与心电图分析

目的:探讨胆心综合征的临床特点和心电图变化规律,以明确诊断减少误诊。方法:对21例胆心综合征患者的临床资料和心电图资料进行回顾分析。结果:21例胆心综合征的心电图均有ST-T改变,其改变在Ⅱ、Ⅲ、avF导联及V 4~V 6导联明显,此改变与冠心病心绞痛的心电图改变相类似,故很容易引起误诊。结论:胆心综合征易误诊为冠心病心绞痛,临床医生应提高对本病的认识,减少误诊。     

胆心综合征误诊1例

胆绞痛导致心绞痛发作，心律紊乱和心电图异常为胆心综合征，在临床上并非罕见，1994年误诊1例，报告如下。     

胆心综合征

１９０９年Ｂａｂｃｏｃｋ氏首先报道胆心综合征,但在很长一段时间内未能引起临床重视。１９３３年Ｍｃｌｅｍｏｒｅ等人证明,扩张胆囊可致心绞痛,认为这是通过迷走神经反射的结果,称之为“反射性心绞痛”＾〔１〕。１９７７年ＢИＨＯＴＰａДＯＢ经过长时间的临床研究,指出胆病患者心功能障碍的原因不仅具有反射性的特点,而且还受各种代谢因素的影响。因此,建议采用“胆心综合征”这一名称。近年来,随着人们膳食结构的改变,胆系疾病的发生率逐年提高,胆心综合征亦随之增多,并且有低龄化的倾向。因此,加强对本病的理论及临床研究,显得极为重要。     

Carcinoma of the gallbladder: CT findings in 50 cases

Fifty patients with histologically proven carcinoma of the gallbladder were examined by computed tomography (CT). The gallbladder masses were categorized into two broad groups: group 1 (74%) included patients in whom the gallbladder was identified along with a mass lesion; and group 2 (26%), where a large mass was present in the gallbladder fossa with no identifiable gallbladder. Group 1 was further divided into three types according to the nature of the tumor: Type 1, mass almost filling the entire gallbladder lumen; Type 2, a polypoidal mass projecting into the lumen; type 3, an infiltrating tumor seen as focal or diffuse wall thickening. Liver involvement, in the form of localized invasion in the vicinity of the primary gallbladder malignancy, was the most common associated finding (80%). Other ancillary features included presence of calculi, lymphadenopathy, and biliary obstruction. CT was found useful for characterizing and defining the extent of carcinoma of the gallbladder. However, it may not consistently demonstrate involvement of the gastrointestinal tract, omentum, and abdominal wall. CT can also be used for aspiration/biopsy guidance of the gallbladder mass in selected cases.     

脑心综合征心电图变化影响因素的临床研究

目的 探讨脑卒中患者的心电图变化的影响因素。方法 对165例脑卒中患者进行分析。均在入院24h内完成心电图检查,以后每周定期复查心电图。结果 心电图异常率为102例（61．8％）,其中按脑卒中性质统计：脑出血组〉蛛网膜下腔出血组〉脑梗塞组;按病变部位统计：脑干,丘脑、基底节组〉内囊、大脑皮质、脑叶组;按意识状态统计：昏迷或嗜睡组〉清醒组;按血糖水平统计：高血糖组〉血糖正常组;按疾病转归统计：死亡组〉好转组。结论 脑卒中异常心电图与脑卒中性质、部位、意识状态、血糖水平、疾病转归有关。     

Adenomyomatosis of the gallbladder with subserosal fatty proliferation: CT findings in two cases

Adenomyomatosis of the gallbladder is frequently seen in ordinary operative specimens. Subserosal fat may proliferate in the presence of adenomyomatosis, but the amount of subserosal fat may be quite variable. Typical and atypical computed tomographic (CT) findings in two cases of adenomyomatosis with subserosal fatty proliferation of the gallbladder are presented. The thick fatty layer surrounding the thickened gallbladder wall with intramural diverticula and stones, typical of CT findings, was seen in one case, and fat interspersed in the periphery of the thickened gallbladder wall without intramural stones, atypical of CT findings, was seen in a second case.     

冠状动脉搭桥术前后心电图变化研究

目的研究冠状动脉搭桥术前后心电图改变。方法对24例冠脉病变患者在入院做冠状动脉搭桥术前、术后第1周、2～4周及1个月后各记录常规12导联或18导联心电图。结果与术前比较,术后第1周窦速、早搏、异常Q波、多导联ST段抬高均较前明显增多,ST-T改变较前明显,2周以后上述改变显著减少或消失。结论冠状动脉搭桥患者由于手术创伤、再灌注损伤等原因致使术后早期出现上述心电图变化,此后逐渐减少至术前水平或消失。     

合肥地区5314名中年干部血压分类及其与临床心电图诊断类型的关系

目的　研究合肥地区中年干部血压水平及其与临床心电图诊断类型的关系。方法　对合肥地区 5 314名中年干部进行体检 ,计算不同性别的血压分类及高血压患病率 ,分析不同血压水平的临床心电图表现。结果　合肥地区中年干部男性 :正常高限血压占 12 % ,高血压病占 2 9% ;女性 :正常高限血压占8 3% ,高血压病占 17 8%。高血压患病率男性显著高于女性 (P <0 0 1)。随着血压升高 ,临床心电图异常分类如窦性心动过速、室性早搏、束支传导阻滞、ST T变化、左室高电压、左室肥厚等的检出率显著升高。结论　随着血压升高 ,临床心电图异常发生率显著升高。心电图异常以心室性为主     

MDCT findings in neuroendocrine carcinoma of the gallbladder: case report

Neuroendocrine tumors are commonly seen in the gastrointestinal tract, but they are extremely rare in the gallbladder. In this study, sonographic and multidetector-row computed tomographic findings of a patient with neuroendocrine tumors of the gallbladder are presented.     

Ultrasonographic features of primary carcinoma of the gallbladder: Report of five cases

The sonographic features of primary carcinoma of the gallbladder in five patients are presented. Two sonographic patterns were seen depending on whether or not the lumen of the gallbladder was visualized. In two patients the gallbladder lumen was visualized and an irregular fixed nonshadowing soft tissue mass was seen arising from the wall and projecting into the lumen. In the remaining three patients a solid mass was seen in the predicted location of the gallbladder without visualization of gallbladder lumen. Ancillary findings such as local involvement of liver and signs of biliary obstruction supported the diagnosis.     

Sonographic findings in gallbladder ascariasis.

Invasion of the adult roundworm, Ascaris lumbricoides, into the gallbladder is rare and was seen in 14(2.1%) of the 665 cases with hepatobiliary ascariasis. The diagnosis was suggested in all 13 cases in which sonography was performed and in 5 of the 11 cases at endoscopic retrograde cholangiography. Sonographic findings included a nonshadowing, long, echogenic structure in the form of a coil, an echogenic strip with central anechoic tube, an echogenic structure extending across the gallbladder giving it a septate appearance, and characteristic erratic, nondirectional, zig-zag movements of these echogenic structures in the gallbladder. Serial sonograms accurately predicted spontaneous exit of the worm. Pregnancy and anomalous origin of the cystic duct directly from the papilla of Vater facilitated worm invasion into the gallbladder. We conclude that real-time sonography offers a simple, rapid approach for the diagnosis and follow-up of patients, whereas endoscopic retrograde cholangiography has limited diagnostic value in this disorder.     

胆囊息肉样病变134例分析

目的探讨胆囊息肉样病变(PLG)的手术适应证和手术方式。方法回顾分析我院2000年1月至2004年12月间134例手术治疗的胆囊息肉样病变的临床和病理资料。结果超声检查胆囊息肉样病变的诊断率为94.77%,年龄大于50岁、超声提示息肉直径大于1 cm和单个息肉者为癌变的高危因素。其中75例行腹腔镜胆囊切除术(LC),12例为胆囊腺瘤,其余均为胆固醇性息肉,无并发症发生。结论适当放宽手术指证,对胆囊癌高危人群施行手术治疗,能有效地预防胆囊癌变;LC是治疗胆囊息肉样病变的理想方法。     

心电图与心脏超声诊断高血压性心脏病的效果比较

目的:分析心电图与心脏超声在诊断高血压性心脏病方面的效果差异。方法:选择2018年1月至2018年12月期间我院所收治的70例高血压性心脏病患者,对其心电图和心脏彩超的临床资料进行回顾性分析。分别使用心电图和心脏超声进行诊断,总结分析两者在诊断方面的作用。结果:本次研究结果显示,患者通过心脏彩超进行检查后,其阳性率远远高于用心电图进行检查,同时能够明确高血压性心脏病患者的早期心脏表现与变化情况。结论:心脏彩超在高血压性心脏病的诊断方面更加具备敏感性与特异性,与心电图进行结合使用可以更加直观、稳定地对疾病特征进行明确,为临床工作提供参考。