手部猫抓病的手术治疗及鉴别诊断

目的: 介绍手部猫抓病手术治疗方法、效果及猫抓病与其他类似疾病的鉴别。方法: 1998年 9月~2003年 6月对 5例手部猫抓病患者在全身应用抗生素控制局部症状基础上,作了患肢肿大淋巴结切除手术, 平均住院 13. 6d。结果: 5例患者病理证实猫抓病, 切口I期愈合。随访 9个月 ~5年半, 无 1例复发。结论: 手术切除猫抓病肿大淋巴结可以缩短病程, 疗效良好。     

猫抓病4例报告

报告4例猫抓病（CSD）患者的临床资料，分析其临床、病理、治疗结果。 4例患者均有动物（猫或狗）接触史;均有局部淋巴结肿大;病理特点是淋巴结内坏死性肉芽肿微脓肿形成;经治疗后临床症状消失。提示猫抓病是一种由汉塞巴尔通体引起的感染性疾病，其临床特点、淋巴结活检及特殊染色有助于确诊;治疗以头孢菌素、氨基糖苷类、四环素、大环内酯类、喹诺酮类、复方新诺明和利福平效果好，必要时可手术清除病灶。     

猫抓病11例诊治体会

猫抓病（catscratch disease,CSD）是由汉氏巴尔通体经猫抓、咬伤后引起的以局部淋巴结炎为主要特征的传染性疾病。随着国内养宠物人群的增加,有关CSD的报道也逐渐增多。我科自2002年9月至2007年1月收治11例CSD患者,现报告如下。     

硫酸依替米星和利福平联合治疗猫抓病疗效观察

随着人们生活水平的不断提高,家庭饲养宠物日益增多,动物源性疾病的发生也随之增多。猫抓病是一种较为常见的人畜共患传染病,2000—2004年,仅浙江省德清县就报道了101例猫抓病患者。     

猫抓病致尺神经受压的诊治

猫抓病（Cat scratch disease CSD）是由猫抓、咬伤后引起的一种传染性疾病，临床上较为少见，常因临床医生对其认识不足而导致误诊误治。2004年9月-10月我院连续收治了2例CSD致尺神经受压的患者，术后疗效满意。     

猫抓病3例报告

猫抓病 (ＣＳＤ)是一种人畜共患的感染性疾病。虽然该病在国内并非罕见 ,但很少有医师能正确诊断该病。我院自 1996～ 2 0 0 0年共收治ＣＳＤ 3例 ,现报告如下。1　病例报告　　例 1.男 ,70岁。发现右肘部肿物 3个月 ,无疼痛 ,未予注意。近月余感肿物逐渐增大 ,伴右手示指感觉障碍。于1996年 7月就诊。入院诊断为右肘部肿物。体检 :于右肘窝可及 2 0ｃｍ× 1 5ｃｍ× 1 2ｃｍ大小肿物 ,质中 ,无压痛 ,稍活动 ,与皮肤无粘连。在局麻下手术切除肿物。术后病理报告 :猫抓病。追问病史 ,半年前曾被猫抓伤手指。　　例 2 .女 ,4 3岁。发现右腋下…     

猫抓病1例报告

病例:女,64岁,因发现左腋部肿块10d来院就诊。无红肿疼痛,无任何前驱症状及伴随症状。查体:左腋下扪及3cm×3cm肿块,质中,轻压痛,表面光滑,边界清,移动度尚好,皮肤无红肿;全身其余浅表淋巴结无异常。辅助检查:血、尿常规及肝、肾功能均正常,心电图、胸片无异常,B超示左腋下实质性肿块。行肿块切除作病理检查,报告为:淋巴结大片坏死伴局灶性脓肿形成,符合猫抓病(CSD)。追问病史有家中养猫,2个月前左手曾被猫抓破。讨论:目前已明确,猫抓病病原体是汉森巴尔通体(bar鄄tonellahenselae),传染源主要是带菌的猫(通常<1岁)。病原体存于猫的口咽部…     

猫抓病致腋淋巴结肿大两例报告

猫抓病致腋淋巴结肿大在临床上较难诊断,常仅在手术后病理检查下才能确诊,但都有动物接触和皮肤损伤史。作者发现2例,现报告如下。     

Dieulafoy病19例临床分析

目的:探讨Dieulafoy病发病情况、诊断及治疗方法。方法:回顾性分析19例Dieulafoy病的临床表现、诊断、治疗方法及疗效。结果:全部病例均表现突发上消化道大出血。初次胃镜检查确诊12例（63.2%），第2次检查确诊4例（21.1%），术中探查确诊3例（15.8%）；14例经一次内镜下止血成功，1例经二次内镜下止血成功，4例行外科手术止血（包括1例内镜下止血后72h再出血者）。结论:急诊胃镜是诊断Dieulafoy病首选方法；治疗首选内镜下止血，内镜下止血不成功者，应立刻手术治疗。     

胸壁肿块-猫抓病2例

我们发现2例以胸壁肿块为特征的猫抓病(Car-scratch disease,CSD),均经手术治疗痊愈.     

手术患儿合并血友病的围手术期处理

目的 探讨手术患儿合并血友病的围手术期处理。方法 回顾性总结21例手术患儿合并血友病的诊断和治疗，其中重型血友病6例，中型血友病7例，轻型血友病5例，亚临床型血友病3例。均需行大中小不同类型手术。结果 通过抗血友病球蛋白或凝血酶原复合物应用，术前术后对患儿血液中ⅧC或ⅨC因子活性动态监测，患儿均顺利手术及痊愈。结论 临床上对需手术并合并血友病患儿，及时明确诊断和凝血因子合理应用是确保防止术中、术后出血的有效方法。     

16例儿童肝外伤的临床分析

目的 探讨儿童肝外伤的临床特点与治疗决择。方法 8年来16例儿童肝外伤临床资料，评价其临床治疗效果。结果 16例患儿中，采取手术及保守治疗各8例，治愈15例，术中死亡1例。结论 儿童肝外伤有其自身特点，多数采取非手术治疗即可治愈。     

内镜下治疗Dieulafoy病出血39例

目的观察内镜下治疗Dieulafoy病出血的疗效及安全性。方法 2004年6月～2009年6月我院对39例Dieulafoy病出血急诊行高张钠-肾上腺素液黏膜内注射联合射频及钛夹治疗。结果 36例经内镜止血成功,首次治疗成功34例(87.2%),2例经2次内镜止血成功(5.1%);3例外科手术治疗(7.7%)。内镜止血术后2～4周再行胃镜检查均未发现溃疡。39例随访0.5～5年,平均2年,均无再发出血。结论高张钠-肾上腺素液黏膜内注射联合射频及钛夹是治疗Dieulafoy病出血的一种较为安全有效的方法 。     

胆漏的原因及防治（附２２例报告）

目的 探讨胆漏的原因及防治策略。方法 回顾分析了１９９３年１月至１９９８年１２月收治的２２例胆漏病人发生胆漏的原因、治疗方法及效果。结果 １９例首选非手术治疗，其中１例死亡，３例中转手术治疗，余１５例治愈，非手术治愈率７９％（１５／１９）。３例首选急诊手术治愈。３例中转手术病人中，１例再手术时遗漏对胆管结扎伤的处理,余２例治愈。全组总治愈率为９１％（２０／２２）。结论 胆漏多发生于胆囊切除术及Ｔ管排除后，主要与炎症、粘连、解剖变异和操作不仔细有关，预防应从首次手术前、中、后三个环节着手，胆漏发生后应根据胆漏大小、病情轻重选择手术治疗和非手术治疗。     

Recurrence of chronic subdural hematoma after trepanation and drainage

Objective: To sum up the causes of recurrence of chronic subdural hematoma (CSDH) from failure of trepanation and drainage and explore its prevention and treatment. Methods- From October 1988 to June 2002 a total of 358 patients with CSDH were treated with trepanation and drainage in our hospital. Among them 15 patients had recurrence of CSDH after operation. The data of the 15 patients were reviewed retrospectively. Results: Of the 15 patients, 13 were cured by retrepanation and redrainage, one cured by removal of hematoma by craniotomy with bone flap, and one, a 1-year old child, gave up reoperation due to severe encephalatrophy. Conclusions: Most CSDHs which recur after trepanation and drainage can be cured by retrepanation and redrainage. For the patients with repeated recurrence of CSDH removal of hematoma capsule can be considered.The causes of recurrence of CSDH are related to disease course, the thickness of hematoma capsule, the severity of encephalatraphy and whether the hematoma cavity is drained or irrigated completely, and operation methods.     

Mid- to long-term results after treatment of 118 cases of periprosthetic infections after knee joint replacement using one-stage exchange surgery

From 1976 to 1985, 157 periprosthetic infections after knee arthroplasty were treated surgically at the ENDO-Klinik in Hamburg. Of these, 118 cases underwent one-stage revision arthroplasty using specific antibiotic-loaded cement; 104 were available for analysis after a postoperative follow-up period of 5-15 years. Seventy-six cases were cured as a result of this single operation. This number was increased to 84 by a repeated operation in cases that had failed to respond to therapy. In 20 cases one-stage revision arthroplasty failed in the treatment of periprosthetic infections after replacement of the knee joint.     

Transcutaneous neuromodulation for the urge syndrome in children: a pilot study.

PURPOSE: Neuromodulation has been used to treat voiding dysfunction in adults. Due to its invasiveness it has rarely been used in children until now with the availability of transcutaneous neurostimulation. We evaluated clinical effects of transcutaneous neuromodulation on detrusor overactivity in children with the urge syndrome. MATERIALS AND METHODS: Between May 1, 1998 and February 28, 1999, 15 girls (mean age 10.2 years) and 26 boys (mean age 10.7 years) with proved detrusor hyperactivity on videourodynamic study underwent neuromodulation. All children had been given anticholinergic therapy previously. Neurostimulation only was used in children in whom anticholinergics had no effect and those who had significant side effects. Anticholinergics were continued in children in whom they had a partial effect. Stimulation of 2 Hz. was applied for 2 hours every day. Surface electrodes were placed at the level of sacral root S3. After 1 month of trial stimulation those children who responded continued the treatment for 6 months, and were evaluated every 2 months. RESULTS: Of the 41 children 15 boys and 13 girls responded after 1 month of trial therapy with an increase in bladder capacity, decrease in urgency, decrease in incontinence and/or better sensitivity. Of the 13 children who did not respond 9 lacked motivation and 4 had no clinical effect despite motivation. After 6 months of therapy a significant increase in bladder capacity, decrease in voiding frequency and decrease in incontinence periods were noted. Adverse effects were not observed. One year after therapy relapse was noted in 7 patients, leaving 21 of 41 children definitively cured. CONCLUSIONS: Although preliminary, our results indicate that transcutaneous neuromodulation can improve symptoms of detrusor overactivity, as response to stimulation was noted in 76% of our patients and 56% were cured after 1 year. This therapeutic option is attractive for children because of its noninvasiveness and absence of adverse effects.     

重症急性胰腺炎术后并发十二指肠瘘

目的　探讨重症急性胰腺炎 (SAP)术后并发十二指肠瘘的原因及防治方法。方法　对 2 2例SAP术后并发十二指肠瘘患者的临床资料进行回顾性分析。结果　 184例手术治疗的SAP发生十二指肠瘘 2 2例 ,15例出现在术后 2周。 18例非手术治疗自行愈合 ,4例再次手术治愈。结论　SAP早期手术、胰周感染、手术时引流管放置不当或时间过长与十二肠瘘发生有关。保持瘘口周围引流通畅 ,积极控制胰周感染 ,抑制胃肠道分泌 ,加强营养支持 ,多数十二指肠瘘可自行愈合     

小儿甲状舌管囊肿和瘘手术成败分析

目的 总结分析小儿先天性甲状舌管囊肿和瘘手术成败原因。方法 18例甲状腺舌囊肿和瘘病例。均行甲状腺舌囊肿和瘘切除术。随访1～3年。结果 全部治愈,随访期间均无复发。结论 应尽早在感染发生前行正规Sistrunk's手术,特别强调舌骨中段切除及术中舌骨以上囊肿或瘘管探查与切除。     

过敏性紫癜并发急性肠套叠的诊治

目的 探讨过敏性紫殿并发急肠套叠的临床特点、诊断及外科治疗。方法 对１２例过敏性紫癜并发急性肠套叠和的临床资料进行回顾性分析。结果 该病症状不典型,小肠套叠多见,眼生肠坏死或肠穿孔且发生时间较早。腹部Ｂ超检查９例仔部确诊;术前漏误诊３全铨组均行手术治疗,无术后并发症和死亡。结论 该病临床症状多不典型。腹部Ｂ超检查有确诊价值。诊断一旦明确即应采取手术治疗。