生长抑素对食管静脉曲张破裂的止血疗效观察

为探讨食管静脉曲张破裂出血的有效止血方法 ,我们将单用生长抑素与综合治疗者进行疗效对比后发现 ,单用生长抑素对轻度出血效果好 ,对中、重度出血综合治疗更有效。1　对象和方法1 1　对象　单用生长抑素组 67例 ,男 58例 ,女 9例 ;平均 50 7岁。肝硬化 56例 ,肝癌 11例。综合治疗组 4 0例 ,男 30例 ,女 10例 ;平均 51 5岁。肝硬化 30例 ,肝癌 10例。两组年龄、性别、基础病变无显著差异 (Ｐ >0 0 5)。两组均有呕血、黑便。治疗前均经胃镜检查证实为食管静脉曲张破裂出血轻度出血 :出血量 <50 0ｍｌ,无头晕、心悸等症状 ,血压无变化 ,血…     

食管贲门粘膜撕裂症胃镜分析

食管贲门粘膜撕裂症(Mallory-Weiss综合征)系指腹内压力或胃内压力突然升高，导致食管与胃贲门联接处的粘膜和粘膜下层纵行撕裂并出血。本文经胃镜证实的84例作简要分析。     

食管贲门粘膜撕裂症胃镜分析

食管贲门粘膜撕裂症(Mallory-Weiss综合征)系指腹内压力或胃内压力突然升高，导致食管与胃贲门联接处的粘膜和粘膜下层纵行撕裂并出血。本文经胃镜证实的84例作简要分析。     

高原急性胃与十二指肠溃疡出血38例护理体会

高原急性胃与十二指肠溃疡出血是高原地区危及生命的急重病症之一 ,我院处在海拔 30 0 0ｍ的缺氧条件下 ,氧分压仅为平原的 6 5 % [1] ,况且溃疡出血发病急、来势凶、变化快 ,可在短时间内出现失血性休克 ,对病人危害极大。现将我院 1 993年以来收治的 38例此类病人的护理体会报告如下。资料与方法1 　 临床资料　本组 38例 ,男 36例 ,女 2例 ,年龄 1 9岁～ 5 6岁。出血情况 :呕血为主 2 0例 ,黑便为主 5例 ,先呕血后黑便 1 3例 ,合并休克 1 5例。出血量 <5 0 0ｍｌ 5例 ,>5 0 0ｍｌ 33例。发病原因 :饮酒、食用刺激性食物及剧烈运动后发病…     

高原上消化道出血258例诊治体会

我院地处高原 ,海拔 310 0ｍ ,气候寒冷 ,低氧低气压 ,空气中氧分压约为平原地区的 65 % [1] ,对上消化道出血救治极为不利。 1988～ 1998年 ,我们收治上消化道出血 2 5 8例 ,由于我们针对高原特点 ,采取了相应预防措施 ,取得了较好的救治效果。1　临床资料1 1　一般情况　男 2 4 0例 ,女 18例 ;年龄 16～ 65岁 ,平均 4 0 5岁。出血情况 :呕血为主 69例 ,黑便为主 2 0例 ,先呕血后黑便 169例 ,合并休克 98例 ;出血量 <5 0 0ｍｌ 17例 ,5 0 0～ 10 0 0ｍｌ 69例 ,10 0 0～ 15 0 0ｍｌ 86例 ,15 0 0～ 2 0 0 0ｍｌ 68例 ,>2 5 0 0ｍｌ18例 ,…     

武警部队病员上消化道出血213例临床分析

1989年至1994年我院共收治武警部队上消化道出血病员213例。报告如下。1 临床资料1.1 213例均为男性,年龄17—31岁,平均19.4岁,战士209人,干部4人。1.2 出血原因 本组共213例,其中消化性溃疡82例(38.50％),出血性胃十二指肠炎105例(49.30％),贲门粘膜撕裂症1例(0.47％),胃息肉3例(1.40％),贲门癌1例(0.47％),未发现病变19例(8.92％)。1.3 就诊主要症状 黑大便128例,占60.09％,呕血9例,占4.23％,呕血并黑便2     

小儿食管静脉曲张一例

患者男,6岁。于7个月前因呕血、黑便来我院就诊,以“上消化道出血”行剖腹探查术。见食管、胃痛静脉明显曲张;门静脉淤血、扭曲,呈海绵窦样变;脾大,约25cmx10cmx7cm大小,质地硬。行脾脏完整切除,同时行食管、胃底静脉断流术。术后患者恢复顺利,末出现呕血及黑便。2小时前,突然出现腹痛,接着出现黑便1次,量不多,过后腹痛消失,无恶心呕吐及心慌。钡餐检查：食管的中下段及上段的部分正常粘膜皱壁消失,呈相互连接的蔓状充盈缺损。管壁柔软,张力可。诊断：食管静脉曲张（图1、2）。彩超示：肝脏大小、形态大体正常,被膜增厚,…     

残胃再发癌32例病理分析

1987～1996年,我院对胃癌根治术后行内镜检查159例,发现残胃再发癌32例(20.2%),现将其发病、病因和诊治情况分析如下。1　临床资料1.1　一般情况　男28例,女4例;年龄32～74岁。距首次手术时间3个月～8.5年,平均28.2个月,其中术后0.5年内3例,0.5～1年9例,1～2年7例,2～3年7例,3～5年3例,5年以上3例。主要症状:均有上腹部不适、疼痛、吞咽困难、恶心、呕吐、呕血、黑便及消瘦等。1.2　胃镜检查　残胃再发癌位于吻合口24例,残胃7例,胃窦1例。胃镜下见溃疡9例,隆起12例,结节3例,糜烂6例,充血、水肿2例,多伴有胃壁僵硬、粘膜脆弱、易出血及蠕动减…     

高原上消化道出血258例临床分析

我院地处高原 ,海拔 310 0ｍ ,气候寒冷 ,低氧低气压 ,空气中氧分压约为平原地区的 65 % 〔1〕。1988年～ 1998年 ,我们收治上消化道出血 2 5 8例 ,现将高原上消化道出血的诊治体会报告如下 :1　临床资料1 1　一般情况　男 2 4 0例 ,女 18例 ;年龄 16岁～ 65岁 ,平均 4 0 5岁。1 2　诊断方法　入院后立即行胃镜检查 2 36例 ,2 2例 4 8ｈ内行急诊胃镜检查。1 3　临床表现　 (1)出血情况 :呕血为主 69例 ,先呕血后黑便 169例 ,黑便为主 2 0例 ,合并休克 98例。 (2 )出血量 :轻度 17例 ,中度 69例 ,重度 172例。 (3)出血原因 ;胃溃疡 110例 (4…     

食管恶性肿瘤的介入治疗

自1997年11月至1999年6月对本院12例中晚期食管恶性肿瘤(含贲门胃底癌和1例平滑肌肉瘤)进行介入性动脉化疗,取得了满意疗效,现报道如下。材料与方法1.一般资料12例中,男7例,女5例。年龄38～83岁,平均62岁。患者进食梗阻感12例,疼痛10例,呕血3例,黑便5例,伴肺转移1例,肝转移1例。所有病例均经食道钡餐,胃镜检查证实,并行活检。病理证实鳞癌6例,腺癌3例,未分化癌1例,粘膜细胞癌1例,平滑肌肉瘤1例。2.方法常规采用Ｓｅｌｄｉｎｇｅｒ技术,经股动脉穿刺插管,其中颈、胸段采用Ｃｏｂｒａ或Ｙａｓｈｉｒｏ导管,腹段采用胃左动脉导管。插管时按病变…     

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.