阴道B超在异位妊娠中的诊断价值（附79例分析）

目的：探讨阴道B超对异位妊娠的早期诊断的应用价值,以提高诊断率。方法：对79例确诊异位妊娠的声像图特征进行回顾性分析。结果：阴道B超检查具有捕获图像清晰、准确、快速的特点,对不典型、未破裂、内出血少的异位妊娠可获得早期诊断。结论：阴道B超对异位妊娠的早期诊断具有重要的临床价值,是当前简便、无创性的诊断技术中最为理想的检查方法。     

阴道斜隔综合征的超声诊断（附3例报告）

目的：探讨阴道斜隔综合征（oblique vaginal septum syndrome ,OVSS）声像图特点,提高超声诊断准确率、降低误诊、漏诊率。方法分析3例OVSS超声声像图特点及临床特征,总结该病的诊断要点。结果3例患者均有不规则阴道流血史,超声显示均为双子宫、双宫颈,伴宫颈管积液、阴道积液,斜隔侧肾缺如,3例均为II型OVSS。结论超声检查可以作为OVSS诊断的首选方法。     

经阴道彩色多普勒超声诊断异位妊娠的价值

目的 探讨经阴道彩色多普勒超声对诊断异位妊娠的重要性.方法 51例临床怀疑异位妊娠的育龄妇女均接受了经阴道彩色多普勒超声检查,并对妊囊包块的血流成像与血流频谱进行了分析.结果 51例异位妊娠患者中,经阴道彩色多普勒超声正确诊断49例,包括输卵管妊娠47例,子宫角妊娠与卵巢妊娠各1例,诊断准确性为95%.2例输卵管妊娠患者由于妊娠包块不明显及腹胀肠气的干扰而漏诊.在声像图上,妊囊包块表现为胎囊型22例,流产破裂型27例,以及类实性光团型2例.在彩色多普勒血流显像上,妊囊包块表现为滋养层血流频谱或怪异频谱.结论 经阴道彩色多普勒超声对异位妊娠有很高的诊断准确性,而且其操作简单、无创,可作为诊断早期异位妊娠的首选方法.     

彩色多普勒超声在宫内残留物诊断中的应用

<正>宫内残留物是流产后引起阴道流血的常见原因。现分析我院105例流产患者流产后子宫的声像图表现,探讨彩色多普勒超声对宫内残留物的诊断价值。1资料与方法1.1一般资料收集我院2007年6月至2011年6月105例流产患者,年龄19~39岁,平均28岁;药物流产73例,人工流产12例,自然流产20例。患者均有流产后阴道不规则流血,流产后7~49d检查。     

超声诊断早期流产及预后的价值

目的　探讨超声诊断早期流产的价值。方法　对妊娠早期阴道出血 ,下腹坠痛 ,临床诊断为先兆早产的孕妇 ,经腹部或阴道超声进行检查、分型并跟踪随访。结果　临床诊断先兆流产 65 3例的孕妇 ,经超声检查分型中 ,先兆流产 2 98例 ,不完全流产114例 ,完全流产 5 6例 ,难免流产 14 1例 ,稽留流产 44例。结论　超声检查对早期流产诊断有实用价值 ,可帮助临床达到早期诊断、早期治疗的目的     

中晚期妊娠宫颈内口静脉丛破裂导致阴道出血的超声诊断

目的：讨论中晚期妊娠宫颈内口静脉丛破裂导致阴道出血的声像图特征。方法：本组中晚期妊娠者23例。均不明原因阴道出血。应用美国HDI5000型彩色多普勒超声诊断仪，病人取仰卧位，探头频率为3．5MHz，作腹部扫查，观察胎盘下缘与宫颈内口的关系。结果：23例病人，超声均未见因前置胎盘及胎盘早剥引起的出血声像，21例胎盘下缘距宫内口距离大于3cm，2例大于2cm，声像图显示胎盘后壁静脉血管延伸覆盖宫内口，同时发现绒毛板下端延伸至宫内口，其静脉丛的前方与延伸的绒毛板问形成无回声区，暗区内未见彩色血流。结论：彩色多普勒超声检查对诊断中晚期妊娠宫颈内口静脉丛破裂导致阴道出血有一定的临床价值。     

经阴道超声对早期未破裂型宫外孕的诊断价值

目的探讨经阴道超声在早期未破型宫外孕中的诊断价值。方法对我院2008年1月至2009年10月经阴道经腹超声对照检查并经手术病理证实的62例早期未破型宫外孕资料进行回顾分析。结果经阴道超声检查确诊59例（95%）,根据声像图特点分为输卵管环型33例（53%）,非特异性包块型20例（32%）,胎心胎囊型6例（9.6%）,无特征性声像图3例（5%）。经腹部超声检查确诊31例（50%）。结论经阴道超声分辨率高,图像清晰,是诊断早期未破型宫外孕的首选方法。     

B超对早孕药物流产后宫腔残留物的诊断价值

目的:探讨B超对药物流产后宫腔残留物的诊断价值。方法:对药物流产后阴道流血超过10 d的589例患者进行B超检查,并与病理诊断结果对照。结果:本组589例早孕药物流产术后,阴道流血超过10 d者,B超提示宫内组织残留553例,病理诊断545例,B超诊断假阳性14例,占2.53%,假阴性6例,占16.66%。因此,B超诊断的阳性预测值为97.47%,阴性预测值为83.33%。结论:B超检查是诊断药物流产后宫内有无组织残留的理想方法。     

经阴道超声介入配合药物治疗剖宫产术后瘢痕妊娠

目的：探讨经阴道超声在子宫瘢痕处妊娠的诊断和保守治疗中的意义。方法：回顾性分析12例子宫瘢痕处妊娠患者的临床资料及诊治经过,并总结其声像图特点。12例患者均有血人绒毛膜促性腺激素升高,其中人工流产术后阴道出血9例,不明原因停经3例。12例均行经阴道超声检查。10例于超声引导下向胎囊内注射氨甲喋呤（MTX）并联合米非司酮口服治疗。2例血管造影检查后行子宫动脉栓塞及清宫。结果：12例患者经阴道超声检查显示子宫前壁下段胎囊,周边及内部血流信号丰富,呈高速低阻型,阻力指数（RI）〈0.6,诊断为剖宫产术后子宫瘢痕处妊娠。经过以上保守治疗后全部病灶内血流信号明显减少,RI〉0.6。结论：经阴道超声检查是诊断剖宫产术后子宫瘢痕处妊娠的主要方法;经阴道超声介入配合药物治疗是其重要治疗方法,对该病的保守治疗具有较大的作用。     

超声在药物流产后宫内残留物中的诊断价值

药物流产后仍有可能发生宫内组织残留,导致术后阴道流血时间延长,准确而简便易行的超声检查不仅为诊断早孕选择药物流产提供了正确的依据而且对药物流产后官腔内残留物的诊断日趋深入。本文对43例药物流产2周后仍有阴道出血的患者进行B超检查,并与清官后病理检查结果进行比较。     

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.