羊膜代阴道成形术11例临床分析

先天性无阴道手术治疗方法较多，1935年Brindean采用新鲜羊膜作为覆盖人工阴道腔穴的材料后，此方法被广泛采用。我院自2003年1月至2008年1月共收治先天性无阴道患者11例，均成功实施羊膜代阴道成形术，收到满意效果。     

先天性无阴道成形术的护理干预

目的探讨先天性无阴道阴道成形术术前术后的护理方法。方法对我院2008年1月～2008年12月对2例先天无阴道成形术患者的护理干预情况进行总结。结果2例病员手术成功，效果满意。结论术前、术后的心理护理、正确放置阴道模具的训练，对手术的成功起到关键的作用。制定有效护理措施，可以缩短住院时间，减少术后并发症的发生。     

四种阴道成形术治疗效果的评价

目的：通过评价四种阴道成形术的治疗效果，为临床恰当选择术式提供依据。方法：对1980—03—2003—05。采用四种不同的手术方法治疗先天性无阴道67例患者的临床资料和随访结果分析总结。结果：游离皮片包膜移植阴道成形术31例中。14例患者出现不同程度的阴道狭窄，成功率为54．8％；盆腔腹膜阴道成形术3例，术后5～8个月均出现阴道顶端塌陷。阴道深度仅4～5cm；小阴唇皮瓣阴道成形术6例与乙状结肠段阴道成形术27例，再造的阴道较理想，已婚者均述术后或婚后性生活满意。结论：乙状结肠段阴道成形术和小阴唇皮瓣阴道成形术是较为理想的阴道再造术式。     

激光泪道成形术治疗难治性先天性鼻泪管阻塞

目的　评价激光泪道成形术治疗难治性先天性鼻泪管阻塞的效果。方法　采用KTP激光泪道成形术对 15例 (15眼 )难治性先天性鼻泪管阻塞患儿进行治疗 ,观察其临床效果。结果　术后随访 6～ 2 4个月 ,治愈率为 93 3% ,无并发症发生。结论　激光泪道成形术能够安全、有效治疗难治性先天性鼻泪管阻塞。     

激光泪道成形术治疗滩治性先天性鼻泪管阻塞

目的 评价激光泪道成形术治疗难治性先天性鼻泪管阻塞的效果。方法 采用KTP激光泪道成形术对15例（15眼）难治性先天性鼻泪管阻塞患儿进行治疗，观察其临床效果。结果 术后随访6～24个月，治愈率为93.3%，无并发症发生。结论 激光泪道成形术能够安全、有效治疗难治性先天性鼻泪管阻塞。     

乙状结肠人工阴道成形术的护理

自 198 1年 1月～ 2 0 0 1年 12月行乙状结肠人工阴道成形术 2 3例 ,临床疗效满意 ,现将临床护理体会报道如下 :1　临床资料和方法1.1　一般资料　本组 2 3例均为女性 ,年龄 18～ 36岁。其中 13例先天性无阴道 ,无子宫 ,卵巢发育良好的 7例 ,不良者 4例 ,无卵巢者 2例。 6例先天性无阴道 ,子宫发育不良 ,卵巢发育良好。 4例先天性阴道、子宫发育可 ,卵巢发育良好。1.2　手术及护理　硬膜外麻行施术 ,取下腹正中切口 ,先切取乙状结肠 15～ 2 0ｃｍ ,再行留下乙状结肠端端吻合 ,取下的乙状结肠近端封闭 ,在尿道下方注射生理盐水及少许去甲肾上…     

双孔二尖瓣成形术应用于先天性二尖瓣关闭不全的矫治

目的 探讨双孔二尖瓣成形术治疗先天性二尖瓣关闭不全的可行性和有效性。方法 将脱垂的前叶边缘与后叶相对应的边缘缝合到一起，形成双孔二尖瓣。结果 本组3例病人，1例为先天性二尖瓣关闭不全，2例为部分型心内膜垫缺损。术后恢复平稳，没有手术死亡，无二尖瓣关闭不全和二尖瓣狭窄发生。结论 双孔二尖瓣成形术是矫治先天性二尖瓣关闭不全的一种简便而有效的方法。     

肋缘下横切口离断式肾盂输尿管成形治疗小儿先天性肾积水21例

目的探讨肋缘下横切口离断式肾盂输尿管成形术（Anderson-Hynes成形术）治疗小儿先天性肾积水的临床价值。方法采用患侧肋缘下横切口,离断式肾盂输尿管成形治疗小儿先天性肾积水21例。所有病例均经静脉肾盂造影和逆行造影诊断为先天性肾盂输尿管连接部梗阻并肾积水,集合系统分离3~10 cm,平均4.5 cm。结果 21例均手术顺利,所有病例均未延长或更改手术方式。手术时间80~105 min,平均98 min,术后无继发出血,继发感染1例,跟踪随访平均18个月,1例出现吻合口狭窄再次出现肾积水合并肾结石形成。结论 Anderson-Hynes成形术具有操作视野显露满意,安全可靠,操作简单,疗效满意等优点,是一种实用的手术方法。     

腹膜代阴道成形术

近年来先天性无阴道就诊患者逐年增多。目前常用的治疗方法有阴道前庭模型扩张,人工阴道自身皮瓣移植,羊膜移植,乙状结肠和外阴皮瓣代阴道等术式。本文报告11例用腹膜代阴道成形术,与其他方法比较,效果较为满意。术后三月开始性生活,双方满意。     

游离空肠移植阴道成形术1例并文献复习

目的探讨游离空肠移植阴道成形术的方法及疗效。方法对1例先天性无阴道患者采用游离空肠移植行阴道再造。结果术后游离空肠存活,术区切口瘢痕不明显,无腹部并发症发生。随访6个月,阴道口无狭窄,阴道腔宽敞,壁红润。再造阴道分泌物不多,无需使用支架和润滑剂。结论游离空肠移植阴道成形术具有操作简单、存活率高、费用少及再造阴道宽敞无狭窄等优点,不失为一种较为理想的方法。     

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.