儿童特发性血小板减少性紫癜部分脾动脉栓塞术的临床应用

目的：探讨儿童特发性血小板减少性紫癜部分脾动脉栓塞术治疗的临床疗效。方法：选择21例儿童特发性血小板减少性紫癜患者,内科用药无效情况下,采用Seldinger技术用PVA微粒行脾动脉部分栓塞术,并于栓塞术后观察临床疗效。结果：术后1个月血小板平均计数（236.46±107.42）×109/L,术后2年血小板平均计数（201.36±71.36）×109/L。术前及术后血小板计数差异有显著性。有效病例血小板相关抗体下降,以PAIgG下降明显。结论：部分脾动脉栓塞术在儿童特发性血小板减少性紫癜中疗效明显,并发症少,值得临床应用。     

脾动脉栓塞治疗特发性血小板减少性紫癜的临床观察

目的 回顾性分析脾动脉栓塞治疗特发性血小板减少性紫癜的临床疗效.方法 选择41例特发性血小板减少性紫癜内科用药无效情况下,采用Seldinger技术经右侧股动脉穿刺插管到脾动脉进行部分脾动脉栓塞,栓塞面积约80%左右.并于术后3 d、1周、2周、1个月及对显效病例行3个月、半年、1年及2年复查血常规,并了解栓塞的疗效.结果 术后1月血小板平均计数(210±50)×109/L,术后2年血小板平均计数(165±80)×109/L.术后显效27例占66%、良效8例占20%、进步3例占7%、无效3例占7%.结论 部分脾动脉栓塞治疗特发性血小板减少性紫癜有一定疗效.     

部分性脾栓塞术62例分析

目的：探讨部分性脾栓塞术的临床应用价值。方法：采用Seldinger用明胶海绵颗粒或／和明胶海绵条行部分性脾栓塞术62例，其中原发性肝癌伴脾功能亢进32例，肝炎后肝硬化伴门脉高压、脾功能亢进25例，原发性血小板减少性紫癜5例。栓塞范围40．0％～80．0％。栓塞前后测定血细胞数量及肝功。结果：检塞术后3d、2w、4w复查血细胞，白细胞及血小板较术前明显升高；术后3d、4w复查肝功，肝功能呈一过性损害。栓塞范围40．0％～70．0％54例，出现少量腹水8例，左侧少量胸腔积液9例，胸腹水6例，胸水伴左下肺炎1例；栓塞量70．0％以上8例，出现左侧胸水、腹水及腹膜炎2例，左侧胸水、左下肺炎1例，左侧胸水、大量腹水伴左膈下脓肿1例，多器官衰竭死亡1例。结论：各种原因引起的脾功能亢进所致的外周血细胞减少，用部分性脾栓塞术治疗安全，疗效好，创伤小，并发症少。     

部分脾栓塞术联合脾动脉灌注长春新碱治疗难治性血小板减少性紫癜和Evans综合征的长期疗效

目的 观察部分脾栓塞术联合脾动脉灌注长春新碱治疗难治性血小板减少性紫癜(ITP)和Evans综合征的长期疗效.方法 对2000- 2007年收治的24例难治性ITP和6例Evans综合征患者行部分脾栓塞术治疗,并在栓塞前给予脾动脉灌注长春新碱(2 mg),观察长期疗效.结果 术后1周,ITP患者血小板从术前(10.23...     

部分脾栓塞治疗难治性原发血小板减少性紫癜

目的：探讨ＰＳＥ治疗难治性原发血小板减少性紫癜的临床应用价值。方法：对６２例经内科治疗无效的ＲＩＴＰ，采用Ｓｅｌｄｉｎｇｅｒ′ｓ法，经股动脉穿刺，脾动脉置管，注射明胶海绵作部分脾栓塞治疗，以期提高患者周围血小板计数，治愈或减轻出血症状。结果：本组６２例ＲＩＴＰ经ＰＳＥ治疗后，获ＣＲ３９例（６２．９％）；ＰＲ１３例（２１．０％）；总有效率８３．９％。１年后复查，复发率２９．０％。结论：ＰＳＥ治疗ＲＩＴＰ与脾切除无显著性差异（Ｐ＞０．０５），可作为脾切除的替代手术。     

特发性血小板减少性紫癜自体脾移植的价值

特发性血小板减少性紫癜自体脾移植的价值６３００３８重庆第三军医大学西南医院梁志清，马宏敏，蔡志民，高德山关键词紫癜，血小板减少性；脾切除；移植中国图书资料分类号Ｒ６５６．６脾切除是临床上治疗待发性血小板减少性紫癜（ＩＴＰ）的有效方法之一，但脾切除后导...     

部分脾栓塞术的临床应用

目的：探讨部分脾栓塞术（PSE）的临床应用。方法：采用PSE治疗肝癌伴脾亢（HCC－HS）86例,其它继发性脾亢（SHS）26例,原发性血小板减少性紫癜（ITP）5例,其中20例行2次以上PSE。结果：平均栓范围HCC－HS组为36％,SHS组为60％,ITP组为74％,临床有效率分别为84．8％、88．5％、100％。HCC－HS组因单次栓塞范围较小,约20．9％（18／86）病人需行再次栓塞。全部病例均未发生严重并发症。结论PSE是安全有效,可作为外科脾切除的替代疗法,HCC－HS组为了减轻术后并发症PSE可分次进行。     

芬太尼贴剂在治疗脾动脉栓塞后综合征中的应用

脾动脉部分栓塞术是临床治疗脾功能亢进、特发性血小板减少性紫癜等疾病的方法之一,因其具有疗效确切、安全、微创等优点,近来在临床上得到广泛应用.栓塞后综合征是脾动脉栓塞术后最常见的并发症,发生率几乎达100%[1,2],主要表现为脾区疼痛、发热、恶心、呕吐等,栓塞后综合征的治疗是术后必须面对的问题.我们将芬太尼贴剂用于栓塞后综合征的治疗,探讨芬太尼贴剂的应用价值.     

脾脏部分栓塞术栓塞方法的探讨

目的：着重探讨脾脏部分栓塞术栓塞方法的实用价值和临床应用价值。材料和方法：选择10例脾脏疾患者,其中脾功能亢进6例、血小板减少性紫癜4例,术中造影后将导管尽可能超选择地进入脾脏中下级的脾段动脉,经导管注入明胶海绵栓塞。结果：10例中6例于手术后24小时、4例于24小时至1周开始血白细胞及血小板计数均明显上升;所有病例术后仅有低热,8例有区轻度隐痛。讨论：脾脏部分栓塞术栓塞方法的使用基本能达到与外科手术后相同的疗效。且发并症少,具有重要的临床使用价值。     

脾动脉栓塞术后脾声像图改变(23例分析)

脾动脉栓塞术(脾栓术)首先在1973年由Maddison等用于治疗肝硬化伴脾亢,上消化道出血。我们将该方法用于治疗免疫性血小板减少症——特发性血小板减少性紫癜(ITP)。自家免疫性溶血性贫血伴血小板减少性紫癜(Evans综合症),获得了显著疗效,为治疗血小板减少症提出了有效的新方法。我们观察了23例接受脾栓术患者术前、术后脾声像图的改变,探讨血小板升高机制。     

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.