腮腺浅叶良性肿瘤功能性切除术与全切术治疗比较分析

目的比较腮腺浅叶良性肿瘤功能性切除术与全切术两种手术治疗方式的临床效果。方法 60例腮腺浅叶良性肿瘤患者,32例行腮腺浅叶良性肿瘤的功能性切除术,28例行肿瘤及全部浅叶切除面神经解剖术。观察手术伤口愈合情况、术后涎瘘发生率、术后1周面瘫率、术后两年内肿瘤复发率。结果手术伤口均为甲级愈合,两组患者术后均无涎瘘、面瘫并发症;所有病例随访2年,行肿瘤功能性切除术患者的复发率为6.25%（2/32）,行肿瘤及全部浅叶切除面神经解剖术者的复发率为7.14%（2/28）,两组肿瘤的复发率无明显差异（P〉0.05）。结论腮腺浅叶良性肿瘤功能性切除术在不增加肿瘤术后复发率基础上,保留了腮腺分泌唾液的功能,减少了术后面部味觉性出汗综合征的发生,不会造成大块切除后的面部畸形。     

腮腺癌根治即期行斜方肌皮瓣修复术后的护理

报告了16例晚期腮腺癌患者行腮腺癌根治＋颈淋巴结清扫后即期行同侧斜方肌肌皮瓣修复的术前术后的护理。术前做好心理护理，增强患者战胜疼痛和病魔的信心；保护好供皮区，避免意外损伤，预防感染，保证手术的顺利进行。术后注意观察患者的呼吸变化，伤口出血、肌皮瓣血运；减少患者头部运动，注意体位，保持伤口敷料干净；鼓励早期离床活动，重视并发症的观察和出院指导。本组1例术后7d出现伤口感染，经治疗护理后痊愈。     

Lipoatrophic Diabetes: A Case Report with a Brief Review of the Literature

Lipoatrophy syndromes are characterized by an absence of adipose tissue and low leptin levels. Metabolic derangements associated with these syndromes can include diabetes mellitus, insulin resistance, and hyperlipidemia.     

胰性脑病一例报道并文献复习

一例以“突发剧烈上腹痛伴腹胀、恶心、呕吐4小时”入院的男性患者,入院后诊断为:急性胰腺炎(重型);胰腺假性囊肿;胰性脑病;低氧血症;代偿性呼吸性酸中毒.予禁食、胃肠减压、抑酸剂,生长抑素等减少消化液及胰液的分泌;抗生素,乌司他丁等抗感染及减少急性炎症反应;丹参改善胰腺微循环,中药(芍药承气汤)排毒及恢复肠功能等综合治疗...     

彩超对腮腺良恶性肿瘤的鉴别诊断

目的 探讨彩超对腮腺肿块的定性价值。方法 用彩超高频探头（10MHz)检查的38例腮腺肿块的声像图及CDFI特征，与手术病理结果进行对照分析。结果 通过对腮腺肿块的二维图像及CDFI特征的综合分析。大部分腮腺肿块是可以在术前确诊。结论 彩超在腮腺肿块良恶性的鉴别诊断方面有重要的价值。     

传染性单核细胞增多症误诊为急性肝炎一例分析及文献复习

目的提高对传染性单核细胞增多症(IM)与肝炎鉴别诊断的认识。方法对2016年3月入住广州市第八人民医院急诊医学科的1例早期诊断急性肝炎,最终诊断为IM的患者的临床特点、检验学、影像学、病原学及诊疗过程进行回顾分析,并对IM进行文献复习。结果患者男性,32岁,以发热,黄疸,肝肿大为临床表现;腹部B超显示胆囊壁增厚,肝大;实验室显示ALT、AST、LDH均2倍以上升高,多次检查异淋>10%,及EB病毒DNA定量(EBV-DNA)<5.00 E+03 Copies/m L,确诊为IM,予对症治疗,治愈出院。结论成人IM临床症状与体征呈多样性和不典型性,可引起多器官损伤,常累及肝脏,易造成漏诊或误诊。故提高对本病的认识,及早多次行异淋和相关病原学检测,以便及时诊断和治疗。     

青少年型囊性子宫腺肌病一例并文献复习

青少年型囊性子宫腺肌病（juvenile cystic adenomyosis）是子宫腺肌病的罕见分型,主要表现为初潮5年内出现严重盆腔疼痛及痛经,药物治疗效果不佳。盆腔磁共振成像是最敏感的检查,术前与梗阻性生殖道畸形难以鉴别。腹腔镜切除病灶是本病最确切的治疗方式,术后复发率低。报告1例青少年型囊性子宫腺肌病病例,患者初潮后2年痛经剧烈,术前被误诊为梗阻性生殖道畸形,腹腔镜探查术中诊断为囊性子宫腺肌病,完整切除病灶后痛经症状明显改善。通过回顾相关文献,加深对青少年型囊性子宫腺肌病的认识。     

卵巢静脉血管平滑肌肉瘤一例并文献复习

报告1例较罕见的卵巢静脉血管平滑肌肉瘤的病例。该患者为34岁年轻女性,临床主要表现为发现盆腔肿物3年,左下腹不适伴月经周期延长1个月余,血清肿瘤标志物升高不明显,磁共振成像示盆腔左侧髂血管旁类圆形异常信号占位影。该患者于2022年4月28日在气管插管全身麻醉下行腹腔镜下盆腔肿物切除术+右侧卵巢囊肿剥除术+盆腔粘连松解术,术后给予多柔比星脂质体化疗,现密切随访中。分析该病例资料,并复习国内外报道的12例卵巢静脉血管平滑肌肉瘤的病例资料,以期提高对该病的认识。     

腮腺良、恶性肿瘤的CT与MRI诊断

目的探讨腮腺良、恶性肿瘤的CT与MR诊断与鉴别诊断,以提高诊断准确率。方法回顾性分析我院经手术与病理证实的28例腮腺良、恶性肿瘤患者的临床资料与CT、MR资料。结果 28例患者中良性腮腺肿瘤18例,CT与MR主要表现为:呈类圆形等密度、MR等信号结节影,边界较清,轻度或中度均匀强化。恶性肿块10例,CT与MR主要表现为:类圆形或不规则形密度不均肿块,边界欠清,MR信号不均匀,增强后不均匀强化,伴侵犯周围组织。结论腮腺良、恶性肿瘤的CT与MR表现具有一定特征性,若肿块密度不均、形态不规则、边界不清、不均匀强化,常提示恶性腮腺肿瘤可能性大。     

卵巢恶性Brenner瘤多发转移死亡一例并文献复习

回顾性分析2019年4月青岛大学附属医院收治的1例首发症状表现为持续性腰部疼痛伴心慌的卵巢恶性Brenner瘤(malignant Brenner tumor,MBT)的年轻女性患者并复习相关文献,总结目前国内外诊断及治疗该病的进展。该例患者经腹腔穿刺活检组织病理学及免疫组织化学标记确诊,免疫组织化学显示GATA3阳性,细胞角蛋白7(CK7)阳性。该类疾病临床表现及影像学表现缺乏特异性,诊断依靠组织病理学及免疫组织化学标记物。晚期患者临床表现多样,要注意各脏器的功能情况,在抢救治疗过程中应注意全身机能状态,避免感染发生,尽可能提高患者的生存质量。     

子宫分割性平滑肌瘤一例并文献复习

子宫分割性平滑肌瘤是一种罕见的良性平滑肌瘤,生长方式特殊,临床症状及辅助检查常无特殊表现,需要术后病理确诊,免疫组织化学进一步证实。回顾性分析1例子宫分割性平滑肌瘤的临床资料,该患者为围绝经期女性,每年体检子宫肌瘤逐渐增大并伴有月经量增多,盆腔超声及磁共振成像为子宫平滑肌瘤,肿瘤标志物正常,行经腹子宫肌瘤剔除术,术后病理确诊为子宫分割性平滑肌瘤。     

解剖游离保留面神经应用于腮腺肿瘤手术的临床体会

目的：探讨解剖游离保留面神经在腮腺肿瘤切除术中的临床应用。方法：对本科2008年1月-2013年12月进行解剖游离保留面神经加全腮腺及肿瘤切除术的20例患者的临床资料进行分析研究。结果：面神经主干平均直径约1 mm,有5分支如丝线。术后3 d面神经轻度不全麻痹18例,术后7 d恢复8例,术后2个月内恢复8例。随访3个月-2年,其中1例因切断面神经下颌缘支行吻合术的患者,半年后恢复;1例损伤面神经颧支,左眼睑闭合无力;味觉出汗综合征1例;耳垂麻痹18例,1年后恢复;无腮腺漏,无肿瘤复发。结论：复发性、多发性以及深叶腮腺肿物行解剖游离保留面神经的全腮腺及肿瘤切除术,并发症少,临床治疗效果满意。     

Congenital Epulis in a Newborn: A Case Report,Immunoprofiling and Review of Literature

Background

Congenital epulis is a rare lesion of the newborn, presenting as mass in the oral cavity which can interfere with respiration and feeding. It should be distinguished from other lesions which can occur in newborns, both clinically and histopathologically.

Case Details

Here, we report a case of congenital epulis in a newborn female on the right alveolar ridge, along with an extensive review of literature and discuss the immunoprofiling.

Conclusion

Early diagnosis of CE in a newborn is of paramount importance in the successful management of these rare cases.     

新生儿面横裂一例并文献复习

面横裂是一种严重影响新生儿美观和生存的先天性面部畸形，其发病率极低，其中以单侧裂常见。面横裂至今病因不明，目前尚无明确有效的手段可以在孕前或者孕期筛查该病，因此新生儿出生前不易诊断，但产后根据其临床表现易于确诊。目前对于面横裂的治疗主要依靠手术矫正面部畸形，但最佳手术方式尚无定论。本文报道一例新生儿面横裂病例，并复习相关文献，总结面横裂的相关知识，以期提高产科医师对该病的认识。     

肾上腺囊肿误诊一例报道并文献复习

目的 提高肾上腺囊肿的术前诊断和治疗.方法 回顾性分析一例肾上腺囊肿,并文献复习肾上腺囊肿的病理学分类、影像学特点、鉴别诊断及手术治疗方式.结果 成功行后腹腔镜下肾上腺囊肿去顶减压术,术后病人恢复良好,6天拆线出院,术后随访1月恢复良好.结论 肾上腺囊肿可多无临床症状和体征,术前诊断率较低、易误诊,术前多方面结合B超、CT、MRI检查可提高术前诊断率,明确诊断依靠术后病理,对于体积小、无症状者可严密随访,外科治疗上目前多采用创伤小的腹腔镜手术.     

Probable Vanishing White Matter Disease: A Case Report and Literature Review

BackgroundVanishing white matter disease is one of the most prevalent inherited childhood leukoencephalopathies. The disease is characterized by chronic, progressive and episodic deterioration with ataxia and spasticity.Case PresentationHere, we report a 15-month-old female child from Dire-Dawa, eastern part of Ethiopia, who presented with regression of developmental milestones and truncal ataxia since her age of 11 months following a febrile illness that occurred one month earlier. Magnetic resonance imaging of brain is suggestive of vanishing white matter disease.ConclusionsWe believe this case report will increase curiosity, awareness and knowledge of health professionals in Ethiopia and sub-Saharan Africa working with children in early consideration and the diagnosis of the disease.     

Chilaiditi Syndrome Precipitated by Colonoscopy: A Case Report and Review of the Literature

Chilaiditi syndrome is a rare condition defined by the presence of gastrointestinal symptoms associated with the radiological finding of segmental interposition of the bowel between the liver and the diaphragm. While it is infrequently indentified as a source of abdominal pain, Chilaiditi syndrome carries clinical significance as it can lead to a number of serious complications including intestinal obstruction, perforation, and ischemia. A 58-year-old woman presented with Chilaiditi syndrome immediately following colonoscopic evaluation. Conservative measures failed to alleviate the patient''s symptoms, and the patient ultimately elected to have operative management. Pexy of the cecum and ascending colon led to full resolution of her symptoms. To our knowledge, this is the first documented case of Chilaiditi syndrome iatrogenically induced by colonoscopy. Identification of this syndrome as a complication of colonoscopy and a source of post-procedural pain bears significance for providers involved in the peri-operative care of patients with factors predisposing them to the development of this condition.     

Meningeal Carcinomatosis From Cervical Cancer: A Case Report and Review of the Literature

Meningeal carcinomatosis (MC) from cervical cancer is rare. Diagnosis of this disease is often delayed due to variable presentation. We report an interesting case of MC from the uterine cervix and review general diagnostic and treatment considerations. The patient received chemotherapy and radiotherapy for stage IIB cervical cancer with resolution of symptoms for 3 years. Metastatic lesions were found in the right lung and paraaotic nodes on follow-up positron emission tomography scan, which completely resolved with subsequent chemotherapy. Unfortunately, the patient developed neurological symptoms consistent with MC, which was confirmed by cerebrospinal fluid cytology. Because of her poor cognition, available options were discussed with her family. She died peacefully in palliative care.