腹臂导联对房性心律失常的意义

目的 探讨腹臂导联对房性心律失常的意义。方法 对心律失常、心房波低小70例患儿,借助FECD-D型胎儿心电图机进行检测,正极置于患儿脐上或脐下,负极置于左臂或右臂,接地电极置于肢导联任意部位,并与常规心电图进行比较。结果 70例中腹臂导联均显示高大心房波,振幅为(7.92±3.35)mm,常规心电图心房波振幅为(0.98±0.29)mm,两者比较有显著性差异(P<0.01)。结论 腹臂导联检测作为一种分析房性心律失常新方法,优于常规导联心电图。     

The acute abdomen in children

Evaluation of abdominal pain in children poses a major challenge for the pediatrician and pediatric surgeon alike. Simple appendicitis remains one of the most difficult diagnoses in children. There has been an alarming increase in the incidence of perforated appendicitis, and professional delay has been found to be a factor in this increased rate. Therefore, this discussion focuses on appendicitis and its differential diagnosis.     

Spectrum of congenital heart disease in a general hospital (study of 200 cases)

Summary Two hundred consecutive patients with congenital heart disease who attended the Kasturba General Hospital over a period of four years were studied. The cases were studied by clinical, electro-cardiographic and radiological evaluation. In 20 cases, the diagnosis was confirmed at operation; in 7 cases at autopsy; and in 22 cases by special investigative procedures. There were 11 groups of G.H.D; of these 28% cases were cyanotic and 72% acyanotic. In this study V.S.D. headed the list. (29%) followed by V.S.D. with P.S. 17%, A.S.D. 12%, P.D.A. 11%, P.S. 7%. This study showed that 50% of the patients were in the paediatric age group and 27% were above 20 years of age. In the older age group, A.S.D. is the commonest lesion with V.S.D. following it.     

Kerosene poisoning in children: a clinico-radiological study of 205 cases

Clinical, radiological and epidemiological data from 205 children with kerosene poisoning, admitted over a period of four years to the Paediatric Department of the Chest Hospital, are analysed. All children had chest radiographs. Of the 205 children, 94% developed fever, 86% pulmonary complications and 7% neurological sequelae. Vomiting was reported in 65%, abdominal pain in 2% and diarrhoea in 2%. There was no mortality. Analysis of radiological data showed a wide spectrum of pulmonary changes with a high incidence of pleural effusions and pneumatocoeles. The most common abnormal respiratory physical sign was rhonchi, which was detected in 75% of patients with pulmonary involvement. This finding strongly supports the concept that the main pulmonary change caused by kerosene toxicity is small air way obstruction. All patients with central nervous system complications had severe pulmonary involvement, suggesting a close relationship between the severity of pulmonary involvement and the development of neurological complications. These data support the concept that central nervous system complications are mainly due to hypoxia secondary to pulmonary involvement rather than a direct toxic effect of kerosene on the central nervous system.     

326例儿童手外伤分析

目的 了解本地区儿童手外伤的流行病学特征,为儿童手外伤的防治提供科学依据.方法 2004年6月至2009年6月4年间我院收治326例儿童手外伤患儿,对其病历资料及随访情况进行回顾性分析.结果 326例患儿中,男209例,女117例,男女比1.79:1.发病高峰年龄为幼儿期(1～3岁),发病高峰时间为中午及16～20点.伤后8 h我院就诊率73.6%.受伤原因多为生活性,以锐器伤、挤压伤和砸伤为主,开放性损伤占92%.受伤部位以手指居多,掌部次之;受伤类型多以挫裂伤、擦挫伤为主.受累组织以单纯皮肤软组织受损及骨折多见,肌腱及神经受损次之.其中,行非手术治疗33例;单纯清创缝合的86例;骨折固定的81例;神经吻合的17例;行肌腱吻合的63例,植皮或者行皮瓣移植的28例;截肢或截指的12例;拔甲,甲床修补的45例;血管吻合的7例.术后感染率4.0%.治疗后优良率达91.2%.结论 儿童手外伤有其自身发病特点,幼儿期多发,生活性损伤多见,受伤程度大部分较轻,经早期恰当治疗预后多良好.应根据这些特点,加强监管,以降低发病率,同时重视儿童手外伤的及时恰当的治疗,可以获得较好的效果,提高生存质量.     

Adenoviral diseases in children: a study of 105 hospital cases

The clinical findings for 105 children hospitalized with adenoviral infection were studied prospectively. In 82 children, the diagnosis was based on the detection of adenovirus antigen in the nasopharyngeal specimens and in 17 children in the feces. In the remaining six patients, findings from nasopharyngeal specimens were negative but a significant increase in CF (complement fixation) titers was detected. The clinical picture of adenoviral infection was characterized by high-grade (mean 39.4 degrees C) and prolonged fever (mean duration 5.4 days). Tonsillitis, otitis, and gastroenteritis were the most common illnesses. In 17% of the patients, no identifiable focus of infection could be demonstrated; nine children with no identifiable focus of infection had febrile convulsions. The WBC count and ESR varied from normal values to values seen in bacterial infections; thus it was difficult to distinguish adenoviral disease from a bacterial disease. Forty-five children were referred to the hospital due to infection unresponsive to antimicrobial therapy. The rapid detection of adenovirus antigen in nasopharyngeal specimens or feces proved to have a great clinical value in the diagnosis of adenoviral infections.