动脉灌注化疗及食管内支架治疗恶性食管狭窄

目的：用动脉管注化疗及食管内支架治疗恶性食管狭窄。方法：对８例食管癌患者分别置放ＷＡＬＬＳＴＥＮＴ,ＳＴＲＥＣＫ－ＥＲＳＴＥＮＴ及ＺＳＴＥＮＴ,共１０个支架,先用导丝探索通过狭窄段,经球囊扩张后置放支架。置放支架１周后行食管动脉管注化疗,１次／４～６周。结果：８例患者造影显示５例患者食管完全梗阻,３例患者严重狭窄。所有患者均一次顺利完成支架置放。３例分别随访１年,２例分别随访８个月及６个月。患者进普食顺利,疗效满意。２例半年后又出现吞咽困难。造影显示原支架上下两端又出现狭窄经第二次置放支架后进食顺利,疗效满意。８例共行供血动脉管注５０次。结论：食管内支架治疗恶性食管狭窄,安全,可靠,疗效好,并发症少。但必须配合动脉灌注化疗     

输尿管狭窄介入治疗一例

球囊扩张术的临床应用日趋广泛,本文报道用球囊扩张术治疗输尿管狭窄１例。患者男性,４５岁。２年前因左输尿管结石伴肾盂积水行开放性取石术,术后情况良好。近２周感左肾区酸胀、坠沉感。ＩＶＰ示左输尿管中上１／３交界处狭窄伴肾积水,狭窄段长约３ｍｍ,宽径仅１ｍｍ。我们在连硬麻醉下经膀胱镜导引下,将７Ｆ超滑加硬导丝从膀胱入口处插入左侧输尿管。在Ｘ线电透监视下,经导丝插入球囊导管并通过狭窄段,然后逐渐向下牵移,对狭窄处由近及远地间断扩张（球囊规格为０．８ｃｍ×４ｃｍ,以５０％泛影葡胺充盈球囊）,使之稳定均匀地…     

上腔静脉狭窄及阻塞的介入性开通治疗：附六例报告

报告６例上腔静脉狭窄及阻塞的介入治疗结果，旨在探讨有关技术问题及评价临床疗效。６例中，男５例，女１例，年龄４８￣７４岁，均表现为上腔静脉综合征，５例为肺癌伴纵隔淋巴结转移所致，１例为纵隔淋巴瘤压迫上腔静脉。４例造影表现为重度狭窄，２例为完全性阻塞。介入治疗时，先用导丝通过梗阻段，继而用球囊导管扩张，最后导入金属内支架。结果：６例均开通成功，无重要并发症，术后临床症状明显改善，侧支静脉消失，梗阻远侧     

输尿管狭窄金属内支架成形术的临床应用(附5例报告)

我们自 1994-0 3至今 ,采用球囊导管扩张术治疗输尿管狭窄 8例 ,其中 5例放置了金属内支架 ,获得良好效果 ,报告如下。1　材料与方法本组 8例 ,单纯球囊扩张 3例 ,球囊扩张加金属内支架放置5例。男 5例 ,女 3例。年龄 10～ 45岁 ,平均 2 1岁。先天性肾盂输尿管交界处狭窄 7例 (其中因开放性手术导致瘢痕性狭窄2例 ) ,损伤性上段输尿管狭窄 1例。病程 3个月～ 5年。 8例患者均有不同程度的患侧腰背部持续性酸胀、疼痛 ,呈间歇性发作 ,其中 5例伴有血尿及尿路感染。方法 :7例采用经尿道逆行法 ,1例采用经皮肾造瘘法。在膀胱镜下将导丝经尿道、…     

消化道良恶性狭窄的介入治疗(附31例报告)

目的：评价食管球囊扩张和／或食管内支架置入术临床效果。方法：本组３１例，男２３例，女８例，年龄６～６９岁，良性狭窄１８例，恶性狭窄１３例。球囊扩张２５例，球囊扩张并支架置入６例。对狭窄部位先球囊扩张后用支架输送释放系统放置食管内支架。结果：１５例贲门失驰缓症随访１年以上，１２例能进普食，３例进食有时稍缓慢。６例置入食管内支架，随访４个月，６例均能进普食，其中２例１个月后出现左主支气管瘘；１０例单纯狭窄球囊扩张随访５～９个月能进普食。结论：球囊扩张和内支架置入术是一种简单易行、安全可靠的治疗方法。     

逆行法介入治疗输尿管良性狭窄

目的探讨输尿管良性狭窄的介入治疗方法及疗效。方法对19例患者20处输尿管良性狭窄病变行球囊扩张并放置双猪尾输尿管支架。结果16例成功,3例失败。失败者1例为迷走血管压迫,1例为纤维索带压迫,1例为输尿管极度迂曲致导丝插入失败。16例成功者经静脉肾盂造影及B超复查显示肾盂积水逐步缓解,肾功能改善,2例输尿管支架尾端进入输尿管内形成医源性异物,后经输尿管镜取出。结论输尿管良性狭窄的介入治疗具有创伤小、操作简单等优点,为输尿管良性狭窄的患者提供了新的治疗方法。     

周围和冠状动脉腔内旋切吸引术的初步经验

经腔旋切吸引术是旋切术中的一种，其远端有二叶锋利的刀片，在马达的驱动下以７５０ｒ／ｍｉｎ高速旋转，其近端连接负压吸引瓶，旋切下来的物质可吸引出体外。本组共行旋切吸引术９例，包括周围动脉３例（髂动脉１例，动脉２例），冠状动脉６例（ＲＣＡ１例，ＬＡＤ５例），病变为几乎完全闭塞或完全闭塞。先将导丝通过病变，然后沿导丝送入旋切刀旋切２～３次，负压瓶吸出切下的物质，残余狭窄用球囊扩张。９例中７例成功，２例因导丝问题而放弃。我们的初步经验表明，动脉旋切吸引术是一较安全的旋切技术，对完全闭塞、长狭窄和开口处病变效果较好，有部分患者需要用辅助球囊扩张。     

球囊扩张治疗输尿管狭窄172例临床观察

目的评价逆行球囊导管扩张输尿管狭窄的治疗效果。方法采用球囊导管对172例输尿管狭窄患者进行扩张治疗,以上病例分为两组,原发性输尿管狭窄组与继发性狭窄组,均采用逆行法,扩张后均留置双J管。结果155例扩张成功,症状和肾积水缓解,肾功能改善,17例拔出双J管后发生再狭窄,其中6例患者严重再狭窄,肾积水加重需手术治疗。结论腔内球囊扩张治疗输尿管狭窄是一种安全有效、简便易行的方法。     

X线监控下直肠狭窄的球囊扩张术

直肠狭窄通常发生于术后的吻合口,传统的治疗方法是用金属扩张器或再次手术。作者自1989年3月～1990年5月对8例术后直肠狭窄病人采用了球囊导管扩张治疗。术前清洁灌肠后,静脉给予必要的镇静或止痛药,病人左侧卧位于导管检查床上,经肛门插入乙状结肠镜抵达狭窄段下端,并造影观察狭窄情况。电视监控下经乙状结肠镜将0.87mm“J”型导丝通过狭窄段,再沿导丝插入19F聚氯乙烯球囊扩张导管于狭窄部,球囊内用50%Conray280持续充胀10分钟,最大囊径为22mm。8例病人中有4例一次扩张成功,另4例需扩张3～4次,所有病人术后随访平均11.5个月,狭窄由扩前平均的7.2mm扩至17.0mm,均获良好效果,     

婴儿食管吻合口狭窄球囊扩张术

目的：本文报告４例婴儿食管吻合口狭窄使用球囊扩张术治疗。材料和方法：４例女婴均为食物闭锁术后２￣１５个月出现吻合口狭窄，狭窄内径３￣６ｍｍ。采用球囊导管分次扩张，球囊直径６￣１５ｍｍ。结果：４例共进行球囊扩张１２次，保持临床无症状期４￣６个月。无食管穿孔并发症。结论：球囊扩张术简单、安全、有效，为婴儿食物吻合口狭窄的首选治疗方法。     

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.