闭合性肾损伤的诊断与治疗(附116例报告)

回顾分析 116例闭合性肾损伤的诊治资料 ,其中保守治疗 84例 (72 .4 % ) ,手术治疗 32例 (2 7.6 % ) ;肾切除 13例 ,死亡 2例。作者认为早期诊断和准确地进行伤情评估 ,严格掌握手术治疗指征是提高闭合性肾损伤治疗效果的关键。     

89例闭合性肾损伤的诊断和治疗

目的探讨提高闭合性肾损伤的诊断和治疗水平。方法对1996年1月～2007年12月收治的89例闭合性肾损伤患者的临床资料进行回顾性分析,综合应用尿常规、B超、CT等检查确诊。肾损伤分级：Ⅰ—Ⅴ级分别为19、23、27、14、6例。合并其他脏器损伤12例,其中颅脑伤1例,肺挫伤1例,肝、脾、肠等腹腔脏器伤7例,肋骨、脊柱、骨盆、四肢骨折3例。根据病情选择保守治疗69例（77．53％）,手术治疗20例（22．47％）,其中肾切除15例,保肾手术5例,其他合并伤均进行了相应手术或其他保守治疗。结果本组89例均痊愈出院,无死亡病例。结论B超可作为肾损伤尤其是急诊肾损伤患者首选检查,CT检查是闭合性肾损伤快速准确诊断、正确评估肾损伤程度和选择治疗方案的重要依据,合理保肾是闭合性肾损伤的有效治疗方法。     

双螺旋CT增强扫描对外伤性肾损伤的诊断价值

肾损伤是较常见的腹部闭合性外伤性疾病,文献报道肾损伤约占腹部闭合性外伤的10%左右[1],近年并有上升趋势.对于肾损伤的分类和范围以及肾脏周围脏器的损伤情况,CT均优于其它影像技术[2].本文收集28例外伤性肾损伤患者,对其CT平扫和增强扫描的影像学表现进行对比研究,以进一步提高CT诊断的准确率.     

闭合性腹部外伤的CT诊断价值（附85例分析）

目的:评价CT检查对闭合性腹部外伤的诊断价值.材料和方法:回顾性分析85例闭合性腹部外伤的CT表现.结果:闭合性腹部外伤以实质性脏器为多,脾损伤45例、肾损伤20例、肝损伤12例、复合伤 7例、外伤性膈疝1例.其中外伤后肝癌破裂出血1例.平扫加增强45 例.结论:CT扫描可对闭合性腹部外伤作出正确诊断,并为临床治疗提供重要信息.     

35例严重闭合性肾损伤诊断及手术治疗探讨

３５例严重闭合性肾损伤诊断及手术治疗探讨龚晓峰李萌马存卿我院自１９８８～１９９４年共收治闭合性肾损伤１２７例，对其中３５例严重闭合性肾损伤进行了手术治疗。现报告如下。临床资料男２３例，女１２例；年龄１７～６２岁。高空坠落伤１５例，平地跌伤６例，车祸伤...     

闭合性肾损伤大剂量静脉尿路造影表现（附四例报告）

大剂量静脉尿路造影是诊断闭合性肾损伤简单而有效的方法之一，近年在我院收治腰腹部挤压伤或打击伤的病例中，选择疑有闭合性肾损伤4例作了本法检查，其中3例经手术证实，1例采取保守疗法，临床资料符合X线诊断，现介绍于下。     

闭合性肾损伤142例临床诊治分析

目的:探讨闭合性肾损伤的诊断与治疗方法,以提高临床诊治水平.方法:对2007-01～2011-12收治的142例闭合性肾损伤患者的临床资料进行回顾性总结分析.本组B超检查127例(89.4%),静脉尿路造影(IVU)98例(69.0%),CT检查142例(100%).保守治疗103例(72.5%),手术治疗39例(27.5%).结果:本组平均住院时间(23.7±8.4)d.治愈133例(占93.7%),9例(6.3%)死于多器官损伤合并休克.106例(74.6%)随访2个月～4.6年,定期复查血压、尿常规、肾功能和IVU均正常.结论:B超检查快捷、无创,可作为首选的筛查诊断方法;CT检查是本病准确诊断与选择治疗方案的重要依据.大部分肾损伤可保守治疗,严重者需手术治疗.     

闭合性肾损伤的CT诊断

<正>随着工业、交通事业的迅速发展,肾损伤的发生率呈上升趋势。肾损伤的及时诊断和正确处理,对预后极为重要。CT在肾损伤的诊断过程中发挥着重要作用。现对我院收治的52例闭合性肾损伤患者的CT表现进行回顾性分析,以期进一步提高对本病的认识。     

肾外伤68例的诊断和治疗

目的：探讨肾外伤的诊断和治疗策略。方法：回顾性总结2000-01-2010-12收治肾外伤患者68例的临床资料,其中闭合性肾损伤65例;并发其它器官损伤16例;开放性损伤3例;并发腹腔脏器损伤1例。结论：对绝大多数闭合性损伤（轻度及腹腔脏器损伤的部分重度肾损伤）者采用保守治疗;对严重肾损伤并腹腔脏器,以及出现严重肾损伤并发症者均要及时手术。     

闭合性肾损伤的诊治分析(附32例报告)

目的 探讨闭合性肾损伤的诊断及治疗。方法 对32例闭合性肾损伤病例的临床表现及诊治方法进行分析。结果 32例病人中30例出现血尿。5例行大剂量IVU检查,3例有异常发现。10例行CT检查均发现异常。27例行保守治疗,除1例死于脑损伤外,余全部治愈。手术探查5例,肾脏仅为挫伤2例,肾裂伤行修补术2例,1例肾粉碎伤行肾切除。结论 肾损伤后血尿为主要临床表现。IVU及CT为主要的诊断手段。治疗方法的选择应根据肾损伤后血流动力学变化以有有无合并症决定。     

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.