4 例风心病瓣膜替换术后上消化道出血原因及治疗

我院自1988～1998年,出现风湿性心脏病瓣膜替换术后上消化道出血4例,其中2例施行胃大部切除;死亡1例,现报告如下。1 临床资料 4例中男性3例,女性1例,年龄21～61岁,平均42岁。二尖瓣替换术3例,二尖瓣及主动脉瓣替换术1例。上消化道出血时间最早术后20h,最晚为术后第12d,出血量为每日100～1800ml。胃镜检查3例,2例证实为十二指肠球部溃疡急性活动性出血(单发);1例为胃溃疡急性活动性出血(单发)。     

肾脏移植术后输尿管梗阻7例报告

肾移植术后由于输尿管梗阻而突然出现少尿和无尿的情况较为少见。近几年来我们在临床工作中遇到 7例 ,其中男性 6例 ,女性 1例 ;年龄 2 2岁～4 5岁。有 4例发生于术后 2周～ 3周内 ,在拔出输尿管支架管后 1ｄ～ 2ｄ突然出现少尿 ;3例发生在术后 0 5年～ 1年之中 ,突然出现少尿或无尿。经积极处理后 ,全部病人恢复满意 ,病人均健在 ,肾功能正常。现报告如下 :1　病例资料病例 1　男 ,2 6岁 ;住院号 :2 160 11。 1996- 0 4- 2 3行肾脏移植手术 ,供受血型为Ａ -Ａ ,淋巴细胞毒性试验为 1% ,术后恢复顺利。术后 15ｄ拔除输尿管支架管 ,1ｄ后出…     

腹壁切口疝80例原因分析及预防

切口疝是腹部术后的常见并发症。为分析、总结其发生原因 ,现将上海第二军医大学长海医院1993～ 2 0 0 1年诊治的切口疝 80例进行分析探讨 ,并提出预防措施。1　临床资料1 1　一般情况　男 31例 ,女 4 9例 ;年龄 2 7～ 84岁 ,平均 6 0 6岁。体重 4 7～ 10 5kg ,平均 6 9 3kg。1 2　手术方法　阑尾切除术 2 1例 ,胆囊切除术和(或 )胆总管切开取石 15例 ,直肠癌根治术或直肠腺瘤切除术 8例 ,脐疝修补术 6例 ,结肠癌根治术 6例 ,膀胱癌根治术或膀胱切开术 4例 ,子宫瘤或宫颈癌行子宫切除术 4例 ,胰腺炎术后 3例 ,胃大部分切除术 2例 ,小肠破裂…     

风心病二尖瓣成形术后的抗凝治疗报告

风心病二尖瓣成形术后需进行抗凝治疗,现就我们1994～1998年20例二尖瓣成形术后抗凝治疗的体会报告如下。 临床资料 (1)一般资料:本组20例风湿性心脏病人作二尖瓣成形术16例,、二尖瓣成形并三尖瓣成形术4例。其中男8例,女12例,年龄21～58岁,平均41岁。1例于术后13d消化道、呼吸道及颅内出血经抢救无效而死亡;1例出现血尿,经调整华法令用量后血尿消失;其余病人均未出现出血及栓     

电视胸腔镜下胸椎前路手术的麻醉体会

20世纪 90年代初开展起来的电视胸腔镜下外科手术(video assistedthoracoscopicsurgery VATS),与常规开胸手术相比,创伤小,术后疼痛减轻,术后呼吸抑制和肺不张减少,术后恢复快,因此,在临床上得到广泛开展 [1]。我们应用电视胸腔镜行胸椎前路手术 15例,现将麻醉体会报告如下。1　临床资料1 1　一般资料　 15例患者ASAⅠ ~Ⅳ级,男 9例,女 6例,年龄 22~63岁,其中胸椎骨折、脱位 8例,胸椎结核 5例,胸椎肿瘤 2例。1 2　麻醉方法　所有病例麻醉诱导时静脉推注丙泊酚(异丙酚 )2. 0mg/kg,芬太尼 4. 0μg/kg,维库溴胺 0. 1mg/kg,插入F35~39号…     

腰穿治疗开颅术后感染12例

我科自1989年5月至今发生开颅术后感染12例,经腰穿治疗效果良好,报告如下.临床资料:本组男9例,女3例;年龄14～56岁.其中脑瘤切除术后2例、颅内血肿清除术后2例、脑脊液鼻漏修补术后1例、开放性颅脑损伤术后7例.临床主要表现:4例出现发热,最高达38.9℃;10例有头痛、头晕;6例有呕吐;2例出现意识障碍,均为嗜     

腹腔镜胆囊切除术后疼痛的观察及护理

1临床资料1.1一般资料本组病例128例,男60例,女68例,年龄24～78岁,平均44岁 住院时间2～8天,平均4天。本组出现术后疼痛88例,其中轻度疼痛44例,中度疼痛32例,重度疼痛12例。颈肩痛31例,剑突下戳口痛6例,2例因结石遗留戳口内引起，4例因戳口过分靠近肋缘或剑突引起；持续性腹腔内疼痛23例，1例因术后胆漏引起，1例因术后继发性胆总管结石引起．1例因术后并发急性胰腺炎引起，     

腰椎间盘突出症术后椎间隙感染围手术期护理

我科于1993年3月～2 0 0 2年5月,经手术治疗腰椎间盘突出症95 0例,术后发生椎间隙感染6例,占0 6 3%。现将其围手术期护理报告如下:1　临床资料1 1　一般资料　本组6例,男4例,女2例;年龄4 0～5 6岁,平均4 8岁。L4、5间隙5例,L5S1间隙1例。术后椎间隙感染确诊日期为7～18d ,平均     

医源性输尿管损伤4例临床分析

1临床资料1.1一般情况医源性输尿管损伤4例,女3例,男1例;年龄31～55岁。其中子宫全切术后2～5周出现腹胀、腰痛,阴道流尿3例;直肠癌根治术,术中发现输尿管裂断伤1例。4例均有明确手术史,且手术部位与输尿管走行区段密切相关。1.2诊断与手术治疗3例妇科手术患者经超声或CT证实     

阴式全子宫切除术前术后的护理体会

阴式全子宫切除术是经阴道进入盆腔将子宫切除的手术方法 ,腹壁不留有切口和疤痕。术后患者起床活动早 ,出现肠胀气者明显少于腹部手术者。且进食早 ,手术效果好 ,副反应少 ,术后机体恢复快 ,此法适用于年龄大 ,体质弱的患者。自 1994年 5月至 1997年 2月行阴式全子宫切除 2 1例 ,护理体会如下 :1　资料与方法1.1　临床资料　本组共 2 1例 ,年龄 4 1岁～ 68岁。其中子宫脱垂 14例 ( 66 6% ) ,更年期功血 3例( 14 2 9% ) ,子宫肌瘤 4例 ( 19 35% ) ,住院 7～ 15天 ,平均 10天 ,术后切口Ⅰ期愈合。术后尿潴留 1例( 4 76% ) ,术后便秘 3例 ( 1…     

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.