针刺治疗胃下垂45例体会

针刺治疗胃下垂４５例体会武警湖北总队荆州市支队卫生队杨美昌（荆州４３４１００）关键词针疗胃下垂胃的正常位置,大部分在左季肋部,小部分在上腹部,但随胃的充盈程度、胃肌层的紧张力以及体位变化等因素,其位置的变化较大。胃下垂是一种慢性疾病,祖国医学认国胃下...     

中药治疗胃下垂的研究进展

胃下垂是临床常见慢性消化系统疾病,属中医“痞症”“胃脘痛”范畴,患者痛苦,治疗棘手。此病于农村中发病率极高,目前西医对此病尚无特效治疗,国外有用胃体部分切除术治疗,虽有一定效果,但难被患者接受,国内主要采用中药和针炙治疗,取得了一定进展。现将近年来中药治疗胃下垂的实验研究概况作一综述。     

中药治疗胃下垂的研究进展

胃下垂是临床常见慢性消化系统疾病，属中医“痞症”“胃脘痛”范畴，患者痛苦，治疗棘手。此病于农村中发病率极高，目前西医对此病尚无特效治疗，国外有用胃体部分切除术治疗，虽有一定效果，但难被患者接受，国内主要采用中药和针炙治疗，取得了一定进展。现将近年来中药治疗胃下垂的实验研究概况作一综述。     

胃下垂程度与胃动力的相关性

胃动力即胃排空能力，是评价人体消化能力的重要功能性指标。胃动力减弱，则胃排空时间延迟．其受多种因素影响，包括食物成分、精神状态、年龄、疫疾病等因素。本文探讨胃下垂对胃动力的影响，现报告如下。     

胃下垂的中西医治疗及X线观察

1．一般资料本组患者108例，年龄15—75岁，平均为35．1岁；其中男性患者19例，女性89例。病程1-38年不等，多表现为上腹不适、腹痛、腹胀、食欲不振；烧心返酸、嗳气，恶心呕吐及便秘等。上述表现常于餐后、站立位、劳累后发作或加重。     

胃下垂X线钡餐诊断标准的探讨

目前胃下垂的Ｘ线诊断标准并不一致 ,国内文献也未见专题报道。本文分析了本院 1988～ 2 0 0 0年经钡餐造影诊断的胃下垂 312 8例的Ｘ线表现 ,并着重探讨其Ｘ线诊断标准。1　材料和方法收集 1988 0 7～ 2 0 0 0 0 8经钡餐造影检查诊断的胃下垂312 8例 ,男 976例 (占 31 2 % ) ,女 2 15 2例 (占 6 8 8% ) ,年龄 18～ 83岁 ,平均 43 6岁 ,其中 2 5～ 5 0岁 2 2 5 8例 (占 72 2 % )。本组病例均未注射低张药物 ,以免因胃平滑肌松弛造成假象。常规摄取站立位胃充盈像 ,以判断胃下垂位置低下的程度和分析胃下垂肌张力低下 (包括蠕动减弱 )的Ｘ…     

腹腔镜下胃体悬吊术治疗重度胃下垂4例

以往对重度胃下垂常采用胃大部分切除术，由于损伤较大，术后并发症较多，往往不为患者所接受。2012年4—6月，我们采用腹腔镜下行胃体悬吊术治疗重度胃下垂4例，效果满意。现分析报告如下。     

高频及低频彩超在急性阑尾炎诊断中的价值

目的：探讨高频及低频彩超对急性阑尾炎的诊断价值和准确性。方法：分析总结了25例急性阑尾炎病例,超声显像检查阑尾的大小、形态、壁的厚度,阑尾腔有无积液,有无扩张、有无粪石,周围有无积液等。结果：高频及低频彩超对急性阑尾炎的诊断符合率以低频最低,约35．9％,高频显示率明显提高,而二者结合效果最好,准确率约达到88．4％。结论：高频及低频彩超对急性阑尾炎的诊断及鉴别诊断有很大的价值。     

彩超检查脑梗死患者颈动脉的分析

目的：探讨脑梗死患者超声检查所见。方法：采用回顾性分析的方法,分析我院收治的脑梗死患者临床资料。结果：脑梗死组颈动脉内膜-中层厚度和粥样斑块积分均明显高于对照组,脑梗死患者的软溃疡斑、纤维斑、钙化斑发生率均明显高于对照组,P〈0.05,差异均有统计学意义。结论：彩色超声对于准确观察颈动脉粥样斑块及狭窄情况,为预防和治疗脑梗死提供了可靠的依据。     

Diagnosis of thyroid nodules by Doppler ultrasonography: a comparison between color Doppler and power Doppler ultrasonography

The purpose of this study was to assess the usefulness of color and power Doppler imaging in thyroid nodules. The following 4 items were compared between malignant thyroid nodules (34 cases) and benign nodules (51 cases): 1) vascularity; 2) distribution of tumor vessels (none, marginal, peripheral, central); 3) nature of tumor vessels (tortuosity, interruption); and 4) FFT analysis. The distribution of tumor vessels on color Doppler images, nature of tumor vessels on power Doppler images, and the indices of PI, RI, and ATI in FFT analysis were useful in making the differential diagnosis between malignant and benign nodules. In terms of vascularity, including the distribution of tumor vessels on power Doppler images and nature of tumor vessels on color Doppler images, no statistically significant differences were found between malignant and benign nodules. Power Doppler images depicted tumor vessels in more detail than color Doppler images and were considered to extend the application of FFT analysis.     

彩色多普勒超声诊断乳腺增生症的临床研究

目的研究乳腺增生症的高频超声表现及与病理组织类型的关系,探讨高频超声对乳腺增生症的诊断价值。方法分析彩超诊断的440例乳腺增生症的声像图表现,并与病理和临床诊断对照。结果本组440例乳腺增生症根据病理类型和结果分为5类：乳腺小叶增生233例,乳腺纤维腺瘤样增生32例,乳腺囊性增生78例,乳腺组织增生67例,乳腺混合性增生30例。相对应的乳腺小叶增生主要超声表现为腺体粗糙不均形成低回声斑块;纤维腺瘤样增生主要表现为腺体组织内出现略欠规则的减低回声结节和包块,其周边区的乳腺结构无明显变化;乳腺囊性增生表现为腺体内不规则的导管扩张及清晰光滑的囊性占位;乳腺组织增生表现为腺体结构不清,密集增厚,弥漫性回声增强或减低,内无包块、结节或斑块,乳腺导管无扩张;乳腺混合增生主要表现为乳腺结构混杂不清,腺体粗大,内出现囊、实性病灶或导管扩张等。结论乳腺增生症超声表现与其病理结构改变相关。以乳腺增生症的超声图像表现结合病理类型诊断乳腺增生,对完善和规范乳腺增生症的超声诊断提供比较客观诊断依据和信息,可对超声和临床鉴别其他乳腺疾病提供一定的理论指导,为临床诊断乳腺增生提供了较好的帮助。     

继发性肾动脉血流动力学改变的彩色多普勒表现

肾动脉血流动力学的改变早于肾功能的改变。以彩色多普勒超声观察肾动脉血流动力学各项参数,可以反应继发性肾灌注的改变     

Determination of the effect of a single hemodialysis session on retrobulbar blood hemodynamics by color Doppler ultrasonography

Background: Retrobulbar hemodynamic alterations can occur during hemodialysis sessions, and patients with chronic renal failure may experience visual problems.

Purpose: To evaluate the effect of single-session hemodialysis on retrobulbar vessel hemodynamics by color Doppler ultrasonography.

Material and Methods: Thirty-five patients were included in the study. Retrobulbar blood flows were examined before and after dialysis sessions. Doppler spectral patterns of retrobulbar blood flow were evaluated. The t test for paired samples and the Wilcoxon matched-pairs signed-rank test were used for comparing the flow values before and after dialysis.

Results: Systolic and diastolic blood flow velocities of the ophthalmic artery, central retinal artery, central retinal vein, nasal posterior ciliary artery, and temporal posterior ciliary artery were found to be decreased bilaterally after hemodialysis sessions. No significant change was observed in resistivity index values after hemodialysis sessions.

Conclusion: Our findings reveal that retrobulbar circulation was disturbed after a single hemodialysis session.     

彩色多普勒超声对甲状腺良、恶性结节的诊断研究

目的 采用彩色多普勒超声对甲状腺进行全方位立体多切面扫描,以判断甲状腺结节的性质,提高甲状腺良性结节和恶性结节的鉴别诊断.方法 取头后仰平卧位,用彩色多普勒超声高频探头置于颈部正前方,自上而下,自左而右,多切面立体扫描甲状腺,对甲状腺良性和恶性结节进行鉴别分析,对照病理结果进行回顾性研究.结果 超声检查37例甲状腺癌,病理确诊35例;35例甲状腺癌中,CDFI见血流信号,有绕边和穿隔血流,阻力指数高,内部回声多表现为低回声或极低回声为主,小钙化,边缘模糊,无包膜,纵横比>1,颈部淋巴结肿大且部分有周边晕;良恶性甲状腺结节在回声类型、内部结构、边界、钙化灶、周边晕、颈部淋巴结肿大等方面差异有统计学意义(P<0.01).结论 彩色多普勒超声对甲状腺良性结节和恶性结节的判断研究具有一定的价值,作为无创伤甲状腺结节的判断,检查可作为首选方法.     

彩色多普勒超声对甲状腺结节内钙化斑的评价

本文对220例甲状腺结节患者声像图特征进行分析，旨在探讨二维彩色多普勒超声对甲状腺结节内钙化斑的诊断价值。     

彩色多普勒超声诊断继发性甲状旁腺功能亢进症的应用价值

 目的 评价彩色多普勒超声对继发性甲状旁腺功能亢进时甲状旁腺增生的诊断价值.方法 肾衰竭并伴有不同程度的血中全段甲状旁腺激素水平增高的患者36例,比较分析其术前彩色多普勒超声检查与手术和病理学诊断结果 ,并与核素检查对比观察.结果 36例中检出增生的甲状旁腺51枚.增生的甲状旁腺边界清晰,形态多样,呈极低回声改变,内部回声欠均匀,可见不同程度的钙化;分析后反映出增生的甲状旁腺个数、大小与血中全段甲状旁腺激素水平呈正相关,与血中肌酐、尿素氮无明显相关性.结论 彩色多普勒超声是继发性甲状旁腺功能亢进症术前定位诊断的有效手段.     

Contrast-enhanced color Doppler ultrasonography in suspected parathyroid lesions

Purpose: To assess the usefulness of US contrast media in the evaluation of patients with primary hyperparathyroidism, with a nodule showing US features of a primary parathyroid lesion but lacking the color Doppler US appearance of a parathyroid mass.Material and Methods: Thirteen patients (7 female, 6 male; age range 51-79 years) were examined with US before and after administration of a stabilized galactose-based microbubble contrast agent. Ten patients underwent surgery and the final histological examination demonstrated parathyroid adenoma in 9 cases and a mesenchymal benign nodule in 1 case. Three nodules were proved to be of thyroid origin at fine-needle aspiration biopsy.Results and Conclusion: The use of a US contrast agent resulted in a diagnostic gain compared to unenhanced studies in 12/13 cases. Color Doppler findings characteristic of parathyroid lesions were observed in 7/13 cases, of thyroid nodules in 4/13 cases, and nonspecific patterns in 2/13 cases. Contrast-enhanced color Doppler US can be proposed in selected patients in whom unenhanced color Doppler provides uncertain findings. Its ideal application should be the evaluation of cervical lesions without detectable intranodular flow at unenhanced Doppler studies. In these cases, the contrast agent helps in visualizing typical color Doppler signals of the parathyroid lesions ("vascular pole" and "mixed pattern").     

Ophthalmic artery color Doppler ultrasonography in mild-to-moderate preeclampsia

OBJECTIVE: To evaluate the hemodynamic changes in mild-moderate preeclampsia using ophthalmic artery Doppler ultrasonography technique. METHODS: Ophthalmic artery pulsatility and resistivity indices were calculated in 30 mild-moderate preeclamptic women and 30 normotensive gravid women of matched gestational age. Student's t-test was performed to test the significance of difference. RESULTS: Both indices of peripheral resistance were found to be significantly lower in the ophthalmic arteries of mild-moderately preeclamptic women than those measured in normotensive gravid women at similar stage of pregnancy. In a small number patients whose disease progressed to severe preeclampsia, both indices increased. CONCLUSION: In patients with mild-moderate preeclampsia, ophthalmic artery color Doppler ultrasonography detects hemodynamic changes that are not present in normotensive gravid women. Reversal of Doppler patterns in a small number of patients with progressive disease supports the hypotheses suggesting the presence of early vasodilation and late vasospasm in the etiology of preeclampsia.     

钼靶X线摄影、彩色多普勒超声联合应用对乳腺癌的诊断价值

<正> 乳腺癌是危害妇女健康和生命的常见恶性肿瘤之一,发病率呈逐年上升趋势。早诊早治颇为重要,能显著提高患者的5年生存率和生存质量。影像学检查对乳腺癌的检出有着重要作用,其中乳腺钼靶和超声是最常用、最实用的两种检查方法。笔者通过回顾性分析72例经手术病理证实的乳腺癌患者的钼靶X线摄影及彩色多普勒超声资料,探讨各自及联合应用对乳腺癌的诊断价值,为临床诊治提供更大的帮助。