动脉留置管持续药物灌注治疗股骨头缺血性坏死

目的 探讨动脉留置导管持续药物灌注对股骨头缺血性坏死(III、IV期)的临床疗效. 方法 19例股骨头缺血性坏死(III、IV期)采用Seldinger's技术经股动脉插管超选择留置导管在旋股内、旋股外及闭孔动脉持续动脉内药物灌注治疗. 结果 19例均经临床6～12个月的随访,并采用血管造影与临床症状改善及骨质改变等方面进行疗效判定,临床症状改善率75.8%.63%股骨头坏死区病灶稳定.结论动脉留置导管持续药物灌注治疗股骨头缺血性坏死(III、IV期)有明显疗效.     

伴动静脉畸形的股骨头缺血性坏死介入治疗

目的探讨伴动静脉畸形(arteriovenous malformations,AVM)的股骨头缺血性坏死(avascular necrosis ofthe femoral head,ANFH)介入治疗的疗效及安全性。资料与方法回顾性分析19支股骨头滋养动脉伴AVM发生在17例ANFH患者的介入治疗,即先行超选择栓塞AVM,然后超选择旋股内侧动脉、旋股外侧动脉及闭孔动脉等股骨头滋养动脉的主干和主要分支行介入溶栓术治疗股骨头缺血性坏死,评估此类患者的疗效和安全性。结果所有患者均成功行AVM栓塞和介入溶栓术治疗,成功率达100%,经临床3～48个月随访,并采用血管造影与临床症状改善及骨质改变等方面进行疗效判定。优良率100%,血管造影改善率100%,显示治疗后股骨头供应血管计数明显增多,股骨头染色区域增大。临床症状改善率100%,股骨头坏死区病灶稳定,见增生、硬化及囊变缩小。结论伴AVM的ANFH介入治疗安全、有效。     

介入疗法治疗股骨头无菌性坏死的临床观察

骨股头无菌性坏死的病因很多，其结果均导致骨股头区供血血管狭窄或堵塞。其治疗方法早期为中医中药治疗，晚期采用外科手术治疗。而所有疗法的疗效欠佳，手术治疗病人痛苦较大，尤其是早期疗效肯定的方法至今还来见明确报道。我们在心脑血管的溶栓中得到了启迪，采用介入疗法治疗股骨头无菌性坏死，本文观察介入疗法在股骨头无菌性坏死治疗中的作用，病人症状的改善情况。取得了满意的临床效果，旨在为临床治疗开辟一个新的途径。     

股骨头缺血坏死的介入治疗分析(附28例报告)

目的评价介入治疗股骨头缺血坏死的疗效，探索股骨头缺血坏死的治疗方法。方法对28例股骨头缺血坏死患者采用介入插管的方法，超选择进入到股骨头营养血管旋股内、外侧动脉和闭孔动脉，造影观察其血液供应情况后，注入溶栓药物、扩血管药物及改善微循环药物，术后再次造影观察对比股骨头供血改变情况，并于12个月-36个月摄x线片与术前x线片对比观察股骨头骨质改变情况。结果治疗前后血管造影对照显示治疗后血管增多，股骨头染色增强，12个月-36个月后平片显示骨密度增高者占97．2％．临床症状明显改善。结论通过介入方法治疗股骨头缺血坏死是一种安全有效的治疗方法，能在临床上广泛应用。     

成人外伤性股骨头无菌坏死的介入治疗

目的：应用导管经旋股内，外动脉，闭孔动脉灌注治疗外伤性股骨头无菌坏死的研究，材料与方法，采用Ｓｅｌｄｉｎｇｅｒ‘ｓ穿刺超选择灌注溶通术，对３８例成人外伤性肥骨头无菌坏死患者经旋股内，外动脉，闭孔动脉灌注溶通药物，结果：介入治疗后３８例患才临床症状明显改善，髋关节疼痛，功能障碍等得到缓解或消失，治疗后Ｘ线复查坏死骨质均有不同程度的吸收，新骨形成及修复，结论：介入插管灌注溶药物法治疗成人外伤性股骨头无     

早期股骨头无菌坏死的治疗（附50例）分析

目的：研究经股动脉插管溶通术对股骨头缺血性坏死的疗效。方法：采用Seldinger穿刺技术经股动脉穿刺插管将5F—cobra导管超选择地送至旋股内、外侧动脉或闭孔动脉，先行股动脉DSA血管造影，观察患侧股骨头血供情况，造影后将导管插入病变血管，注入药物进行溶栓治疗。结果：治疗前后患髋股骨头血供情况明显改善，治疗前DSA血管造影显示：旋股内侧动脉分支部份狭窄或阻塞，治疗后血管记数明显增多，血管管经增宽，相互间吻合支增多，再通的血管显示良好。结论：介入治疗股骨头缺血性坏死能明显改善血供状况，创伤小、并发症少，血管再通率高，治疗疼痛症状明显改善，疗效显著。     

股骨头无菌性坏死的介入治疗

股骨头无菌性坏死是近年来非常多见的骨关节病之一，其主要病因是骨骼血运中断而引起的骨缺血坏死，介入方法通过导管经旋股内、外动脉、闭孔动脉灌注溶栓及扩张血管的药物，可使坏死骨质吸收，新骨形成及修复。临床症状明显改善，髋关节疼痛，功能障碍等得到缓解或消失。     

股骨头缺血性坏死的介入治疗

目的 探讨股骨头缺血性坏死介入治疗的临床效果。材料与方法 对２０例股骨头缺血性坏死病人,将溶栓药物和血管扩张药直接注入旋股内、外动脉和闭孔动脉。结果 ２０例病人在治疗后髋部疼痛及关节功能障碍均有不同程度减轻和改善。随访Ｘ线平片可见股骨头明显修复。血管造影及ＤＳＡ显示股骨头区血管数目基本达到正常。结论 通过介入治疗股骨头血性坏死,是一有在临床上广泛应用的新技术。     

股骨头无菌性坏死行介入治疗的护理

股骨头无菌性坏死介入治疗是采用经外周动脉穿刺插管的方法，经血管造影明确供血血管的位置，经导管向其内灌注溶栓药和扩张血管药物，达到改善股骨头供血状况的目的。其手术创伤小、见效快、病人容易接受。我院近年来．行股骨头无菌性坏死介入治疗术32例，对其进行回顾件总结．现将护理方法介绍如下。     

介入治疗股骨头缺血坏死(附28例报告)

目的 评价经股动脉插管溶通术对股骨头缺血坏死的治疗效果。方法 28例经临床和血管造影证实的股骨头缺血坏死患均接受了经股动脉插管溶通术治疗。该介入治疗操作是以Seldinger技术将5Fcobra导管经股动脉超选送至内，外侧旋股动脉后，进行血管造影与溶通治疗，结果 溶通治疗后，血管造影及DSA显示，股骨头缺血坏死病变区的血管计数明显增多。伴临床症状改善见于全部病例，其中，22例（79%）的疗效尤为显。结论 经股动脉插管溶通术能明显改善股骨头血供状况，它是目前治疗股骨头缺血坏死最安全，有效，可靠的方法。     

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.