部分性脾栓塞术62例术后并发症原因分析及防治措施探讨

目的探讨部分性脾栓塞(PSE)治疗脾亢的术后并发症及其预防、处理。方法62例各种原因所致的脾亢患者，采用Seldinger技术，用明胶海绵颗粒或／和明胶海绵条行PSE。结果技术成功率loo％，术后发热、腹痛62例，恶心、呕吐30例，穿刺部分血肿7例，肝功损害加重5例，肝功一过性损害22例。栓塞面积40％～70％54例，15例出现少量胸水，1例少量胸水伴左下肺炎，栓塞面积70％以上8例，4例出现较严重的并发症。结论PSE治疗脾亢安全、疗效肯定，术后综合症常见，经一般对症处理好转；只要病例选择适当，技术操作熟练，栓塞面积恰当，严重并发症少见。     

部分性脾栓塞介入治疗后并发症的相关性分析

目的：探讨部分脾动脉栓塞术后并发症的发生原因及预防措施和处理办法。方法：26例各种原因引起脾功能亢进患者，采用经股动脉穿刺插管行部分脾动脉栓塞术（PSE），栓塞材料为明胶海绵碎屑。术后注意生命体征，定期复查血常规、肝功能、脾CT或B超检查，并随访6月至一年。结果：术后6例患者出现各种并发症。并发症包括胸水、腹水、顽固性呃逆、肝肾功能损害、门静脉血栓、左下肺炎、脾脓肿等。结论：术后并发症发生率及其严重程度与栓塞面积及栓塞部位有直接关系；掌握脾栓塞术后的并发症及发生的原因，对预防和减少并发症的发生具有十分重要的临床意义。     

部分脾栓塞在肝癌伴脾亢介入治疗中的应用

目的：对原发性肝癌伴腺功能亢进（脾亢）患者行部分脾栓塞，使其血细胞恢复正常，以便能进一步行肝动脉化疗。方法：对46例不能行手术切除，且血细胞明显低于正常的肝癌伴脾亢的患者行部分脾栓塞，栓塞面积控制在50％－70％，栓塞前后测定血细胞数量，并作方差分析和t检验。结果：脾栓术后24h、48h、72h、1周、2周、4周的血白细胞和血小板均较栓塞前明显升高（P＜0．05或P＜0．01）。结论：部分脾栓塞能治疗脾功能亢进，提高血细胞数量，使肝癌伴脾亢患者的肝动脉化疗能正常进行。     

部分脾动脉栓塞治疗功能亢进临床探讨

笔者对７例脾功能亢进患者作部分脾动脉栓塞（ＰＳＥ）治疗，２例应用明胶海绵栓塞，２例应用真丝线段、３例应用明胶海绵、真丝线段行脾下极动脉超选择栓塞。经治疗后，全部病例均有效控制了脾功能亢进所至血小板减少和出血倾向。脾下极动脉真丝线段栓塞的优点：脾下要有动脉栓塞副作用少，且不会引起左侧膈肌和胸膜刺激症状；２．大网膜向梗死的脾下极游走包囊减轻和限制反应性炎症，使术后继发症状明显减轻；３．可准确控制栓塞面     

肝硬化门脉高压硬脾功能亢进的部分栓塞治疗

目的；对３６例肝硬化同压脾机能亢进患采用部分性脾栓塞术的治疗效果进行分析，找出确定其产的观测指标、栓塞范围和ＰＳＥ的临床应用价值。材料和方法：术前患周围血细胞计数三系均低，以白细胞、血小板降低为显。选择性插入脾动脉靶血管后先造影然后用抗生素液浸泡的明胶海绵颗粒栓塞。结果；脾动脉插管技术成功率１００％。３０例外周血白细胞和血小板计笋恢复到正常水平，５例部分缓解，、例无明显变化。术后凝血酶的时间     

部分脾栓塞术治疗肝硬化性脾功能亢进15例临床分析

目的　探讨部分脾栓塞术对治疗肝硬化性脾功能亢进的疗效及临床价值。方法　对 15例肝硬化性脾功能亢进患者进行了部分脾栓塞治疗 ;观察术前术后外周血象的变化、腹水消退及并发症发生情况。结果　 15例术后外周血象较术前明显改善。 5例有腹水者 ,腹水消失 4例 ,腹水减少 1例。术后并发症主要有左上腹疼痛 (15例 )、发热 (10例 )、左侧少量胸水 (3例 )。结论　部分脾栓塞术对治疗肝硬化性脾功能亢进症有明显疗效和重要的临床价值。选择合适的病人和严格的操作技术能避免严重并发症的发生     

部分性脾栓塞术治疗脾亢的疗效评价

目的:探讨部分性脾动脉栓塞术(PSE)在治疗脾功能亢进中的临床应用价值。方法:回顾性分析了02.12到05.4间采用部分性脾栓塞治疗的19例肝炎后肝硬化所致的脾功能亢进患者的临床材料,方法均采用明胶海绵颗粒加用庆大霉素选择性或超选择性脾动脉栓塞。结果:部分性脾动脉栓塞术后,患者血小板和白细胞在近期有明显升高,其中血小板较为持久和显著。结论:部分性脾动脉栓塞术治疗脾亢疗效肯定,并发症少,值得推广。     

经脾动脉行明胶海绵与碘化油栓塞治疗脾功能亢进的对照研究

目的探讨经脾动脉行明胶海绵和碘化油栓塞治疗肝硬化脾功能亢进(脾亢)的疗效与并发症,为临床治疗肝硬化脾亢栓塞剂的选择提供依据。方法回顾性分析40例肝硬化脾功能亢进患者行经脾动脉明胶海绵栓塞和39例行经脾动脉碘化油栓塞治疗的临床资料,观察两组患者外周血三系细胞改善和并发症以及复发情况。结果两组患者的脾脏体积回缩、血红蛋白、白细胞和血小板计数差异无显著性(P>0.05),但碘化油栓塞组患者6个月后有部分病例出现血小板再次减少,明胶海绵栓塞组术后并发症发生率高于碘化油栓塞组(P<0.05),碘化油栓塞组肝、胃肠道毒性分级均较明胶海绵栓塞组低。结论对高龄、肝功能差、腹水较多、凝血功能严重障碍、肝硬化门脉高压明显的患者可行经脾动脉碘化油栓塞治疗脾亢。     

明胶海绵在部分性脾栓塞中的应用

目的探讨明胶海绵在部分性脾栓塞中应用方法及价值。方法75例脾亢患者，根据导管位置，采用不同大小的明胶海绵行部分性脾栓塞治疗，栓塞范围50％～70％。结果75例，脾动脉主干用明胶海绵条栓塞8例，脾动脉远端用明胶海绵颗粒栓塞21例，脾中下极动脉用明胶海绵粉末加脾动脉远端明胶海绵颗粒栓塞20例，脾中下极动脉明胶海绵粉末栓塞26例。栓塞成功率100％，脾亢缓解率100％，无异位栓塞并发症发生。结论根据导管头端位置选用不同大小明胶海绵作栓塞剂，安全有效，栓塞成功率高，可避免或减少异位栓塞并发症。     

部分脾动脉栓塞术治疗肝硬化性脾功能亢进的临床评价

目的探讨部分脾动脉栓塞术(PSE)对治疗肝硬化性脾功能亢进的疗效及临床价值。方法对20例肝硬化性脾功能亢进患者进行了PSE;观察术前术后外周血象的变化、腹水消退及并发症发生情况。结果 20例患者术后外周血象较术前明显改善。8例有腹水者,腹水消失6例,腹水减少2例。术后并发症主要有左上腹疼痛(15例)、发热(10例)、左侧胸水(3例)。结论 PSE对治疗肝硬化性脾功能亢进症有明显疗效和重要的临床价值。选择合适的病人和严格的操作技术能避免严重并发症的发生。     

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.