外伤性脾破裂102例

1982～1995年我们共收治外伤性脾破裂102例。1临床资料1．1一般情况本组男73例，女29例。年龄4～76岁，平均33．57±14．69岁。真性脾破裂96例，占94.1％，其中延迟性脾破裂21例，占20．6％。假性脾破裂（包膜下出血）6例，占5．9％。真性脾破裂均行手术治疗，假性脾破裂行非手术治疗。102例全部治愈。1．2致伤因素交通事故47例，占46．1％，其中汽车致伤38例，占373％；殴打伤30例，占29．4％；摔伤18例，占17.6％；其它7例，占6.9％。1．3伤情发生休克66例（64．71％），腹腔积血100～6000ml，平均1949．5±1242．4ml。多发伤56例（54．9…     

卵泡破裂合并脾破裂1例

患者××× ,43岁 ,农民 ,住院号 2 3 3 3 4,以持续性酸痛 5ｈ ,伴晕厥 3次于 1999年 2月 2 1日住院。末次月经 1999年 2月 8日。 2月 2 1日早晨 9点左右进餐时突然感觉下腹酸痛伴下坠感 ,随之晕倒 ,扶至床上休息后疼痛未减轻 ,并出现恶心 ,呕吐一次 ,立即送往医院 ,路途中发生 3次晕厥。既往体检 ,否认外伤史。查体 :体温 3 6.8Ｃ ,脉搏 112次 /ｍｉｎ ,呼吸 2 4次 /ｍｉｎ ,血压9/6Ｋｐａ。贫血外貌 ,腹稍膨隆 ,全腹压痛明显 ,有反跳痛 ,可叩及移动性浊音 ,肝脾触诊不满意。妇科检查 :外阴婚产式 ,阴道通畅 ,无流血 ,后穹隆饱满 ,宫颈举痛…     

外伤性脾破裂保脾治疗59例

1975年1月～1997年3月,我院收治外伤性脾破裂135例,其中保脾治疗59例,疗效满意。1　临床资料1.1　一般情况　男41例,女18例;年龄4～55岁,平均28.5岁,其中8～20岁42例(71.2%)。致伤原因:车祸伤32例(54.2%),坠落伤18例(30.5%),挤压伤6例(10%),斗殴致伤3例(5%)。伤后至入院时间:1h内9例,2h23例,3h19例,6h5例,48h3例。按李广华等〔1〕1992年提出损伤分度方法:本组度19例(32.1%),度15例(25.3%),度22例(37.3%),度3例(5%),均为闭合性损伤。合并休克45例。伴有合并伤8例,其中左侧肋骨骨折4例,后腹膜血肿1例,肾挫伤2例,轻度脑挫裂伤1例。1.2　治疗方…     

脾动脉结扎伴脾修补治疗外伤性脾破裂

１９５２年Ｋｉｎｇ和Ｓｃｈｕｍａｃｋｅｒ首次证实婴儿脾切除术与暴发性败血症的关联后，逐步深入的脾免疫功能研究已确认脾是一个重要的免疫器官。因此，尽可能地施行保脾性手术成为当今处理脾损伤的主旋律。笔者自１９８８年１月～１９９６年１２月，应用脾动脉结扎伴...     

脾外伤行脾部分切除术11例报道

我院自2003年以来，对11例外伤性脾破裂实施脾部分切除术，效果好，报道如下：     

脾部分切除治疗外伤性脾破裂15例报告

目的:探讨脾部分切除在脾破裂治疗中的应用.方法:回顾分析我院2001～2007年共15例采用脾部分切除治疗的外伤性脾破裂病人的临床资料,总结手术适应证、手术方法及技巧.结果:15例病人均手术成功,痊愈出院,术后随访1年免疫学及血常规均正常.结论:脾部分切除治疗外伤性脾破裂安全、有效.     

外伤性脾破裂脾动脉栓塞的治疗

外伤性脾破裂脾动脉栓塞既保留了脾脏又阻止了脾脏继续出血,临床效果良好。本文介绍最近几年外伤性脾破裂的基础与临床研究。     

迟发性脾破裂的CT诊断（附11例分析）

目的：分析迟发性脾破裂的临床CT特点,旨在为临床诊断提供客观依据。方法：11例病人伤后至就诊时间为2－14天,CT先按常规平扫,其中9例加做了9例加做了强化检查。4例经手术治疗,7例保守治疗并追踪随访。结果：（1）实质血肿5例,其3例为界限清楚的低密度“血湖”影,2例呈不规则低密度“裂隙”影。（2）包膜下血肿3例,呈边界清楚光滑的“新月形”或“半月形”低密度区。（3）混合血肿2例,表现为实质血肿与包膜下血肿并存。（4）脾挫裂伤1例,表现为弥漫性低密度区内有斑片状高密度出血影。结论：CT表现具有特征性,对临床治疗方案的选择有重要价值。     

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.