宫腔纱条填塞法治疗前置胎盘剖宫产术中大出血疗效

目的观察宫腔纱条填塞法治疗前置胎盘剖宫产术中大出血的效果。方法对30例前置胎盘剖宫产术中大出血患者在采用常规环形间断缝合止血无效情况下,实施宫腔纱条填塞法治疗,回顾性分析患者的临床资料。结果除1例宫腔纱条填塞失败后行子宫大部切除术外,余29例均止血成功。24 h后经阴道顺利取出填塞纱布。2例术后体温升高患者经对症治疗后痊愈,未再出现大出血及产褥感染等并发症。本组平均手术时间(38.60±12.66)min,平均输血量(468.22±189.78)mL,平均住院时间(11.26±3.22)d。28例患者产后获1.5~3个月随访,子宫复旧良好。结论对前置胎盘剖宫产术中大出血患者,采用宫腔纱条填塞法止血,有效率高,术后并发症少,预后良好。     

3种牙膏用于缓解超声龈上洁治术后牙本质敏感症的疗效观察

目的:观察对治疗超声龈上洁治术后牙本质敏感的疗效.方法:采用区组随机分组法将患者分为3组,分别于超声龈上洁治术后采集基线资料,采用指定的牙膏进行牙面抛光处理,然后按照指导的方法使用指定的牙膏刷牙7天.分别在基线时、抛光完成后以及7天试验结束后测定患者对冷水刺激反应的目测摸拟疼痛评分法(visual analogue scale,VAS)值,以及吹气敏感刺激值.结果:114例患者完成了本试验.在抛光后检查发现:无论是冷水刺激VAS评分还是吹气刺激评分,高露洁专效抗敏牙膏和口腔脱敏糊剂均能有效的减轻牙本质敏感症状.高露洁专效抗敏牙膏与口腔脱敏糊剂和高露洁健白防蛀牙膏相比,冷水刺激VAS评分降低了33.50％和34.25％,吹气刺激评分降低了48.75％和50.48％.在使用相应牙膏刷牙7天后,3组牙本质敏感症状均有所降低.高露洁专效抗敏牙膏与另两组相比冷水刺激VAS评分降低了41.81％和51.86％,吹气刺激评分降低了41.83％和60.96％.结论:在超声龈上洁治术后,使用高露洁专效抗敏牙膏和口腔脱敏糊剂进行牙面抛光能够有效缓解牙本质敏感程度:术后使用3种牙膏刷牙7天均能有效缓解牙本质敏感程度.组间比较发现:无论是在洁治抛光后还是使用相应的牙膏刷牙7天后,与另两组相比较,高露洁专效抗敏牙膏能更好的缓解牙本质敏感症程度.     

脾动脉栓塞治疗慢性特发性血小板减少性紫癜51例疗效观察

目的回顾性分析脾动脉栓塞治疗特发性血小板减少性紫癜的临床疗效。方法选择5l例药物治疗无效的特发性血小板减少性紫癜,采用seldinger技术对脾动脉进行部分栓塞,栓塞面积约80%左右,并于术后定时复查血常规,观察其疗效。结果手术的即时性疗效为50例（98.0%）,近期疗效为41例（80.4%）,远期疗效为66.7%。结论对内科治疗无效的特发性血小板减少性紫癜部分脾动脉栓塞术是一种较理想的治疗方法。     

纯钛等离子涂层圆柱状骨内种植体与周围骨界面的三维结构分析

目的:通过组织形态学的方法评价和分析纯钛等离子涂层圆柱状骨内种植体与周围骨界面的三维结构情况。方法:选择2只成年雄性比格犬,拔除双侧下颌第二、第四前磨牙,自行愈合3个月,植入纯钛等离子涂层圆柱状种植体,共8枚。3个月后处死动物,取下包含种植体的下颌骨,固定后用自动磨片机切片、染色、拍照数字化后输入计算机构建三维结构模型并分析。 结果:种植体平均骨接触率(bone contact ratio,BCR)为(64.5±5.3)%,最高在舌侧和上部,最低在近远中和底部。平均骨体积率(bone volume ratio, BVR)为(68.9±4.4)%,最佳在舌侧150~225 μm带和上部,最差在近远中0~75 μm带和底部。 结论:纯钛等离子涂层圆柱状骨内种植体与周围骨界面的三维结构能清晰的构建出来,二者能形成良好的结合,特别是在皮质骨致密的舌侧和上部。     

Effect of Liujunzi Decoction (六君子汤)Supplemented with Radix Astragali to Enhance Cellular Immune Function of Hepatocarcinoma Patients after Transcatheter Arterial Chemoembolization

Inrecentyears,transcatheterarterialchemoembolization(TACE)hasbeenthefirstchoiceofnon-surgicaltherapytotreathepatocarcinoma(HC),especiallytheHCinintermediateandlatestages.Thepost-operativeimmunotherapyforHCusinginterferon,interleukin-2,tumornecrosisfactor(TNF),andotherbiologicreponsemodifiers(BRM)hasbecomeanewmodeloftreatment(1,2).ButtheclinicalapplicationofBRMislimitedbecausethedrugsareveryexpensiveandproduceserioussideeffectswhenusedinlargedoses.Accordingtosomereports(3,4),theLi.ujunz…     

014.颌内动脉结扎治疗鼻衄

本文分析192例因鼻衄严重而住院的病例。病因分析计:高血压89,血液病15,手术后13,肿瘤4,外伤4,未明67例。处理方法分析计:前鼻孔充填61例,后鼻孔前鼻孔充填71例。手术处理计:颌内动脉结扎14,筛前动脉结扎6,颈外动脉结扎3,中隔矫正3,中隔植皮3,其他31(包括电灼)。颌内动脉结扎方法:用加肾上腺素之2％利多卡因局部麻醉,注入翼上颌裂、上唇下面、下鼻道及下鼻甲,经上颌窦径路,切除上颌窦骨性后壁,打开骨膜,露出脂肪垫,轻轻将脂肪移向窦内,去除脂肪后,即可见到颌内动脉,分别在动脉近侧端远侧端用银夹夹闭。全部病例即刻止血。作者并提出颈外动脉结扎虽然止鼻血的效果也很好,但其防碍了面部的重要循环。     

HYPERCATECHOLAMINISM CLINICAL AND PATHOLOGIC MANIFESTATIONS OF 37 CASES

This paper presents the clinical and patho- logic material of 37 cases of catecholaminism including 34 cases of pheochromocytoma and paraganglioma and 3 cases of hyperplasia of adrenal medulla. Among the 34 cases with tu- mor, 36 tumors were found, 1 patient had mul- tiple tumors. Except for 6 tumors iocated beside the abdominal aorta and extra-abdominal cavity, most were found in the adrenal glands on both sides. Tumor size varied from l.5 x 1.5 X 1.2 t0 16 X 13X16 cm. Of the 34 cases, 28 had benign tumors, 3 malignancy and 3 suspected malignancy. There were no differences in manifestations of tumors or hyperplasia. The series was classified into pa- roxysmal hypertensive type 16, persistent hyper- tensive type 20 and asymptomatic type l. During attacks 3 exhibit.ed hypotension and 3 were as- sociated with obesity. In diagnosis, patients with the disease mani- fest notably hypertension associated with poly- morphic vegetative nervous symptoms like sweating, pallor and vomiting. Laboratorily, determination of urinary catecholamines and 3- methoxymandelic acid or vanilmandelic acid (VMA) is recommended preferentially, the re- sults being conspicuously elevated in the disease. In this series, VMA determination was more advantageous than catecholamine determination. In t.umor localization, retroperitoneal pneu- mography with aortic angiography seem to give satisfactory results. In some patients with pneu- mographic negative findings the tumor site may be shown by aortic angiography. The diagnostic criteria of medullary hyper- plasia are: a. clinical manifestations and esti- mation of urinary VMA and catecholamines support presence of hypercatecholaminism, b. perirenal pneumography and aortic angiography fail to show a space-occupying lesion.     

颈静脉球体瘤的治疗

颈静脉球体瘤又称化学感受器瘤或非嗜铬性副交感神经瘤。颈静脉球体正常直径为0.5～2.5毫米,位于颈静脉球隆起静脉壁外膜,含有神经纤维和小血管团块。亦可原发于舌咽神经鼓室支。肿瘤50％发生在中耳下壁,首先充满中耳,破坏鼓膜,突出在外耳道,或经乳突岩部破坏迷路,向上入后颅凹,偶见侵犯至鼻咽部者。颅内侵犯多局限于硬脑膜之外。患者年龄40—60岁,女性较多。主要症状为耳鸣、耳聋、耳流脓、眩晕、耳疼、声嘶、头痛、霍纳(Horner)氏征,运动失调等。凡肿瘤已穿破鼓膜,在耳内可见出血性肿物,呈息肉状、暗红色,血管丰富。可合并Ⅶ、Ⅷ、Ⅸ、Ⅹ、Ⅺ、Ⅴ及Ⅻ颅神经症状。病理切     

脾动脉栓塞术在肝癌伴肝硬化脾功能亢进中的应用

目的 探计部分脾动脉栓塞术(PASE)对原发性肝癌伴肝硬化脾功能亢进综合治疗的应用价值. 方法对20例在综合治疗过程中应用PASE的原发性地癌伴肝硬化脾功能亢进串者的临床资料进行回顾性分析. 结果 PASE术后24h、48h、72h、1周的血白细胞和血小板均较栓前明显升高(P ＜ 0.05 和 P ＜ 0.01).结论 PASE能有效改善肝癌合脾功能亢进患者的外周血象,控制脾功能完亢进,减少术前及中用血,提高患者手术耐受力,与肝动脉栓塞化疗联合应用,能延长生存期,提高生存质量.     

金属内支架置入治疗恶性胆道梗阻的临床效果

目的评价金属内支架置入治疗恶性胆道梗阻的临床效果。方法对37例恶性阻塞性黄疸患者行经皮肝穿刺金属内支架置入术。结果采用经皮经肝穿刺置入胆管支架均获成功,37例患者术前血清胆红素(388±153)μmol/L,术后1周复查血清胆红素下降至(170±99)μmol/L(P<0.01)。结论胆道金属支架置入是有效解除胆道恶性梗阻的方法,对中晚期恶性梗阻性黄疸病人为一种较好的姑息性治疗手段。