外伤性颈动脉－海绵窦瘘球囊栓塞治疗

分析１８例外伤性颈内动脉－海绵窦瘘（ＴＣＣＦ）采用可脱性球囊栓塞治疗，１例ＴＣＣＦ采用弹簧圈栓塞治疗，均获成功。其中１０例栓塞后保持颈内动脉通畅，本文讨论了栓塞方法效果和有关的技术问题。     

肺外军团病1例报告

<正> 1 临床资料患者男性,26岁,入院前20d 无明显诱因出现畏寒、发热伴咽痛、胸闷,曾以感冒诊治,体温在39℃左右持续不退。入院前4d 出现腹泻、稀水样便,7～8/d,有时为血水样便,无明显腹痛、腹胀及里急后重,亦无恶心、呕吐,因高热持续不退而收     

广东省39所医院医务人员锐器伤调查

目的了解广东省医务人员血源性职业暴露的发生情况,为制定预防措施提供科学的依据。方法采用问卷调查方法,对广东省39所医院医务人员2011年6月锐器伤的发生情况进行横断面调查。结果发放调查表32 617份,回收32 297份,回收率为99.02%;实际有效问卷32 007份,有效率为99.10%。发生锐器伤1 460例,1 909例次,锐器伤发生率为4.56%,例次率为5.96%,平均月发生密度为0.06次/（人月）。发生污染锐器伤1 495例次,污染锐器伤例次发生率为4.67%（1 495/32 007）;污染锐器伤占锐器伤总例次的78.31%（1 495/1 909）,其中61.67%(922/1 495)能追踪到暴露源,38.33%（573/1 495）不能确定其是否具有传染性。血源性污染器械中,81.71%（67/82）为乙型肝炎暴露源,14.63%（12/82）为梅毒暴露源,3.66%（3/82）为丙型肝炎暴露源,无艾滋病暴露源。锐器伤发生的地点主要为普通病房（47.72%）与手术室(20.27%);频率最高的操作是加药(15.92%),其次为医疗废物处置(12.78%)和拔除动（静）脉针（12.21%）;主要医疗器具为一次性注射器 (35.99%)、头皮钢针 (19.43%)和手术缝针(13.41%)。医务人员职业暴露相关知识培训率为93.25%。结论锐器伤是导致血源性传播疾病感染的主要职业因素, 医疗机构应建立健全职业病防治组织机构和规章制度,规范医务人员的血源性职业暴露预防与控制行为,降低血源性职业暴露伤害风险。     

国产电解可脱弹簧圈的初步临床应用

目的 初步总结了国产JASPER电解可脱弹簧圈的临床应用经验.方法 采用117枚国产JASPER电解可脱弹簧圈栓塞颅内脑血管病共20例,其中颅内动脉瘤15例,硬脑膜动静脉瘘4例,外伤性颈动脉海绵窦瘘1例.20例中,单独应用JASPER电解可脱弹簧圈治疗9例,与其他品牌可脱弹簧圈联合使用者11例.结果 国产JASPER电解可脱弹簧圈在顺滑程度、解旋情况、软硬程度、成篮效果、致密填塞情况与进口同类产品无明显差别,电解脱时间为(41.19±8.68)s,15例颅内动脉瘤完全栓塞10例,次全栓塞5例;4例硬脑膜动静脉瘘3例完全栓塞,部分栓塞1例;1例外伤性颈动脉海绵窦瘘完全栓塞.数字减影造影(DSA)复查7例无复发迹象.结论 国产JASPER电解可脱弹簧圈性能可靠,临床效果确实.

Abstract：

Objective To report the primary clinical experience of JASPER electrolytically detachable coils in neurovascular intervention. Method 117 coils were used in 20 patients including 15 aneurysms ,4 dural arterio - venous fistula ( DAVF) and 1 CCF. Nine cases were embolized only with JASPER electrolytically detachable coils,and 11 cases were embolized by combined using of electrolytically detachable coils and other detachable coils. Results There was no significant difference between JASPER electrolytically detachable coils and other coils in visibility,flexibility,effect of forming a basket,uncoiling, dense packing and convenience of deployment The time needed for detachment was(41. 19 ± 8. 68) s. Ten aneurysms were totally embolized, the other 5 were subtotally occluded. Three DAVFs were totally embolized, the other one was subtotally occluded. One CCF was totally embolized. Seven cases of follow-up by DSA showed that there was no recurrence. Conclusions The efficiency and safety of JASPER electrolytically detachable coils are confirmed. The extensive use of JASPER electrolytically detachable coils could decrease the expense of patients for endovascular treatment.     

"三九"战酷寒

“三九”是一年中最冷的时段,进入“三九”也就意味着寒冬的到来。 由于强冷空气和寒潮冷锋活动频繁,每年的“三九”,都是各种疾病的高发期,不但流感易发,呼吸道疾病、心脑血管疾病、糖尿病、关节炎等常见病也伺机而动。