子宫肌瘤CT误诊28例分析

目的:探讨子宫肌瘤CT误诊原因,提高子宫肌瘤CT诊断。方法:回顾分析28例术前CT误诊的子宫肌瘤的临床资料。结果:28例子宫肌瘤误诊为卵巢癌、卵巢子宫内膜异位囊肿、宫外孕及子宫肥大症。26例子宫肌瘤过大,CT表现为宫外肿块,密度不均,对子宫肌瘤囊变、坏死、变性认识不足是误诊的主要原因;2例CT表现为子宫弥漫性增大,宫腔偏位不明显,肌瘤与正常子宫壁密度差别不明显造成误诊。结论:提高对CT诊断子宫肌瘤准确率,减少误诊。     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

VSD治疗76例皮肤缺损创面的护理体会

方法:总结76例手、足皮肤软组织严重缺损伴肢体骨折、血管、肌腱损伤的创面,前期采用有效清创后给予VSD治疗,后期再行植皮术或皮瓣转移术封闭创面。术后加强负压装置的管理、密切观察创面情况变化、指导早期功能锻炼,同时做好心理护理和营养支持。结果:76例病人通过VSD治疗后,73例病人创面肉芽组织生长新鲜、覆盖良好,后期植皮成活良好;其中2例足部脱套伤创面部分组织坏死严重,经过再次扩创后VSD治疗后创面修复良好,植皮成功;1例创面挤压严重,水泥和机油污染重,经过三次扩创并VSD治疗后植皮成功。     

医护人员文献获取满意度影响因素及对策

以首都医科大学附属北京妇产医院图书馆为例，分析医护人员文献获取存在的问题，探讨相应的策略，包括构建一站式检索平台、建立多元化信息沟通渠道、改革培训方式、提高馆员素质等方面。     

YC2270/0.3-12Ⅳ型高压氧舱特殊检修

故障现象正常工作中,突然断电,停止工作. 分析检修由于操纵台及氧舱全部断电,考虑总电源部分故障.先查电控柜,电源输入正常,而隔离变压器 TC次级熔断器 FU1/10A烧断,说明电路有大电流经过,可能是短路所致,不能冒然更换 FU1,以防烧毁其他器件.关闭总电源,将隔离变压器 TC次级所带负载断开,并分成两部分 (见操纵台电路图和电控柜电路图 ),先检查前部分,用万用表欧姆挡按线号接 1、 2端,测其阻值为 0,说明故障出在该部分电路.依次断开开关 SA1、 SA2、 SA4、 SA5,其阻值为 0;断开小型交流-直流交换器、 UPS、对话机、舱氧浓度显示仪,其阻值仍为 0;电路中只剩下两只照明灯和一电源指示灯,结果测出副舱应急照明灯短路,将这批非正规厂家生产的节能灯全部更换后,开机设备运转正常.     

低张服水螺旋CT扫描对胃癌的TNM分期诊断价值

目的 探讨胃癌螺旋CT的TNM分期诊断价值。资料与方法 50例经胃镜证实的胃癌患者进行低张服水螺旋CT扫描。根据胃癌的部位，大小，范围，浸润程度，周围淋巴结及脏器转移情况进行TNM分期，并与术后病理分期对照。结果 低张服水螺旋CT对胃癌TNM分期准确性为76%，其中T分期准确性为78%，N分期准确性为62%，M分期准确性为96%。结论 低张服水螺旋CT检查的TNM分期对评估胃癌的手术方案及临床治疗有较大的价值。     

网上图书馆自动化管理系统—CSLN

进入新世纪后,医疗服务市场竞争更加激烈,医院间合并或扩建新院址渐成一种风潮,同时也带来了分院与总院、新院与老院之间统一管理的问题.在两院物理距离较远,又没有联网的情况下,要想做到统一管理十分困难.     

维生素K_3在胃螺旋CT检查中的低张评价

低张服水是胃螺旋CT检查前的至关重要的准备工作.654-2作为低张药物,在胃螺旋CT检查前肌注低张效果已得到临床认可.然而,由于654-2存在一些禁忌证和不良反应,受到一定的限制.笔者应用Vit K3代替654-2进行胃螺旋CT检查,达到较好的效果.现报道如下.