血液净化治疗急性氟硅酸钠中毒

氟硅酸钠是一种剧毒的无机氟化物 ,一般用于金属防腐剂。 2 0 0 1年 3月 2 3日下午 5时左右 ,乡村某户主误将氟硅酸钠粉末混同米粉炒黄当成炒粉 ,厚涂于糯米圆外层 ,因混和不均 ,每只糯米圆约含有氟硅酸钠 2～ 3ｇ左右 ,导致11例食物中毒的重大事件。发病 10ｈ后死亡 1例 ,其余     

医源性股动脉假性动脉瘤的治疗方法

Objective To evaluate the effect on ultrasound-guided locsl comprression and surgical to treat iatrogenic fem- oral artery pseudoanerurysms. Methods 197 patients were diagnosed as iatrogenic femoral artery pseudoaneurysms from Apri 1199 to April 2008.There were 122 male and 75 female, aged 59.7 years (rimed 40- 81 years). One. Hundrel and severty-one stahle cases were managed by ultrasound-guided local compression initially and 26 patients were directly treated with surgical repair because d the rupture of femoral artery pesudoaneurysms or the pseudoaneurysms≥40mm in diameter. Results 171 patients received llocal com- pression therapy, 137 cases were cured directly (the effective rate was 80%), but the last failed 34 cases were required conversion to surgical reparr. The nymber of the surgical repaired patients was 60 (incluing 26 cases with direct operation and 34 cases with required conversion to surgical repair). Forty-seven patients received direct excision of femoral artery pseudoaneurysm, six patients underwent angioplasty with autogenously saphenous vein patch, and seven patients got bypass operation with artificial vascular graft. During the perioperative period, no serious complications including bleeding, neuralgia, and lymphatic fistula even arterio venous fis- tula and so on, no death occurred. All patients were followed up for 1 month to5 years after the procedures, no local FAP recurred, no limb ischemia developed and no deaths occurred. Conclusion Uitrasound-guided compression, surgical repair, and ultrasound- guided percutaneous thrombin injection are the three main modalities of treating iatrogenic FAP, while ultrasound-guided compresson and magical therapy get popularized domestically. Ultrasound-guided comperession seems a safe, inexpensive, and effective method for the managerment of iatrogenic femoral artery pseudoaneurysms. It may be used as a lust-line therapetic modality for mint of the un-complicated patients. However, surgical repair can be reserved for those who failed comperssion therapy or unsuitable as mentioned above.     

周围动脉硬化性疾病与脑卒中及冠心病的相关性

目的 探讨我国周围动脉性疾病(PAD)与冠心病和脑卒中的相关性.同时调查在下肢缺血的周围动脉性疾病患者中凉、麻、疼痛及间歇跛行等症状的发生率及其与踝臂指数(ABI)下降程度的关系.方法 前瞻性地对2006年3月至2007年12月心脏科、神经科和血管科患者进行统一ABI测量并记录病史、射血分数、冠状动脉造影和颈动脉超声结果 ,统计ABI与观察指标的相关性.对PAD患者记录其凉、麻、痛、间歇跛性行和溃疡等症状的程度,并统计各种症状的发生率及其与ABI的相关性.结果 心脏科132例患者中,ABI<0.9的发生率为29.5%,神经科124例患者中,ABI<0.9的总发生率为17.7%.随着ABI的降低,射血分数逐渐降低,冠状动脉和颈动脉病变程度也逐渐加重.在血管科患者中,ABI均值越低,凉、麻、痛、间歇跛行的程度越重,各种症状为重度时ABI的值大致都在0.4左右.结论 29.5%的的冠心病和17.7%的脑卒中患者合并PAD,患者中7.2%的人同时患有这3种疾病.PAD的严重程度与冠心病和脑卒中的严重程度相关.在PAD患者中,随着ABI的降低,肢体缺血症状逐渐加重,当ABI<0.40时各种症状显著加剧.     

大鼠不同部位骨骼对外源性甲状腺激素反应性的研究

目的：用左旋甲状腺素（L－T4）制备实验性甲状腺功能亢进（甲亢）大鼠模型，以探讨甲亢大鼠的胫骨和椎骨对外源性甲状腺激素的反应性，为临床监测长期L-T4治疗提供依据。方法：9周龄雄性Sprague-Dawley(SD)大鼠18只，随机分为甲亢组11只、对照组7只。甲 亢组予L－T4腹腔内注射，对照组予生理盐水注射，连续注射3周后取大鼠的胫骨近端、第四腰椎用非脱钙骨组织形态学计量法进行同期观察和研究。结果：在胫骨甲亢组的骨小梁数量降低，骨形成表面、吸收表面均增加，但骨吸收表面增加更明显，骨小梁平均宽度、骨纵向生长率降低，而骨矿化率增加。椎骨未观察到此变化。结论：L－T4引起继发性胫骨骨量减少，骨转换增加，椎骨无反应，表明不同部位的骨骼对甲状腺激素的反应存在异质性。     

23例锁骨下动脉瘤的诊治经验

目的总结和探讨锁骨下动脉瘤的诊断和治疗方法。方法1990年1月至2006年8月诊治锁骨下动脉瘤23例,其中真性动脉瘤10例,假性动脉瘤13例。男15例,女8例,年龄16-68岁,平均26．8岁。病因包括：创伤性12例,动脉硬化性5例,感染性1例,动脉炎性2例,病因不清3例。合并动脉瘤破裂2例,动脉栓塞1例、外伤性动静脉瘘2例。本组行外科手术16例,采用锁骨上、下或开胸入路,15例重建锁骨下动脉,1例结扎;行腔内隔绝术3例;保守治疗4例。结果本组无手术死亡;重建的锁骨下动脉通畅率为100％;有1例因动脉炎出现吻合口假性动脉瘤,其余无复发。结论外科手术治疗锁骨下动脉瘤是很困难的,正确切口入路的选择是确保手术成功避免并发症的关键。腔内修复术治疗操作简单,但并不能完全替代外科手术,其远期疗效尚待观察。     

医源性股动脉假性动脉瘤的治疗方法

Objective To evaluate the effect on ultrasound-guided locsl comprression and surgical to treat iatrogenic fem- oral artery pseudoanerurysms. Methods 197 patients were diagnosed as iatrogenic femoral artery pseudoaneurysms from Apri 1199 to April 2008.There were 122 male and 75 female, aged 59.7 years (rimed 40- 81 years). One. Hundrel and severty-one stahle cases were managed by ultrasound-guided local compression initially and 26 patients were directly treated with surgical repair because d the rupture of femoral artery pesudoaneurysms or the pseudoaneurysms≥40mm in diameter. Results 171 patients received llocal com- pression therapy, 137 cases were cured directly (the effective rate was 80%), but the last failed 34 cases were required conversion to surgical reparr. The nymber of the surgical repaired patients was 60 (incluing 26 cases with direct operation and 34 cases with required conversion to surgical repair). Forty-seven patients received direct excision of femoral artery pseudoaneurysm, six patients underwent angioplasty with autogenously saphenous vein patch, and seven patients got bypass operation with artificial vascular graft. During the perioperative period, no serious complications including bleeding, neuralgia, and lymphatic fistula even arterio venous fis- tula and so on, no death occurred. All patients were followed up for 1 month to5 years after the procedures, no local FAP recurred, no limb ischemia developed and no deaths occurred. Conclusion Uitrasound-guided compression, surgical repair, and ultrasound- guided percutaneous thrombin injection are the three main modalities of treating iatrogenic FAP, while ultrasound-guided compresson and magical therapy get popularized domestically. Ultrasound-guided comperession seems a safe, inexpensive, and effective method for the managerment of iatrogenic femoral artery pseudoaneurysms. It may be used as a lust-line therapetic modality for mint of the un-complicated patients. However, surgical repair can be reserved for those who failed comperssion therapy or unsuitable as mentioned above.     

静脉曲张术后深静脉内径及功能变化的研究进展

原发性下肢静脉曲张是由于血液由深静脉向浅静脉反流而引起的.高压反流的血液通过反流点远心端的一支或多支穿静脉回流入深静脉,从而形成了"深静脉-浅静脉-穿静脉-深静脉"之间的无效循环.进入该循环的血液增加了穿静脉及深静脉的血流负荷,导致二者扩张,继而可能出现功能不全,此即为"超载理论".而不同类型的静脉曲张手术,若能有效阻...     

北京市某医院医务工作者感染性职业暴露状况调查

<正>医务工作者频繁接触罹患各类疾病的患者，在提供诊疗、护理服务过程中，容易接触带有各类病原体的体液、血液或含患者体液、血液的医疗废弃物，是感染性职业暴露的高危人群^[1]。合理减少锐器的使用、更换安全器械、规范诊疗护理操作及规范职业防护措施等，有助于预防感染性职业暴露^[2]。本研究调查分析北京市某医院医务工作者感染性职业暴露现状，旨在寻找职业暴露的危险环节或时间等，为其职业防护提供参考依据。1对象与方法1.1研究对象     

瑞舒伐他汀辅助治疗下肢深静脉血栓形成的临床疗效观察

目的 探讨瑞舒伐他汀辅助治疗下肢深静脉血栓形成（deep vein thrombosis, DVT）的疗效。方法 选取2018年1月至2020年12月首都医科大学附属北京世纪坛医院DVT患者262例。按DVT治疗方式分为手术组（98例）和非手术组（164例），各组按1∶1比例随机分为干预组和对照组。干预组给予瑞舒伐他汀（10 mg/次，1次/d，晚饭后口服），对照组给予安慰剂片（由我院制剂室采用淀粉制成，性状及用法同瑞舒伐他汀），疗程均为4周，入组后第3、6、12个月末门诊复查随访。比较各组近期疗效，包括症状、肢体周径差、D-二聚体、静脉再通率；及远期疗效，包括DVT复发率和血栓后综合征（post-thrombotic syndrome, PTS）发生率及并发症。结果 262例患者中，男119例，女143例，年龄20～70岁，平均（57.6±13.7）岁；完成随访243例，失访19例，失访率7.25%。手术组中，两组近期疗效及远期疗效的比较，差异均无统计学意义（P>0.05）；非手术组中，干预组近期疗效有效率高于对照组（92.86%比81.01%）,DVT复发率和PTS发生率低于...     

基于倾向性评分匹配的三维CT静脉造影与下肢静脉顺行造影对复发性静脉曲张评估效果的比较

目的比较下肢三维CT静脉造影与下肢静脉顺行造影在评估复发性静脉曲张中的应用价值。方法回顾性收集2015年1月至2020年12月就诊于首都医科大学附属北京世纪坛医院血管外科并接受微创手术治疗的235例单侧复发性静脉曲张患者的临床资料。男性112例, 女性123例, 年龄(62.5±11.4)岁(范围:24～75岁), 按照影像学检查方法将患者分为三维CT静脉造影(CTV)组(检查方法为下肢静脉超声+CTV)和对照组(检查方法为下肢静脉超声+静脉顺行造影), 采用倾向性评分匹配法对两组患者进行1∶1匹配, 匹配后CTV组和对照组均43例。采用独立样本t检验、Willcoxon秩和检验、χ2检验、线性回归分析等方法比较匹配后两组患者术后1年的随访情况。结果术后1年, CTV组患者的静脉疾病严重程度评分(VCSS)低于对照组[M(IQR), 3.0(4.3)分比4.0(5.8)分, Z=-2.038, P=0.040], 慢性静脉功能不全患者生活质量问卷(CIVIQ-20)评分高于对照组[89.0(8.0)分比 82.5(17.0)分, Z=-2.627, P=0.010]。CTV组患者溃疡愈...