2孔法腹腔镜胆囊切除术8例

目的探索2孔法腹腔镜在胆囊切除术中的应用。方法分析8例施行2孔法腹腔镜胆囊切除术患者的临床资料。结果8例手术无中转开腹,均未放置引流,平均手术时间30min,平均出血量约30ml。术后无黄疸,恢复良好,平均住院天数3d。结论2孔法腹腔镜胆囊切除术是可行的。     

承德地区青少年肥胖现状及相关因素分析

青少年单纯性肥胖已引起全社会的关注,与肥胖有关疾病的发病率呈显著上升趋势。为了解承德地区中小学生肥胖的现状及其相关因素,笔者于2004年9月~2005年3月对承德市市区和郊区的5所学校4 857名中小学生进行了相关调查,结果报道如下。1对象与方法1.1对象根据承德市各区情况,以分层二级整群随机抽样的方法,确定承德市区和郊区5所学校的7~18岁学生4 857名作为调查对象。1.2方法自行设计肥胖调查问卷,调查项目有体格测量、实验检查、现场观察,并由调查人员填写问卷内容。肥胖的判断标准为中国肥胖工作组(WGOC)推荐的中国儿童青少年超重、肥胖…     

肾移植术后并发自体尿路上皮多器官癌六例的临床分析

Objective To analyze the etiology, clinical diagnosis and outcomes of 6 cases of multifocal urothelial carcinomas following transplantation. Methods A retrospective analysis was performed on 6 cases of multifocal urothelial carcinomas following renal transplantation in our center. Results Six patients were diagnosed as having multifocal urothelial carcinomas, including 1 case of related renal transplantation. Five cases were diagnosed by painless gross hematuria 2～48 months after renal transplantation, and I patient was diagnosed as having bladder tumors by B-uhrasound. All lesions happened un-simultaneously, from 1.5～16 months, and each case accepted operation 2～5 times. One case accepted radical cystectomy and cutaneous ureterostomy of the graft, and one accepted radical cystectomy, cutaneous ureterostomy of the graft and urethrectomy. All of 6 cases received OKT3 or Daclizumab as the induced-immunosuppressive therapy and tacrolimus or cyclosporine A + mycofenolate mofetil + steroid as the maintenance therapy. Intravesical chemotherapy started in all patients immediately after the surgery. All operations were successful and most patients got satisfactory results. Conclusions Kidney recipients have a higher rate of transitional cell carcinomas which are characterized by easy metastasis, and mostly have unsatisfactory prognosis. Kidney recipients with hematuria should be examined carefully with cystoscopy, retrograde pyelography and cystourethroscopy. A routine examination at regular intervals after transplantation is very important.     

肾移植术后并发自体尿路上皮多器官癌六例的临床分析

Objective To analyze the etiology, clinical diagnosis and outcomes of 6 cases of multifocal urothelial carcinomas following transplantation. Methods A retrospective analysis was performed on 6 cases of multifocal urothelial carcinomas following renal transplantation in our center. Results Six patients were diagnosed as having multifocal urothelial carcinomas, including 1 case of related renal transplantation. Five cases were diagnosed by painless gross hematuria 2～48 months after renal transplantation, and I patient was diagnosed as having bladder tumors by B-uhrasound. All lesions happened un-simultaneously, from 1.5～16 months, and each case accepted operation 2～5 times. One case accepted radical cystectomy and cutaneous ureterostomy of the graft, and one accepted radical cystectomy, cutaneous ureterostomy of the graft and urethrectomy. All of 6 cases received OKT3 or Daclizumab as the induced-immunosuppressive therapy and tacrolimus or cyclosporine A + mycofenolate mofetil + steroid as the maintenance therapy. Intravesical chemotherapy started in all patients immediately after the surgery. All operations were successful and most patients got satisfactory results. Conclusions Kidney recipients have a higher rate of transitional cell carcinomas which are characterized by easy metastasis, and mostly have unsatisfactory prognosis. Kidney recipients with hematuria should be examined carefully with cystoscopy, retrograde pyelography and cystourethroscopy. A routine examination at regular intervals after transplantation is very important.     

肝硬化伴脾功能亢进的部分脾栓塞治疗

目的：评价部分性脾栓塞治疗肝硬化所致脾功能亢进(脾亢)的效果和优势。方法：13例肝硬化伴脾亢的患者行经脾动脉大部栓塞术，并比较术前后相关指标，结果：脾栓塞为50％-80％，患者术后白细胞和血4、板计数明显上升，患者术后体力，精力明显改善，免疫功能无损害。结论：部分性脾栓塞是治疗肝硬化伴脾亢的有效方法，安全，损伤小，且能保留脾脏的免疫功能，使肝硬化患者能进一步治疗。     

胼胝体发育不全并颅内畸形的MRI诊断

目的 探讨胼胝体发育不全并颅内畸形的MRI诊断价值. 资料与方法 分析18例胼胝体发育不全并颅内畸形的常规MRI颅脑平扫资料. 结果 MRI显示10例胼胝体完全缺如,6例部分缺如,2例变薄.胼胝体发育不全在MRI上表现为半球间裂增宽,与第三脑室前部异常靠近或相连（100%）;两侧脑室前角平直、分离;室间孔分离;侧脑室体部扩大、平行或体部脉络丛夹角缩小;侧脑室枕角扩大;第三脑室扩大、上移.合并灰质异位（3例）、脑裂畸形（2例）、蛛网膜囊肿（2例）、脂肪瘤（4例）、透明隔缺如（1例）、光滑脑（1例）、脑穿通畸形（3例）、丘脑融合（1例）和空洞脑（1例）. 结论 MRI可以直接显示胼胝体形态,是诊断胼胝体发育不全并颅内畸形的最佳方法.     

颞下颌关节盘移位的MRI表现及其临床诊断价值

目的:探讨颞下颌关节盘移位的MRI表现及其临床诊断价值。方法:23例共46侧关节盘行斜矢状面和冠状面T1WI、T2WI及T2*WI扫描,分析关节盘在开口位和闭口位上的位置变化和关节盘的形态等。结果:46侧关节盘中有17侧(17/46)正常;可复性关节盘前移位11侧(11/46),主要MRI表现为闭口位时关节盘在髁状突前方,关节结节前下方,开口位时,关节盘回到关节窝正常位置,关节盘可变形伸长,后带膨大,信号基本正常;不可复性关节盘前移位15侧(15/46),主要MRI表现为在闭口位和开口位时关节盘位置均位于髁突前方,关节结节前下方,不回到关节窝内,关节盘形态严重变形,出现圆形、折叠型、伸长型等,关节盘信号基本正常;关节盘内侧移位2侧(2/46),外侧移位1侧(1/46),这两种类型主要MRI表现为关节盘变形,呈低信号改变。结论:MRI可以清楚显示关节盘的位置、结构及盘突关系,对颞下颌关节盘移位有重要的临床诊断价值。     

肾移植术后并发自体尿路上皮多器官癌六例的临床分析

Objective To analyze the etiology, clinical diagnosis and outcomes of 6 cases of multifocal urothelial carcinomas following transplantation. Methods A retrospective analysis was performed on 6 cases of multifocal urothelial carcinomas following renal transplantation in our center. Results Six patients were diagnosed as having multifocal urothelial carcinomas, including 1 case of related renal transplantation. Five cases were diagnosed by painless gross hematuria 2～48 months after renal transplantation, and I patient was diagnosed as having bladder tumors by B-uhrasound. All lesions happened un-simultaneously, from 1.5～16 months, and each case accepted operation 2～5 times. One case accepted radical cystectomy and cutaneous ureterostomy of the graft, and one accepted radical cystectomy, cutaneous ureterostomy of the graft and urethrectomy. All of 6 cases received OKT3 or Daclizumab as the induced-immunosuppressive therapy and tacrolimus or cyclosporine A + mycofenolate mofetil + steroid as the maintenance therapy. Intravesical chemotherapy started in all patients immediately after the surgery. All operations were successful and most patients got satisfactory results. Conclusions Kidney recipients have a higher rate of transitional cell carcinomas which are characterized by easy metastasis, and mostly have unsatisfactory prognosis. Kidney recipients with hematuria should be examined carefully with cystoscopy, retrograde pyelography and cystourethroscopy. A routine examination at regular intervals after transplantation is very important.