山药粉治疗婴幼儿腹泻110例

山药粉治疗婴幼儿腹泻１１０例青岛市第二人民医院（２６６０３３）徐丽园，王素珍，周文丽青岛市市北区中医院（２６６０３１）徐秀芳关键词山药粉；婴幼儿腹泻；疗效观察腹泻是婴幼儿常见病，其发病率高，对婴幼儿健康危害较大，是导致小儿营养不良、影响生长发育的重要...     

家兔饥饿死亡过程中肝脏~(31)P MRS磷代谢物变化特征与病理改变相关性研究

目的:探讨家兔饥饿死亡过程中肝内~(31)P磁共振波谱学(MRS)磷代谢物变化特征与病理改变相关性.方法:建立家兔饥饿死亡模型22只,分成2组,即病理组和MRS检测组.病理组12只:分成4个亚组,即正常对照组、过度饥饿组、濒临死亡组和死亡组,每组3只,取肝组织作病理检测.MRS检测组10只:分别于饥饿前、过度饥饿期、濒临死亡期及死亡期行~(31)P MRS检测4个阶段的磷代谢物含量变化,检测内容包括磷酸单脂(PME)、无机磷(Pi)、磷酸二脂(PDE)、三磷酸腺苷(ATP)的相对值,并与病理检测结果作对照分析.所有数据采用Kruskal-wallis H统计学方法进行非参数χ~2检验,并用Sperman方法进行等级相关性检验.结果:家兔饥饿死亡过程分的4个阶段,即从正常-饥饿-濒临死亡-死亡,4种肝内磷代谢物相对量从正常至死亡过程中均出现明显变化,经统计学分析均有显著性差异, χ~2值为23.13～35.41,P值均 < 0.01;ATP相对值与疾病严重程度呈负相关,即随着病程加重呈明显下降趋势至最后耗尽,其相对值分别为2.54±0.53、1.73±0.14、0.88±0.23、0.05±0.08,经等级相关性检验,r_s=1.0,P<0.01;而PDE和Pi相对值均呈正相关,即随着病程加重呈明显上升趋势,死亡后最高,PDE相对值分别为1.25±0.54、2.76±0.23、3.33±0.49、3.87±0.43,Pi相对值分别为0.42±0.02、0.65±0.05、0.89±0.15、0.99±0.08.经等级相关性检验,r_s= 1.0,P<0.01;PME相对值与病程无明显相关性,经等级相关性检验,r_s=0.4,P=0.6.家兔从正常-饥饿-濒临死亡-死亡4个阶段的病理改变为:肝细胞形态逐渐变小、数量减少;肝细胞肿胀、变性逐渐加重,并最终出现不同程度肝出血和肝细胞坏死.结论:~(31)P MRS可动态监测并准确反映家兔从饥饿到死亡过程中磷代谢变化特征,肝细胞的损伤程度与多种磷代谢物含量变化有明显相关性.     

彩超诊断子宫直肠陷凹积液300例分析

目的探讨彩超诊断子宫直肠陷凹积液的临床价值。方法我院自2007年10月～2009年3月采用TOSHIBA-7000、TOSHIBA-Xario型超声显像仪,检查诊断子宫直肠陷凹积液300例,分析病理性子宫直肠陷凹积液及生理性子宫直肠陷凹积液的超声声像图特点。结果 300例子宫直肠陷凹有积液者与疾病有关的264例,占88.0%。病理性子宫直肠陷凹积液98例,生理性子宫直肠陷凹积液202例。结论彩超诊断子宫直肠陷凹积液具有直观、方便、无损伤的优点,同时结合病史、临床资料及其他相关检查或动态随访,对明确子宫直肠陷凹积液的诊断具有重要的临床诊断价值。     

住院糖尿病患者的健康教育

HEALTHY EDUCATION METHOD The subject is population and population guide is performed.Healthy education was given to patients every week and prevention, treatment nutrient,parmacy and notice items of DM were instructed to the patients.Through blackboard,wallpaper,prevention manual of DM, the patients were told to control blood glucose by adjusting diet.Education direction were aimed at individuals.According to conditions,educational levels,sex,age and familial status,the nurses communicated with the patients and carefully answer their questions to receive confidence,understanding and support and promote confidence of defeat diseases.     

胰腺原发性恶性纤维组织细胞瘤CT和MRI表现一例

患者男,76岁.体重下降半年,体检B超发现胰腺占位性病变.体检:中腹部可触及一个9.0 cm×10.0 cm的质硬肿块,活动度差,无明显压痛.实验室检查未发现明显异常.     

桡动脉穿刺点渗血处理方法的改进

桡动脉穿刺常用于急诊血液透析（下称血透）和过渡性血透建立暂时血管通路。因穿刺针较粗，穿刺点渗血时有发生，给患者带来心理压力。鉴此，笔者采用消毒棉签的棉头（带木芯）侧压穿刺点后再加棉球固定替代常规无菌棉球加压法，用于50例次血透渗血患者，效果理想，报告如下。     

湿热敷配合海普林软膏涂搽保护血透血管效果观察

目的 保护血液透析患者直接动静脉穿刺(直穿)血管,减轻患者痛苦.方法 将46例维持性血液透析直穿血管患者随机分为观察组与对照组各23例.对照组患者透析后24 h,直穿局部进行湿热敷.观察组患者在湿热敷基础上将海普林软膏涂搽直穿局部,并辅以按摩.结果 观察组血管弹性、血流量显著优于对照组(均P＜0.05),穿刺局部并发症发生率显著低于对照组(P＜0.05).结论 湿热敷配合海普林软膏涂搽穿刺局部对直穿血管有较强保护作用.     

成人白血病中枢神经系统并发症的CT与MRI表现

目的 探讨成人白血病中枢神经系统并发症(CNSCL)的CT和MRI表现及其诊断价值.方法 回顾性分析18例经临床及手术病理证实的成人CNSCL的CT和MRI表现,其中急性淋巴细胞白血病7例,急性非淋巴细胞白血病10例,慢性粒单细胞白血病1例.CT平扫11例,其中增强1例;MR平扫16例,其中增强11例.结果 颅内受累14例:(1)颅内出血7例,其中脑内血肿4例,脑内血肿合并微出血1例,微出血2例.脑内血肿均为多发病灶.CT表现为团状高密度影;MRI表现为T1WI低信号或高低混杂信号,T2WI高信号或等高信号伴环状低信号环,病灶呈环形强化或无明显强化.脑微出血在磁敏感加权成像(SWI)上表现为多发斑点状及小条状低信号,其病灶检出率明显优于CT及MRI其他常规序列检查;7例中,伴脑梗死及蛛网膜下腔出血各1例.(2)颅内肿块5例:其中左额部内板下梭形病灶或跨颅板肿块2例,T1WI呈低信号,T2WI呈高低混杂信号,并有明显均匀强化,均见脑膜尾征;鞍区肿块1例,CT示鞍区高密度影,MRI示鞍区T1WI稍低信号,T2WI高信号,有不均匀强化;右侧脑室体旁肿块1例,T1WI、T2WI均呈等信号,有明显均匀强化.左额顶叶壁厚囊性肿块1例,呈环形强化.(3)梗阻性脑积水1例,表现为中脑导水管以上脑室系统扩张.(4)脑膜病变1例,MRI表现为广泛脑膜增厚伴明显均匀强化.椎管内病变4例:其中胸腰椎左侧椎旁软组织肿块2例,侵犯椎管内,伴邻近肋骨骨质破坏1例;椎管内肿块1例,表现为胸椎管后方梭形T1WI等高信号,T2WI等低信号灶,无明显强化;胸髓信号异常1例,表现为胸髓条状T2WI及液体衰减反转恢复(FLAIR)序列高信号影.结论 成人CNSCL影像表现多种多样,CT与MRI对该病的诊断价值相辅相成;白血病患者疑脑内病变者,建议常规使用SWI检查,以尽早发现脑微出血,降低脑内血肿发生的风险.

Abstract：

Objective To evaluate the CT and MRI findings and their diagnostic value of central nervous system complications of leukemia (CNSCL). Methods The CT and MRI findings of 18 adult patients with CNSCL proved by clinical features or pathology were retrospectively analyzed. Among 18 cases,7 were acute lymphocytic leukemia, 10 acute non-lymphocytic leukemia and 1 chronic myelomonocytic leukemia. Eleven cases underwent plain CT scan with one of them also receiving contrast-enhanced CT scan enhancement, 16 cases underwent plain MR scan with 11 of them receiving contrast-enhanced MR scan.Results Intracranial lesions in 14 cases: (1)intracranial hemorrhage was found in 7 cases, including intracerebral hematoma in 4 cases, micro-haemorrhage in 2 cases, and intracerebral hematoma accompanying by multiple intracerebral micro-haemorrhage foci in 1 case. All cases with intracerebral hematoma showed multiple lesions, which demonstrated high-density on CT images, and low or mixed signal on T1 WI, high- or intermediate signal with low-signal rim on T2 WI and ring enhancement or no evident enhancement. Microhaemorrhage manifested as multiple mini-mottling and strip hypointense foci on susceptibility weighted imaging, on which the detection rate of micro-haemorrhage foci was much higher than that on CT and other sequences of MRI. Among the 7 cases, one also had cerebral infarction and one subarachnoid hemorrhage.(2) Intracranial mass was found in 5 cases, among which two appeared as masses under or bestride cranium in the left frontal region with hypointensity on T1 WI, mixed signal on T2WI, strong homogeneous enhancement and dural tail sign;one showed a mass in saddle area, with high density on CT, slightly low signal on T1WI, high signal on T2WI and heterogeneous enhancement; one case displayed a mass near lateral ventricle with iso-intensity on T1 WI and T2WI and strong homogeneous enhancement; and one case manifested as cystic mass in the left fronto-apical lobe, with thick wall and ring enhancement (3)Obstructive hydrocephalus was found in 1 case, manifesting dilation of ventricles above the aquaeductus mesencephali. (4) Meningopathy was found in 1 case, manifesting diffuse thickening of meninges with strong homogeneous enhancement on MRI. Pathological changes of spinal canal was found in 4 cases among which two showed para-spinal mass involving vertebral canal and causing bone destruction of adjacent ribs; one case showed fusiform mass posterior to vertebral canal with high and intermediate signal on T1 WI and low and iso-signal on T2WI without enhancement; one showed zonale leison in thoracic cord with high signal on T2WI and fluid attenuated inversion recovery. Conclusion The radiologic manifestations of adult CNSCL are various and the role of CT and MRI for the diagnosis of CNSCL may complement each other. SWI is suggested as routine examination for patients of leukemia, in whom intracerebral lesions were suspected in order to find micro-haemorrhage as early as possible and reduce the risk of intracerebral hematoma occurrence.     

昏迷病人鼻饲常见并发症的原因分析及对策

脑卒中、脑外伤及脑手术后昏迷病人常不能正常进食，鼻饲营养的应用越来越引起临床医生的重视，直接向肠道内提供营养不仅满足了机体对营养的需求，而且维持了肠道正常功能。自2004年7月～2005年7月，通过对28例鼻饲病人的观察以及临床分析，现总结如下。