幽门管溃疡206例内镜下特点

在内镜下，幽门管溃疡是指发生在幽门通向十二指肠球部一段长约0．5～1．0cm管腔的溃疡，属消化性溃疡的特殊类型。我们经内镜检出206例，现将其特点总结如下。     

急性心肌梗死PTCA及支架植入术后的康复护理

近年来，随着介入心脏病学的迅速发展，经皮冠状动脉腔内血管成形术（Percutaneous transluminal coronary angioplasty，PTCA）及冠状动脉支架植入术已成为治疗冠心病的重要方法之一。国内外在急性心肌梗死PTCA及支架植入术后患者的早期康复医疗方面已有较多研究，并在实践中证明，进行早期康复治疗能延长患者寿命及降低病死率。本院对58例此类患者进行早期康复活动观察，观察介入患者的最佳康复时间和指标，现将结果报道如下。     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

腹腔镜辅助下的腹主动脉瘤手术与传统手术的对比

腹主动脉瘤传统手术采用开腹人工血管置换，手术创伤大，术后患者恢复慢。随着腹腔镜在腹部外科应用的进展，传统腹主动脉瘤手术已经可以被腹腔镜辅助下完成人工血管置换所替代。此外，腹主动脉瘤腔内隔绝术部分并发症也能用腹腔镜辅助方式得到解决，现就该技术的操作、效果以及与传统手术的比较作一综述。     

原位植骨配合中药治疗下肢长管骨带锁髓内钉固定后骨不连

2001年2月-2004年8月收治下肢长管骨骨折后采用带锁髓内钉固定治疗导致骨不连者13例，采用原位植骨。内服外用中草药治疗，获得满意疗效，报告如下。     

电视胸腔镜手术30例麻醉处理

电视胸腔镜（VATS）创伤小、恢复快，使用日渐增多。我院从2004年12月-2005年6月共进行了30例电视胸腔镜手术，取得了满意的效果，现将麻醉处理报告如下。     

神经病、神经外科和精神病学杂志

严重脑损伤后17年的社会心理调整;由琥珀酸脱氢酶（SDHA）黄素蛋白（Fp）亚单位突变所致Leigh综合征;动脉瘤性蛛网膜下腔出血早期循环中的内皮细胞激活标记物水平：与脑缺血事件和预后的关系;CSF前列腺素E2水平与认知功能下降和阿尔茨海默病存活率的关系；变异型克罗伊茨费尔特-雅各布病患者的CSF磷酸-tau蛋白浓度升高：诊断和病理学意义。     

手掌骨外软骨瘤误诊一例报告

患者男,48岁,因右手掌侧肿物伴环指屈伸活动受限1年而入院。患者1年前右手环指无明显诱因出现伸屈活动不利,先后就诊于当地医院,诊断为狭窄性腱鞘炎,予局部封闭、理疗处理,症状好转。近期因再次复发来我院就诊,以狭窄性腱鞘炎收住入院。查体:一般情况良好,右手第四掌指关节掌侧可触及一约1cm×2cm大小肿块,质硬,边缘不清,无移动,压痛明显,环指屈伸功能受限,环指末梢血运,感觉正常。局部麻醉下行肿块摘除术。术中见:环指指屈肌腱与掌骨之间见一约1.5cm×2.0cm白色肿块,表面欠光滑,与周围组织粘连,质硬,血供不丰富,钝性分离周围组织,完全摘除…     

胆囊大部分切除术临床应用体会

胆囊大部分切除术是指将胆囊底、体及颈部之前壁及后壁大部分切除,取净胆囊内结石,留下粘连紧密的一部分后壁,并将后壁残留的黏膜予以破坏,分离胆囊管后予以结扎的方法[1].1999年6月至2004年6月我院共收治胆囊结石872例,其中68例行胆囊大部分切除术,疗效满意,报道如下.     

密闭式吸痰管在机械通气病人气道护理中的应用

用循证医学的方法探索密闭式吸痰管应用在机械通气病人气道护理中的利弊.提出临床问题后,用主题"Endotracheal and Closed suction"检索Cochrane CDSR,ACP Journal Club,DARE,CCTR(OVID平台)、Medline、中国学术期刊全文数据库(CNKI)获得相关证据.吸痰时使用密闭式吸痰管,可明显减轻由吸痰引起的并发症症状,从而降低病人对吸痰的恐惧程度,避免由吸痰导致的不良事件的发生.