改良法注射消痔灵治疗脏器大囊肿的临床研究

目的探讨超声引导下改良法注射消痔灵对脏器大囊肿的疗效。方法将154例患者分为改良法治疗组和常规治疗组,改良治疗组68例患者共76个脏器大囊肿,在超导引导下抽尽囊液后注射消痔灵60ml,硬化5min抽出,再注入1/8囊液量的消痔灵保留;常规治疗组86例共96个大囊肿在抽尽囊液后注入1/8囊液量的消痔灵保留。治疗后3月复查B超。结果①改良组76个脏器大囊肿治愈64个,治愈率为84.2%;常规组96个脏器大囊肿治愈60个,治愈率为62.5%,改良组的治愈率明显高于常规组(P<0.05)。②两组出现的并发症和不良反应无明显差异(P>0.05)。结论超声引导下改良法注射消痔灵能明显提高脏器大囊肿的治愈率,是治疗脏器大囊肿安全有效的方法。     

32例女性尿道旁囊肿的临床分析

目的:探讨女性尿道旁囊肿的诊断与治疗方法。方法:回顾性分析32例女性尿道旁囊肿的临床资料。其中包括尿道旁腺囊肿30例,前庭大腺囊肿1例及尿道憩室1例。结果:30例尿道旁腺囊肿和1例尿道憩室行囊肿切除术,1例前庭大腺囊肿先保守治疗、后行囊肿切除术。随访3～60个月,没有发现囊肿复发、尿道狭窄和尿瘘等并发症。结论:触诊、B型超声波检查及MRI等综合检查方法是诊断的主要手段,尿道旁囊肿切除术是有效的治疗方法。     

激素与骨髓血注射治疗孤立性骨囊肿

目的:探讨激素囊内注射和自体骨髓血移植治疗孤立性骨囊肿的效果。方法:对确诊的64个病理性骨折愈合后孤立性骨囊肿患儿,采用经皮穿刺抽吸囊液后注射激素或自体骨髓血,回顾性分析其影像学资料和随诊结果。结果:激素组和自体骨髓血组治愈率分别为43.2%和77.8%(P<0.05);发病年龄在10岁以下者治愈率分别为25.0%、75.0%(P<0.05);10岁以上者治愈率分别为57.1%、80.0%(P>0.05)。结论:骨髓血移植治疗孤立性骨囊肿的疗效优于激素,是一种微创、安全有效的方法。     

Treatment of an antenatally diagnosed fetal ovarian cyst by needle aspiration during the neonatal period

Summary An ultrasound scan revealed an ovarian cyst in the fetal lower abdomen at 29 weeks of gestation. Repeated examinations demonstrated that the cyst increased in size to 6.5 cm×6.1 cm×5.0 cm at 33 weeks of gestation, and the cyst showed no complications between 29 weeks of gestation and early infancy. The female infant was vaginally delivered at 41 weeks of gestation without any complications. Transabdominal needle aspiration of the cyst fluid was performed on the 14th day after birth. The concentrations of estrone, estradiol, estriol, and progesterone in the cyst fluid were almost the same as those in the infant’s serum, while the concentration of pregnenolone was six times that in the infant’s serum. Cytology of the cyst fluid was negative. The cyst thus seems to have been a non-functioning simple cyst of ovarian origin. Follow-up until the baby was one year old showed no recurrence of the cyst.     

Oculo-cerebro-cutaneous syndrome: description of a new case

A newborn girl is described with the following multiple congenital anomalies: an orbital cyst, cutaneous appendages, focal hypo-aplasia of the skin and multiple cerebral cysts. This case of oculo-cerebro-cutaneous syndrome is compared with four previously published cases.     

输尿管囊肿的诊断与治疗

目的探讨输尿管囊肿临床处理的优选方案.方法回顾分析10年间收治的输尿管囊肿32例,全部病例均经膀胱镜和输尿管镜检查确诊并加用彩色多普勒能量显像(CDEI)检查.耻骨上经膀胱输尿管囊肿切除12例,耻骨上经膀胱输尿管囊肿切除同时行输尿管膀胱抗反流吻合4例.经尿道输尿管囊肿切开或去顶治疗6例.单纯囊肿切除黏膜下隧道成形术(Mason术)5例.经腹膜后囊肿切除输尿管整形手术5例.结果全部病例中仅发生3例膀胱输尿管反流,平均随访18个月也没有发现结石复发和尿路感染发生.结论膀胱镜检查是诊断输尿管囊肿的确切手段;CDEI检查对鉴别输尿管囊肿还是肿瘤、结石、血栓有益.经尿道手术治疗输尿管囊肿是一种简便、安全和行之有效的治疗手段;而Mason手术临床医生容易掌握.     

Morphological assessment of the umbilical cord with three-dimensional ultrasonography

The long cylindrical cord covered by a layer of amnion that extends from the umbilicus of the fetus to the fetal surface of the placenta is known as the umbilical cord, or, in older medical textbooks, as funiculis umbilicalis. The two umbilical arteries extend as branches of the internal iliac arteries that emerge from the fetal body at the umbilicus, and run a helical course through the umbilical cord carrying venous blood to the placenta. In most normal placentas, the umbilical arteries anastomose within 2 cm of insertion into the placenta. The fetal umbilical vein emerges from the placenta and carries oxygenated blood to the fetus. The cord vessels are supported by a matrix of myxomatous connective tissue known as Wharton's jelly. The average length of the umbilical cord is approximately 55 cm at term, but extreme variations in length can occur for unknown reasons. The normal umbilical cord is spiralled. On rare occasions, remnants of the omphalomesenteric and allantoic ducts may be found in the term cord. True knots, false knots, cysts, tumors and vascular abnormalities occur occasionally. Early detection is desirable because some of these abnormalities may affect the fetus adversely, and others are associated with fetal malformations and chromosomal anomalies. Complementary use of Doppler scanning two-dimensional ultrasonography and three-dimensional ultrasonography allows the prenatal diagnosis of most cord abnormalities.     

Conservative Management versus Aspiration of Functional Ovarian Cysts Before Ovarian Stimulation for Assisted Reproduction

Purpose: To compare the efficiency of transvaginal ultrasound-guided functional ovarian cyst aspiration, withconservative management, in the outcome of patientsundergoing assisted reproductive technique (ART) (in vitrofertilization or intracytoplasmic sperm injection). Thesecysts were identified before ovarian stimulation begun andafter administration of a midluteal GnRH agonist. Methods: Fifty nine patients undergoing ART from January1, 1997 to February 28, 1999, who developed functionalovarian cysts were included. Aspirations of these cysts(n = 14) versus conservative management(n = 45) were compared. Total number of ovarian folliclesdeveloped, number of oocytes retrieved, estradiol levels onthe day of human chorionic gonadotropin, fertilization rate,number of good quality embryos transferred, implantation,and clinical pregnancy rate per cycle were evaluated. Results: No statistical differences were observed betweenthe two groups in any of the selected parameters. Conclusions: Cyst aspiration and conservative managementshowed similar implantation and pregnancy rates, in patientswho develop functional ovarian cysts after pituitarydown-regulation following luteal phase gonadotropin-releasinghormone agonist administration. Prospective studies areneeded to confirm this trend.     

鞍区Rathke囊肿的MRI诊断

目的:分析Rathke囊肿的MRI特点。方法:病理证实的Rathke囊肿10例,男4例,女6例,年龄18岁～48岁,平均33岁。所有病理均行MRI平扫+增强扫描。分析其MRI表现。结果:病变单纯位于鞍内者5例,单纯鞍上者2例,鞍内鞍上者3例。Rathke囊肿的MRI信号多种多样,一般无明显强化,少数囊壁强化。结论:MRI对Rathke囊肿的诊断有重要价值。