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73.
因症就诊检出早期大肠癌的临床及病理学特征 总被引:1,自引:0,他引:1
目的探讨在就诊的肛肠病人中如何提高早期大肠癌的检出率。方法在11家医院推广对肛肠病人的四项检查程序——直肠指检,乙结镜检查,大便隐血试验,和X线气钡灌肠造影。结果在4821例有肛肠症状的病人中,检出大肠癌188例,检出率为3.9%,其中180例有术后病理诊断。47/180例(26.1%)属早期癌(DukesstageA)。41/47例由上述四项检查作出初步诊断。初发症状为:(1)便血(26例,持续15.2±9.4周后就诊,肿瘤平均直径2.58cm);(2)大便习惯改变(9例,33.4±19.7周,3.39cm);(3)腹痛腹块(10例,19.2±11.2周,5.0cm);(4)贫血(2例,17.2±9.9周,4.75cm)。8/12例的A0和A1期病例属便血组,并多位于直肠。41/47例以高、中分化腺癌为主,其中15例伴有腺瘤癌变。术前曾作活检的27例中,12例未检出癌变细胞。结论四项检查对检出早期大肠癌是有效的,便血是提示早期癌最有价值的症状,加强大肠癌防治宣教,采用瘤灶多点或全瘤活检技术,高度重视大肠腺瘤和不典型增生等癌前病变,将有助于提高早期大肠癌的检出率 相似文献
74.
不断强化医务人员的服务意识是消除医患纠纷的首要条件,认真培养敬业精神是避免医患纠纷的根本途径;提高道德境界是避免医患纠纷的决定因素. 相似文献
75.
P. Bertram K. -H. Treutner G. Winkeltau H. -J. Booß G. Staatz Prof. Dr. V. Schumpelick 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1993,378(4):249-254
Zusammenfassung Die Pneumatosis cystoides intestinii (PCI), das Auftreten submuköser oder subseröser, gasgefüllter Zysten in der Wand des Gastrointestinaltrakts, tritt als seltene Erkrankung ohne eindeutige Geschlechtspräferenz vorwiegend in der 3. bis 5. Lebensdekade auf. Atiopathogenetisch werden unterschiedliche Faktoren diskutiert, am wahrscheinlichsten ist eine bakterielle Ursache (Clostridium perfringens) in Verbindung mit einer minimalen Unterbrechung der Mukosaintegrität. Eine pathognomonische Symptomatik gibt es nicht, das klinische Bild reicht von asymptomatischen Zufallsbefunden bis zur Hämatochezie. Die Diagnose wird durch den Nachweis der Gaseinschlüsse mittels Abdomenübersichtsaufnahme und Kolonkontrasteinlauf gestellt. Als Behandlungsmethoden für symptomatische Patienten stehen Sauerstofftherapie, Antibiotikagabe (Metronidazol) und in schweren Fällen die Resektion des betroffenen Darmabschnitts zur Verfügung.
Pneumatosis cystoides intestinalis (PCI), a condition involving submucosal or subserosal gas-containing cysts of the wall of the gastrointestinal tract, is a rare entity. It is mostly diagnosed between the third and fifth decades of life without a clear sexual predominance. Different aetiopathogenetic factors are under discussion, the most probable being a bacteriologic cause (Clostridium perfringens) in combination with minimal leaks in mucosal barrier. There are no pathognomonic symptoms; the clinical picture ranges from incidental findings to haematochezia. Diagnosis is based on plain abdominal film and X-ray following barium enema. Methods of treatment in symptomatic cases are oxygen and antibiotic (metronidazole) therapies and, in severe cases, resection of the diseased part of the intestine.相似文献
76.
In the last few years, survival of patients infected with human immunodeficiency virus (HIV) has been improved because of a decreased incidence of some opportunistic complications attributable to prophylactic treatments and antiretroviral drugs. The impact of these agents should also be reflected in the quality of life (QoL) of patients. We have reviewed this topic with an emphasis on different types of measurements such as Q-TWIST, MOS and the Spitzer score which seem to be most appropriate for this patient population. We do not think that a special type of assessment should be designed for HIV-infected persons. It would be less time-consuming to improve already existing validated scores focusing on HIV infection. QoL in intravenous drug users with HIV should be evaluated more often. 相似文献
77.
环丙沙星与氧氟沙星注射液治疗细菌性感染的疗效观察 总被引:3,自引:0,他引:3
以乳酸环丙沙星(CPLX)注射液和氧氟沙星(OFLX)注射液随机分组治疗各种细菌性感染40例及42例,并以注射用头孢噻肟钠(CTX)治疗49例作对照。三组平均年龄、体重、疗程及病情程度相比无显著性差异,具可比性。病种分布以消化道感染最多,共81例,占总数的61.8%。三组131例病人细菌阳性率为94.7%。一疗程CPLX组、OFLX组、CTX组治愈率分别为87.2%、83.3%、71.4%,有效率 相似文献
78.
Clinical Evaluation of a New Type of Centrifugal Pump 总被引:2,自引:0,他引:2
J. Ninomiya T. Shoji S. Tanaka M. Ikeshita M. Ochi S. Yamauchi T. Yajima H. Yamauchi T. Sugimotox T. Aizawa 《Artificial organs》1994,18(9):702-705
Abstract: The major problems with existing centrifugal pumps are leakage, mechanical trauma, and thrombus formation. In consideration of these problems, a new compact centrifugal pump system was developed. The purpose of this study was to evaluate the new centrifugal pump system clinically. Ten patients underwent open heart surgery with a centrifugal pump or a roller pump. During surgery, hemodynamic and hematological data were obtained. A pulsatile assist device in the pump circuit was used in patients with severe heart disease. There was neither operative death nor hospital mortality, and there was no difference with regard to hemodynamic data between the two groups. The centrifugal pump group, however, had significantly lower hemolysis, especially during prolonged cardiopulmonary bypass. This centrifugal pump could also create sufficient pulsatile flow with a pulsatile assist device. Postoperative macroscopic and microscopic findings demonstrated the smooth surface of the pump without thrombus formation. This centrifugal pump system might be useful for prolonged cardiopulmonary bypass. 相似文献
79.
医用低值材料采供管理的探讨 总被引:4,自引:2,他引:2
医疗消耗材料是医疗工作开展的基础,本文从医用低值消耗材料的计划制定、材料采购、库房库存结构、材料供应、成本核算等多方面探讨了如何对医疗消耗材料进行科学管理,这对医院的医疗发展和管理建设有着重要意义。 相似文献
80.
Industrial back belts and low back pain: Mechanisms and outcomes 总被引:1,自引:0,他引:1
The recent increased utilization of industrial back belts as personal protective equipment in the workplace has generated considerable controversy among occupational health and safety professionals in the United States. The purpose of this article is to review the literature regarding proposed mechanisms of action of these devices and studies related to outcome of belt utilization in the prevention of low back pain and disability in the workplace. At the present time, neither the suspected mechanisms of action nor the efficacy of these devices in the primary, secondary, and tertiary prevention of work-related low back pain has been adequately demonstrated in clinical trials. As a result, generally accepted guidelines regarding the safe use of belts in the occupational setting have not been established. Based on this review it is recommended that further well-controlled, prospective, randomized clinical trials are necessary to evaluate the effectiveness of these devices as personal protective equipment. During the interim, the decision to prescribe belts to employees in the workplace should be at the discretion of an adequately trained occupational health care provider. These devices should not be provided as an alternative to appropriate administrative and/or engineering controls. 相似文献