腹膜后脓肿的诊断和治疗

目的探讨腹膜后脓肿的病因,诊断和治疗。方法回顾性分析了1990-2004年诊断和治疗腹膜后脓肿33例的临床资料。结果急性坏死性胰腺炎后20例,胆囊切除胆总管探查术后4例,十二指肠损伤2例,阑尾穿孔3例,肾结石4例。超声检查确诊80%(20/25),CT检查确诊100%(22/22)。经腹部腹膜后脓肿切开置管引流25例,手术1~4次不等,后腰部切开引流8例。手术后并发应激性胃粘膜损伤致消化道出血7例,成人呼吸窘迫综合征(ARDS)5例,急性肾功能衰竭3例,死亡4例。治愈时间1~6个月,平均3.5个月。结论及时明确诊断,进行有效引流并加强营养支持是治疗成功的关键。     

Bipolar disorder in children and adolescents: obstacles to early diagnosis and future directions

Aim: This article reviews research centred around juvenile bipolar disorder with particular reference to diagnostic difficulties. Putative deficits are scrutinized with respect to trait likelihood and the roles of neuropsychology and neuroimaging in enhancing our understanding of juvenile bipolar disorder are discussed. Methods: Search terms including childhood, adolescent, youth and juvenile combined with the terms ‘bipolar disorder’, mania, depression and hypomania were used to identify relevant studies in MEDLINE and PsychLit. Results: Over recent years research into this relatively new disorder has increased phenomenally. Key issues within the field include diagnostic specificity, the heritability of the disorder, the impact of comorbidity and the implications of neuropsychological and neuroimaging findings. Conclusion: Despite concerning controversies in literature the diagnosis of bipolar disorder in children and adolescents as compared with adults, promising future research directions include better neurological characterization of the disorder through the application of findings from clinical populations, neuropsychological and neuroimaging research.     

胆道癌ERCP诊断(附49例分析)

本文报道用ERCP诊断胆管癌24例、胆囊癌6例、壶腹癌19例、共49例,都经手术或病理证实,诊断符合率为85.7％。 文章描述了胆道癌ERCP的X线表现。依造影所见把胆管癌分为阻塞型、狭窄型和息肉型。狭窄型又分闭塞型、环型及弥漫型三个亚型。胆管癌以阻塞型和闭塞型狭窄多见。胆囊癌表现为胆囊内基底宽广固定不变的充盈缺损。壶腹癌为壶腹部边缘不整的占位病变,可阻塞胆管或胰管或同时阻塞胰胆管。肝内胆管的软藤状改变是胆道恶性肿瘤的特征性表现。     

416例甲状腺肿瘤临床病理分析

目的了解本地区甲状腺肿瘤的发病情况，探讨甲状腺肿瘤的诊断与鉴别诊断6方法对416例甲状腺肿瘤病理资料进行回顾性分析。结果甲状腺肿瘤以良性多见，良恶性之比为8．2：1。各类型肿瘤均以女性明显多于男性，男女之比为1：5．4，好发年龄为21～50岁，肿瘤发生于甲状腺右侧多见。结论本组甲状腺肿瘤的发生率、好发年龄、性别差异、良恶之比与文献报道基本一致。乳头状腺瘤与乳头状癌的鉴别有一定难度，对可疑标本要多处取材，连续切片，仔细观察，找出其特征，提高诊断的准确性。     

乳管镜对乳腺导管内疾病的诊断及介入治疗--附100例临床分析

目的:探讨乳管镜在乳腺疾病诊断和治疗中的作用.方法:应用乳腺纤维导管内视镜对100例伴乳头溢液的乳腺导管性疾病进行诊断或介入治疗.结果:13例导管内占位性疾病得到了正确诊断,87例渗出性导管病经治疗后治愈.结论:乳管镜对乳管内病变的正确诊断及手术方式可提供依据,并可对渗出性病变进行介入治疗.     

老年性痴呆的病理特征与防治对策

老年痴呆症的发生与AB以及Tau蛋白的错误折叠密切相关，是蛋白质折叠相关的疾病，早期诊断是预防老年痴呆症的首要任务，而综合治疗是人类对抗老年痴呆症的必然举措。     

胎盘早剥的超声诊断

目的:探讨超声对胎盘早剥的诊断价值。方法:对过去16年间我院收治的19例经手术或阴道分娩证实的胎盘早剥患者的声像图与产后结果对照。结果:B超对Ⅰ度胎盘早剥(剥离面积<1/3)的诊断符合率为37.50%,对Ⅱ度(剥离面积1/3左右)、Ⅲ度胎盘剥离(剥离面积>1/2)的诊断符合率为88.89%。结论:超声对中重型胎盘早剥的诊断符合率较轻型患者为高。