贲门失弛缓症的内镜诊断与治疗（附7例报告）

对７例贲门失弛缓症的内镜诊断与治疗进行讨论，认为内镜检查与活检组织检查合并应用不仅能诊断贲门失弛缓症，而且对于排除癌变或与贲门癌及其它性质的狭窄相鉴别很有用，但仍需和钡餐检查相互配合。内镜下食管狭窄扩张术和内镜下肌切开术被认为是目前治疗贲门失弛缓症的简单、快速、有效、安全的新方法，值得提倡。     

Endoscopic laser imaging of tissue perfusion: new instrumentation and technique

BACKGROUND AND OBJECTIVES: New instrumentation, based on a previously established laser speckle perfusion imaging (LSI) technique is evaluated for its ability to capture and generate blood flow images during endoscopic surgery. STUDY DESIGN/MATERIALS AND METHODS: Investigations are detailed in an in-vitro blood flow model simulating physiological properties of vascularized tissue, and in-vivo in rabbit joint capsule tissue. RESULTS: In-vitro measurements showed a linear response of the instrument to blood flow in the range of 0-800 microl/minute, where data points were significantly correlated with an r(2) value of 0.96. In-vivo measurements showed a 58.7% decrease to the medial collateral ligament during occlusion of the femoral artery. CONCLUSIONS: Blood flow images demonstrate that the endoscopic LSI technique is capable of measuring relative tissue blood flow changes at high resolutions and rapid response times and incorporates well with endoscopic surgeries.     

In vivo diagnosis of nasopharyngeal carcinoma using contact rhinoscopy

OBJECTIVES: To evaluate the potential use of contact endoscopy for the diagnosis of nasopharyngeal carcinoma (NPC). STUDY DESIGN: Prospective study to examine the nasopharynx of 30 patients with nasopharyngeal carcinoma and 18 subjects with normal nasopharynx in a clinic setting using contact rhinoscopes (Karl Storz, Tuttlingen, Germany, 7215 AA, 00 and 7215 BA, 300; 23 cm long; 4 mm in diameter). METHODS: The superficial cells of the normal nasopharynx and the nasopharyngeal tumors were stained with 1% methylene blue and examined with contact rhinoscopes at high magnifications (x 60 and x 150). The areas under examination were then biopsied. The contact endoscopic images were compared with the corresponding hematoxylin and eosin-stained histologic sections of the biopsied tissues. RESULTS: Sixty-six procedures were performed in 48 patients. The images of normal pseudostratified ciliated epithelium and squamous epithelium were readily recognized by contact endoscopy in all subjects with normal nasopharynx (10 men and 8 women; mean age, 51.9 y). Twenty-six of 30 patients with NPC (86.6%; 18 men and 8 women; mean age, 50.6 y) were successfully examined by contact endoscopy under local anesthesia. In these 26 patients, two patterns of malignant cells were identified with contact endoscopy. The patterns of contact endoscopic images corresponded well with the histologic findings. CONCLUSION: Contact endoscopy is an accurate and reliable office-based procedure, which allows for in-vivo diagnosis of nasopharyngeal carcinoma.     

Endoscopic management of skull base osteoradionecrosis

OBJECTIVE: Osteoradionecrosis is one of the most serious complications in radiotherapy of nasopharyngeal carcinoma. We describe a new endoscopic approach to resolve resultant skull base osteoradionecrosis. The objective of this study is to evaluate the efficacy of endoscopic management of skull base osteoradionecrosis. STUDY DESIGN: A prospective study of the outcome of endoscopic management for patients with skull base osteoradionecrosis. METHODS: Between 1994 and 1998 six patients who had irradiation previously for nasopharyngeal carcinoma had skull base osteoradionecrosis. A sinoscopic approach was applied for diagnosis and sequestrectomy. This diagnosis was based on the criterion of exposed necrotic bone after removing all crust in the nasopharynx and further confirmed on pathological examination after sequestrectomy. Effective cure was defined as intact mucosal coverage without any ulcer or exposed necrotic bone observed in the nasopharynx and the absence of antecedent accompanying symptoms after management. RESULTS: Six patients (10%) were symptom free. Five (83.3%) patients had effective cure. There was no surgical morbidity or mortality. CONCLUSION: Endoscopic sequestrectomy is a justified approach to skull base osteoradionecrosis.     

经内镜注射D-TH胶治疗胃静脉曲张出血的疗效观察和护理

报告98例内镜注射组织黏合剂D-TH胶治疗胃静脉曲张出血的观察和护理。术前做好心理护理,术后加强病情观察,做好健康教育。疗效观察结果提示,D-TH胶治疗胃静脉曲张近期疗效显著。     

内镜在眼科手术中的应用研究进展

眼科医生借助内镜能够更好地观察前房角、睫状体、虹膜后面和周边视网膜,如内镜联合激光可以施行青光眼前房角手术、睫状体光凝手术、白内障手术、视网膜玻璃体手术等等。本文详细介绍了内镜在眼科手术中的应用研究进展。     

Rhinosporidiosis: Its varied presentations

Rhinosporidiosis is the fungal infection generally affecting the nasal mucosa. In this article we are presenting two unusual cases of rhinosporidiosis. First case presented with nasopharyngeal mass, without any past history of bathing in stagnant water or epistaxis. Mass was excised using nasal endoscope. Second case presented with recurrence of rhinosporidiosis even after nine times surgical intervention with systemic Amphotericin-B. In this patient, surgical excision of mass was assisted with Amphotericin-B nasal douching and oral Itraconazole. Both patients are doing well with no recurrence till date.     

鼻内窥镜下翼管神经切断术对血管运动性鼻炎的治疗作用

目的:探讨鼻内窥镜下翼管神经切断术对血管运动性鼻炎的治疗作用,方法:对14个尸头进行细致的解剖测量研究,并对51例血管运动性鼻炎患者实施了鼻内窥镜下切除中鼻甲后端进路的翼管神经切断术,术后随访5年.结果:解剖测量显示,翼管位于蝶腭孔的后方,外口呈漏斗型,垂直径为(3.5±0.9)mm,横径为(2.9±0.5)mm,距离圆孔为(6.1±1.2)mm,距离鼻中隔(10.5±5.9)mm.翼管的纵轴与水平面成角(27±9.6)度,与矢状平面成角(7.8±2.5)度.51例病人的随访结果显示,术后5年内显效病例为41例(80.4%),有效病例3例(5.9%).结论:鼻内窥镜下切除中鼻甲后端进路的翼管神经切断术,是治疗血管运动性鼻炎的有效方法.     

内窥镜电脑成像系统的研制及应用

内窥镜电脑成像系统是基于Ｗｉｎｄｏｗ ｓ９８平台开发的医用检查系统． 系统将ＣＣＤ摄取的图像通过图像采集卡处理,再经计算机成像显示、处理、储存、检索及统计,最后打印出图文报告,系统将所有患者资料（包括病历和病理图片）保存在数据库中,用户可自己管理患者档案．     

老年与中青年胃癌内镜和病理的对比分析(附115例报告)

目的探讨老年与中青年胃癌在内镜和病理上的特点及差异。方法回顾性分析75例老年胃癌（≥60岁）和40例中青年胃癌（＜60岁），在性别、肿瘤部位、肿瘤大小、内镜分型及组织学类型间的对应关系。结果老年胃癌男性明显多于女性，胃底贲门癌发生率高，隆起型病灶增多，分化程度偏高；而中青年胃癌男女性别差异小，多发生于胃窦部，大癌灶相对多见，以溃疡型病灶为主，分化程度低，预后差。结论两组在性别、发病部位、病灶大小、肿瘤生长方式及组织学分化程度上各有不同特点。