彩色多普勒超声心动图在房间隔缺损和室间隔缺损介入治疗中的应用

目的探讨经胸超声心动图(TTE)及实时三维超声心动图在房间隔缺损(ASD)、室间隔缺损(VSD)封堵术中的临床应用价值。 方法应用二维及三维超声心动图对2004 10—2005 10在天津市儿童医院就诊的24例继发孔ASD，10例VSD进行术前检查筛选，术中超声引导及术后随访检查。 结果24例ASD患儿术前经TTE检测ASD直径(15.6±7.9)mm(5~26mm)，所选Mmplatzer封堵器直径为(19.1±5.1)mm(5~32mm)，23例封堵成功。室间隔膜部缺损直径：左室面缺损为5~9mm，右室侧口的直径为2.4~6.0mm，术中选择Amplatzer封堵器型号为4~6mm，10例VSD无残余分流。 结论二维及三维TTE联合应用于ASD、VSD介入治疗具有很好的应用价值。     

Perforation of the bowel from intrauterine contraceptive devices: case series and discussion

The intrauterine contraceptive device is used extensively in the female population. Serious complications are rare, but they do occur. We discuss three cases of bowel perforation caused by these devices following their perforation through the uterine wall. It is important that cases of perforation be recognised swiftly and the possibility of involvement of other organs considered.     

Levonorgestrel-releasing intrauterine system vs. transcervical endometrial resection for dysfunctional uterine bleeding.

OBJECTIVE: To compare the acceptability, efficacy, adverse effects, and user satisfaction of a levonorgestrel intrauterine system (LNG-IUS) and transcervical resection of the endometrium (TCRE) for the treatment of dysfunctional uterine bleeding. METHOD: Of 50 women with a pictoral blood loss assessment chart (PBAC) score of 100 or greater, 25 had a LNG-IUS inserted (Mirena; Schering, Berlin, Germany) and 25 underwent TCRE. Procedure-related complications, PBAC score, hemoglobin levels, adverse effects, and rates of acceptability and satisfaction were recorded at 3-month intervals for a period of 12 months. RESULTS: At the end of 1 year there were a 97% and a 94% reduction in menstrual blood loss in the LNG-IUS and TCRE groups, respectively, and hemoglobin concentration had increased by 5.5% in the LNG-IUS group and 5.2% in the TCRE group. Adverse effects were similar in both groups except for systemic effects, which were seen only in the LNG-IUS group. Satisfaction rates were about 80% in the 2 groups. CONCLUSION: Both treatments were found to be equally effective but LNG-IUS placement requires less operator skill and entails no operative hazards, and the device provides effective contraception.     

多种工作模式的踝关节活动器的研制

各种原因导致患者长期卧床后将引起严重的并发症:踝关节跖屈畸形。新型踝关节活动器以大扭矩、超低速电机为动力,结合定时控制电路,具有多种工作模式,能使踝关节在被动的情况下背伸20～30°,跖屈40～50°,并能根据患者的个体情况设置不同的运用角度与时间,且能根据需要进行缓慢、连续、往返式运动,这对那些踝关节不能或较难进行主动活动的病人防止踝关节跖屈畸形、踝关节僵硬的及下肢肌肉萎缩有良好的作用。     

一种新型颈椎椎弓根置钉定位器的研制

介绍一种可三维调节的颈椎椎弓根置钉定位器,该装置作为钻模应用于颈椎椎弓根的钻孔定位,实现个体化置钉。给出了设计原理、使用方法,推导出椎弓根术前影像学数据与定位器钻套调整角的关系,并编制了计算应用软件。进行了功能评价和误差分析。     

预防性维修在放射设备维修中的探索

介绍我们对放射设备进行预防性维修的探索工作,总结在放射科实施预防性维修的意义。     

医疗器械不良事件监测工作的信息化建设

医疗器械不良事件监测工作即将全面展开,建立一个功能强大、科学准确的医疗器械不良事件监测管理信息系统将对这项工作的开展起到良好的推动作用.本文针对目前国内外医疗器械不良事件监测管理工作的现状,提出了在医疗器械不良事件监测和再评价工作中引入信息技术,并从国内外建设现状、项目建设的必要性及项目建设的主要内容和各部分的主要特点几方面进行了阐述,对医疗器械不良事件监测和再评价管理的信息系统建设提出了初步的规划和设想.     

宫角妊娠的诊断及误诊原因分析

目的:探讨提高宫角妊娠诊断准确率的方法。方法:回顾性分析27例经病理确诊的宫角妊娠病例临床资料,包括临床表现、诊治过程、各项检查结果与手术病理结果的符合率,以及产生误诊的原因等。结果:宫角妊娠临床主要表现为停经、下腹痛、阴道流血。术前诊断为宫角妊娠15例(诊断符合率55.6％),其余12例中7例(25.9％)诊断为宫外孕,4例(14.8％)诊断为人流不全,1例(3.7％)诊断为异常子宫出血。B超单项检查准确率为31.7％。结论:提高B超诊断技术,合理运用宫腔镜、腹腔镜等检查手段可提高诊断准确率。     

壁式氧气管道装置消毒方法的研究

目的解决壁式氧气管道装置的污染和消毒问题,特别是对其不可拆卸部位的消毒. 方法通过细菌学的实验检测,在了解其污染状况的基础上,针对壁式氧气管道装置的结构特点,采用 0.2%过氧乙酸(PAA) 局部浸泡加吹氧的消毒方法. 结果消毒后瓶盖及送氧管出口、通气导管内、外壁等全部部件无细菌生长. 结论必须高度重视壁式氧气管道装置的消毒工作.     

Use of Ilizarov Device to Gain Early Range of Motion in the Treatment of Pediatric Talus Body Fractures: A Series of Four Cases and Literature Review

BackgroundTalus fractures are rare in children but can lead to severe outcomes if untreated. The Ilizarov external fixator has been used in the treatment of a variety of lower extremity pathologies. The purpose of this study was to investigate the clinical outcomes of talus body fractures treated with the Ilizarov external fixator.Case PresentationFour male pediatric patients (age range, 5–11 years) with talus body fractures who were treated by open reduction and internal fixation combined with Ilizarov external fixator between November 2015 and April 2016 were reviewed. Mean follow‐up period was 4 years (range, 4–5). Clinical outcome was evaluated using the clinical rating scale of the American Orthopaedic Foot and Ankle Society (AOFAS). All four patients achieved good to excellent results at the last follow‐up. None of the patients developed avascular necrosis. One patient developed automatic fusion of tibiotalar joint.ConclusionUse of the Ilizarov external fixator to gain early range of motion is a valuable option for treatment of talus body fractures in children.