卵巢妊娠43例临床分析

目的:探讨卵巢妊娠的病因、临床特征及诊治特点。方法:回顾性分析1993年7月~2005年12月我院收治的43例卵巢妊娠病例。结果:卵巢妊娠占同期异位妊娠1.81%,绝大多数卵巢妊娠患者(97.67%)社会经济地位低下,有人流(65.12%)及妇科病史(60.47%),37.21%放置宫内节育器。卵巢妊娠最主要症状是腹痛(93.02%),仅74.42%有停经史,37.21%阴道出血。所有患者无1例术前确诊,均手术治疗,其中5例行腹腔镜手术。结论:卵巢妊娠发生率呈上升趋势,与人流、妇科疾病及放置宫内节育器有关。开展以社区为基础的综合健康教育来提高妇女健康意识十分迫切。因临床表现不典型,术前很难确诊,应充分结合血β-HCG及阴道B超以提高术前诊断率。治疗应以手术为主。腹腔镜手术安全、有效,值得推广。     

胆道大出血20例临床分析

目的 探讨胆道大出血的病因、诊断与治疗方法.方法 对2000年8月至2009年8月20 例胆道出血患者的临床资料进行回顾性分析.结果 20例均先行保守治疗, 4例治愈, 7例行肝动脉血管造影术与栓塞术,6例止血成功, 1例失败,后经手术治疗痊愈.共有10例经保守治疗无效后手术治疗,均未发生再出血,无死亡病例.结论 在条件允许的情况下, 肝动脉血管造影与栓塞是术后胆道出血诊断治疗的首选,如果非手术治疗无效或栓塞疗法失败,则应积极手术治疗. Abstract： Objective To investigate the etiopathogenisis, diagnosis and treatment for massive hemobilia.Methods A retrospective analysis was made on the clinical data of patients with massive hemobilia from Aug. 2000 to Aug. 2009.Results All of the 20 patients accepted conservative therapy and 4 cases cured. Six patients were cured and 1 was failed after hepatic artery angiography and embolization for the 7 patients.At last, 10 cases were treated by operation methods and all of patients were cured and none died.Conclusions If condition is permitting, hepatic artery angiography and embolization are the first choices for the patients with massive hemobilia.On the other hand, surgical procedures should be operated actively if conservative therapy and hepatic artery embolization are failed.     

历代痹证医案文献的病因、病位、发病时间分析

为了探讨历代医家医案中对痹证病因、病位、发病时间记载的规律性,指导临床治疗,从历代名老中医临床医案数据库中收集治疗痹证的医案,对病因、病位、发病时间采用频数分析进行统计,结果显示医案所记载痹证病因与传统中医理论存在一致性,痹证发病病位与治疗药物的归经及脏腑辨证结果存在一致性,痹证发生发展与时间关系紧密,说明中医理论对痹证的认识与临床实践较为符合。     

血管刺伤致筋膜室综合征的原因分析及对策

目的:探讨血管刺伤致筋膜室综合征的发生原因及护理对策.方法:回顾性分析4例血管刺伤致筋膜室综合征的临床资料.结果:4例病人中有1例术后14d出院时右前臂感觉和运动功能无恢复,出院后失访;余3例病人伤口均一期愈合,术后2～4周感觉运动功能恢复正常.结论:根据骨筋膜室综合征致死率和致残率极高的特点,早期诊断、早期手术是影响预后的关键;而对病人进行动态观察,采取措施加强护理对疾病的康复起了积极作用,降低致死率和致残率.     

糖尿病肾病中西医诊疗研究进展

通过对糖尿病肾病的西医诊断相关指标及中医病名、病因病机、中西医治疗做了简要综述,对糖尿病肾病的诊疗有一定指导意义。     

中医药治疗糖尿病视网膜病变研究进展

糖尿病视网膜病变表现为视网膜水肿、黄斑水肿、视力减退等,严重时可致盲.本文通过查阅近几年来临床运用中医药治疗糖尿病视网膜病变的文献并对其进行归纳,以其为临床治疗糖尿病视网膜病变提供参考.     

Comparison of somatosensory evoked potentials between adolescent idiopathic scoliosis and congenital scoliosis without neural axis abnormalities

Background contextAbnormal somatosensory evoked potentials (SEPs) have been documented in patients with adolescent idiopathic scoliosis (AIS) with different cure severity. However, few studies investigated whether abnormal SEPs were the cause or effect of idiopathic scoliosis.PurposeThe purpose of this study was to investigate the significance of abnormal SEPs in patients with AIS, and to explore its effect on the etiopathogenesis of AIS.Study design/SettingThis study evaluated SEPs in patients with AIS and congenital scoliosis (CS) with similar curve pattern and severity both in coronal and sagittal planes.Patient sampleFemale patients with AIS and CS in our spine surgery center from 2000 to 2009 were recruited for this study.Outcome measuresRate of abnormal SEPs.MethodsPosterior tibial nerve SEPs (PTN-SEPs) were performed on female patients with AIS and CS. The inclusion criteria were patients with AIS with a Lenke type 1 curve and patients with CS with right thoracic curve (apex between T5 and T12) and normal sagittal profile (kyphosis less than 50° measured from T2 to T12). All patients were evaluated with total spine magnetic resonance imaging, and those with neural axis abnormalities were excluded. The patients with neurological deficits on detailed physical examination were also excluded. Absence of SEPs waveforms or prolongation of peak latency or asymmetrical peak latency were defined as pathological change. The incidence of pathological SEPs and clinical characteristics were compared between patients with AIS and patients with CS.ResultsForty-six patients with AIS and 33 patients with CS were included in this study. There was no significant difference in coronal and sagittal Cobb angle between the two groups. The rate of abnormal SEPs was 32.6% (15/46) and 12.1% (4/33) in AIS and CS groups, respectively, and the difference was statistically significant (p<.05).ConclusionSomatosensory pathway dysfunction could be found in both AIS and CS without neural axis abnormalities, and the patients with AIS tended to have higher rates of somatosensory disorders than patients with CS with similar scoliosis curve, which indicates that both scoliosis curve and primary etiopathogenic factor contribute to the sensory deficit in patients with AIS.     

老年人阻塞性黄疸的病因及临床特点分析

目的探讨老年人阻塞性黄疸的病因及临床特点。方法回顾分析2006年1月～2010年12月治疗的67位确诊为梗阻性黄疸的老年患者（年龄60～90岁）的临床资料。结果老年人梗阻性黄疸患者的性别比例男：女=1：l.16。67例老年人梗阻性黄疸患者中消化系统肿瘤42例（62.69%）,其中胰腺癌22例（包括胰头癌18例）,肝癌3例,胆囊癌2例,胆管癌9例,乳头癌5例,十二指肠癌1例。结论老年患者是首位致梗阻性黄疸的因素,往往早期缺乏典型临床表现,显性黄疸既是主要的临床特征又是最有价值的诊断依据,中晚期黄染常伴有腹痛等伴发症状。超声可使多数患者确诊,ERCP可明显提高诊断的阳性率。     

男性乳房发育症的处理

目的 探讨男性乳房发育症的病因、发病机制及最佳诊断和治疗方法。方法将本院自1999年1月至2008年12月门诊诊治和收住院的268例男性乳房发育症患者的l临床资料结合文献复习进行综合分析。计数资料的比较采用y。检验。结果生理性男性乳房发育240例,病理性男性乳房发育28例。后者根据其病因又分为：药物性男性乳房发育12例;肿瘤性男性乳房发育11例,其中肺癌4例,胃癌2例,肾上腺肿瘤2例,睾丸肿瘤2例,肾癌1例;其他5例,其中Klinefelter＇s综合征2例,甲状腺机能亢进和甲状腺机能低下各1例,尿毒症1例。随访结果：单纯临床观察组乳房发育完全消退率72．73％（56／77）;药物治疗组的完全消退率达77．34％（99／128）,疼痛缓解率达85．16％（109／128）,其中他莫西芬组和乳癖散结胶囊组的完全消退率相似（x^2=0．289,P=0．591）,且两组患者的疼痛缓解率亦相似,分别为84．12％（53／63）和86．15％（56/65）。结论多数男性乳房发育属生理性,可予以临床观察,中药（乳癖散结胶囊）不仅可以改善患者的乳房疼痛或触痛等症状,还可提高其完全消退率,且无明显不良反应。     

原发性三叉神经痛的病因及显微血管减压治疗(附91例临床分析)

目的探讨原发性三叉神经痛病因及显微血管减压治疗的手术技巧。方法回顾性分析显微血管减压术治疗的91例原发性三叉神经痛病例资料。结果三叉神经入脑干区有血管压迫者89例。术后疼痛立即消失或显著减轻者78例,1周内明显减轻者11例。随访3~48个月(平均32个月),疼痛消失86例(94.5%),明显缓解、服得理多能够控制满意者5例,无复发病例。结论三叉神经入脑干区血管压迫是原发性三叉神经痛的常见病因。显微血管减压术是有效的治疗方法。准确判定责任血管并采取适当材料及方法使入脑干区减压是提高有效率,减少复发的主要措施。