妊娠期阑尾炎临床病例分析(附33例报告)

目的探讨妊娠期阑尾炎的临床表现,研究其诊治分析影响措施与母儿预后的。方法回顾性分析1990年至2005年收治的妊娠期阑尾炎33例的诊治方法。结果延误诊断3例治疗后2例流产,及时准确诊断并手术治疗30例,母儿安全,足月顺产。结论妊娠期阑尾炎影响母儿生命安全的主要原因是延误诊断或延误手术,准确诊断和及时手术,辅以积极的保胎和抗感染治疗是确保母儿生命安全的关键措施。     

胆石症胆道感染并发心包积脓7例分析

本院26年中胆石症、胆道感染并发心包积脓7例。其中6例死亡,作者指出,凡胆石症并感染的患者出现心肺症状和体征,应警惕本并发症的发生。A型超声和X线检查对诊断有重要帮助。一旦确诊应及时行心包穿刺抽脓或心包造口引流;及时有效地处理胆道原发病灶是预防和减少本并发症的根本措施。     

药物治疗慢性鼻-鼻窦炎嗅觉障碍的疗效观察

目的观察药物治疗慢性鼻-鼻窦炎嗅觉障碍的疗效。方法对本院2006年1月～2008年8月26例慢性鼻-鼻窦炎（不伴鼻息肉）嗅觉障碍患者进行回顾性分析。减充血剂、抗炎、抗感染、黏液促排药物治疗20例,在此基础上给予全身激素及营养神经治疗5例,全身激素、营养神经及抗病毒治疗1例。治疗前后行嗅觉测试、鼻窦CT和鼻内镜检查。结果本组26患者中24例治愈,治愈率92.00%,平均治疗时间25.64 d。结论以嗅觉障碍为主诉的慢性鼻-鼻窦炎,根据病因,选择正确的治疗方案,可获满意治疗效果。     

慢性胰腺炎的内镜治疗

慢性胰腺炎(CP)是一种进行性、不可逆性炎症疾病,可引起慢性腹痛、营养不良及其他并发症,药物、内镜、外科手术的治疗均很重要。内镜治疗可运用包括胰管括约肌切开术、支架置入、狭窄扩张、ESWL、取石、囊肿引流和超声内镜引导下的治疗等多种方法,为药物治疗失败及不适合外科手术的患者提供了治疗手段。本文对内镜治疗CP所致胆胰管结石及狭窄、胰漏、胰腺假性囊肿的效果进行了综述,对EUS引导下腹腔神经丛阻滞术治疗胰性疼痛也进行了讨论。     

300例异位妊娠的疗法分析

目的探讨异位妊娠的疗法分析。方法回顾性分析300例异位妊娠患者的诊治情况。结果 300例异位妊娠中采用非手术治疗65例,成功51例,成功率78.46%,失败14例;手术治疗249例,成功率100%。经病史、症状、体征、超声及血人绒毛膜促性腺激素检查来综合确定,手术病例均经病理证实,诊断符合率达100%。结论在目前的医疗条件,患者就诊及时,除少数需剖腹手术治疗外,绝大多数采用非手术治疗及熟练的腹腔镜手术治疗,效果良好。     

老年人肝内胆汁瘤6例治疗体会

目的 探讨老年人胆汁瘤的治疗方法及其效果.方法 患者共6例,术中均将相通胆管关闭后,行囊肿开窗引流术.结果 6例患者均痊愈出院,随访无复发.结论 将相通胆管关闭后行囊肿开窗引流术是治疗部分老年人胆汁瘤的一种安全有效的方法.     

多囊卵巢综合征诊断与治疗的新进展

多囊卵巢综合征(PCOS)的发病机制目前仍不完全清楚,临床主要表现为月经失调、排卵障碍、肥胖等。该病的诊断标准尚存争议,大多认为鹿特丹准则比较适用于我国PCOS的诊断。治疗方法也繁多各异,包括非手术治疗(调整月经周期、促排卵治疗、应用胰岛素增敏剂和他汀类药物)、手术治疗(卵巢楔形切除术、经阴道超声引导的卵巢间质水凝术)和中西医结合治疗。     

Reducing Psychological Distress in Patients with Inflammatory Bowel Disease by Cognitive-Behavioural Treatment: Exploratory Study of Effectiveness

Background: This prospective study aimed to determine whether cognitive-behavioural group treatment accompanying medical standard care is effective in reducing psychological distress in patients with inflammatory bowel disease. Methods: Twenty-eight outpatients with Crohn disease or ulcerative colitis completed the treatment programme. Psychological treatment consisting of 12 weekly sessions was conducted in a group setting. Medical and psychometric assessments were taken at the beginning of the 3-month pretreatment waiting period, at pretreatment, at post-treatment and at the 3, 6 and 9-month follow-ups. Results: During baseline, no change was observed in psychological distress. Disease-related worries and concerns decreased significantly from pretreatment to the follow-ups. The disease groups differed in the decline of concerns between pre- and post-treatment, with a significant reduction of concerns in patients with ulcerative colitis but not Crohn disease. This difference did not occur at the follow-ups, indicating long-term improvement for both disease groups. Depressive coping decreased significantly in women and remained stable at the follow-ups, whereas depressive coping did not change in men. The same gender difference was found for depressive symptoms. Conclusions: The exploratory findings suggest that psychological group treatment for outpatients is a feasible and effective approach for the short- and long-term reduction of psychological distress for patients with inflammatory bowel disease. However, the revealed gender differences on coping and depression might indicate the necessity to consider gender-specific aspects of inflammatory bowel disease when designing and evaluating psychological interventions.