Mammotome微创旋切术切除乳腺肿块1081例分析

目的探讨超声引导下Mammotome微创旋切术治疗乳腺肿块的方法和效果。方法回顾性分析1081例、1913处乳腺肿块经超声引导下Mammotome微创旋切术治疗后的疗效和随访效果。结果对1081例患者、1913处肿块行Mammotome微创旋切切除术,每处病灶平均用时4分钟,平均旋切组织15次。1063例、1894处（99.01%）为乳腺良性病变,18例、19处（0.99%）为乳腺癌。共发生术中、术后并发症39处。结论Mammotome微创旋切系统是目前临床治疗乳腺良性肿块和诊断早期乳腺癌的有效方法之一。     

超声引导经皮肝穿刺胆汁引流治疗梗阻性黄疸

目的：观察超声引导经皮肝穿刺胆汁引流的成功率及安全性。方法：对56例恶性肿瘤导致梗阻性黄疸的患者,在超声引导下进行经皮肝穿刺胆汁引流,观察胆汁引流情况及并发症。结果：51例成功置管引流,术后胆汁引流通畅,血胆红素降低,未出现大出血、胆汁性腹膜炎、感染等并发症。结论：超声引导经皮肝穿刺胆汁引流是解决恶性肿瘤导致的梗阻性黄疸安全有效的方法。     

Ultrasound-guided submandibular gland injection of botulinum toxin for hypersalivation in cerebral palsy

Hypersalivation associated with cerebral palsy may be treated with injection of botulinum toxin A (BTX-A) into the submandibular gland, and the use of ultrasound permits its accurate administration. In our series four patients with cerebral palsy and hypersalivation had bilateral ultrasound-guided injection of BTX-A into the submandibular gland. At 4 weeks there was objective improvement in all patients and subjective improvement in three. The only reported side effect was the temporary inability to retain prosthetic orbital globes in one patient. Ultrasound-guided injection of BTX-A for hypersalivation is effective, and side effects are rare, but they have yet to be fully described.     

C臂血管减影机（DSA）引导经皮肾造瘘治疗癌性肾积水的临床分析

目的分析超声引导下经皮穿刺肾造瘘（percutaneous nephrostomy,PCN）治疗肾积水的临床意义及并发症。方法在DSA引导下对35例肾积水患者PCN治疗,其中8例患者行双侧PCN。全部住院治疗,总结对PCN的临床疗效及并发症进行观察分析。结果35例患者共39次置管全部一次性成功,成功率100%,35例患者肾功能在3天内得到改善,有效率100%。全组无1例因治疗的相关并发症而死亡。结论PCN能够改善肾功能,避免肾功能因梗阻而衰竭,是一项操作简便、有效且并发症少的治疗方法。     

经腹超声引导绝经妇女取环31例

目的：经腹超声引导下为绝经后妇女取环,增加了取环的成功率,减少出血和并发症。方法：对2002年8月～2007年8月期间,观察31例绝经后妇女,经腹超声引导下取环为实验组（A组）,绝经2～7年21例,绝经8～12年10例,绝育器部分嵌入肌层者6例;随机观察门诊绝经两年以上未经超声引导取环者31人,为对照组（B组）,绝经2～7年24例,8～12年7例,绝育器部分嵌入肌层者8例。（绝育器不嵌入肌层者在这里不做观察）。观察参数：观察病例数、出血量、取环所用时间,成功病例数,以及成功率。结果：A组31例经腹超声引导下去患者27例成功,4例失败,出血量最多约10ml,取环时间最长40min。另外B组31例,未经腹超声引导取环的患者,其中21例成功,10例失败,出血量最多约15ml,取环时间最长60min。A、B两组相比较,A组成功率与B组成功率相比,差异有统计学意义（P〈0．05）。结论：经腹超声引导下取环,成功率明显提高,出血量明显减少,取环时间缩短,极大减轻了病人的痛苦,这种方法值得推广使用。     

超声引导射频消融治疗肝癌

目的探讨超声引导射频消融(RFA)对肝癌的治疗效果。方法应用超声引导经皮射频消融治疗253例肝癌患者,共计384个癌灶,肿瘤大小为1.1~8.5 cm。采用彩超、CT及血AFP检查综合评价疗效。结果射频消融治疗术后347个癌灶完全被灭活,灭活率为90.3%(347/384)。5例患者出现胸腔积液,1例肝脓肿,1例胆瘘。结论超声引导RFA对肝脏恶性肿瘤提供了有效的微创治疗手段,规范的手术操作可避免RFA并发症的发生。     

Evaluation and indications of ultrasound-guided vacuum-assisted core needle breast biopsy

BACKGROUND: The Mammotome is a diagnostic tool used under stereotactic or with ultrasound guidance. A clear indication for Mammotome use under stereotactic guidance is when a non-palpable microcalcification is a target. However, the indications for the use of the Mammotome under ultrasound guidance vary among institutions, and it is difficult to find a place for the Mammotome among conventional biopsy techniques. The Mammotome biopsy has been available in our hospital since July 1999. We assessed the effectiveness and indications of ultrasound-guided Mammotome biopsy. METHODS: We performed Mammotome biopsies in 433 cases requiring histological diagnosis from July 1999 to September 2006, using an 11-gauge articulated arm-type Mammotome under ultrasound guidance. There were 377 mass lesions including 83 non-palpable cases and 56 hypoechoic lesions. RESULTS: The indications for Mammotome biopsy were 162 cases with inconsistent fine needle aspiration (FNA) and imaging findings, 114 cases indeterminate by FNA, 68 cases of an identified pathological type before neoadjuvant chemotherapy and confirmation of hormone receptor status, 36 inadequate cases by FNA, 20 cases of confirmation of fibroadenoma and other benign tumors, 8 removal cases of fibroadenoma, 8 microcalcification cases, and 17 others. The target lesion was obtained in 99.5% of the cases. CONCLUSIONS: Ultrasound-guided Mammotome biopsy is an accurate and useful diagnostic method that enables sufficient amounts of tissue to be obtained with minimal invasion and few complications. The Mammotome is the first choice for obtaining a definitive pathological diagnosis in breast lesions.     

A Prospective Series Case Study of Pyogenic Liver Abscess: Recent Trands in Etiology and Management

Our study aims to review the literature on the management of pyogenic liver abscess, focusing on the choice of drainage. A case series of our experience with clinicopathological correlation is presented to highlight the indication and outcome of each modality of drainage. Intravenous antibiotic is the first line, and mainstay, of treatment. Drainage is necessary for large abscesses, equal to or larger than 5 cm in size, to facilitate resolution. While percutaneous drainage is appropriate as first-line surgical treatment in most cases, open surgical drainage is prudent in cases of rupture, multiloculation, associated biliary, or intra-abdominal pathology. Percutaneous drainage may help to optimize clinical condition prior to surgery. Nevertheless, in current good clinical practices, the choice of therapy needs to be individualized according to patient’s clinical status and abscess factors. They are complementary in the management of liver abscesses.