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111.
目的评价B超对肺癌急症的快速鉴别诊断价值。方法应用B超诊断肺癌急症35例,其中有中央型右上肺癌肿块压迫引起的上腔静脉综合征(SVC)5例,探查取胸骨右缘第2、3肋间;中大量心包积液伴亚急性心包填塞症10例,包括心肌与心包转移癌致急性出血性心包积液2例,探查取心前区及左腋前线第5、6肋间;恶性胸腔大量积液20例,探查位于两侧背部膈上。介入性治疗,B超定位穿刺抽液并腔内注入中药榄香烯乳,配合临床化疗药物、输血等综合治疗。结果在4周内急症得到暂时缓解者占82.8%,稳定占8.5%,无效占8.5%。结论简便、可重复性的超声诊断及时、可靠,并可提供疗效参考依据,证实榄香烯乳对控制急性心肌心包出血有特效,起乳剂微栓止血作用。对部分包裹性胸腔积液无效。B超对SVC诊断有一定局限性。 相似文献
112.
The clinical usefulness of measuring serum concentrations ofprogesterone, human chorionic gonadotrophin (HCG) and the free-subunit of HCG in distinguishing between early viable and non-viablepregnancy, before an accurate ultrasound diagnosis is possible,was evaluated in a prospective study of patients presentingto our emergency gynaecology service with a clinical suspicionof ectopic pregnancy. Patients were selected on the basis ofinitial HCG concentrations; samples with HCG 2510 000IU/I were later analysed for progesterone and free HCG. Of the181 patients studied, 38 (21%) had an ectopic pregnancy, 108(60%) had a spontaneous abortion and 35 (19%) had a viable intra-uterinepregnancy. Concentrations of HCG and free HCG in the group withviable pregnancies were significantly higher than in the groupwith ectopic pregnancy (P < 0.001) and than those destinedto miscarry (P < 0.01). Progesterone concentrations werealso significantly higher in the viable versus the ectopic andthe spontaneous abortion groups (P < 0.001 in each case).Despite these highly significant differences there was a degreeof overlap such that it was impossible to devise a cut-off levelfor any hormone analysed, either singly or in combination, whichwould offer a clinically useful predictor of outcome. 相似文献
113.
153例肝内结石病人行术中B超检查(IOUS),以确定结石部位、分布.显示狭窄与扩张的部位.决定手术方式。待认为结石取净后再行IOUS.了解有无残石,如发现结石.再行B超引导下取石.直到结石取净或小残石无法取净.本组不同方式肝叶切除67例.肝肠吻合54例.单纯“T”管引流86例,术毕残石率22.22%,术后胆镜取净结石11例.自行排净5例.出院时残石率11.76%.IOUS显示肝内结石清晰.定位准确.无损伤.术中可反复使用,可显示隐蔽的结石、异位结石和易被忽视的尾叶结石. 相似文献
114.
This article evaluates the costs and outcomes associated with TEE during and after cardiac surgery. The costs include the direct and indirect costs--the complications of TEE. The outcomes include the positive consequences or the benefits: money and lives saved. The article uses liberal (high) estimates of the direct and indirect costs of TEE and conservative (low) estimates of the benefits. The exact cost or benefit depends on the number of cases performed. The analysis shows that patients having surgery for congenital heart disease derive the greatest overall benefit: around $600 per case studied. Patients having valvular repair surgery derive the next greatest benefit: around $450 per case studied. In contrast patients having valve replacement have an overall cost of around $150 per case studied. Patients having surgery for coronary artery disease also derive an overall benefit: around $100-$300 per case studied, depending upon assumptions regarding TEE's role in prevention of intraoperative strokes. This analysis indicates that the financial benefits of TEE are substantial and frequently outweigh costs in patients requiring cardiac surgery. 相似文献
115.
儿童偏头痛脑电图和经颅多普勒检查结果分析 总被引:1,自引:0,他引:1
本文对25例儿童偏头痛患者进行发作期和间歇期脑电图及经颅多普勒检查。结果发现,脑电图异常率72%,经颅多普勒异常率85%,脑电图诱发试验60%为阳性,其中3例脑电图在枕区可见单个非典型痫性波。提出儿童偏头痛的诊断应与癫痫鉴别,脑电图与经颅多普勒同时检查能提高诊断,对治疗有指导意义。 相似文献
116.
Laparoscopic partial adrenalectomy 总被引:2,自引:0,他引:2
Imai T Tanaka Y Kikumori T Ohiwa M Matsuura N Mase T Funahashi H 《Surgical endoscopy》1999,13(4):343-345
Background: Most laparoscopic adrenalectomies involve total removal of the whole adrenal gland, and reports of laparoscopic partial adrenalectomies
have been very few. The criteria for performing a laparoscopic partial adrenalectomy have not been described.
Methods: (a) Patients with functioning adrenal tumors smaller than 3 cm in diameter were selected. (b) The solitary adrenal tumors
were evaluated by preoperative thin-slice computed tomography (CT) scan. (c) Solitary lesions were reconfirmed with intraoperative
ultrasonography. (d) Partial adrenalectomy was performed with at least a 5-mm margin using a vascular stapler.
Results: Laparoscopic partial adrenalectomy was performed in five patients using the vascular stapler. Hemostasis was perfect in all
five patients. The tumor was located in the inferior part of the right adrenal gland in three cases and in the upper pole
of the left adrenal gland in two cases. The postoperation pathologic diagnosis was adrenocortical adenoma in all five patients,
and excessive hormonal levels or symptoms all disappeared.
Conclusions: Laparoscopic partial adrenalectomy can be performed safely using a vascular stapler.
Received: 26 May 1998/Accepted: 30 June 1998 相似文献
117.
Purpose: To evaluate the effects of topical timolol and apraclonidine on retrobulbar blood flow velocity waveforms in a group of healthy volunteers.Methods: Apraclonidine 1% and timolol maleate 0.5% single dose administrations were crossed over double masked in 12 healthy volunteers. The intraocular pressure measurements were followed by Doppler examination of the ophthalmic artery and the central retinal artery.Results: Intraocular pressure was reduced significantly on both treated and fellow eyes after timolol (p = 0.003, p = 0.04 respectively) and after apraclonidine (p = 0.002, p = 0.01 respectively). After apraclonidine administration end diastolic velocity, mean velocity decreased and pulsatility index increased in the ophthalmic artery of both treated and fellow eyes. Resistivity index increased and peak systolic velocity decreased only in the ophthalmic artery of treated eyes. All Doppler indices remained nonsignificant for central retinal artery of both eyes.After timolol administration there were no significant changes of the Doppler indices in the ophthalmic artery and central retinal artery of the treated and fellow eyes.Conclusion: Topical timolol and apraclonidine significantly reduced the intraocular pressure. Single dose administration of apraclonidine 1% increased the vascular impedance distal to the ophthalmic artery. On the other hand, timolol 0.5% had no effect on vascular impedance. 相似文献
118.
目的 :探讨B超在近视眼巩膜后葡萄肿中的应用价值。方法 :用B型超声仪检查 >3.0 0D的 38例76眼进展性近视眼的巩膜后葡萄肿的发生情况。结果 :76眼中 5 8眼发生后葡萄肿。其中各级后葡萄肿的平均屈光度及眼轴差异均有非常显著性意义 (P <0 .0 1和P <0 .0 0 1)。 1~ 4级后葡萄肿与 0级葡萄肿的弧形斑发生率比较差异有非常显著性意义 (P <0 .0 1)。结论 :B超是诊断巩膜后葡萄肿最安全、快速、可靠的方法 ,对近视眼的预后判断有着重要作用。近视眼的屈光度和眼轴随巩膜后葡萄肿的加重而增加 ,眼底弧形斑的形成与后葡萄肿的形成有密切关系 相似文献
119.
Twelve cerebral lesions were operated upon with various laser sources (carbon dioxide, neodymium-yttrium-argon-garnet, and argon) and with an ultrasonic aspirator utilizing the intraoperative "real-time" ultrasonography. With the last method, the tumor was imaged just as well through the intact dura mater as on the brain surface itself, allowing a precise localization of deep intracranial lesions. A sharp selectivity on the healthy tissues is, in this way, achievable to reach the tumor, which is successively removed with the laser and ultrasonic aspirator checking the surgical maneuvers on the visual control of the ultrasonograph. 相似文献
120.
Summary Intraoperative spinal sonography (IOSS) was performed in 28 patients with extramedullary spinal tumours. Images were obtained of 31 tumours, because 2 patients had multiple tumours. There were 17 neurilemmomas, 9 meningiomas and 2 dermoid, cysts. All tumours appeared well-defined and highly echogenic. There was no difficulty differentiating extramedullary spinal tumours from intramedullary nasses excepting case, a big neurilemmoma at the conus medullaris. All images were assessed with reference to the surface of the lesions, the existence of cysts, and movement. Neurilemmomas had smooth surfaces, some cysts, and exhibited a floating movement. Meningiomas had irregular surfaces, were more highly echogenic than neurilemmomas, and adhered tightly to the dura mater. However, some neurilemmomas and meningiomas did not have these, and it was not always possible to differentiate them. Although, IOSS has limitations of resolution, it gave useful information about the size of the tumours, the degree of displacement of the spinal cord, and even about the type of tumour in some cases. It was extremely helpful to the surgeon. 相似文献