16层螺旋CT脑血管造影的临床应用

目的探讨16层螺旋CT脑血管造影（CTA）的临床应用价值。方法利用16层螺旋CT对159例临床怀疑脑血管疾病的患者做脑血管增强扫描，采用VR、MIP和MPR后处理技术重建脑血管图像。结果本组159例，其中正常74例，血管变异44例，动脉瘤11例，大脑中动脉栓塞2例，脑动脉狭窄29例，脑动静脉畸形1例，Moyamoya病1例。结论CTA能多方位清晰显示脑血管病变，为病变与邻近血管的关系提供更精确具体的解剖图像，可发展作为脑血管疾病的一种筛选手段，部分代替数字减影血管造影术（DSA）。     

85例老年患者下肢动脉血管成像技术检查结果分析

目的 评价16层螺旋CT下肢动脉成像在诊断老年患者下肢动脉硬化闭塞症合并其它不同基础疾病中的临床价值.方法 对85例临床疑似下肢动脉硬化的老年患者行16层螺旋CT下肢动脉血管成像（CT angiography,CTA）扫描,以容积再现（volume rendering,VR）,最大密度投影（maximum intensity projection,MIP）以及曲面重建（curved reformate,CR）技术重建.按糖尿病、高血压病因分组,比较下肢动脉CTA检查结果.结果 CTA检查可以清晰显示双下肢动脉及主要分支病变的部位、范围及侧枝循环.49例血管不同程度钙化患者中,高血压组、糖尿病合并高血压组较糖尿病组下肢动脉管壁钙化的病例出现更多（P＜0.05）.43例不同程度的下肢动脉狭窄及闭塞患者中,糖尿病合并高血压组较高血压组、糖尿病组的闭塞病例出现更多（P＜0.05）.结论 糖尿病合并高血压组患者的下肢动脉硬化闭塞症表现较糖尿病组及高血压组患者更为严重.对存在易患因素的老年人群,尤其是同时具有高血压和糖尿病病因者,下肢动脉CTA检查具有筛选价值.     

黄杨宁与硝酸甘油伍用治疗心绞痛的初步研究

将黄杨宁与硝酸甘油合用作治疗组,与单用硝酸甘油组对照,通过60例病人临床观察,治疗组与对照组之间,无论是心绞痛症状改善情况、硝酸甘油增减量及S—T、T缺血性改变改善情况,两组之间均有显著性差异(P<0.01)。证实黄杨宁片具有减少心肌耗氧量,扩张冠脉血管,并能明显改善心绞痛症状及心电图缺血性S—T、T改变,与硝酸甘油合用,能起到协同作用,减少硝酸甘油用量,避免或减少硝酸甘油的副作用。     

CT灌注成像在超早期脑梗死中的应用

Objective To investigate the role of computed tomography perfusion (CTP)in the diagnosis and differential diagnosis of hyperacute cerebral infarction. Methods After CT scan was performed in 33 patients who were clinically diagnosed as cerebral infarction ＜5 hours of symptom onset,CTP imaging was performed. CT was reexamined after 24 hours.Results CT scan did not fred abnormality in 33 patients. CTP imaging showed 15 were normal and 18 were abnormal. The regional cerebral blood flow (rCBF),regional cerebral blood volume (rCBV),and regional mean transit time (rMTT) in patients with normal CTP imaging were 32.588±5.877 ml/(100 g · min),1.205 ±0.261 ml/100 g,and 2.937±0.887 s,respectively. There were no significant differences compared to the contralateral sides (33. 208 ± 6. 740)ml/(100 g · min),1. 233 ± 0. 290) ml/100 g,and 2. 854 ± 0. 799 s) (all P ＞ 0. 05).Clinical follow up and CT reexamination confirmed that 11 patients were diagnosed as transient ischemic attack (TIA),2 were hypoglycemia,and 2 were brain stem infarction. The rCBF,rCBV,and rMTT in the ipsilateral sides of 18 patients with CTP imaging abnormality were 6. 580 ±3. 457 ml/(100 g·min),0. 803 ±0. 285 ml/100 g,and 14. 947 ±4. 665 s,respectively. There were significant differences compared to the contralateral sides (34. 756 ± 4. 126 ml/(100 g·min),1. 622 ±0.708 ml/100 g,and (3.794 ± 1. 775 s) (all P ＜0. 05). Clinical follow up and CT reexamination confirmed as cerebral infarction in the basal ganglia region. Conclusions CTP imaging can be used for the diagnosis of hyperacute cerebral infarction and has the significance of differential diagnosis.     

换血疗法抢救重症有机磷中毒21例

近年来我们采用换血疗法抢救重症有机磷中毒21例,特报告如下。资料和方法21例重症有机磷中毒患者,男9例、女12例,年龄18～40岁。其中昏迷18例次,呼吸衰竭6例次、脑水肿5例次。1605中毒5例、1059中毒1例、乐果中毒8例、DDV中毒7例。血胆碱酯酶均低于30%,其中13例为0.对阿托品反应差5例、无反应16例.静注3～5mg阿托品后,心率<70次/分、瞳孔0.1cm、皮肤出汗无变化为无反应,静注3～5mg阿托品后,心率>90次/分,瞳孔仍小于0.2cm、皮肤出汗稍减轻为反应差。方法首先静脉放血300ml;然后输入同型鲜     

特殊表现的大叶性肺炎69例临床分析

典型大叶性肺炎临床诊断并不困难,但以呼吸道以外症状为突出表现者,临床诊断往往不易。笔者总结69例以肺外症状为主要表现的大叶性肺炎,进行临床分析,并略加讨论。误诊分析一、以休克为主要表现而误诊为感染性休克、过敏性休克38例例1:女,13岁。发热咳嗽半天。当地医院检查:体溫39.5℃,心率110次/分,律齐,两肺呼吸音清。白细胞(WBC)13×10~9/升,中性(N)0.83,     

阿托品对抗三磷酸腺苷转复阵发性室上性心动过速时产生的瞬间心律失常

三磷酸腺苷(ATP)转复阵发性室上性心动过速(PSVT)有效率高达90%。目前已列为转复PSVT 首选药物。但其转复时产生的瞬间心律失常发生率颇高,并有潜在危险性。我们用阿托品对抗 ATP 转复 PSVT 时产生的瞬间心律失常,特报告如下。一、临床资料和方法:本组男20例,女22例;除用 ATP 及阿托品外,未用其他抗心律失常药物。42例随机分为两组;其中单用 ATP 组20例     

CT灌注成像在超早期脑梗死中的应用

Objective To investigate the role of computed tomography perfusion (CTP)in the diagnosis and differential diagnosis of hyperacute cerebral infarction. Methods After CT scan was performed in 33 patients who were clinically diagnosed as cerebral infarction ＜5 hours of symptom onset,CTP imaging was performed. CT was reexamined after 24 hours.Results CT scan did not fred abnormality in 33 patients. CTP imaging showed 15 were normal and 18 were abnormal. The regional cerebral blood flow (rCBF),regional cerebral blood volume (rCBV),and regional mean transit time (rMTT) in patients with normal CTP imaging were 32.588±5.877 ml/(100 g · min),1.205 ±0.261 ml/100 g,and 2.937±0.887 s,respectively. There were no significant differences compared to the contralateral sides (33. 208 ± 6. 740)ml/(100 g · min),1. 233 ± 0. 290) ml/100 g,and 2. 854 ± 0. 799 s) (all P ＞ 0. 05).Clinical follow up and CT reexamination confirmed that 11 patients were diagnosed as transient ischemic attack (TIA),2 were hypoglycemia,and 2 were brain stem infarction. The rCBF,rCBV,and rMTT in the ipsilateral sides of 18 patients with CTP imaging abnormality were 6. 580 ±3. 457 ml/(100 g·min),0. 803 ±0. 285 ml/100 g,and 14. 947 ±4. 665 s,respectively. There were significant differences compared to the contralateral sides (34. 756 ± 4. 126 ml/(100 g·min),1. 622 ±0.708 ml/100 g,and (3.794 ± 1. 775 s) (all P ＜0. 05). Clinical follow up and CT reexamination confirmed as cerebral infarction in the basal ganglia region. Conclusions CTP imaging can be used for the diagnosis of hyperacute cerebral infarction and has the significance of differential diagnosis.     

不同分娩方式对母婴的影响分析

帮助产妇选择最佳分娩方式，产后尽快恢复体力。将４００例产妇分为阴道及剖宫产组，现察两组产后子宫收缩，乳汁分泌及各时间段新生儿体重情况。结果：两组产后子宫收缩情况差异无显著性（Ｐ〉０．０５）；乳汁分泌情况阴道产优于剖宫产；新生儿体重通过生理下降后阴道产第５天回升与出生比较差异无显著性（Ｐ〉０．０５）；剖宫产新生儿第５天体重仍呈下降趋势，与出生时比较差异有显著性（Ｐ〈０．０５）。结论：阴道产有利于产后     

不同读片方式下数字医学影像显示一致性研究

目的通过对临床大量硬读片和软读片诊断结果的分析，说明PACS系统在读片上的优越性以及不同读片方式之间的统计一致性，为诊断效果分析及放射科数字影像诊断的质量控制提供合乎统计规律的科学依据。方法基于我院拥有的大量X线胶片数据，在保证取样随机性的前提下，选择合适的胶片取样数目（6000例）；在保证医生判读一致性的条件下，获取医生在不同读片方式下的诊断结果（阳性，阴性，可疑阳性）；利用Kappa方法对医生判读结果进行统计分析。结果软读片方式杜绝了可疑阳性诊断结果的出现；软读片、专业灰度显示器及图像处理技术都可以提高诊断结果的阳性率；从Kappa值分析的角度，胶片与普显、胶片与专显、图像处理前后的普显、图像处理前后的专显之间有着几乎一致的诊断结果。结论软读片除了有易于保存与处理等优点外，我院现在采用的专业灰度显示器及对诊断影像进行图像处理有助于阳性率的提升。Kappa值的分析结果说明了我院现有诊断方式的可行性。