腹腔镜胆囊切除治疗急性胆囊炎115例

腹腔镜胆囊切除治疗急性胆囊炎１１５例张晓东高德宝周维平鲁焕章天津市南开医院第三外科３００１００ＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＣｈｏｌｅｃｙｓｔａｃｔｏｍｙ，ｌａｐａｒｏｓｃｏｐｉｃＣｈｏｌｅｃｙｓｔｉｔｉｓ／ｓｕｒｇｅｒｙ主题词胆囊切除术，腹腔镜...     

针刺对提高机体免疫力的观察

在病原菌的感染过程中,人体常以特异性和非特异性的两组免疫防御系统自卫。网状内皮系统吞噬功能及血液中小噬细胞吞噬力,均为已知的非特异性防御因素。急腹症中的炎症疾病及其继发感染,均可造成机体功能减退和免疫力的相应降低,为观察针刺对机体免疫力的影响,我们进行了以下几项实验。一、针刺足三里等对增强家兔全血小噬细胞吞噬能力的观察: 1.方法:静脉采血0.05毫升加入枸橼酸钠0.05毫升,再加入金黄色葡萄球菌0.05毫升(菌液浓度     

胃肠超声造影诊断肠系膜上动脉压迫综合征的价值

目的 探讨胃肠超声造影诊断肠系膜上动脉压迫综合征(SMAS)的价值.方法 经螺旋CT检查证实的SMAS患者29例,全部进行口服胃窗超声造影检查,分析SMAS的经口服胃窗的超声造影表现.结果 29例患儿胃肠超声造影均可显示明显减少的肠系膜上动脉(SMA)-腹主动脉角度和SMA-腹主动脉距离,仰卧位患儿出现由SMA引起的十二指肠压迹和"漏斗形"、"葫芦形"图像,可见十二指肠近端扩张和造影剂来回流动.经口胃肠超声造影检查和CT检查诊断SMAS具有高度的一致性.结论 胃肠超声造影检测SMAS具有特征性表现,并对筛选可疑的SMAS病例有一定作用.

Abstract：

Objective To explore oral contrast-enhanced ultrasonography findings in superior mesenteric artery syndrome (SMAS).Methods Twenty-nine patients with SMAS were examined using oral contrast-enhanced ultrasonography,which was confirmed by contrast-enhanced spiral computerized tomography.Results Abdominal ultrasonography with oral contrast-enhanced ultrasonography revealed a significant reduction of the SMA angle and diminished SMA-aorta distance in 29 subjects.Duodenum was showed the indentation and "funnel shaped" or "dumbbell shaped" findings which was caused by pressure of the SMA in patients with recumbent position.The proximal part of duodenum expanded distinctively with contrast media movement fro.Ultrasonography and CT examinations had a good agreement in diagnosing pathological aortomesenteric angle and distance.Conclusions Oral contrast-enhanced ultrasonography presents characteristic findings in patients with SMAS,which is useful in epidemiological screening of suspicious cases of SMAS in children.     

肠系膜上动脉压迫综合症多层螺旋CT诊断价值

肠系膜上动脉压迫综合症（superior mesenteric artery compressing syndrome，SMACS）又称Wilkie病、压迫性肠梗阻，系指由于肠系膜上动脉压迫十二指肠的水平部所引起的十二指肠部分或完全梗阻而出现的一系列症状。我院于2007年8月-2010年3月对收治的肠系膜上动脉压迫综合症患者采用16层螺旋CT诊断，取得了良好的临床诊断效果，现将结果报道如下。     

先天性肝静脉门静脉瘘的常规超声及超声造影表现

先天性肝内门-体静脉分流(intrahepatic portosystemic venous shunts,IPSVS)被认为是发病率极低的疾病,可导致肝性脑病.先天性肝内门-体静脉分流中肝内肝静脉门静脉瘘分流量常较小,近年来经超声检查偶然发现没有症状的肝静脉门静脉瘘的病例数量明显增高.本研究运用超声造影技术对先天性肝静脉门静脉瘘进行检查,以评价其超声及造影表现.     

多层螺旋CT对肺癌肾上腺转移的诊断价值

目的探讨多层螺旋CT对肺癌肾上腺转移的诊断价值和CT影像学图像特征。方法应用CT检查肺癌肾上腺转移患者36例。结果螺旋CT对肾上腺转移癌的检出率为88．8％（32／36），CT图像特征表现为圆、椭圆形或分叶状不规则肿块。结论多层螺旋CT对绝对多数肾上腺转移癌可作出诊断，可作为肾上腺转移癌较佳的检查方法，有利于正确制定治疗方案。     

温中散寒Ⅱ号药理作用的初步研究

温中散寒法是“里寒证”的相应治法。“里寒证”的主要表现为脘腹痛、呃逆吐泻、饮食不消及肢冷、汗出等,即脾胃虚寒症状。常用温中散寒药有干姜、高良姜、吴茱萸、薤白、川椒及细辛等;方剂有四逆汤、理中丸、良附丸及吴茱萸汤等。本实验选其中主要药味吴茱萸及高良姜组成温中散寒Ⅱ号进行了初步实验研究。现将结果报告如下。     

大承气汤冲剂对人血浆胃动素的影响

本研究以放射免疫分析法测定了健康人服用大承气汤冲剂后血浆胃动素浓度并观察了其动态变化。结果发现:服药后平均血浆胃动素浓度较服药前明显升高(P<0.01)。自服药后55分钟,血浆胃动素浓度即显升高,这种上升态势至少维持至服药后145分钟。结果提示:大承气汤冲剂增强肠运动的作用与其兴奋肠道运动的体液调节途径使血浆胃动素浓度升高有关。从肠道运动功能的内分泌调控角度为阐明该方的作用机理提供了新依据。     

多层螺旋CT面神经管曲面重建图像的解剖与临床应用研究

目的 探讨多层螺旋CT面神经管曲面重建图像的解剖与临床应用.方法 选择2010年1-11月收治的面部神经疾病患者50例作为研究组,50例面部神经正常者作为对照组.采用多层螺旋CT对患者进行扫描,扫描将眼眶上缘至外耳道下缘连线作为水平线,范围从乳突下缘至颞骨岩部上缘,将获得的数据在Wizard工作站中进行重建.所有测量数据均为两位以上医生的测量结果 的平均值.结果 对照组面神经管均可以在一幅图像中清晰地显示出来,显示率为100.00%(50/50),且各段数据可以准确测量得到;轴向重建、冠状位重建和矢状位重建三个方向测量的结果 比较,迷路段、水平段和垂直段的长度和直径的差异均无统计学意义(P＞0.05),且第一弯曲角度和第二弯曲角度的差异均无统计学意义(P＞0.05);与对照组比较,研究组不同面部神经疾病患者的显示率均明显下降,差异均有统计学意义(P＜0.05).结论 多层螺旋CT曲面重建技术对面部神经疾病的诊断具有十分重要的临床意义,值得推广应用.

Abstract：

Objective To probe into the anatomy and clinical application of the facial nerve canal surface by multislice spiral CT image curved planar reformation. Methods Fifty patients with facial nerve disease were selected as study group from January to November in 2010, 50 healthy subjects were selected as control group, using models of multislice spiral CT scan for the patient, scanning from the upper edge of the orbital under external auditory canal edge of the connection as a horizontal line, ranging from the lower edge of mastoid process to the petrous bone on the edge of the data obtained in the Wizard workstation reconstruction. All the measurements were more than two measurements of the average physician. Results Normal facial nerve canal in control group could be displayed clearly in an image, display rate was 100.00%(50/50), and the segment data could be accurately measured; axial reconstruction, reconstruction of coronal and sagittal reconstruction of the three comparison of measured direction, fan sections, horizontal and vertical segments of the length and diameter were not significantly different (P＞0.05), and the first and second bending angle of bending angle was no significant difference (P ＞ 0.05 ). Compared with control group, the patients with vascular disease in study group showed significantly decreased rate, the difference was significant (P ＜ 0.05). Conclusion Curved planar reformation of multislice spiral CT diagnosis of facial nerve canal disease has great clinical significance, should be widely applied.