应用心电脉冲技术降低64层螺旋CT冠状动脉成像的辐射剂量

Objective To evaluate the value of reducing radiation dose with ECG-pulsing and image quality in 64-row multi-alice CT coronary angiography.Methods Fifty-nine consecutive patients whose heart rates were less than 80 beat per minute and cardiac rhythm was regular were randomly divided into two groups from October 26, 2007 to March 12, 2008.Conventional technique of CT coronary angiography was employed in group 1, while ECG-pulsing technique was applied in group 2.CT dose index volume (CTDIvol) and dose length product (DLP) were obtained automatically, and then the corresponding effective dose (ED) were calculated.The quality scores were performed on obtained imaging by using double blind method.Student t-test was applied in the comparison of value of CTDIvol, value of ED and quality of imagiugbetween two groups.Results The value of CTDIvol was (70.0±1.1) and (39.0±2.7) mGy, the value of ED was (16.8±2.0) and (9.5±1.7) rosy in group 1 and group 2, respectively, which reached statistically significant differences between the groups(t=57.675,15.346 ,P <0.01, respectively). The quality scores of coronary images were 3.8±0.2 and 3.8±0.1 in the groups, which did not reach the statistical significance (t=-0.222, P 0.05).Conclusions The proper application of ECG-Pulsing technology in 64-slice spiral CT coronary angiography can reduce radiation dose significantly while having no influence on the quality of the imaging.     

术中B型超声检查对胰岛素瘤定位诊断的价值

目的：探讨术中Ｂ型超声检查（ＩＯＵＳ）对胰岛素瘤定位诊断的价值。方法：１９９０年１月～２０００年１０月我院共收治胰岛素瘤３２例,均采用ＩＯＵＳ进行胰岛素瘤定位及指导手术。结果：术中触摸定位胰岛素瘤病灶２７例（８４．４％）,ＩＯＵＳ定位３１例（９６．９％）。结论：ＩＯＵＳ能准确定位胰岛素瘤,并显示肿瘤与重要结构（如胆总管、胰管及重要血管等）的毗邻关系。ＩＯＵＳ不仅提高手术成功率,避免了不必要的盲目胰腺切除,并由此降低手术并发症的发生率。     

47例重症急性胰腺炎的非手术治疗

20世纪70～80年代,多数学者对重症急性胰腺炎(SAP)主张早期甚至急诊手术,但早期手术尤其72小时以内手术,不仅未能降低早期多器官功能障碍综合征等并发症的发生,而且总的死亡率较高[1].因此,20世纪80年代后期90年代初期提出"个体化治疗方案"[2],认识到感染与SAP预后密切相关.外科手术针对SAP坏死并感染的病例,对SAP尚无明显感染者采用非手术治疗.我们回顾性总结了1995～2000年经非手术治疗47例SAP的经验.现报告如下.     

严重钝性肝损伤35例救治体会

严重的肝损伤并不少见,在腹部闭合性伤中多者可达45%,最低也占20%,其死亡率亦甚高,约为25%[1].我院1990年2月～2000年10月共救治钝性严重肝损伤35例,对其救治情况进行了回顾性分析,现报告于下.     

应用心电脉冲技术降低64层螺旋CT冠状动脉成像的辐射剂量

Objective To evaluate the value of reducing radiation dose with ECG-pulsing and image quality in 64-row multi-alice CT coronary angiography.Methods Fifty-nine consecutive patients whose heart rates were less than 80 beat per minute and cardiac rhythm was regular were randomly divided into two groups from October 26, 2007 to March 12, 2008.Conventional technique of CT coronary angiography was employed in group 1, while ECG-pulsing technique was applied in group 2.CT dose index volume (CTDIvol) and dose length product (DLP) were obtained automatically, and then the corresponding effective dose (ED) were calculated.The quality scores were performed on obtained imaging by using double blind method.Student t-test was applied in the comparison of value of CTDIvol, value of ED and quality of imagiugbetween two groups.Results The value of CTDIvol was (70.0±1.1) and (39.0±2.7) mGy, the value of ED was (16.8±2.0) and (9.5±1.7) rosy in group 1 and group 2, respectively, which reached statistically significant differences between the groups(t=57.675,15.346 ,P <0.01, respectively). The quality scores of coronary images were 3.8±0.2 and 3.8±0.1 in the groups, which did not reach the statistical significance (t=-0.222, P 0.05).Conclusions The proper application of ECG-Pulsing technology in 64-slice spiral CT coronary angiography can reduce radiation dose significantly while having no influence on the quality of the imaging.     

亚低温状态5周游泳运动联合干预对NAFLD大鼠肝组织HSP70mRNA的影响

目的：探讨在非酒精性脂肪肝病（NAFLD）动物模型建造过程中实施亚低温状态5周游泳运动联合干预对诱导NAFLD大鼠肝组织HSP70mRNA表达量及其HSP70生成量变化的影响,旨在研究延缓NAFLD的机制。方法：60只SD大鼠随机分为对照组（C）、高脂组（F）、常温游泳高脂组（TS）、常温浸泡高脂组（TI）、亚低温游泳高脂组（HS）和亚低温浸泡高脂组（HI）各10只。建造NAFLD动物模型的过程中,除C组外均给予相应高脂液体饲料喂养,并分别进行不同温度的游泳或浸泡干预。5周后采用固相夹心法酶联免疫吸附实验（ELISA）检测各组肝脏组织HSP70浓度和Real-Time PCR相对定量测试HSP70mRNA。结果：肝组织HSP70浓度及HSP70mRNA,HS组均明显高于C、F组（P〈0.01）。结论：在SD大鼠NAFLD模型建造过程中,实施亚低温状态下联合有氧运动干预措施,可以诱导NAFLD肝细胞生成大量应激蛋白,而延缓NAFLD的发生与发展。     

应用心电脉冲技术降低64层螺旋CT冠状动脉成像的辐射剂量

Objective To evaluate the value of reducing radiation dose with ECG-pulsing and image quality in 64-row multi-alice CT coronary angiography.Methods Fifty-nine consecutive patients whose heart rates were less than 80 beat per minute and cardiac rhythm was regular were randomly divided into two groups from October 26, 2007 to March 12, 2008.Conventional technique of CT coronary angiography was employed in group 1, while ECG-pulsing technique was applied in group 2.CT dose index volume (CTDIvol) and dose length product (DLP) were obtained automatically, and then the corresponding effective dose (ED) were calculated.The quality scores were performed on obtained imaging by using double blind method.Student t-test was applied in the comparison of value of CTDIvol, value of ED and quality of imagiugbetween two groups.Results The value of CTDIvol was (70.0±1.1) and (39.0±2.7) mGy, the value of ED was (16.8±2.0) and (9.5±1.7) rosy in group 1 and group 2, respectively, which reached statistically significant differences between the groups(t=57.675,15.346 ,P <0.01, respectively). The quality scores of coronary images were 3.8±0.2 and 3.8±0.1 in the groups, which did not reach the statistical significance (t=-0.222, P 0.05).Conclusions The proper application of ECG-Pulsing technology in 64-slice spiral CT coronary angiography can reduce radiation dose significantly while having no influence on the quality of the imaging.     

CT成像下左心耳形态和左心耳孔面积与缺血性卒中的关系

目的：通过CT成像技术探讨左心耳形态和左心耳孔面积与缺血性卒中的关系,希望提供一种无创且有效的方法预测缺血性卒中的危险因素。方法：连续入选2020年4月—2021年4月东南大学附属中大医院接诊的60例缺血性卒中的非瓣膜性房颤患者（卒中组）。对照组包括60例年龄匹配的无卒中病史的非瓣膜性房颤患者。所有患者均接受了经胸超声心动图（transthoracic echocardiography,TTE）、经食道超声心动图（transesophageal echocardiography,TEE）和计算机断层扫描血管造影（computed tomography angiography,CTA）检查。CTA检查完成后获得原始图像,并测量左心耳孔面积;使用GE公司的AW4.61工作站进行三维重建获得左心耳图像,根据左心耳形态将其分为鸡翅型和非鸡翅型,分析左心耳形态、左心耳孔面积与缺血性卒中的关系。结果：卒中组中持续性房颤所占比例较对照组明显增加,卒中前CHA2DS2?VASc评分明显增高;与对照组左心耳流速（left atrial appendage flow velocity,LAAFV）［（50.8±15.4）cm/s］比较,卒中组［（32.0±12.4）cm/s］明显降低（P < 0.001）;与对照组比较,卒中组的非鸡翅型左心耳形态比例明显增加（P < 0.001）,左房内径和左心耳孔面积明显增大（P < 0.001）;而卒中组的左心耳容积与对照组相比差异无统计学意义。将有统计学意义的变量纳入多元Logistic回归分析,结果显示,非鸡翅型左心耳形态、左心耳孔面积、左房内径、卒中前评分、LAAFV是缺血性卒中的独立预测因子。结论：非瓣膜性房颤患者中,房颤类型、左心耳形态、左心耳孔面积、卒中前CHA2DS2?VASc评分、左房内径、LAAFV和缺血性卒中密切相关,非鸡翅型左心耳、较大的左心耳孔面积和左房内径是非瓣膜性房颤患者缺血性卒中的独立预测因子。     

肺脑综合征的护理

肺性脑病是中度或重度呼吸衰竭引起的高碳酸血症、低氧血症,是以中枢神经系统机能障碍为主要表现的综合征,是肺心病的严重并发症,临床上常因呼吸道感染,严重电解质紊乱,使用镇静剂以及吸氧治疗不当等而诱发。患者一般有头痛、头昏、白天嗜睡、夜间兴奋、表情淡漠、反应迟钝、记忆力和判断力减退等现象。重者可出现烦躁不安、神志恍惚、谵妄、     

经急诊腹腔镜置管灌洗治疗急性胆源性重症胰腺炎

重症胰腺炎是一种病情凶险、并发症多及死亡率高的急腹症,可分为早期的急性生理紊乱期及后期的坏死感染期.低血容量、休克、ARDS、心肺肾功能不全等是致早期死亡的重要原因.以胆道疾患为病因的占50%,是急性胰腺炎的主要病因[1].多数人主张对急性胆源性重症胰腺炎应早期手术,手术方式虽众多,但多数主张简化手术,常用的有开腹灌洗引流、坏死组织清除等方式[2].我院于1995年6月～2000年5月间采用经急诊腹腔镜置管灌洗治疗急性胆源性重症胰腺炎11例,取得了并发症少、死亡率低及损伤小等良好的效果.