朱砂轻粉治疗肛瘘的疗效观察

肛管或直肠下端与肛门周围皮肤相通的瘘管称为肛瘘。临床上治疗多以挂线方法和肛瘘切除术，创伤大、疗程长。我们在实践中研究用中药治疗取得满意效果，现报告如下。     

小肠先天性狭窄1例报告

1　病例介绍患者男 ,4 7岁 ,上腹部阵发性疼痛、恶心、呕吐 2年。在家服用药物治疗 (药名不详 ) ,上述症状有时减轻 ,但反复发作。查体 :上腹部轻压痛 ,未扪及包块。化验检查均在正常范围。X线所见 :中腹区对应的 2组小肠见一长约 3 5cm的狭窄段 ,管腔内径约 1 0cm ,狭窄段肠壁轮廓光滑规则 ,管壁柔软 ,肠粘膜纹清晰 ,无破坏、中断 ,近段肠管扩张 ,最宽处直径约 10cm ,钡剂通过缓慢。诊断 :小肠良性狭窄 ,先天性狭窄可能性大。手术所见 :距十二指肠悬韧带 30cm处有一长约3cm的小肠环形狭窄 ,管腔直径约 1 0cm ,狭窄段以上肠管扩张 ,最粗处…     

左克与丹参存在配伍禁忌

随着《医疗事故处理条例》的实施和护理记录作为客观资料归入病历之后，护理记录中主客观资料的区分处理问题已成为困惑护士的一个难点和疑点，并在一定程度上影响着护理记录改革的不断深入，据此笔者提出以下问题与同道共同探讨。     

SPECT/CT骨显像对SAPHO综合征的诊断价值

目的探讨SPECT/CT骨显像在滑膜炎、痤疮、脓疱病、骨肥厚、骨髓炎（SAPHO）综合征诊断中的临床价值。方法回顾性分析临床怀疑SAPHO综合征的11例患者的临床资料及SPECT/CT骨显像结果,所有患者均行99Tcm-MDP全身骨显像+局部断层显像及同机或异机CT扫描,获得SPECT全身骨显像和局部SPECT骨显像、CT显像、SPECT/CT融合显像图像。分析比较SPECT骨显像和SPECT/CT融合显像对SAPHO综合征诊断的准确率、灵敏度和特异度,组间准确率的比较采用χ2检验。结果11例临床怀疑SAPHO综合征患者中,9例经穿刺组织病理或随访病情最终转归而确诊,另外2例为转移瘤。其中,SPECT诊断6例,共发现41个病灶出现放射性浓聚;SPECT/CT诊断9例,共发现44个病灶。SPECT骨显像的灵敏度、特异度和准确率分别为66.7%（6/9）、50.0%（1/2）和63.6%（7/11）;SPECT/CT融合显像的灵敏度、特异度和准确率分别为100%（9/9）、50.0%（1/2）和90.9%（10/11）,SPECT/CT融合显像对SAPHO综合症诊断的准确率明显高于单纯的SPECT显像,且差异具有统计学意义（χ2=11.82,P < 0.05）。结论SPECT/CT的联合应用提高了对病灶解剖定位的准确率及骨显像特异度,可用于SAPHO综合征患者的病灶精准定位、早期诊断与鉴别诊断、更多隐匿病灶检出以及病灶代谢活性评价等,对SAPHO综合征的诊断有较高的临床价值。     

雄黄与醋治疗带状疱疹的疗效观察

恶性肿瘤患者晚期因机体抵抗力下降 ,常易并发带状疱疹 ,增加了患者的痛苦。自 2 0 0 3年以来 ,我们以雄黄和醋治疗带状疱疹患者 10例 ,取得了满意的效果。1　方法　用 75 %乙醇消毒疱疹及周围皮肤 ,然后将雄黄 5 0g用米醋调成稀糊状 ,均匀涂于患处 ,面积稍大于患处 ,每 6h涂抹 1次 ,直至痊愈。同时给予口服或静滴抗生素、抗病毒药及营养神经药物。2　结果　在用药的第 2天 ,疱疹处疼痛消失 ,3～ 4d即开始结痂 ,5～ 6d疱疹消退 ,无明显瘢痕和色素沉着 ,无任何不良反应。3　讨论　雄黄属矿物中药 ,主要成分为二硫化二砷 ,其主要功能为解毒杀…     

食洋葱治疗高血脂

临床上治疗高血脂的方法很多,口服及静滴降血脂药物,疗程长,副作用大,价格昂贵,食用洋葱治疗高血脂,效果满意。将洋葱6 0g切成细丝,用食油炒熟食用,亦可生食,每天一次,半年后查血脂,VLDL和LDL均有不同程下降,大部分降至正常水平。高血压患者血压也明显降低。洋葱又称葱头,属百合科植物。洋葱中含有丰富的蛋白质、糖类、维生素、钙、磷、铁、硒等多种元素,以及多种化学物质,几乎不含脂肪。其中,二烯丙基二硫化物及硫氨基酸等物质,具有降血脂、降血压、抗动脉粥样硬化和预防心肌梗死的奇异功能。前列腺素A是一种较强的血管扩张剂,可以降低…     

高场强MRI在胃癌术后复发诊断中的应用价值

Objective To evaluate the clinical application of high-field-strength magnetic resonance imaging to diagnose recurrent gastric cancer. Methods Forty three postoperative patients with gastric carcinoma were divided into two groups. The group with recurrent gastric carcinoma has 33 patients, they were clinically confirmed by barium meal of alimentary canal, CT or pathological results. There were 10 cases in control group confirmed by pathological results. All the subjects took hypotonicity agent, followed by water as negative contrast medium. Then patients underwent magnetic resonance imaging including fast spoiled gradient recalled T1WI, T2WI, diffusion weighted imaging, fast imaging employing steady state sequence, magnetic resonance cholangiopancreatographyand dynamic contrast enhancement sequences when gastrointestinal tract was in hypotonic, patients drank or were primed with water as contrast. Results Thirty patients were diagnosed as recurrent gastric cancer with MRI, 28 of them were confirmed by clinical results. Three patients were missed and two patients were incorrectly misdiagnosed by MRI. Wall thickness of gastric remnant was (4.5±0.3) mm and that of stomas was (6.3±1.4) mm in control group. Types of lesions were found on MRI: thickening of remnant stomach stomas was more than 8 mn(n=30), thickening of neighbor rem-nant stomach stomas was more than 5mm (n=19), mass of stomas (n=11), metastasis of neighbor viscus (n=5), and metastasis of lymph nodes (n=9). On enhancement scan, 9 patients showed inhomogeneous enhancement in arterial phase and 30 patients showed gradual delayed enhancement in venous phase and equilibrium phase. Conclusion MRI is an effective imaging method in illustrating wall thickness of gastric remnant and stomas, invasion depth by carcinoma, relationship with neighbor tissue structures and metastasis of lymph nodes and abdominal viscus. It plays an important role in directing clinical therapy.     

胰腺实性假乳头状瘤1例

胰腺实性假乳头状瘤（solid pseudopapillary tumor of the pancreas,SPTP）是一种罕见的良性或低度恶性的胰腺肿瘤,局部切除后很少复发或转移,因此术前明确诊断对手术方式的选择及预后评估具有重要意义。本院曾收治1例,报告如下。     

中西医结合治疗顽固性心力衰竭48例

顽固性心力衰竭是各种心脏病的最终结局，常规治疗难以见效，且对洋地黄的显效阈提高，容易发生洋地黄中毒反应。自1996年以来，我科采用了中西医结合方法治疗该病，取得较好的疗效，报道如下。     

小脑非典型畸胎瘤样/横纹肌样瘤一例

患者女性,16月,来我院半月前出现无明显诱因的呕吐,呕吐物为胃内容物,发作频繁,无明显肢体活动障碍.曾在当地其他医院以"胃肠型感冒"住院治疗,治疗效果不佳.查体:患儿神志清醒,双侧瞳孔对光反射灵敏,眼球活动正常,张口、伸舌居中,无发热,颈软,无明显颈抵抗,四肢肌力正常,肌力V级,神经专科病理反射未引出.实验室检查:血、尿、粪便常规和肝功、血生化指标均在正常范围内,心、脑电图检查未见异常.因患者为一岁的婴儿,与患儿有关的所有医学检查均征得患儿父母的理解并签署知情同意书[1].