彩超引导无水酒精介入治疗卵巢囊肿蒂扭转的临床疗效

目的:探讨彩超引导无水酒精介入治疗卵巢囊肿蒂扭转的临床疗效。方法:对35例卵巢囊肿蒂扭转患者在彩超引导下进行无水酒精介入治疗,术后3天、1个月、3个月、6个月复查彩超,随访治疗结果。结果:35例蒂扭转患者,33例经无水酒精介入治疗后取得了显著疗效,另外2例采用手术治疗,均未出现严重并发症;术后6个月,24例囊肿消失,9例囊肿大小≤术前1/3,总有效率为94.29%(33/35)。结论:彩超引导无水酒精介入治疗卵巢囊肿蒂扭转疗效确切且创伤小,是治疗卵巢囊肿蒂扭转的有效方法。     

中西医结合保守治疗输卵管妊娠的临床观察

目的观察使用甲氨喋呤（MTX）与米菲司酮配合活血化瘀中药保守治疗输卵管妊娠的疗效。方法将84例输卵管妊娠患者分为治疗组45例,使用甲氨喋呤、米非司酮配合活血化瘀中药治疗2～3周;对照组39例单纯使用甲氨喋呤、米非司酮治疗2～3周。观察两组患者输卵管妊娠的盆腔包块缩小或消失时间、血β-HCG定量下降情况及患者腹痛、阴道流血等症状的缓解情况。结果治疗组成功率95．6％,对照组成功率89．7％。两组比较差异无显著性,但血HCG下降至正常的时间、包块缩小或消失时间、腹痛及阴道流血症状缓藕时间均明显短于对照组。结论中西医结合保守治疗输卵管妊娠的疗效显著,且明显缩短了输卵管妊娠各症状缓解时间。     

卵巢巧克力囊肿腹腔镜结合中药治疗的临床观察

目的:探讨卵巢巧克力囊肿患者行腹腔镜囊肿剥除手术后中药治疗的效果.方法:对90例卵巢巧克力囊肿患者随机分两组:第一组对照组,单纯腹腔镜治疗;第二组研究组,腹腔镜术后中药治疗.两组治疗后均随访临床症状、复发情况、监测血清CA125水平以及妊娠情况.结果:两组间比较,对照组症状消失或改善的总有效率为82.2%,囊肿复发率为40.O%,血清CA125的转阴率为55.3%,妊娠率32.13%;研究组症状消失或改善的总有效率为100%,囊肿复发率为13.3%,血清CA125的转阴率为95.1%,妊娠率72.7%.二组比较,研究组的术后治疗总有效率和复发率均明显低于对照组(P＜0.01),研究组血清中CA125转阴率明显高于对照组(p＜0.01),研究组治疗后的妊娠率高于对照组(p＜0.01).三项指标的差异均有显著性.结论:腹腔镜术后结合中药可有效治疗卵巢巧克力囊肿.     

慢性淋巴细胞性甲状腺炎合并甲状腺结节的临床分析

目的:研究分析中国东北地区慢性淋巴细胞性甲状腺炎(CLT)合并甲状腺结节的诊断和治疗方式.方法:回顾性分析2009年9月--2010年12月收治经病理证实的CLT合并甲状腺结节的共151病例,依据不同的病理类型分组,就临床特点、诊断和治疗进行比较.结果:CLT合并甲状腺乳头状癌组共58例,女性51例,男性7例,平均年龄37.5±4岁,平均病程18个月,28例为腺体内单发结节,病灶平均直径为0.9± 0.56 cm,36例病灶直径小于1.0 cm,42例见结节内伴钙化.CLT合并良性结节组98例,女性患者93例,男性患者5例,平均年龄48.1±9岁,平均病程72个月,34例为腺体内单发结节,病灶平均直径1.8± 0.42 cm,35例病灶直径小于1.0 cm,10例见结节内伴钙化.两组在发病年龄、病程、结节个数及钙化方面的差异均有统计学意义.结论:CLT合并甲状腺癌微小癌多见,淋巴结转移率低,彩超提示单发结节或者结节合并钙化的病例,应行手术治疗.     

振腹疗法对代谢综合征患者血脂、血糖及人体测量学指标的影响

目的:探讨振腹疗法对代谢综合征(MS)患者血脂、血糖及人体测量学指标的影响。方法:将符合纳入标准和排除标准的70例MS患者随机分为振腹组35例(脱落3例)和贴敷组35例(脱落7例),最终振腹组32例和贴敷组28例纳入本次研究。在两组常规治疗皆不停止的基础下,振腹组予以振腹疗法治疗,1周3次,连续4周;贴敷组于双侧膈俞、脾俞、足三里、三阴交、丰隆、梁门、太乙、天枢及中脘进行胶布穴位贴敷治疗,1周3次,连续4周。比较两组患者治疗前后的血脂、血糖、中医症状评分以及人体测量学指标。结果:治疗后振腹组甘油三酯(TG)较贴敷组降低,高密度脂蛋白(HDL-C)较贴敷组升高(P0.05);治疗后两组总胆固醇(TC)、低密度脂蛋白(LDL-C)、空腹血糖(FPG)比较无统计学差异(P0.05)。治疗后振腹组中医症状评分、体质量指数(BMI)、腰围、腰臀比、腰高比和内脏脂肪指数(VAI)均低于贴敷组(P0.05)。结论:振腹疗法与胶布穴位贴敷治疗相比更能改善MS患者的临床症状,提升患者的生活质量,还能协同常规治疗改善患者的血脂,但是对血糖的影响差异不明显。     

蓝科肤宁联合胶原贴敷料治疗颜面再发性皮炎的临床观察

目的:探讨蓝科肤宁联合胶原贴敷料治疗颜面再发性皮炎的疗效和安全性。方法:将90例入选的颜面再发性皮炎的患者随机分成治疗组、对照1组和对照2组,每组各30例。治疗组给予蓝科肤宁湿敷,早晚各一次,同时给予胶原贴敷料每晚1次,连用4周;对照1组外用蓝科肤宁湿敷;对照2组外用胶原贴敷料每晚1次,连用4周。治疗结束后4周,观察和比较各组患者的主观症状感觉、皮损情况及不良反应的发生情况。结果:所有患者均按要求完成整个疗程。治疗4周后,三组患者的症状评分均显著低于治疗前,且治疗组的症状评分显著低于对照2组(P0.001),而与对照1组比较差异无统计学意义(P0.05)。治疗组、对照1组和对照2组的临床有效率分别为93%、90%、63%,治疗组、对照1组均显著高于对照2组(P0.05),而治疗组和对照1组之间比较差异无统计学意义(P0.05)。三组不良反应的发生率比较均无统计学差异(P0.05)。结论:蓝科肤宁联合胶原贴敷料治疗颜面再发性皮炎的疗效更好,安全性高。     

丹黄祛瘀胶囊联合阿奇霉素对慢性盆腔炎患者血液流变学和血清炎症因子的影响

摘要 目的：观察阿奇霉素联合丹黄祛瘀胶囊在慢性盆腔炎患者中的应用价值。方法：研究病例选自2019年6月至2021年6月期间我院收治的慢性盆腔炎患者127例,采用随机数字表法将符合要求的患者分为对照组（63例,阿奇霉素治疗）和观察组（64例,丹黄祛瘀胶囊联合阿奇霉素治疗）,两组均治疗2周。对比两组疗效、临床症状消失时间、血液流变学和血清炎症因子变化情况,观察两组不良反应的发生情况,并作记录。结果：观察组临床总有效率高于对照组（P<0.05）。观察组的腰骶胀痛、下腹疼痛、带下异常等症状消失时间短于对照组（P<0.05）。观察组治疗2周后的白介素-6（IL-6）、白介素-1β（IL-1β）、C反应蛋白（CRP）低于对照组（P<0.05）。观察组治疗2周后的全血高切黏度、全血低切黏度、纤维蛋白原及红细胞沉降率低于对照组（P<0.05）。两组患者的不良反应发生率组间对比无统计学差异（P>0.05）。结论：慢性盆腔炎在阿奇霉素治疗基础上联合丹黄祛瘀胶囊,症状得到明显缓解,同时还可改善机体血液流变学和炎症因子水平,临床应用价值较好。     

拉米夫定治疗慢性重型乙型肝炎疗效观察

目的观察拉米夫定治疗慢性重型乙肝的疗效.方法49例慢性重型乙肝患者,随机分成2组,对照组给予综合保肝护肝治疗;治疗组在此基础上加用拉米夫定口服.结果治疗8周后2组症状体征及实验室检查指标均有好转,治疗组好转率为86.2%（25/29）,病死率为13.8%（4/29）;对照组好转率为70%（14/20）,病死率为30%（6/20）.2组比较差异有显著性（P＜0.05）.2组治疗后HBV-DNA变化差异也有显著性.结论拉米夫定在综合治疗基础上,可使多数慢性重型乙肝患者临床症状、体征、肝功能和HBV-DNA有明显改善,提高生存率,值得在慢性重型乙肝治疗中推荐使用.     

经结肠透析联合中药灌肠治疗后慢性重型肝炎的疗效观察及护理

目的:观察慢性重型肝炎经结肠透析联合中药灌肠治疗后的疗效及护理方法。方法:使用CTJ-A全自动结肠透析联合中药灌肠机对60例重型肝炎病人进行治疗,运用针对性护理措施,评估护理效果。结果:经中药灌肠及结肠透析后,本组病人除出现2例轻度腹胀外无其他不良反应出现,临床症状、体征基本消失。结论:结肠透析联合中药灌肠治疗可作为慢性重型肝炎的一种治疗方法,同时配合相应的护理可减少并发症,提高临床疗效。     

伊曲康唑注射剂治疗伴有肺结核史的侵袭性真菌感染2例

目的报道2例伴有肺结核史的侵袭性真菌感染经伊曲康唑注射剂治疗经过,探讨伴有肺结核史患者的抗真菌治疗经验。方法例1为49岁＂支气管肺囊肿合并感染,陈旧性肺结核＂男性患者,诊断为侵袭性肺曲霉感染确诊病例。例2为51岁＂右侧自发性气胸,慢性阻塞性肺病,陈旧性肺结核＂男性患者,诊断为侵袭性肺念珠菌感染拟诊病例。均予伊曲康唑注射剂治疗2周结合抗细菌治疗,并作临床和真菌学疗效监测。结果治疗两周后两患者临床症状和体征均得到明显改善,标本真菌镜检转阴,培养仍为阳性。结论在有肺结核病史存在的侵袭性真菌感染抗真菌治疗时间可能需要延长。合理应用抗生素、激素,严格掌握用药指针、时机、剂量与疗程是控制真菌感染的重要因素。     

高频彩色多普勒超声对甲状腺结节的临床诊断价值

目的:探讨彩色多普勒超声对甲状腺结节的临床诊断价值。方法:在我院经手术病理确诊的甲状腺结节患者142例中,使用彩色多普勒超声进行检查,记录结节的单多发类型、有无边界、有无声晕、内部回声、有无钙化和血流分布情况。结果:142例甲状腺结节患者中,有96例良性,46例恶性。超声诊断结果与病理结果比较,其准确性、灵敏度、特异度分别为81.69%、91.67%和79.66%。结论:甲状腺结节使用彩色多普勒超声检查,能获得很高的确诊率。     

超声介入治疗常见妇科囊性炎症包块的疗效评价

目的：比较超声引导介入治疗盆腔脓肿、输卵管积脓、输卵管积液、包裹性积液及宫颈囊肿的,临床效果,了解超声引导介入治疗常见的妇科囊性炎症包块的临床价值。方法：选取我院妇科门诊2007年1月～2011年3月收治的常见妇科囊性炎症包块共108例,其中盆腔脓肿11例、输卵管积脓19例、输卵管积液43例、盆腔包裹性积液31例、宫颈囊肿4例,给予超声实时引导抽囊液、甲硝唑冲洗治疗,治疗后3个月内复查超声评价和比较疗效。结果：盆腔脓肿、输卵管积脓、盆腔包裹性积液包块均明显缩小（12／43）或消失（29／43）,治疗有效率100％;输卵管积液包块治疗有效率95％（41／43）,宫颈囊肿均痊愈。各组间比较无统计学差异（P〉O．05）。结论：超声引导介入治疗对输卵管积脓、盆腔脓肿、盆腔包裹性积液均有显著的疗效,且治疗效果无差异,值得推广应用,代替传统的非必要的手术治疗。     

多层螺旋CT联合彩色多普勒超声对小儿先天性胆总管囊肿的诊断价值分析

摘要 目的：探讨多层螺旋CT（MSCT）联合彩色多普勒超声对小儿先天性胆总管囊肿（CCC）的诊断价值。方法：选取2018年1月～2021年12月来我院治疗的78例CCC患儿为研究对象,所有患儿均接受彩色多普勒超声检查及MSCT检查,以病理诊断结果为金标准,对比两种检查方法对CCC的诊断价值。结果：所有CCC患儿中均未出现肝门部纤维斑块（TC征）阳性、肝动脉内径增宽,33例出现囊肿内胆泥沉积和肝内胆管扩张,16例出现胆囊异常;囊肿长径、宽径分别为（5.41±0.60）cm、（3.26±0.38）cm,脾脏内径为（1.56±0.17）cm。所有患者的Todani分型结果显示：Ⅰ型67例,Ⅱ型2例,Ⅲ型2例,Ⅳ型5例,Ⅴ型2例。与病理学诊断结果对比,彩色多普勒超声对CCC患儿Todani分型有一定的诊断效能,对Ⅰ型、Ⅳ型、Ⅴ型的诊断准确率分别为83.33%、93.59%、93.59%（P＜0.05）。与病理学诊断结果对比,MSCT对CCC患儿Todani分型有较好的诊断效能,对Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型、Ⅴ型的诊断准确率分别为88.46%、89.74%、93.59%、94.87%、97.43（P＜0.05）。彩色多普勒超声联合MSCT检查的诊断准确率高达96.15%,明显高于两种方法单独应用（P＜0.05）。结论：不同Todani分型的CCC患儿具有不同的超声征象,彩色多普勒超声及MSCT对CCC患儿Todani分型均有一定的的诊断价值,且两者联合应用时诊断价值较高。     

Giant choroid plexus cyst as an accidental finding in an older man

Choroid plexus cysts (CPC) are usually found at the end of the second trimester of pregnancy. Sometimes they can be accidentally and found on prenatal ultrasound examinations. Vast majority of CPC resolve spontaneously by 28th weeks gestation. In the older aged group the choroid plexus cysts are extremely rare pathomorphologic medical entity. Since they are almost always asymptomatic, they are therefore accidentally found on brain magnetic resonance (MR) or computed tomography (CT) scans. They are usually located in the lateral ventricles and measure around 2 cm in diameter. We present a case of a 75-year-old male with a giant choroid plexus cyst whose leading symptom was excruciating headache refractory to previous conservative therapy. He underwent surgery when osteoplastic craniotomy was performed with cyst fenestration and ablation. His recovery was uneventful with total regression of headaches. Reviewing the recent literature we did not find such a case considering the patients age and the size of the choroid plexus cyst.     

The Ultrasonic Evaluation of Nonfunctioning Thyroid Nodules

Thyroid echography was carried out on 100 patients with thyroid abnormalities to evaluate the diagnostic accuracy of ultrasound in differentiating simple thyroid cysts from solid thyroid nodules.In all 46 proven cases, the ultrasonic diagnosis of the solid or cystic nature of thyroid nodules was correct.A proposed diagnostic workup of a hypofunctioning (cold) thyroid nodule is suggested with primary needle aspiration and cytologic examination of the cyst fluid being recommended if the nodule is shown to be entirely cystic by ultrasound.     

高强度聚焦超声治疗子宫肌瘤300例的临床疗效分析

目的：探讨高强度聚焦超声（high intensity focused ultrasound,HIFU）治疗子宫肌瘤的临床疗效及其安全性。方法：回顾性分析我院2007年1月～2011年1月300例采用高强度聚焦超声治疗的子宫肌瘤患者的临床资料,比较分析治疗前后瘤体大小、病灶内部回声、临床症状改善情况、血流的变化及超声造影图像改变。结果：HIFU治疗后1、3、6及12个月,瘤体体积均较治疗前显著缩小（P〈0.05）,显效率80.33%（241例）,有效率19.33%（58例）,无效率0.33%（1例）,肌瘤所致的临床症状减轻或消失,瘤体内部回声增强,彩色血流均消失,超声造影瘤体内无灌注。治疗期间,患者出现治疗部位疼痛、骶尾部酸胀及肛门坠胀,治疗结束时症状消失;治疗过程中出现腿部疼痛、麻木症状,经过重新定位后症状消失,少数出现阴道少量流血,给予止血药;治疗后出现血尿,经大量喝水排尿后消失。结论：HIFU治疗子宫肌瘤是安全有效的,在妇科领域便于推广。     

Les kystes intraprostatiques: à propos de trois observations

Introduction

Intraprostatic cysts are considered to be rare. Some forms may be responsible for male infertility. The authors study the various clinical aspects, with the aim of defining guidelines for the exploration and treatment of different types of intraprostatic cysts.

Materials and methods

Between 2002 and 2007, we studied 3 cases of intraprostatic cyst in 3 men aged between 32 and 39 years.

Results

The clinical presentation was primary infertility (2 cases) and pelvic pain (2 cases). Digital rectal exam revealed prostate mass in 2 cases. Spermogram results were abnormal in 2 cases. The diagnosis was confirmed by prostate ultrasound. Trans-rectal ultrasound guided needle aspiration was performed in one case with secondary recurrence. Two patients had urethroscopy showing an absence of communication between the cyst and urethral channel. Transurethral incision of the cyst was made with resection of the protruding dome. Progress was favourable in all cases with improvement of semen and dissipation of symptoms without recurrence.

Conclusion

Intraprostatic cysts are benign lesions, often of congenital origin. Imaging is an essential component of diagnosis and can sometimes guide therapeutic procedures. The treatment is not yet codified, but symptomatic and/or complicated cysts can be treated by effective and minimally invasive endoscopic methods.     

Fine needle aspiration of epididymal nodules in Chandigarh, north India: an audit of 228 cases

BACKGROUND: Epididymal nodules are not infrequently encountered in surgical practice. These are generally small and slippery and fine needle aspiration cytology (FNAC) is not easy. But as it is rapid and less traumatic than a biopsy, this is a favoured technique in the assessment of epididymal nodules. PATIENTS AND METHODS: In the present study, all the cases of epididymal nodules aspirated from January 1998 to August 2004 were retrieved from the cytology files of the Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. RESULTS: A total of 228 cases were retrieved and divided as follows: tuberculous epididymitis 70 (30.7%), non-specific inflammation 10 (4.4%), microfilaria 2 (0.9%), hydrocele 26 (11.4%), spermatocele 42 (18.4%), spermatic granulomas 12 (5.3%), adenomatoid tumour 3 (1.3%), leiomyosarcoma 1 (0.4%) and lipoma 1 (0.4%). Thirty-six (15.8%) cases were labelled as benign aspirate not otherwise specified. FNAC material was inadequate for opinion in 22 (9.65%) cases and three (1.3%) cases revealed evidence of a haematoma. CONCLUSIONS: FNAC was useful in the diagnosis of 90.3% of cases, thereby avoiding surgical biopsy and other investigations. Therefore, FNAC has an important role in the differential diagnosis of epididymal nodules as it can detect malignancy and benign conditions such as tuberculosis and acute and chronic epididymo-orchitis.     

Treatment Response of Cystic Echinococcosis to Benzimidazoles: A Systematic Review

Over the past 30 years, benzimidazoles have increasingly been used to treat cystic echinococcosis (CE). The efficacy of benzimidazoles, however, remains unclear. We systematically searched MEDLINE, EMBASE, SIGLE, and CCTR to identify studies on benzimidazole treatment outcome. A large heterogeneity of methods in 23 reports precluded a meta-analysis of published results. Specialist centres were contacted to provide individual patient data. We conducted survival analyses for cyst response defined as inactive (CE4 or CE5 by the ultrasound-based World Health Organisation [WHO] classification scheme) or as disappeared. We collected data from 711 treated patients with 1,308 cysts from six centres (five countries). Analysis was restricted to 1,159 liver and peritoneal cysts. Overall, 1–2 y after initiation of benzimidazole treatment 50%–75% of active C1 cysts were classified as inactive/disappeared compared to 30%–55% of CE2 and CE3 cysts. Further in analyzing the rate of inactivation/disappearance with regard to cyst size, 50%–60% of cysts <6 cm responded to treatment after 1–2 y compared to 25%–50% of cysts >6 cm. However, 25% of cysts reverted to active status within 1.5 to 2 y after having initially responded and multiple relapses were observed; after the second and third treatment 60% of cysts relapsed within 2 y. We estimated that 2 y after treatment initiation 40% of cysts are still active or become active again. The overall efficacy of benzimidazoles has been overstated in the past. There is an urgent need for a pragmatic randomised controlled trial that compares standardized benzimidazole therapy on responsive cyst stages with the other treatment modalities.     

Ultrasonic diagnosis of liver hydatidosis

The paper is concerned with a study of an ultrasound picture of verified hydatidosis in 62 patients. The symptoms of hydatid cysts are the presence of daughter cysts and "hydatid sand", cuticular membrane desquamation, local cyst wall thickening and parietal layers, a necrotic zone in a preparasitic space and cyst calcification. The detection of these symptoms helps to estimate not only the type of a hydatid cyst but also the state and character of parasite activity permitting a choice of therapeutic tactics.