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1.
目的:探讨甲状腺微小癌的临床诊断和治疗方法。方法:对诊断明确的47例甲状腺微小癌进行回顾性分析。结果:术前仅12例疑为甲状腺癌.余35例均于术中冰冻和术后病理确诊。34例合并甲状腺良性疾病,伴颈淋巴结转移3例。47例中有11例术后无瘤生存时间≥10年,24例术后无瘤生存时间≥5年。结论:甲状腺微小癌术前不易确诊,且易漏诊,对甲状腺良性疾病手术时应仔细触诊,对可疑结节行冰冻切片。首次手术应行患侧腺叶及峡部切除术.有淋巴结转移者行功能性淋巴结清扫术可取得较好疗效。  相似文献   

2.
目的探讨经腹部及经阴道彩色多普勒超声在异位妊娠诊断中的临床价值。方法经腹部及经阴道彩色多普勒超声检查160例异位妊娠患者。结果 160例宫外孕,经手术证实输卵管妊娠129例,宫颈妊娠8例,卵巢妊娠8例,均与超声诊断相符。5例超声诊断为腹腔妊娠,其中4例手术证实为卵巢妊娠,4例超声诊断为残角子宫妊娠,3例手术证实为输卵管间质部妊娠,子宫肌壁间妊娠1例,5例超声初次检查为阴性,再次复查诊断为异位妊娠,超声诊断符合率90.6%。结论经腹及经阴道彩色多普勒超声图像直观、方便、安全,可以多次复查而无创伤性,联合运用为超声诊断异位妊娠提供更多重要的参考信息。  相似文献   

3.
目的 研究牙源性角化囊肿的诊断特点和治疗方法。方法 对78例牙源性角化囊肿的临床症状,x线及手术方法进行回顾性研究。结果 78例患经过2~5年随访,复发率为11.54%,手术加冷冻的治疗效果最佳。结论 通过临床和x线特征可正确诊断和治疗牙源性角化囊肿。  相似文献   

4.
目的 :探讨B超诊断腰大肌寒性脓肿的临床应用价值。方法 :对 36例腰大肌寒性脓肿的图象进行分析 ,并与手术、超声引导下穿刺及病理对照。结果 :36例腰大肌寒性脓肿 ,33例符合 ,3例为非寒性脓肿 ,诊断符合率 91%。结论 :B超对腰大肌寒性脓肿的诊断有较高的临床应用价值 ,为手术、保守治疗及随访观察提供有力的依据。  相似文献   

5.
目的:探讨创伤性腹膜后血肿及其合并各类腹部脏器损伤的诊断治疗。方法:回顾性分析我院46例临床资料,总结致伤原因及诊断治疗方法。结果:本组42例手术治疗,手术率91.3%;治愈43例,死亡3例。结论:创伤性腹膜后血肿是严重而复杂的腹部创伤,多合并腹腔脏器及大血管损伤而使伤情危重多样,病死率高。严格掌握手术适应证,抓住抢救时机是提高治愈率的关键。  相似文献   

6.
目的总结二尖瓣病变合并冠心病的外科治疗体会。方法对13例二尖瓣病变合并冠心病患者同期行二尖瓣置换或成型及冠脉搭桥术,回顾性分析,临床资料。结果术后1例死于严重心律失常,其余均存活。随访3—36个月,心功能恢复至Ⅰ-Ⅱ级9例,Ⅲ级3例,未出现心肌缺血症状。结论术前明确诊断,充分准备,术中加强心肌保护,提高手术水平,缩短手术时间,加强围手术期治疗是手术成功的关键。  相似文献   

7.
杨渊 《宜春学院学报》2005,27(4):96-96,98
目的:总结外科治疗胆源性胰腺炎的体会.方法:回顾性分析外科治疗胆源性胰腺炎37例的临床资料,包括早期诊断、早期治疗、手术时机及手术方式的选择.结果:本组37例病例中,26例水肿型胆源性胰腺炎和11例坏死型胆源性胰腺炎经非手术治疗及早期手术治疗,治愈33例,死亡4例,其中坏死型胆源性胰炎死亡3例.结论:胆源性胰腺炎早期应进行综合性治疗,发现胆道梗阻及胰腺感染坏死应手术治疗;而胰腺坏死继发细菌感染致败血症及多器官功能衰竭是胆源性胰腺炎引起死亡的根本原因.  相似文献   

8.
目的探讨腔镜甲状腺手术病人围手术期护理的原则和措施。方法对我科近4年所做的11例腔镜甲状腺手术病人的临床资料进行分析总结。结果11例均顺利完成手术,手术时间平均(139-18)min,出血量平均(70±5)ml。术后第1天患者可适度下床活动,5-7d出院。所有患者切口愈合好,瘢痕小而隐蔽,无不适感,美容效果好。随访3-36月,局部无肿块复发。结论腔镜甲状腺手术具有切口隐蔽、颈部无疤痕、美容效果好等优点,可根据患者要求在临床开展,而术前、术中及术后的正确护理,是该手术得以顺利开展的必要支持和重要保证。  相似文献   

9.
目的:探讨肾错构瘤破裂出血的诊断和治疗方法。方法:回顾性分析了2000~2005年诊治的4例肾错构瘤破裂出血患者的临床资料,3例行手术治疗,1例行保守治疗。结果:3例术后恢复良好,1例保守治疗者病情稳定。结论:B超和CT检查对诊断肾错构瘤破裂出血有帮助;对肾错构瘤破裂的治疗应全面考虑,手术仍为主要的治疗方法。  相似文献   

10.
目的:通过27例高位腰椎间盘突出症的回顾性研究,提高对本症的认识,减少漏诊、误诊。方法:回顾性分析高位腰椎间盘突出症患者27例的临床和手术资料。结果:27例患者均采用手术治疗,术后对21例进行了0.5~6年(平均2,5年)的随访,结果优12例,良6例,可2例,差1例,手术优良率85.7%。重点讨论了高位腰椎及椎间盘和神经根的解剖特点和临床特征及诊断治疗。结论:对不同程度的患者需用不同治疗方式。  相似文献   

11.
Endoscopic retrograde cholangiopancreatography (ERCP) was performed preoperatively on 29 patients suffering from hepatocellular carcinoma (HCC) invading bile ducts. The outstanding features were: 1. Most of the filling defects were situated within the common, right or left hepatic duct associated with proximal bile duct dilatations (17 cases);2. Tumor encasement resulted in localised or diffused irregular strictures and dilatations (9 cases); 3. Displacement and stretching of the intrahepatic ducts by pressure of tumor mass (3 cases). These features are different from that in cholangiocarcinoma.ERCP should be considered as an important diagnostic procedure for HCC. It is especially useful for cases with obscure intrahepatic duct dialatation and/or an increase of AFP, and will help early diagnosis of HCC.  相似文献   

12.
INTRODUCTIONMucunnewasthefirsttouseERCP (Endo scopicRetrogradeCholangiopancreatography)inthediagnosisofdiseasesofbileductsandpan creasin 1 968.Withimprovementofendoscopicequipment,thetechniquewasdevelopedrapid ly.TherearefewreportsintheworldontheuseofERCPfo…  相似文献   

13.
本文选择89年9月至90年1月住院病人39例,进行分组;另设对照组17例;采用国产WYX—402型原子吸收分光光度计(ASS)分别测得血清铜、锌及铜/锌比值。结果表明肝硬化组与正常组比较血清铜无显著差异(P>0.05),血清锌降低(P<0.05),铜/锌比值显著增高(P<0.001)。肝硬化并发肝癌组与肝硬化组比较,血清铜显著增高(P<0.001),血清锌无显著差异(P>0.05),铜/锌比值显著增高(P<0.001)。继发性肝癌组与原发性肝癌组比较,血清铜、锌及铜/锌比值均无显著性差异(P 值分别大于0.1;0.2)。研究表明,血清铜/锌比值 AFP测定有互补作用。  相似文献   

14.
Diagnosis and treatment of pheochromocytoma in urinary bladder   总被引:1,自引:0,他引:1  
Objective: To study the diagnosis and treatment ofpheochromocytoma in urinary bladder. Methods: Six cases of bladder pheochromocytoma were studied. Four cases showed hypertension, 3 of which were paroxysmal hypertension during urination. Catecholamine (CA) was increased in a case, and vanillymandelic acid (VMA) was increased in 2 cases. Bladder submucosal mass was detected by B-ultrasound in 5 cases (5/5), computerized tomography (CT) in 3 cases (3/3), cystoscopy in 5 cases (5/6). Four cases took a-receptor blocker for 2 weeks, 1 case took β-receptor blocker to decrease heart rate. All patients were treated with surgical operation including 4 partial cystectomies, 2 excavations. Results: Three cases had manifestations including headache, excessive perspiration and hypertension during cystoscopy. Four cases were confirmed before operation. Two cases showed hypertension during operation. All patients were pathologically diagnosed as pheochromocytoma post- operatively. In five cases followed up, blood pressure returned to normal. No patient had relapse and malignancy. Conclusions: Typical hypertension during urination comprised the main symptoms. We should highly suspect bladder pheochromocytoma if a submucosal mass was discovered with B-ultrasound, CT, ^131I-M1BG (methyliodobenzylguanidine) and cystoscopy. The determination of CA in urine is valuable for qualitative diagnosis. The preoperative management of controlling blood pressure and expansion of the blood volume are very important. Surgical operation is a good method for effective treatment. Postoperative long-time followed up is necessary.  相似文献   

15.
Objective: Adrenocortical carcinoma (ACC) is a rare but highly malignant tumor, and its diagnosis is mostly delayed and prognosis is poor. We report estrogen receptor (ER) expression in this tumor and our clinical experiences with 17 ACC cases. Methods: The data of the 17 patients (9 females and 8 males, age range from 16 to 69 years, mean age of 42.6 years) with ACC were reviewed, and symptoms, diagnostic procedures, treatment, and results of follow-up were evaluated. Immunohistochemistry was used to detect ER expression in tumor samples from the 17 patients. Results: At the time of diagnosis, 4 tumors were classified as Stage Ⅰ, 4 as Stage Ⅱ, 3 as Stage Ⅲ, and 6 as Stage Ⅳ. Eight patients demonstrated positive nuclear immunostaining of ER. The prognosis of patients with ER positive was significantly better (P<0.05) than that of patients with ER negative, with 1- and 5-year survival rates at 86% and 60% for ER-positive patients, and 38% and 0% for ER-negative patients, respectively. Conclusion: ER-positivity may be one of the factors associated with a worse prognosis of ACC.  相似文献   

16.
Objective: To investigate the factors favoring a positive prognosis for advanced primary peritoneal carcinoma (PPC). Methods: Twenty-four cases meeting the criteria for PPC were analyzed retrospectively for the clinicopathologic profiles. Immunohistochemistry was used to determine the expressions of p53, Top2α, Ki-67 and Her-2/neu. Then all these clinicopathological factors and molecular markers were correlated with the prognosis. Results: There were 15 cases of primary peritoneal serous papillary carcinoma (PPSPC), 6 cases of mixed epithelial carcinoma (MEC) and 3 cases of malignant mixed Mullerian tumor (MMMT). All patients underwent cytoreductive surgery with optimal debulking achieved in 3 cases. Among those receiving first-line chemotherapy, 13 patients received the TP regimen (paclitaxel-cisplatin or carboplatin) and 7 patients received the PAC regimen (cisplatin-doxorubicin-cyclophosphamide). The median overall survival of all patients was 42 months, while the breakdown for survival time for patients with PPSPC, MMT and MEC was 44, 13 and 19 months, respectively. The expressions of p53, Top2a and Ki-67 were all demonstrated in 11 cases respectively. None showed the expression of Her-2/neu. There were significant differences in the median survival between patients with PPSPC and those with MMMT (44 months vs 13 months, P<0.05), also between patients receiving TP combination and those receiving the PAC regimen (75 months vs 28 months, P<0.05). Another significant difference in the median progression-free survival (PFS) was identified between patients with positive p53 immunostaining and those with negative p53 immunostaining (15 months vs 47 months, P<0.05), whereas age, menopausal status, residual tumor size and the other molecular factors did not significantly impact survival. Conclusion: Patients with PPC should be treated with a comprehensive management plan including appropriate cytoreductive surgery and responsive chemotherapy. Overestimating an optimal debulking surgery may not benefit survival. The pathologic subtype, chemotherapy regimen and p53 overexpression were significant prognostic factors.  相似文献   

17.
We conducted a retrospective study of the accuracy of liver biopsies in 392 patients with liver lesions. Postbiopsy diagnosis was 297 cases of primary liver cancers, 79 cases of secondary malignant tumors, 2 cases of non-Hodgkin's lymphoma, 10 cases of focal nodular hyperplasia, 2 cases of chronic inflammation, 1 tuberculosis case and 1 schistosomiasis case. Biopsy provided histological diagnosis in 100% of cases, sensibility and specificity of Ultra-Cut biopsy was 98.95% and 100% for the diagnosis of malignancy respectively; positive predictive value, 100%; negative predictive value, 71.43%; and accuracy, 98.98%. We identified no major procedure related complications despite the presence of thrombocytopenia in 37.5% of cases. Pain was the only reported adverse effect of liver biopsy (10.97%), and 11 patients required analgesics. We concluded that Ultra-Cut liver biopsy was a safe and effective technique, and was invaluable in the investigation and management of patients with liver lesions.  相似文献   

18.
细菌L型在泌尿系感染中的作用   总被引:4,自引:0,他引:4  
探讨细菌L型与泌尿系感染性疾病的关系.细菌由细菌型变异为细菌L型后,仍然具有致病性.作者从64例泌尿系感染的患者分离出细菌型9例,细菌L型22例,开展细菌L型检查,大大提高了阳性率,认为泌尿系感染的迁延不愈并反复发作是由于细菌L型所致,并建议临床对泌尿系感染的患者治疗应根据药敏结果合理用药.  相似文献   

19.
应用免疫组化SP法对94例乳腺癌、41例乳腺良性病变和10例正常乳腺组织进行了细胞粘附分子CD_(15)检测。结果发现,CD_(15)。在乳腺癌和乳腺良性病变的阳性率分别为79.8%和58.3%,两者有显著差异性(P<0 01),10例正常乳腺组织仅4例呈CD_(15)弱阳性反应。CD_(15)表达与患者年龄和肿瘤大小无显著关系。CD_(15)表达阳性率在浸润性导管癌中显著高于单纯癌(P<0.05),组织学Ⅱ~Ⅲ级显著高于Ⅰ级者(P<0.05),临床Ⅲ一Ⅳ期显著高于Ⅰ期和Ⅱ期者(P<0.05),淋巴结转移阳性组显著高于阴性组(P<0.01)。在一组原发部位和淋巴结转移性乳腺癌配对标本中,CD_(15)表达无明显差异性。CD_(15)阳性的乳腺癌Cath-D和c-erbB-2的表达阳性率均显著高于CD_(15)阴性者(P<0.001)。结果提示,CD_(15)的表达与乳腺癌的发生发展、浸润转移及预后有密切关系。  相似文献   

20.
目的:探讨恶性肿瘤临床误诊的原因。方法:对内科门诊27例恶性肿瘤进行了回顾性分析。结果:近半数患者延误诊断半年以上。结论:恶性肿瘤的早期诊断对预后影响很大。  相似文献   

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