Problem analysis and solutions of the B-ultrasound-guided peripherally inserted central catheter process

Objective： The purpose of this study was to address the issues that occur during the B-ultrasound guided peripherally inserted central catheter（PICC） process and to give a summary of the effective management to these issues accordingly.Methods： The information was collected retrospectively on all of the 1950 PICCs inserted during the 2-year period from July 2013 to July 2015. PICC catheter insertion was performed using the Seldinger approach and was delivered from the basilic vein to the superior vena cava in a B-ultrasound guided manner. Moreover, the point raised during the PICC process would be treated immediately.Results： All of the PICCs were inserted successfully. The problems encountered are shown in the inserted central catheter（PICC） process, such as failures of venipuncture, the problem of inserting guide wire, the catheter was dif？cult to be delivered etc.Conclusions： The B-ultrasound guided approach enhanced the average success regarding the PICC insertion, particularly for the subset with a poor condition in the elbow super？cial vein. Due to the items that emerged in the PICC process, the effective prevention prior to surgery and treatment during the operation would be necessary.

Analysis of B-ultrasound and contrast-enhanced ultrasound characteristics of different hepatic neuroendocrine neoplasm

BACKGROUND Hepatic neuroendocrine neoplasm(hNEN) is a highly heterogeneous tumor. The exact identification of the source and malignant degree of hNEN is important.However, there is a lack of information regarding diagnosis of hNEN with imaging. In addition, no studies have compared the imaging between hNEN and hepatocellular carcinoma(HCC) and among different sources and malignant degrees of hNEN.AIM To compare the ultrasound characteristics between hNEN and HCC and among different sources and malignant degrees of hNEN.METHODS A total of 55 patients with hNEN were recruited and defined as the hNEN group.Among them, 35 cases of hNET were defined as the hNET group. Twenty cases of hepatic neuroendocrine carcinoma(hNEC) were defined as the hNEC group.Among the 55 lesions, 29 were transferred from the pancreas, 20 were from the gastrointestinal tract, and six were from other sites. In total, 55 patients with HCC were recruited and defined as the HCC group. The characteristic differences of Bmode ultrasound and contrast-enhanced ultrasound(CEUS) between hNEN and HCC and among different sources and malignant degrees of hNEN were compared.RESULTS In the hNEN group, the proportions of multiple liver lesions, unclear borders,and high echo lesions were higher than those in the HCC group. The proportions of non-uniform echo and peripheral acoustic halo were lower than those in the HCC group(P < 0.05). The washout to iso-enhancement time and washout to hypo-enhancement time were lower than those in the HCC group(P < 0.05). The characteristics of B-ultrasound and CEUS among different sources of hNEN were similar, and the differences were not statistically significant(P > 0.05). B-mode ultrasound characteristics of hNET and hNEC were similar. The proportions of low enhancement at portal venous phase, non-uniform enhancement forms, and combined tumor vasculature in the hNEC group were larger than those in the hNEN group(P < 0.05).CONCLUSION Compared with HCC, hNEN showed multiple intrahepatic lesions, uniform high echo, uniform high enhancement at arterial phase, and rapid washout. Low enhancement at portal venous phase, overall non-uniform enhancement form,and the proportion of combined tumor vasculature in hNEC were larger than those in hNET.

Effect of Chinese herbal compound on liver fibrosis in rabbits with schistosomiasis by B-ultrasound

Objective: To explore the value of B-ultrasound on the evaluation of the effects of traditional Chinese medicine compound of Radix astragali , Salvia miltiorrhiza and Angelica sinensis , and TCM + praziquantel on liver fibrosis in rabbits with schistosomiasis. Methods: The hepatic fibrosis model in rabbits with schistosomiasis was established. The experimental animals (24 rabbits) were randomly divided into four groups (group A, B, C and D, n =6). Group A (control group) was only treated by praziquantel; Group B was treated by mixture of Radix astragali and Salvia miltiorrhiza + praziquantel; Group C was treated by mixture of Radix astragali and Angelica sinensis + praziquantel; Group D was treated by mixture of Radix astragali, Salvia miltiorrhiza and Angelica sinensis + praziquantel. Then B-ultrasonogram was used to evaluate the effects. Results: Each group showed certain curative effect on liver fibrosis in rabbits with schistosomiasis. The efficacy of group B, C and D was better than group A, and that of group D was the best. The differences in long diameter, thickness diameter, transverse diameter and portal vein inner diameter of liver before and after treatment were statistically significant ( P <0.05). The liver function indexes and liver fibrosis indexes were significantly improved after treatment ( P <0.05). Conclusions: The mixture of Radix astragali, Salvia miltiorrhiza and Angelica sinensis combined with Western medicine treatment can obviously improve the efficacy on liver fibrosis of schistosomiasis.

Treatment of hepatic cysts by B-ultrasound-guided radiofrequency ablation

BACKGROUND: The traditional therapy for hepatic cysts has limited success because of recrudescence. Radiofrequency ablation (RFA) has become popular because of its advantages including little damage, therapeutic effect and reduced suffering. This report describes the effects and reliability of RFA in the treatment of 29 patients with hepatic cysts. METHODS: B-ultrasound-guided REA was used to treat hepatic mono-cyst or multi-cysts of 29 patients (63 tumors). Ablative efficiency and complications were assessed by imaging and clinical symptoms. RESULTS: The tumors were abated completely in 34 cysts with a diameter <5 cm and no recurrence was seen after 3 months. In 21 cysts with a diameter of 5-10 cm, tumor volume was decreased by over 70%, then reduction and fiberosis were found. In 8 cysts with a diameter greater than 10 cm, tumor volume was decreased by more than 60%, and in 2 cysts it was increased more slightly than that at I month after REA. In subsequent follow-up (6 and 12 months after REA), tumors <10 cm in diameter were fully ablated. No significant discomfort and complications were found in any patient. CONCLUSION: RFA for the treatment of hepatic cysts is safe, and free from complications.

Evaluation of The Effectiveness of Abdominal and Vaginal B-Ultrasound in The Diagnosis of Acute Abdomen in Obstetrics and Gynecology

Objective: To explore the clinical effect of the combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen in obstetrics and gynecology. Methods: Eighty patients admitted to our hospital from March 2023 to March 2024 were selected, all of whom were acute abdomen patients admitted to the Department of Obstetrics and Gynecology. In this study, the patients were divided into two groups. One group of 40 patients was given a simple abdominal B-ultrasound diagnosis (control group). The other group of 40 patients was given both abdominal and vaginal B-ultrasound examinations (experimental group). The diagnostic accuracy between the two groups was compared. Results: Patients in the experimental group had higher consistency rates with pathological diagnosis results in ectopic pregnancy rupture, embryonic arrest, acute pelvic inflammation, corpus luteum rupture, and intrauterine adhesions as compared to the control group. At the same time, the inspection accuracy rate of the experimental group (92.50%) was higher than that of the control group (70.00%) (P < 0.05). Conclusion: The combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen was of great significance in improving the accuracy of clinical diagnosis and guiding doctors to provide effective treatment.

Analysis of the Efficacy of Prenatal B-Ultrasound in Diagnosing Fetal Abnormalities

Objective:To explore the positive significance of using prenatal B-ultrasound in diagnosing fetal abnormalities.Methods:A total of 200 pregnant women who visited Shaanxi Provincial People’s Hospital between January 2023 and January 2024 were recruited as the research subjects.All pregnant women received prenatal examinations.A retrospective analysis was carried out to analyze the positive significance of prenatal B-ultrasound examination in the diagnosis of fetal abnormalities.Results:Prenatal B-ultrasound examination detected 10 cases of fetal abnormalities,with a detection rate of 5.00%.When compared with the postnatal examination results of 5.50%,the difference was insignificant(P>0.05).Moreover,comparing the fetal limb abnormalities and cardiovascular abnormalities in prenatal B-ultrasound examination and postnatal examination,one case of congenital heart disease was missed in the prenatal B-ultrasound examination,and the others were consistent with the postnatal examination results,with a coincidence rate of 90.91%,indicating a high compliance rate.Conclusion:Fetal abnormalities have a great impact on mothers,babies,and families,and it is particularly important to strengthen diagnosis during this process.Prenatal B-ultrasound examination can improve the accuracy of diagnosis of fetal abnormalities and can be promoted in clinical practice as a basis for screening fetal abnormalities.

盐酸消旋山莨菪碱在小儿肠套叠B超引导整复中的临床应用价值

目的:探讨盐酸消旋山莨菪碱在小儿肠套叠B超引导整复中的临床应用价值。方法:选取2020年11月—2021年12月安顺市妇幼保健院儿外科小儿肠套叠患儿220例,根据选用普通补液和盐酸消旋山莨菪碱分为两组,各110例,两组患儿均采用B超引导整复治疗,对照组患儿灌肠前0.5 h静脉补液后灌肠,研究组患儿灌肠前0.5 h静脉滴注0.6~2.0 mg/kg盐酸消旋山莨菪碱后灌肠。比较两组B超引导整复效果,比较两组复位压力、复位时间。结果:研究组B超引导整复首次成功率为95.5%,明显高于对照组的83.6%,差异有统计学意义(P<0.05)。研究组复位压力低于对照组,复位时间短于对照组,差异有统计学意义(P<0.05)。结论:在灌肠复位前静脉滴注盐酸消旋山莨菪碱,在小儿肠套叠B超引导整复治疗中,能够极大降低患儿手术率,提高首次整复成功率,减少复位时间,患儿复位压力更小。

B超引导下塞丁格技术置入中长管在神经外科患者中的应用效果

目的探讨B超引导下塞丁格技术置入中长管在神经外科患者中的应用效果。方法选取2022年2月~2023年2月于张家港市第一人民医院收治的104例神经外科静脉治疗患者为研究对象,采用随机数表法将其分为对照组和观察组,每组各52例,对照组行传统盲穿下塞丁格技术PICC置管,观察组行B超引导下塞丁格技术置入中长导管,比较两组置管成功率、置管情况(置管安全性及非计划拔管率)、患者置管疼痛程度(VAS)和置管部位舒适度(GCQ)、置管期间相关并发症发生率(穿刺点渗血、导管移位脱出、静脉炎和导管堵塞)及满意度。结果观察组一次置管成功率高于对照组,差异有统计学意义(P<0.05);观察组置管安全性高于对照组(P<0.05),差异有统计学意义,观察组非计划拔管率低于对照组,差异有统计学意义(P<0.05);观察组疼痛程度评分低于对照组,差异有统计学意义(P<0.05),观察组舒适度高于对照组,差异有统计学意义(P<0.05);置管期间,观察组穿刺点渗血、导管移位或脱出、静脉炎、导管堵塞的总并发症发生率(3.84%vs 15.37%)低于对照组,差异有统计学意义(P<0.05);观察组的满意度(94.23%vs 75.00%)高于对照组,差异有统计学意义(P<0.05)。结论B超引导下塞丁格技术导入中长导管应用于神经外科患者静脉治疗,可有效提高一次性置管成功率,保障置管的安全度,提高患者的舒适度,降低患者置管的疼痛程度,减少相关并发生症发生风险,具有较好应用价值。

瞬时弹性成像技术对乙肝及自身免疫性肝病诊断效能对比分析

目的 探讨瞬时弹性成像技术(fibrotouch,FT)对乙型肝炎及自身免疫性肝病诊断效能对比价值。方法 选取我院收治的乙型肝炎患者59例(A组)、原发性胆汁性胆管炎患者31例(B组),两组均接受肝组织穿刺病理检查,获取患者病理纤维化程度分期;分别对两组进行FT检查,获得两组患者的肝硬度值(LSM),尝试分析患者LSM与病理纤维化分期的关联及差异。结果 两组患者的肝细胞炎症程度、肝组织纤维化变化基本趋于一致,Pearson分析结果显示,炎症、纤维化程度呈正相关(P<0.05);两组无纤维化、轻中度、重度纤维化患者的肝硬度值呈上升趋势,病理分期越严重,LSM越大,且不同病理分期LSM差异有统计学意义(t=234.599,321.819;均P<0.001);两组患者LSM:A组无纤维化、中轻度及重度纤维化患者LSM均低于B组,其中S0分期差异无统计学意义(t=1.780;P=0.079);S1~S2、S3~S4分期差异具有统计学意义(t=8.352,6.392;P<0.001)。结论 FT为无创、定量评估肝病患者肝脏纤维化程度的有效方式,为临床诊治提供科学依据;肝纤维化程度越高则FT检查提示LSM越高;同一病理分期下,乙型肝炎、原发性胆汁性胆管炎患者LSM存在差异;后续可尝试构建不同类型肝炎患者FT检查肝脏损伤程度参考标准。

急性期新型冠状病毒感染的肺部床旁超声特征及其与临床指标相关性的研究

目的分析急性期新型冠状病毒感染(COVID-19)的肺部床旁超声特征,探讨肺部床旁超声半定量评分(LUS)与临床指标的相关性。方法选取川北医学院附属医院收治入院的急性期COVID-19患者30例,采用BLUE-PLUS方案对患者行肺部顺序扫查,行床旁超声半定量评分;并收集患者的二氧化碳分压、阴离子间隙、PH值、标准碳酸氢根、氧分压、淋巴细胞百分比(LYM%)、淋巴细胞绝对值(LYM#)、临床分型、住院时间等临床指标,比较急性期COVID-19不同临床分型患者的LUS,分析LUS与临床指标的相关性。绘制受试者工作特征(ROC)曲线,分析LUS用于普通型与(危)重型分型的效能。结果30例急性期COVID-19患者中,双侧均至少有一个肺点受累者29例(96.7%),单侧至少有一个肺点受累者1例(3.3%),15例患者出现至少一个肺点的肺实变大小>1 cm。行左、右肺相同肺点得分比较,左、右肺总得分之间比较,差异有统计学意义(P<0.05);行不同临床分型患者各肺点得分之间比较:普通型与危重型患者的左肺总得分、右肺总得分及全肺总得分比较,差异均有统计学意义(P<0.05)。全肺总得分诊断普通型与(危)重型分型的曲线下面积(AUC)为0.870。左肺总得分、右肺总得分、全肺总得分与LYM%、LYM#、阴离子间隙无相关性(P>0.05),与临床分型、住院时间呈正相关,与标准碳酸氢根呈负相关(P<0.05);左肺总得分、全肺总得分与PH值、氧分压呈负相关,与二氧化碳分压呈正相关(P<0.05),右肺总得分与PH值、二氧化碳分压、氧分压无相关性(P>0.05)。结论急性期COVID-19不同临床分型患者的床旁超声特征具有差异性,LUS与PH值、二氧化碳分压、标准碳酸氢根、氧分压、临床分型、住院时间存在相关性,危重型患者LUS得分较高;肺部床旁超声有望用于急性期COVID-19患者的临床分型及病情评估。

不同方法建立小鼠肝癌原位移植瘤模型差异性的探讨

目的 比较肿瘤细胞注射和肿瘤组织块移植方法建立小鼠肝癌原位模型的差异,为小鼠肝癌原位模型的建立提供技术参考。方法 取健康雄性KM小鼠,随机分为4组:A组注射小鼠肝癌H22细胞;B组注射腹水型肝癌H22细胞;C组采用小鼠肝癌组织块移植法;D组肝部注射生理盐水作为假手术组。定期观察各组小鼠活动情况、体重变化。记录4组小鼠的生存时间。观察各组小鼠肝部成瘤状况、肿瘤程度、与腹腔脏器粘连程度和转移情况,并进行B超成像,检测血清中甲胎蛋白(alpha-fetoprotein, AFP)、异常凝血酶原(des-gamma-carboxyprothrombin, DCP)的浓度及苏木素-伊红(HE)染色观察肝组织病理学变化。结果 A组、B组、C组小鼠造模操作时间分别为(3.36±0.44)min、(3.30±0.41)min、(5.68±0.65)min。建模第25天,A组、B组、C组小鼠成瘤率均100.0%,A组腹腔重度粘连率为40.0%,B组腹腔重度粘连率为60.0%,C组与D组均未出现重度腹腔粘连。A组、 B组、C组小鼠腹水出现率分别为40.0%、100.0%、0.0%;腹壁瘤出现率分别为30.0%、60.0%、0.0%。B组小鼠还存在肝转移情况(40.0%)。B超成像、血清AFP和DCP水平检测、组织病理学检查结果显示,与D组小鼠相比,A组、B组、C组小鼠肝边缘均不光滑,回声欠均匀,可见稍低回声包块;保持AFP、DCP高分泌;存在大量炎症细胞与肿瘤细胞。结论 在第25天时,3种方法均可以建立肝癌原位移植模型,其中,相较于肝癌组织块移植,肿瘤细胞注射具有操作简单、肝内存在多个转移结节的特点。而肝癌组织块移植相较于肿瘤细胞注射,则具有对腹腔等脏器影响较小等特点。

B超引导下0.25%与0.15%罗哌卡因双侧腹横肌平面阻滞对剖宫产术后镇痛效果比较

目的:探究B超引导下比较0.25%与0.15%罗哌卡因双侧腹横肌平面阻滞对剖宫产产妇的镇痛效果。方法:选取2020年9月-2023年9月本院拟行剖宫产产妇90例,随机分为两组各45例。分别行B超引导下0.15%(0.15%组)及0.25%(0.25%组)罗哌卡因双侧腹横肌平面阻滞,对比两组术后恢复、术后镇痛、不同时点动态和静态疼痛评分(VAS)、氧化应激指标皮质醇(COR)和C反应蛋白(CRP)水平及不良反应。结果:0.25%组自主排尿时间(17.23±2.26h)、首次下床时间(11.32±2.56h)、24 h按压镇痛泵次数(3.37±0.59次)和镇痛泵液用量(50.02±5.34)均少于0.15%组(25.37±1.83h、15.19±2.37 h、6.28±0.81次),有效镇痛(41.33±3.18h)及术后首次按压镇痛泵时间(13.37±3.50h)高于0.15%组(29.62±1.87h、6.38±2.08h);相较于术后1h,两组术后动态和静态12h、24h VAS评分均降低且0.25%组(4.22±0.26分、3.01±0.35分,3.15±0.21分、2.16±0.24分)低于0.15%组(5.37±0.24分、3.89±0.17分,3.62±0.19分、2.95±0.28分);术后12h两组COR、CRP水平均高于术前但0.25%组(643.47±20.49 nmol/L、18.79±2.74 mg/L)低于0.15%组(757.43±17.49 nmol/L、27.54±3.83 mg/L)(均P<0.05)。不良反应0.25%组(15.6%)与0.15%组(11.1%)无差异(P>0.05)。结论:剖宫产术应用B超引导下0.25%罗哌卡因双侧腹横肌平面阻滞,可提高镇痛效果,降低产妇术后应激反应,且未显著增加不良反应。

B超引导腰丛阻滞(“三叶草”法)复合不同熵指数控制水平的喉罩全身麻醉在老年THA患者中的应用研究

目的:探讨B超引导腰丛阻滞(“三叶草”法)复合不同熵指数控制水平的喉罩全身麻醉在老年全髋关节置换术(THA)患者中的应用效果。方法:选取2021年6月—2023年10月云浮市人民医院收治的42例行THA老年患者,按手术时间顺序分组法(奇数日为L组,偶数日为D组)分为两组,其中D组给予深麻醉喉罩全身麻醉,熵指数维持于40~50,L组给予浅麻醉喉罩全身麻醉,熵指数维持于50~60,比较两组术前及术后6、12、24、48 h视觉模拟评分法(VAS)评分,术前及术后1、3、7 d简易智力状态检查量表(MMSE)评分,术后恢复情况,入室时、切皮即刻、手术开始15 min、手术开始30 min、术毕即刻生命体征,术后自控镇痛使用情况。结果:两组术前及术后6、12、24、48 h的VAS评分对比差异均无统计学意义(P>0.05),但与术前相比均显著下降(P<0.05)。术前及术后1、3、7 d两组MMSE评分差异均无统计学意义(P>0.05),L组术后苏醒时间、拔管时间、定向力恢复时间均较D组显著早(P<0.05),入室时、切皮即刻、手术开始15 min、手术开始30 min、术毕即刻两组心率(HR)、呼吸频率(RR)、平均动脉压(MAP)水平差异均无统计学意义(P>0.05),但与入室时比较,两组切皮即刻、手术开始15 min、手术开始30 min、术毕即刻RR、HR、MAP水平均显著下降(P<0.05),两组术后自控镇痛首次时间使用时间、平均使用次数、舒芬太尼使用量、有效按压率差异均无统计学意义(P>0.05)。结论:B超引导腰丛阻滞(“三叶草”法)复合喉罩全身麻醉可提高THA患者麻醉及术后镇痛效果,维持患者处于稳定的状态,但是熵指数控制在50~60(浅度麻醉)即可起到显著麻醉和镇痛效果,尤其是在患者术后恢复方面更具有优势。

探讨臂丛神经阻滞麻醉在B超引导下的临床效果

目的探究B超引导下臂丛神经阻滞麻醉的效果。方法随机选取2021年7月—2023年7月成武县人民医院收治的100例实施麻醉的上肢骨折手术患者为研究对象,以随机数表法分成参照组与研究组,各50例。参照组采取肌间沟臂丛神经阻滞麻醉,研究组采取B超引导下臂丛神经阻滞麻醉。比较两组患者的临床镇静评分(Ramsay Sedation Scale,Ramsay)、阻滞起效时间、完全阻滞时间、神经阻滞程度、镇痛维持时间、阻滞消退时间、循环系统功能以及不良反应发生情况。结果研究组患者的Ramsay评分、血氧饱和度(Oxygen Saturation,SpO_(2))水平、镇痛维持时间优于参照组,差异有统计学意义(P均<0.05);研究组阻滞起效时间、完全阻滞时间、舒张压(Diastolic Blood Pressure,DBP)及心率(Heart Rate,HR)水平、阻滞消退时间均优于参照组,差异有统计学意义(P均<0.05)。研究组患者的神经阻滞程度Ⅰ级高于参照组,神经阻滞程度Ⅱ级与Ⅲ级均低于参照组,差异有统计学意义(P<0.05);研究组患者的不良反应总发生率为2.00%,低于参照组的16.00%,差异有统计学意义(χ^(2)=4.396,P<0.05)。结论B超引导下的臂丛神经阻滞麻醉在手术中的应用具有高度的精准性、安全性和可控性,为医生提供了更可靠的术中引导,同时也减少了辐射暴露的风险。

腹部CT、B超与磁共振胰胆管成像检查对肝外胆管结石的诊断效能比较

目的:比较腹部CT、B超与磁共振胰胆管成像检查对肝外胆管结石的诊断效能。方法:选取2021年5月至2022年5月该院收治的100例疑似肝外胆管结石患者进行前瞻性研究,均行腹部CT、B超和磁共振胰胆管成像检查,以经内镜逆行胰胆管造影结果为金标准,统计3种检查方法诊断肝外胆管结石的结果,并比较其对肝外胆管结石的诊断效能、直径≤8 cm结石检出率和检查时间。结果:100例疑似肝外胆管结石患者中,经内镜逆行胰胆管造影检查结果显示,阳性91例,阴性9例;腹部CT检查结果显示,阳性88例,阴性12例;腹部B超检查结果显示,阳性83例,阴性17例;磁共振胰胆管成像检查结果显示,阳性90例,阴性10例;腹部CT、B超检查诊断肝外胆管结石的灵敏度、特异度和准确度比较,差异均无统计学意义(P>0.05);磁共振胰胆管成像检查诊断肝外胆管结石的灵敏度、特异度均高于腹部B超,准确度高于腹部CT、B超,差异有统计学意义(P<0.05);磁共振胰胆管成像检查对直径≤8 cm结石的检出率均高于腹部CT、B超,差异有统计学意义(P<0.05);磁共振胰胆管成像检查时间均长于腹部CT、B超,差异有统计学意义(P<0.05)。结论:磁共振胰胆管成像检查对肝外胆管结石的诊断效能高于CT、B超,但检查时间相对较长。

B超引导下连续腹横肌平面阻滞在剖宫产术后镇痛中的研究

目的:研究B超引导下连续腹横肌平面阻滞在剖宫产术后镇痛的效果。方法:选取剖宫产术患者80例,随机分为硬膜外PCA组及腹横肌平面阻滞组,硬膜外PCA组接硬膜外术后镇痛泵,腹横肌平面阻滞组在B超引导下行腹横肌阻滞并置管接镇痛泵行连续镇痛。对比视觉模拟评分,阿片药物辅助镇痛的次数、恶心,呕吐发生率、排尿时间,早期下床时间以及住院时间。结果:腹横肌平面阻滞组视觉模拟评分,阿片药物辅助镇痛的次数、恶心,呕吐发生率、排尿时间,早期下床时间以及住院时间优于硬膜外PCA组(P<0.05)。结论:剖宫产术后实施B超引导下行腹横肌阻滞并置管接镇痛泵行连续镇痛可以改善疼痛指标,降低阿片药物辅助镇痛的次数、恶心,呕吐发生率,缩短排尿时间,早期下床时间以及住院时间。

常熟口岸出入境人员腹部B超检查结果分析

目的通过对出入境人员腹部B超检查结果进行分析,掌握这一人群的健康状况,有针对性地进行医学指导。方法对2018年1月至2022年12月经常熟口岸出入境的3302名体检人员的腹部B超检查结果进行分析。结果检出疾病种类24种,阳性病例共1478例,检出率为44.76%。肝脏患病最多,为961例,占总阳性病例的65.02%;其次是胆道系统疾病268例,占阳性病例的18.13%;肾脏疾病227例,占阳性病例的15.36%;脾脏21例,占阳性病例的1.42%;胰腺1例,占阳性病例的0.07%。男性疾病检出率为58.47%,女性疾病检出率为19.98%,男性检出率高于女性。结论根据统计结果,了解这一人群的疾病谱,为保健中心科学有效的制定防治措施提供依据。

B超引导下无痛人工流产术后放置宫内节育器预防宫腔粘连的效果

目的探讨B超引导下无痛人工流产术后放置宫内节育器预防宫腔粘连的效果。方法选取2022年1月至12月于铜仁市碧江区妇幼保健院进行无痛人工流产术的123例患者,按照随机抽签法分为研究组(62例)与对照组(61例)。对照组术后采用屈螺酮炔雌醇片,研究组术后采用宫内节育器联合屈螺酮炔雌醇片,观察两组宫腔粘连发生情况、月经恢复时间及月经量情况。结果研究组宫腔粘连总发生率低于对照组(P<0.05);研究组月经恢复时间短于对照组(P<0.05);研究组月经量总异常率低于对照组(P<0.05)。结论B超引导下无痛人工流产术后放置宫内节育器预防宫腔粘连的效果较好,能够降低宫腔粘连发生率,促进月经恢复正常。

B超监视下宫腔镜手术与腹腔镜手术切除Ⅰ型和Ⅱ型粘膜下子宫肌瘤后患者妊娠结局的临床研究

目的比较B超监视下宫腔镜手术与腹腔镜手术切除Ⅰ型和Ⅱ型粘膜下子宫肌瘤的临床效果。方法选取2021年5月至2022年9月江门市五邑中医院收治的60例Ⅰ型和Ⅱ型粘膜下子宫肌瘤患者作为研究对象,根据不同术式分为对照组与研究组,每组各30例。对照组行腹腔镜手术,研究组行B超监视下宫腔镜手术,比较两组手术相关指标、临床疗效、并发症发生情况及随访结果。结果研究组术中出血量少于对照组,手术时间、首次离床时间、首次排气时间及住院时间短于对照组,术后6 h视觉模拟评分法评分低于对照组(P<0.05);两组Ⅰ型与Ⅱ型治疗有效率比较,差异无统计学意义(P>0.05);研究组并发症总发生率为3.33%,低于对照组的20.00%(P<0.05);研究组妊娠成功率与足月分娩率高于对照组,流产率与早产率低于对照组(P<0.05)。结论与腹腔镜手术相比,B超监视下宫腔镜手术效果更好,患者疼痛轻微,术后恢复快,可改善粘膜下子宫肌瘤切除术患者的妊娠结局。

乳腺非肿块性病变的超声特征探讨及多模态超声诊断

目的 分析非肿块性乳腺病变(NML)在B型超声(US)、彩色多普勒超声、应变弹性成像(SE)和对比增强超声(CEUS)中的特征,建立多模态超声方法鉴别恶性NML病变,并比较多模式超声方法诊断恶性NML的诊断效能。方法 回顾性分析2020年12月—2023年7月本院行乳腺多模超声(B超+CDFI+SE+CEUS)检查患者的临床资料,以病理学结果作为金标准,分为良性组和恶性组。比较两组患者的年龄、临床症状及月经史、US、彩色多普勒、SE、CEUS各种模式下多个参数的差异,并使用二元逻辑回归法确定诊断恶性NML独立的危险因素,进一步建立恶性NML预测模型并检查模型的ROC曲线下面积(AUC)、敏感度、特异度、阳性预测值(PPV)及阴性预测值(NPV)并比较不同超声模式下的NML诊断效能。结果 共纳入68例患者(共71个乳腺病变)。患者平均年龄(46.32±9.96)岁。病变的最大直径0.47~5.62 cm,平均值为(2.25±1.30)cm。恶性组40个(56.3%),良性组31个(43.7%)。两组的年龄、微钙化、血管分布、达峰时间、峰值强度、蟹爪状形态和硬度均具有统计学差异(P<0.05)。其中微钙化、高峰值强度、质硬是恶性NML的独立危险因素,包含上述危险因素建立的预测模型诊断恶性NML的敏感度、特异度、PPV、NPV、准确度分别为92.5%、83.9%、90.2%、89.7%、92.9%,较其他超声模式的准确度明显提高。结论 多模式超声方法简单、诊断性能高,有助于预测NML的潜在恶性。