脾脏、淋巴结及网状内皮系统疾病

900855 亚急性坏死性淋巴结炎一例/胡玫∥云南医药。-1989,10(6)。-378～395 患儿,女,11岁。因持续高热,咽痛, 颈淋巴结肿痛4天入院。诊断上感。体检:体温39.2℃,左颈部有个黄豆大及蚕豆大淋巴结,可移动,质软,有明显压痛。咽充血,扁桃体不肿大。外周血WBC5.9×10~9/L,N43％,L57％。给予抗生素,体温持续不降,扁桃体Ⅱ°肿大并有脓性分泌物。考虑“化脓性扁桃体炎”。改用抗生素,体温仍不降,颈淋巴不见增大,但疼痛加剧,复查周围血细胞减少或正常,不符合化脓性感染。并出现肝大,查肝功除SGPT偏高外,其余正常。始考虑“亚急性坏死淋巴结炎”,经做淋巴结活检证实。

甲状腺癌颈淋巴清扫术后并发双侧乳糜胸一例

患者女,27岁,因发现甲状腺肿物并颈部淋巴结肿半年,于2014年1月11日入院.体格检查：双侧甲状腺Ⅱ度肿大,甲状腺左叶近峡部处可触及一大小约20 mm×15 mm×15 mm肿块,质地硬,活动度差,界限清,无压痛,随吞咽上下活动,甲状腺右叶质地软,无压痛,未触及明显结节.左侧颈部Ⅱ～Ⅵ区可触及数枚肿大淋巴结,质地硬,呈串珠样改变.

川畸病误诊急性菌痢1例

病例:女,9个月。因发热、咳嗽、流涕3天以“上呼吸道感染”收住小儿科。入院当天出现腹泻4次,为稀水样便,并有少量脓球,呕吐一次,为胃内容物。体检:体温39.2℃,神志清楚,热性病容,口唇潮红,干裂,咽部充血,扁桃体未见肿大,颈后双侧各触及一大小约0.5cm×0.5cm淋巴结,心肺(一)。腹软,肝脾未扪及。实验室检查:血红蛋白:lOOg/L,红细胞2.6×10~12/L,白细胞12.0×10~9/L,中性0.65,淋巴0.35,血小板180×109/L,尿常规正常。

31例甲状腺癌诊疗体会

回顾性总结我院2000～2008年收治的31例甲状腺癌患者的临床资料,关于甲状腺癌诊疗体会如下。1资料与方法1.

Analysis of 30 patients with persistent or recurrent squamous cell carcinoma of the cervix within one year after concurrent chemoradiotherapy

Objective： To investigate the recurrence sites, risk factors, and prognosis of＇patients with persistent or recurrent squamous cell carcinoma （SCC） of the cervix within one year after undergoing concurrent chemoradiotherapy （CCRT）. Methods： Clinical data of 30 patients with persistent or recurrent SCC of the cervix within one year after CCRT between July 2006 and July 2011 were analyzed retrospectively： These data were compared with those of 35 SCC cases with no signs of recurrence after complete remission. These 35 patients were treated during the same period （between 2,006 and Z011） and selected randomly. Results： Among these 30 patients, 25 exhibited distant metastases of which 14 were observed within 6 months after CCRT. Univariate analysis showed higher incidence of pelvic or para-aortic lymphadenectasis and SCC-ag 〉 10 ng/mL in the group with persistent or recurrent disease before treatment （P〈0.01）. Multivariate analysis by logistic regression revealed that the pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉 10 ng/mL were the independent risk factors. Palliative chemotherapy was the main treatment option for patients with persistent or recurrent disease. The 2-year survival rate was 21.7%, and the median survival time was 17 months. Conclusion： Patients with persistent or recurrent SCC of the cervix after CCRT exhibited a high rate of distant metastasis with poor prognosis. The pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉10 ng/mL were identified as the independent risk factors for persistent or recurrent SCC within i year after CCRT.

WHO推荐的小儿呼吸道感染的治疗

小儿呼吸道感染发病率高,我国医务人员处理的方法不尽合理,有滥用抗生素的倾向。世界卫生组织(WHO)于1988年在日内瓦出版了一本“没有X线机的小型医院推荐的处理小儿呼吸道感染的方法”小册子,在有充分科学依据的基础上,提出了诊治原则和方法,兹简介以作参考。