脂肪肝的CT、B超诊断及对比研究(附280例报告)

本文 2 80例脂肪肝均由CT诊断并经临床证实 ,B超诊断符合率 88% ,其中弥漫性脂肪肝诊断符合率91% ,局限性脂肪肝诊断符合率 6 9%。CT检查特异性高 ,以肝脏CT值低于脾脏CT值多少分为轻、中。

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

BACKGROUND B-mode-ultrasound-guided percutaneous cholecystostomy(PC)may be performed by a transhepatic or transperitoneal approach,called percutaneous transhepatic gallbladder drainage(PHGD)and percutaneous transperitoneal gallbladder drainage(PPGD),respectively.We compared the impact of PC related to the route of catheter placement on subsequent laparoscopic cholecystectomy(LC).AIM To compare the impact of PC related to the route of catheter placement on subsequent LC.METHODS We retrospectively studied 103 patients with acute calculous cholecystitis who underwent scheduled LC after PC between January 2010 and January 2019.Group I included 58 patients who underwent scheduled LC after PHGD.Group II included 45 patients who underwent scheduled LC after PPGD.Clinical outcomes were analyzed according to each group.RESULTS Baseline demographic characteristics did not differ significantly between both groups(P>0.05).Both PHGD and PPGD were able to quickly resolve cholecystitis sepsis.Group I showed significantly higher efficacy than group II in terms of lower pain score during puncture(3.1 vs 4.5;P=0.001)and at 12 h follow-up(1.5 vs 2.2;P=0.001),lower rate of fever within 24 h after PC(13.8%vs 42.2%;P=0.001),shorted operation duration(118.3 vs 139.6 min;P=0.001),lower amount of intraoperative bleeding(72.1 vs 109.4 mL;P=0.001)and shorter length of hospital stay(14.3 d vs 18.0 d;P=0.001).However,group II had significantly lower rate of local bleeding at the PC site(2.2%vs 20.7%;P=0.005)and lower rate of severe adhesion(33.5%vs 55.2%;P=0.048).No significant differences were noted between both groups regarding the conversion rate to laparotomy,rate of subtotal cholecystectomy,complications and pathology.CONCLUSION B-mode-ultrasound-guided PHGD is superior to PPGD followed by LC for treatment of acute calculous cholecystitis,with shorter operating time,minimal amount of intraoperative bleeding and short length of hospital stay.

根据“以痛为腧”理论对肱二头肌长头肌腱炎针刺方案选择的研究

目的根据"以痛为腧"理论,以视觉模拟评分法(VAS)及肩关节疾患治疗成绩判定标准(JOA)评分作为观察指标,观察传统针刺部位、阿是穴及经B超精确定位损伤部位3种针刺方案的疗效。方法选取江苏省中医院针灸康复科门诊就诊患者,随机分为传统针刺组、阿是穴组、B超定位针刺组,每组15例,共45例患者。分别选择传统针刺部位、阿是穴、B超定位损伤部位进行针刺治疗,每日1次,每周5次,10次为一个疗程,共观察2个疗程。结果 VAS评分:患者治疗后即时,传统针刺组与B超定位针刺组比较有统计学差异(P <0. 05);第1、第2疗程结束后,传统针刺组与其他2组比较皆有统计学差异(P <0. 05)。JOA评分:患者治疗后即时,传统针刺组与B超定位针刺组比较有统计学差异(P <0. 05);第1疗程结束后,传统针刺组与其他2组比较皆有统计学差异(P <0. 05);第2疗程结束后,传统针刺组与B超定位针刺组比较有统计学差异(P <0. 05)。结论阿是穴及B超定位损伤部位针刺,在缩短治疗周期,改善患者疼痛症状,改善关节活动度,改善肌力、耐久力及日常生活动作等功能方面较传统针刺方案有优势,B超定位损伤部位针刺方案在改善疼痛及日常生活动作等功能方面优势更为明显,而阿是穴在改善关节活动度方面要更有优势。

B超引导下穿刺留置导管无水乙醇灌洗治疗肾囊肿

目的:探讨经皮穿刺置管无水乙醇灌洗治疗肾囊肿的效果及安全性。方法:经B超引导下穿刺留置导管无水乙醇灌洗治疗肾囊肿,术后3、6、12个月随访,观察囊肿大小变化及不良反应发生情况,以确定其疗效与安全性。结果:138例肾囊肿经B超引导下穿刺留置导管无水乙醇灌洗后3、6、12个月随访,治愈率为89.13%、94.20%、98.55%,有效率为100%。结论:B超引导下穿刺留置导管无水乙醇灌洗治疗肾囊肿,方法简单,疗效确切,设备要求低,适于在基层医院推广应用,是肾囊肿有效治疗方法之一。