目的 分析痔疮手术患者采用集束化护理的临床效果.方法 80例痔疮手术患者,随机分为对照组与试验组,每组40例.对照组患者采用常规院内护理,试验组患者在对照组基础上采用集束化护理,比较两组患者术后住院时间、临床效果及护理满意度.结果 试验组患者术后住院时间短于对照组,差异具有统计学意义(P<0.05).试验组患者总有效率为95.0％,高于对照组的75.0％,差异具有统计学意义(P<0.05).试验组患者护理满意度为92.5％,高于对照组的72.5％,差异具有统计学意义(P<0.05).结论 对痔疮手术患者应用集束化护理,可有效提高患者护理满意度,促进患者早日恢复健康.

OBJECTIVE:To determine the morphological characteristics of myocardial bridge and mural coronary artery (MB-MCA) and initially quantify the changes of MB-MCA in diastole and systole phase with multiple-phase reconstruction technique using 256-slice CT angiography (256-slice CTA).METHODS:We retrospectively collected the coronary artery imaging data of 861 patients undergoing 256-slice CTA with suspected or documented coronary artery disease. The images were reviewed by two independent radiologists, the diagnosis of MB-MCA was confirmed when consistency was obtained. The length, diameter and thickness of MB-MCA in the middle segment of LAD (LAD2) in diastole and systole phase were recorded, and changes of MB-MCA were calculated.RESULTS:Among the 861 patients, 150 MB-MCA were found in 131 patients (15.2%). 99 MB-MCA (66.0%) were located in LAD2, the remaining 51 (34.0%) in the other segments of coronary arteries. The average length and thickness of MB was (17.6 ± 5.7) mm and (2.6 ± 0.7) mm, respectively. The average diameter change of MCA in LAD2 from systole phase to diastole phase was (1.2 ± 0.5) mm, and 41% of MCA have diameter stenosis more than 50% in systole phase.CONCLUSION:The changes of MB-MCA from diastole to systole phase could be determined to some extent by 256-slice CTA multiple-phase reconstruction technique.

医学辐射防护指导的总原则是:检查必须有临床指征,辐射剂量在合理的范围内尽可能低,即正当化和最优化原则.正当化要求临床医师和放射医师之间应有共同责任,指导患者为了需求的诊断任务而采用最合适的影像模式.并确保所有的检查技术的最优化:在接受辐射剂量尽可能低的情况下,保证获得所需的影像质量水平[1].因此,只有当辐射剂量的使用有助于患者病情的诊断,才应该使用CT检查.

Objective:To discuss application of three-dimensional digital subtraction angiography(3D DSA)and virtual endoscopy(VE)in cerebrovascular examination.Methods:One hundred and three cases of suspected cerebral vascular disease patients did rotational 3D-DSA examinations and passed through workstation to do the VE reconstruction.Rusults:The aneurysms(36 case of 103 patients)was clearly displayed with the parent artery and the coarse inside surface.In the patients with artery stenosis(47 cases),the main indication of which was the decrease of ramose number and the visual field.In patients of arteriovenous malformation(7 cases)only the bulky feeding artery and the draining veins could be seen.In patients of vascular obstruction(6 cases)the signal interruption of vascular occlusion were found.3D DSA and VE showed a round and smooth cavity in 7 normal artery patients.Conclusion:3D DSA and VE technology could provide a more comprehensive image data for the diagnosis of cerebrovascular diseases,and an important basis for the choice of location and program of treatment.

目的:探讨慢性阑尾炎的影像学表现,提高术前诊断水平。方法:对经手术病理证实的47例慢性阑尾炎患者回顾性分析其影像学表现,术前对27例进行胃肠道钡剂造影检查,20例进行钡剂灌肠检查,9例同时进行腹部CT检查。结果:47例X线钡剂造影中39例阑尾显影,32例阑尾形态异常,其中24例合并单个或多个充盈缺损,11例阑尾位置固定,诊断为慢性阑尾炎;7例阑尾形态基本正常,其中2例可见充盈缺损,术前未诊断慢性阑尾炎。8例阑尾未见显示,24h延时观察,其中2例阑尾部分充盈,考虑排空延时,此2例诊断为慢性阑尾炎;9例CT检查中,5例可见阑尾内粪石,2例可见阑尾周围肿块。结论:X线钡剂造影对慢性阑尾炎的诊断具有重要价值。

目的 评价影像学检查在随访嗅神经母细胞瘤的价值.方法 分析5例嗅神经母细胞瘤随访过程中的CT、MRI表现.结果 2例病人的存活时间超过5年. 2例就诊时病变局限于鼻腔,在随访过程中, 1例表现为右侧眼眶区硬膜外软组织肿块,同时左侧鼻腔内亦可见软组织肿块影,CT、MRI显示病变强化均匀,1个月后左侧鼻腔病变显著增大,且破坏了邻近硬腭.另1例病变则呈浸润性生长,CT显示颅底骨质广泛破坏,翼腭窝、颈动脉管、圆孔、卵圆孔均受累.MRI显示病变侵及颅内海绵窦、颈内动脉以及鞍区结构.另3例就诊时已为T4期,病变以鼻腔顶壁、筛窦为中心,侵犯颅内海绵窦以及鞍区结构,颅底骨质破坏.结论 CT/MRI可清晰地显示病变的侵袭范围,对评价病变的生物学生长行为提供了客观依据.