目的:探讨经桡动脉入路治疗自体动静脉内瘘(AVF)闭塞的疗效、安全性及随访12个月的内瘘通畅情况.方法:选取2019年1月至2021年1月在我院介入科行经皮血管腔内成形术(PTA)的AVF闭塞患者96例,根据穿刺入路不同分为动脉组(经桡动脉远心端入路)和静脉组(头静脉近心端逆血流入路),记录两组患者穿刺成功率、穿刺时间、射线暴露时间、手术时间、手术成功率、术后并发症发生情况.并随访两组患者术后第3、6、9、12个月的通畅率.结果:两组患者穿刺成功率、穿刺时间、手术成功率无统计学差异(P>0.05);动脉组射线暴露时间、手术时间、术后并发症优于静脉组(P<0.05).两组间一期通畅率差异无统计学意义(P>0.05).结论:经桡动脉远心端入路治疗AVF闭塞射线暴露时间短,手术时间短,术后并发症少,安全性高且在术后的持续随访中有较好的远期畅通性,可作为AVF失功介入治疗时的一个重要入路.

目的 探讨磁共振成像(MRI)测量子宫结合带(JZ)厚度及弥散加权成像(DWI)的表观弥散系数(ADC)值在卵巢型子宫内膜异位症(EMS)中的诊断价值.方法 回顾性采集2021年1月至2021年12月我院卵巢肿瘤病例46例,所有病例均行MRI检查并且行手术、腹腔镜得到相应病理结果证实,根据病理结果分为研究组即EMS组,对照组即非EMS组.分别测量研究组及对照组的最大结合带厚度(JZmax)、最小结合带厚度(JZmin)、JZmax-JZmin(JZdif);病灶的最低ADC值、对照区域的平均ADC值、相对表观弥散系值(rADC)即:最低ADC值与对照区域的平均ADC值的比值,两独立样本t检验进行统计分析.结果 EMS组JZmax、JZmin、JZdif值均大于非EMS组,差异有统计学意义(t=3.830,P=0.001;t=2.529,P=0.013;t=2.183,P=0.024),EMS组与非EMS组结合带ADC值及rADC值比较差异无统计学意义(t=1.671,P=0.243;t=1.974,P=0.130).结论 异常增厚的子宫结合带对卵巢型EMS具有诊断价值,结合常规MRI形态学表现有助于提高EMS的诊断.

目的 探讨数字减影全脑数字减影血管造影(DSA)在脑血管疾病诊断中的应用价值与安全性.方法 选取我院导管室758例行全脑DSA的患者为研究对象,采用回顾性方法分析全脑DSA的阳性率、脑血管病变分布特征及安全性评价.结果 758例患者中阳性发现率高达85.2％,其中以缺血相关性脑血管病阳性率最高为87.1％,共检出病变血管1050支.出血相关性脑血管病阳性率为83.7％,以动脉瘤检出率最高,共检出动脉瘤232个.有31例患者出现手术并发症,发生率为4.1％,其中全身并发症9例(5例迷走神经反射,4例碘对比剂过敏),局部并发症22例(穿刺点皮下血肿9例,穿刺口渗血5例,穿刺处动静脉瘘3例,穿刺处假性动脉瘤3例,脑血管痉挛2例),治疗过程中无严重手术并发症,无血管相关性感染暴发、死亡情况发生.结论 全脑DSA是一种简单、安全、可靠的检查方法,对脑血管疾病的临床诊断和治疗有重要的应用价值和临床意义.充分的术前准备,严格把握适应证和禁忌证以及规范化手术操作有助于预防和降低手术并发症,从而提高检查的效果,使全脑DSA的临床应用优越性得到体现.

Objective To summarize the clinical data of penile fracture,and to improve the level of the diagnosis and treatment of penile fracture.Methods Retrospective analysis was performed on the clinical data of 12 cases of penile fracture,including the symptoms and signs,examination methods,treatment and prognosis.Results All the patients presented penile swelling and ecchymosis.Ten patients reported hearing snap sound.Three patients were verified by ultrasongraphy to be with cavernosum tunica tear.All the patients were successfully treated by operation,without erect dysfunction,peyronie's disease and pain during erection after 3 months to 5 years of follow-up.The mean IIEF score was 22.6.Conclusion Penile fracture has typical history and clinical manifestations.Ultrasound has a certain diagnostic value.Surgical repair was effective,safe and reliable for penile erectile function recovery after the break,and timely surgical repair with no sexual dysfunction.

>2008年12月至2011年8月,我们对24例复杂性肾结石行二期经皮肾镜取石手术(percutaneous nephrolithotomy,PCNL),疗效满意。现报告如下。对象与方法本组24例。行24 F标准通道经PCNL或经皮肾穿刺造瘘置管引流术,常规留置20 F肾造瘘管。术后3 d行B超、KUB或CT检查:残留结石最大径25～42 mm,残留结石表面积>300 mm。其中10例为术中穿刺、扩张或碎石操作损伤出血较多导致视野

目的：分析外伤性和前列腺术后尿道狭窄各种治疗方法的优缺点及影响因素，为临床上合理选择治疗方式、减少狭窄复发提出有益建议。方法：对本科64例外伤性和59例前列腺术后的尿道狭窄初次治疗共123例进行回顾性多因素分析。结果：64例外伤性尿道狭窄患者中，尿扩22例，20例（90．9％）复发；尿道内切开21例，16例（76．2％）复发；尿道端端吻合21例，4例（19％）复发；59例前列腺术后尿道狭窄中，尿扩16例，15例（93．6％）复发；尿道内切开37例，5例（13．5％）复发；6例切开膀胱行膀胱颈疤痕切开切除膀胱颈整形术，3例（50％）复发。结论：①经尿道疤痕切开切除治疗外伤性尿道狭窄，其疗效与狭窄长度有关，狭窄长度〈2cm复发率低，〉2121／1则复发率高。②尿道疤痕切除端端吻合治疗外伤性尿道狭窄，其疗效与狭窄长度、狭窄部位、既往手术史无关，与手术本身有关，即术中如彻底切除狭窄疤痕及坏死组织、吻合无张力则复发率低，反之则高。⑧尿扩适用于尿道黏膜下狭窄，不适用于合并有尿道海绵体纤维化的尿道狭窄。④尿道内切开是治疗前列腺术后尿道狭窄的首选方法且疗效好。

<正>动静脉瘘是动脉与静脉之间非正常的通道,肾动静脉瘘分为后天获得性、先天性及特发性3种,后天性大多是由于肾脏活检,钝性或开放性肾创伤,炎症,肿瘤,肾脏的手术所引起。先天性的原因不清,可能是出生即已发生或先天性的动脉瘤破溃入邻近的静脉所引起,随着经皮肾镜的推广与肾穿刺活检数量增加,肾动静脉瘘有所增加,然而先天性肾动静脉瘘仍少见。传统的肾动静脉瘘治疗依赖外科手术。1例患者以大量肉眼血尿就医,最后确诊为肾动静脉瘘,进行介入栓塞术治疗得以痊愈,现报道如下。

Objective To study the applied method and the corresponding efficacy of curing nurseling's nympha conglutination through analyzing clinical data.Methods 72 cases with nympha conglutination of nurselings from the gynecology clinic's 5-year record to adopt two ways of treatment:the first,external use of estrogen erythromycin ointment;the second,manual separation of nympha conglutination.Results The efficacy of external use of estrogen erythromycin ointment,which was 100% successful to cure nympha conglutination,was much better than that of manual separation,the efficacy of which was only 3% due to difficult coordination with the nurselings.Conclusion The external use of estrogen erythromycin ointment is the best way to treat nympha conglutination of nurselings.

Objective To analyze the clinical data,so that both the methods and the efficacy of curing functional uterine hemorrhage and medium anemia of women in their menopausal transition period can be studied.Methods 65 cases with functional uterine hemorhage and medium anemia in their menop ausal transition were chosen randomly from the gynecological clinic and were divided into 3 groups.The first group took mifepristone orally;the second group took medroxyprogesterone acetate orally;the third group took Marvelon orally.Before the treatment,the diagnostic uterine curettage were performed to see whether the pathologic result is the pute hyperplasia of the endometrium or not.If it is the complicated hyperplasia,the treatment will not be adopted.Results The patients which had taken mifepristone and marvelon attained better therapeutic effect.The patients which had taken the medroxyprogesterone acetate were not beneficial from the treatment because the magnitude of their hemorrhage became too much after they stopped taking the medicine.Conclusion The patients with functional uterine hemorrhage and medium anemia in their menopausal transition period can be treated by taking mifepristone or marvelon.

Objective To evaluate the curative effect of curing Bartholin gland cyst or abscess by means of stoma transfixion and fastness drainage. Methods Adopt the methods of stoma transfixion and fastness drainage to cure Bartholin gland cyst or abscess, and periodically compare with the traditional marsupialization of Bartholin gland cyst/abscess in terms of operation methods and curative effect. Results Compared with the traditional marsupialization of Bartholin gland cyst/abscess, the methods of stoma transfixion and fastness drainage to cure Bartholin gland cyst/abscess have the following advantages: short operating duration, easily handled, pletitudinous drainage without drainage stripe and low relapse rate. Conclusion The methods of stoma transfixion and fastness drainage is better than the traditional marsupialization, thus worth of clinically adoption and generalization.