本文探讨超声下光动力疗法联合窦道切开引流对化脓性汗腺炎的效果.选取80例化脓性汗腺炎患者随机分为试验组和对照组,每组40例.试验组行超声引导下光动力疗法联合窦道切开引流治疗,对照组行单纯窦道切开引流治疗,观察患者治疗前后的视觉模拟量表(VAS)评分、外周血白细胞(WBC)、超敏C反应蛋白(hs-CRP)变化,对患者的创面愈合情况及肿胀度进行评分,分析两组疗效.结果显示,试验组患者在术后3 d、术后1周时的VAS评分均低于对照组(P＜0.05);试验组术后3 d的 WBC,术后3 d及术后1周的血清hs-CRP水平均低于对照组(P＜0.05);试验组术后3 d、术后1周的创面愈合评分、肿胀度评分均低于对照组(P＜0.05);试验组患者总体治疗效果优于对照组(P＜0.05).超声下光动力疗法联合窦道切开引流治疗化脓性汗腺炎能显著减轻患者术后疼痛感受,促进创面早期愈合.

超声医学住院医师规范化培训的学员存在临床知识薄弱,难以将超声表现与临床疾病的病理生理改变有效结合.为提高超声医学规培学员的教学质量,以"加强临床知识背景,提高超声诊断能力"为中心,通过急慢性肾脏病为例,强化肾脏疾病的临床知识的培训、了解疾病的解剖学、病理生理学改变,从而强化培养学员临床思维能力,提高规培学员超声临床诊断能力.以期能为各级医疗机构培养具有丰富理论知识,独立胜任临床工作的超声医师.

随着超声医学的飞速发展,临床医生及患者对超声的不同需求急剧增加,超声教学多种层次的不同要求日益增加,因此为了更好开展和落实超声医师分级教育和培训,设立超声科专职教学岗.超声科实践教学专职教学岗医师需经过遴选,满足学校、医院及科室制定的入选条件;在这期间必须遵循学校、医院及科室制定的要求,面向实习生、住院医师、研究生及进修生四类学员开展工作.实现医学生入科有人管、过程有人教、出科有考核的培养体系.切实促进了超声分层教学落实、有效提高教学效率、提升各级学员的满意程度,实现了以年轻超声医师为中心的超声医学人才培养模式.

木村病是一种病因不明的淋巴组织增生性疾病,又称为嗜酸性粒细胞增多性淋巴肉芽肿,临床表现为单发或多发的无痛性肿块,好发于皮下软组织及头颈部.本病少见,临床及超声医师对其认识有限,常发生误诊.本组回顾性分析经手术病理证实的颌面部木村病患者的临床表现和声像图特征,旨在提高对其的认识.

Objective To discuss he enhanced character of contrast-enhanced ultrasonography of different parts of carotid atherosclerotic plaques.Methods Seventy-Eight patients with carotid atherosclerotic plaques were examined with real-time contrast-enhanced ultrasonography (CEUS).The perfusion modes of the neovascularization in carotid atherosclerotic plaques were observed.Quantitative analysis results of different parts of the plaque were compared.Results The enhanced intensity degree of different parts of the plaque ranged from high to low.The parts of the plaque were the upstream shoulder,the top,the downstream shoulder and the central part(P＜0.05).Conclusion The real-time contrast-enhanced ultrasonography can assess the vulnerable parts of carotid atherosclerotic plaque non-invasive and quantitatively.

目的:探讨超声造影与常规超声诊断小肾癌的临床价值.方法:收集疑似小肾癌患者78例为研究对象,均接受常规超声与超声造影检查,以手术病理结果为金标准,观察超声造影及常规超声对小肾癌的诊断准确性.结果:经常规超声检查准确率为67.95%,超声造影准确率为91.03%,两组差异具有统计学意义(P<0.05);超声造影诊断特异度、敏感度、阴性预测值、阳性预测值与常规超声比,差异有统计学意义(P<0.05).结论:超声造影能为临床诊断小肾癌提供丰富信息,具有较高的诊断准确性、特异度及敏感度,可作为早期小肾癌首选影像学诊断方法.

OBJECTIVETo determine the value of contrast-enhanced ultrasound (CEUS) for assessing renal blood perfusion changes and severity of early chronic kidney diseases (CKD).METHODSThe study included 20 patients with clinical diagnosed CKD (grade 1-3) (case group) and fifteen normal adults (control group). They were given real time CEUS, assessing left renal cortex blood perfusion. We identified the time-intensity curve (TIC) parameters that could differentiate participants between the two groups, and tested their correlations with glomerular filtration rate (eGFR), quantity of urinary protein and cystatin C.RESULTSSignificant differences were found in rise time (RT), area under the curve (AUC), time from peak to one half, and time to peak (TTP) between the two groups (P< 0.05). eGFR was negatively correlated with all of the four TIC parameters (P<0. 05). The quantity of urinary protein was positively correlated with three of the four TIC parameters (except RT). Cystatin C was positively correlated with all of the four TIC parameters (P<0. 05).CONCLUSIONCEUS can detect changes of blood flow perfusion in patients with early chronic kidney disease. The perfusion parameters are associated with laboratory results reflecting renal damages.

腺瘤样瘤(adenomatoid tumor of epididymis)是一种间皮细胞起源的良性肿瘤,发生在男性和女性生殖道[1],最早由Godman和Ash在1945年提出[2],临床少见.多数患者在20～40岁发病,青春期前罕见,无明显临床症状,偶然触及阴囊内孤立肿物,多数为单发,以附睾尾居多,其次是附睾头,肿块生长缓慢.本研究回顾分析我院2006年3月至2012年8月的9例附睾腺瘤样瘤的超声表现特点,旨在探讨二维及彩色多普勒超声对附睾腺瘤样瘤的诊断价值。

目的探讨在斜视手术中巧用输液敷贴作术眼贴膜代替术眼剪眼睫毛的术眼准备护理要点、操作规范及优点。方法 2011年1月-6月,239例1～10岁儿童斜视矫正手术患儿,术中使用输液敷贴作术眼贴膜代替术眼剪眼睫毛的术眼准备,分析患儿术后术眼感染和皮肤损伤的情况和效果。结果小儿斜视手术中使用输液敷贴后无一例术眼感染和皮肤损伤。术后反应轻,术中严格无菌操作术可协助提高手术成功率。结论通过斜视手术术中使用输液敷贴,保护术野和切口,降低感染的危险,保护小儿的皮肤不被损伤,简化术前准备护理,缩短平均住院日。

[目的]探讨肝囊型包虫病超声表现与其病理关系,以提高超声对该病认识. [方法]回顾性分析经手术切除治疗69例肝囊型包虫病患者病理资料及其超声声像图表现. [结果]本组69例患者共有86个病灶,据其声像图表现可分为6型,其中,单房囊肿型14个(16.28%),多房子囊型20个(23,26%),内囊塌陷型24个(27.91%),实变型16个(18.6l%),钙化型8个(9.30%).合并感染或破裂者4个(4.65%). [结论]肝囊型包虫依据其发育不同阶段及其退行性改变不同病理基础而其超声声像图表现备异.据肝囊型包虫病不同声像图表现,并结合病史,超声可对其做出较明确诊断和鉴别诊断.

Objective:To evaluate the diagnostic value of testicular diseases with high frequency ultrasonography by analysed the ultrasonographic appearance of testicular diseases.Methods:Retrospectively analysed the ultrasonographic appearance of the different testicular diseases in 241 patients verified by clinic diagnosis or pathology in our hospital.Results:Of 241 cases,40 cases were with blunt testicular trauma,81 cases were with blunt testicular tumor,testis torsion in 42cases,undescend testis in 56 cases,testis tuberculosis in 14 cases,testis atrophy in 8 cases.The ultrasonographic appearance of the different testicular diseases had oneself characteristic.The accurate rate of ultrasonographic diagnosis in the group of testicular diseases was probably 96.3%.Conclusions:the shape and size and inner structure of the testis could be showed by high frequency ultrasonography,and the different testicular diseases could be diagnosed elementary by the ultrasonographic appearances.

Objective To detect the carotid elasticity quantitatively in end-stage renal disease(ESRD) patients using echo-tracking(ET)technique.Methods Using ET technique,the carotid elastic index(β),Ep,AC,AI and PWVβ in 20 end-stage renal disease (ESRD)patients and 150 normal adults were calculated and analyzed.Within the 20 patients,10 cases were without and ten with hypertension.Results Compared with the normal adults,the carotid β,Ep and PWVβ of ESRD were different in both patients with and without hypertension.Conclusions The carotid elasticity was decreased in ESRD patients no matter whether hypertension was present,so that ET can be used to detect arterial elasticity.

患者男,41岁,5 d前受凉后出现咳嗽,后相继出现腹泻、腹痛,心悸、气紧,皮肤巩膜发黄,1 d前上述症状加重急诊入院.既往有风湿性心脏病史.体格检查:体温、血压正常,精神差,巩膜黄染,腹部平软无压痛,肠鸣音正常.

Objective:To determine the high frequency ultrasound imaging features of mammary ductal ectasia(MDE).Material and methods:The thirty examinations by high frequency ultrasound images of twenty-seven patients with MDE confirmed by operation and pathology were studied retrospectively.Results:According to the high frequency ultrasound images of thirty cases,MDE could be classified into four types:typeⅠ,duct dilataion(6.1%);typeⅡ,cystosolid masses within or around the duct(23.3%);type Ⅲ,hyperechoic or heterogeneous-echoic mass with a hypoechoic rim(53.3%)and type Ⅳ,partly or fully fludified abcess(16.7%),Conclusion:High frequency ultrasound could evaluate the sonographic appearance of MDE.The features of MDE in chronic phase are specific,in accordance with type Ⅲ or type Ⅳ.The features in subacute and acute phase were nonspecific,in accordance with typeⅠ,type Ⅱ or type Ⅲ,might be more difficult to make the differentiate diagnosis.

目的:探讨高频超声诊断附睾疾病的价值。方法:分析我院经手术治疗的89例附睾疾病的病理类型及其超声声像图表现。结果:本组89例附睾病变中,病理类型有:急性附睾炎5例、慢性附睾炎17例,附睾结核39例、附睾囊肿14例、附睾精子肉芽肿12例,附睾肿瘤2例。不同病理类型的附睾病变,其高频超声声像图各有一些不同的特点。结论:高频超声能够清楚发现附睾病变,且对不同病理类型的病变可作出一定的鉴别诊断。

Objective:To determine the high frequency ultrasonographic imaging features of intraductal papilloma of breast.Materials and methods:The high frequency ultrasound images of thirty-two cases with intraductal papilloma of breast confirmed by operation and pathology were studied retrospectively.Results:According to the high frequency ultrasound images of thirty-two cases,intraductal papilloma of breast could be classified into five types:type Ⅰ,duct dilataion with papillary solid processes or solid masses(469%);type Ⅱ,cystosolid masses(188%);type Ⅲ,irregular or discontinuous ductal wall at the end of limitative dilated duct(188%);type Ⅳ,solid masses detected at the end of dilated duct(94%) and typeⅤ,purely low-echo solid masses(63%).Twenty-three of thirty-two cases were diagnosed correctly by high frequency ultrasonographic imaging.The accurats diagnostic rate was 719%.Conclusion:The high frequency ultrasonography could provide the information about the dilated duct and the masses of intraductal papilloma of breast.The accurate diagnostic rate of typeⅠwas higher than that of typeⅡ.

Objective:To evaluate the diagnostic value of color doppler ultrasonography with high frequency for Backer cyst.Methods:The pathologically proved 56 patients having ultrasonograms of Backer cysts and their pathologic results were retrospectively studied and comparatively analyzged.Results:The correct rate of the patterns on ultrasonograms in comparison with the pathologic results was 98 percent.Conclution:There is a higher clinical value for diagnosing Backer cyst with high frequency ultrasonography.

Objective:Complete excision of masses of breasts with an ultrasound-guided Mammotome device.Method:Biopsy excision of masses of breasts by using combination of vacuum-assisted biopsy device and a stereotactic unit(Mammotome) were carried out.All the operations could be observed on the ultrasonograph.Result:Forty-nine masses of the breasts in 28 cases were excised completely.Conclusion:With an ultrasound-guided Mammotome device was an accurate,effective,safe and minimally invasive procedure.It was crucial to develop a useful minimally invasive operation method which could be applied without difficulty.

Objective To explore the reason why ectopic thyroid is misdiagnosed as thyroglossal duct cyst. Methods The normal thyroid,ectopic thyroid and thyroglossal duct cyst were observed and measured,and the surgical and pathological results were analyzed. Results Becsuse of shortage in understanding of ectopic thyroid,it was misdiagnosed as thyroglossal duct cyst frecquently. Conclusion When diagnosing ectopic thyroid,more attention should be paid to differential diagnosis with ectopic thyroid. In case of misdiagnosis,it would do harm to the patient. With ultrasonic examination,ectopic thyroid and thyroglossal duct cyst can be determined.