Renal artery stenosis as a complication from radiation therapy is not common, but it is life threatening and needs to be corrected urgently in order to prevent renal failure even losing kidney. The diagnostic criteria of renal artery stenosis in the adults by color duplex ultrasonography have been established, which may play an important role in screening radiation induced renal artery stenosis.

硫酸氢氯吡格雷治疗68例2型糖尿病患者下肢动脉病变的疗效观察

目的 观察硫酸氢氯吡格雷片治疗68例2型糖尿病患者下肢动脉病变的疗效.方法 通过下肢血管彩超和踝肱比(ABI)测量明确有下肢动脉病变的2型糖尿病患者98例,随机分为硫酸氢氯吡格雷组(68例),阿司匹林组(30例),分别给与硫酸氢氯吡格雷75 mg,1次/d,阿司匹林肠溶片75mg,1次/d,共6个月.观察治疗前后2型糖尿病患者下肢动脉病变的症状、股动脉、胭动脉、足背动脉的内径、血流速度和ABI的变化.结果 硫酸氢氯吡格雷治疗组总有效率81.38%,阿司匹林治疗组总有效率52.24%,2组疗效差异具有显著性.治疗中无严重不良反应发生.硫酸氢氯吡格雷治疗组2型糖尿病患者胴动脉、足背动脉的内径增大,血流速度增加;ABI明显升高,差异均具有显著性.阿司匹林治疗组2型糖尿病患者恫动脉、足背动脉内径增大,血流速度有所增加,ABI有所升高,但差异无显著性.结论 硫酸氢氯吡格雷通过对血小板聚集的影响,能明显改善2型糖尿病患者下肢动脉的血流,可用于2型糖尿病下肢动脉病变的治疗.

飞行员二叶式主动脉瓣一例

一、临床资料患者男性,40岁,歼-7飞行员,总飞行时间1900 h.患者于2006年7月,在我院改装体检时发现主动脉瓣区收缩期杂音.患者诉剧烈活动后有心悸、胸闷、心前区不适,偶有头晕和乏力等症状.查体:一般情况好,无口唇紫绀,血压110/70 mm Hg.肺部检查未见异常.心前区无隆起及震颤,心浊音界无扩大,心音有力,A2＞P2,心率72次/min,律齐,胸骨右缘第二肋间可闻及Ⅱ级吹风样收缩期杂音,不传导,其余各瓣膜区未闻及杂音.心电图正常,胸部X片未见异常.

微型Doppler和内窥镜在脑动脉瘤手术中的应用

目的 探讨Doppler微型探头和硬性神经内窥镜在脑动脉瘤手术中的应用价值.方法 2005 年4月至 2006年7月,96位脑动脉瘤患者在手术中同时应用Doppler和内窥镜,动脉瘤数为107个.Doppler探头的直径为 1.5 mm,频率为 20 MHz;内窥镜有0、30、70三种角度.在动脉瘤夹闭前和(或)夹闭后使用Doppler和神经内窥镜.结果 107个动脉瘤中的39个动脉瘤,内窥镜提供了显微镜所没有提供的信息;19例在内窥镜和Doppler探查后对动脉瘤夹进行了调整,其中10例因瘤颈不完全夹闭, 9例因穿通支受到动脉瘤夹的影响.结论 Doppler和神经内窥镜在动脉瘤手术中具有应用价值,可在夹闭前和(或)夹闭后应用.

射频消融对室上性心动过速(左侧旁道)患者左室功能的影响

目的观察射频消融术(RFCA)对房室折返性心动过速(左侧旁道)[AVRT(L)]患者左室功能的影响.方法利用二维和Doppler超声检查AVRT(L)患者手术前、后三天左室收缩功能及舒张期充盈情况.为提高敏感性,检查时增加了三级等长收缩运动.结果 (1)在各级运动中心率(HR)、收缩压(SBp)、舒张压(DBp)均显著增加,但三者均值分别不超过90 bpm、160 mmHg、95 mmHg,运动后五分钟均恢复.(2)RFCA术前、后同级运动量时左室功能各参数无显著变化.结论对于AVRT(L)患者,在有经验医师操作下,RFCA术中施放总能量在一定范围内时,对左室功能无影响.

术中微型Doppler探头监测在脑动脉瘤手术中的应用

目的 探讨Doppler微型探头在脑动脉瘤手术中的价值.方法 作者将直径1.5 mm,频率20 MHz的Doppler微型探头应用于80位患者的86个脑动脉瘤的术中监测.在动脉瘤夹闭前和/或夹闭后都使用Doppler.结果 通过Doppler探测,有9例因发现不完全夹闭而对动脉瘤夹进行了调整.术中有2例发生动脉瘤破裂,7例因为发现载瘤动脉或穿通支血流受影响而对动脉瘤夹进行了调整.结论 Doppler在动脉瘤夹闭前后都有应用价值.

Objective: To study the curative effect of wilsoniiinjecta on severe head injury (SHI).Methods: A total of 120 patients with SHI weredivided randomly into 2 groups, the patients treated withconventional methods as Group A (n = 60) and the patientstreated with wilsonii injecta as Group B (n = 60). Thechanges of neural function indexes were evaluated withGlasgow Coma Scale (GCS) before treatment and withGlasgow Outcome Scale ( GOS ) after treatment,simultaneously, the paramneters of hemorrheological indexes(HI), brain electrical activity map ( BEAM ) andtranscranial Doppler sonography (TCD) were observedbefore and after treatment.Results: In Group B, the clinical GCS, the HI, theBEAM and the prognosis GOS were improved much morethan those in Group A. And the TCD parameters in GroupB decreased, which had significant difference comparedwith that in Group A (P ＜0.01).Conclusions: Wilsonii injecta can rapidly improve theinjured persons' conscious states, the abnormal BEAM and the surviving quality. It suggests that the improvement of the HI is related to the relief of the vasospasm of thearterial blood vessels in the brain, which may be one of theimportant mechanisms of wilsonii injecta in improving theprognosis.