目的 報告四川大學華西醫(yī)院蘆山地震傷員靜脈血栓篩查與防治的情況。方法 采用血管彩色多普勒篩查該院收治的蘆山地震傷員，對檢出靜脈血栓的傷員進行合理治療；對未發(fā)現(xiàn)靜脈血栓者進行早期預防。結(jié)果 截至震后11天，采用血管彩色多普勒篩查仍在四川大學華西醫(yī)院住院治療的235例蘆山地震傷員，共檢出26例靜脈血栓傷員，其中下肢靜脈血栓25例，上肢靜脈血栓1例。采用單純康復干預及單純藥物干預各3例，康復干預聯(lián)合藥物干預20例。截至震后30天，26例靜脈血栓傷員復查結(jié)果顯示，11例好轉(zhuǎn)（5例完全再通，6例部分再通）。地震傷員進行藥物及其他干預，其中只予藥物干預的3例傷員有1例靜脈血栓完全再通，只予康復干預的3例傷員有1例靜脈血栓部分再通，藥物聯(lián)合其他干預措施的20例傷員有4例完全再通，5例部分再通。結(jié)論 蘆山地震靜脈血栓傷員大部分為老年及女性，絕大多數(shù)在ICU住院，大部分存在不同程度骨折，及時篩查防治靜脈血栓可緩解局部疼痛，促使其早期進入康復治療，防止肺栓塞等風險發(fā)生。對檢出靜脈血栓者采取康復和/或藥物干預，對未檢出靜脈血栓但存在高危因素者采取康復和/或藥物干預，能有效防治血栓進一步形成及血栓脫落帶來的不良后果。
目的 探討彩色多普勒超聲在透析患者動靜脈內(nèi)瘺并發(fā)癥中的應用價值。 方法 2009年1月－2012年4月應用彩色多普勒超聲檢測129例透析患者動靜脈內(nèi)瘺瘺口、橈動脈、頭靜脈的解剖及血流動力學狀況。 結(jié)果 129例透析患者動靜脈內(nèi)瘺中103例動靜脈內(nèi)瘺通暢，12例血栓形成，7例狹窄，4例靜脈瘤樣擴張，2例血腫，1例局部感染。 結(jié)論 彩色多普勒超聲是監(jiān)測透析患者動靜脈內(nèi)瘺血管通路的無創(chuàng)、簡便、快速、有效的檢測方法，能明確診斷動靜脈內(nèi)瘺并發(fā)癥，還能快速診斷其低血流量原因，從而為臨床及時治療提供科學依據(jù)。
目的 探討經(jīng)腹部彩色多普勒超聲（腹部超聲）聯(lián)合高頻超聲診斷良性膽囊息肉樣病變的價值。 方法 回顧性分析2008年1月－2011年11月121例腹部超聲聯(lián)合高頻超聲檢查提示為良性膽囊息肉樣病變、且有手術病理檢查結(jié)果的患者資料進行對照，以此評價經(jīng)腹部超聲聯(lián)合高頻超聲對良性膽囊息肉樣病變的診斷準確性。 結(jié)果 121例術前經(jīng)腹部超聲聯(lián)合高頻超聲診斷為良性膽囊息肉樣病變的患者，手術后病理檢查結(jié)果示膽固醇息肉62例（51.24%），炎性息肉27例（22.31%），腺瘤6例（4.96%），腺癌3例（2.48%），膽囊結(jié)石14例（11.57%），腺肌癥3例（2.48%），囊壁腺體結(jié)構紊亂3例（2.48%），黏膜下層軟結(jié)節(jié)3例（2.48%）。經(jīng)腹部超聲聯(lián)合高頻超聲與手術后病理對比檢查，其診斷符合率為78.51%（95/121），誤診率為21.49%（26/121）。 結(jié)論 經(jīng)腹部超聲聯(lián)合高頻超聲檢查對良性膽囊息肉樣病變診斷準確性較高，可為臨床預防膽囊癌前病變提供依據(jù)。Objective To investigate the value of abdominal color Doppler ultrasonography (CDU) combined with high-frequency ultrasonography (HFU) diagnosing benign polypoid lesion of gallbladder (B-PLG). Methods A total of 121 patients with B-PLG diagnosed by CDU combined with HFU between January 2008 and November 2011 were randomly selected. All of the patients underwent the surgery and had the record of surgical pathological examination results, which were compared with the results of the ultrasonography in order to evaluate the diagnostic accuracy of CDU combined with HFU for B-PLG. Results In 121 patients with B-PLG diagnosed by CDU combined with HFU before the surgery, cholesterol polyp was found in 62 (51.24%), infective polyp was found in 27 (22.31%), adenoma was found in 6 (4.96%), adenocarcinoma was found in 3 (2.48%), gallstones was found in 14 (11.57%), adenomyosis was found in 3 (2.48%), the wall structure gland disorder was found in 3 (2.48%), and submucosal soft nodules was found in 3 (2.48%) after the surgical pathological examination. Coincidence rate between CDU combined with HFU diagnosis and surgical pathological diagnosiswas 78.51% (95/121), and the misdiagnosis rate of CDU combined with HFU was 21.49% (26/121). Conclusion The accuracy of CDU combined with HFU diagnosing B-PLG is high, which can help to prevent precancerous lesion of gallbladder cancer.
目的 探討彩色多普勒超聲診斷膀胱破裂的診斷價值,以提高膀胱破裂的超聲診斷水平。 方法 回顧性分析2002年1月－2011年9月術前行彩色超聲檢查診斷膀胱破裂并經(jīng)手術證實的5例患者資料，下腹加壓檢查和經(jīng)導尿管注水試驗檢查作為超聲判斷有無膀胱破裂的重要檢查方法。 結(jié)果 5例均為腹膜外型膀胱破裂,彩色多普勒血流顯像明確診斷4例，漏診1例，超聲檢查是診斷膀胱破裂的有效方法。 結(jié)論 彩色多普勒超聲可以作為膀胱破裂的首選檢查技術。Objective To investigate the value of color doppler flow image (CDFI) in diagnosing bladder rupture, in order to promote the ultrasound diagnosis for the disease. Methods We retrospectively analyzed the medical data of 5 patients with bladder rupture diagnosed by CDFI before operation and confirmed by surgery. Pressing the lower abdomen and injecting water through catheter were the main examination methods for CDFI in diagnosing bladder rupture. Results All the 5 cases were bladder rupture of extraperitoneal type. Four were diagnosed with CDFI, and 1 was misdiagnosed. The ultrasonic examination was an effective technology in diagnosing bladder rupture. Conclusion CDFI may be regarded as the first diagnostic technology for bladder rupture.
【摘要】 目的 探討2型糖尿?。═2DM）胰島素抵抗導致糖尿病性心功能不全的臨床表現(xiàn)特點及相關激素的改變?！》椒ā?008年1-4月對T2DM患者35例（胰島素抵抗指數(shù)HOMA-IRlt;2.69者19例為A1組，HOMA-IR≥2.69者16例為A2組）及健康體檢者20人B組測體重指數(shù)（BMI）、空腹血糖（FPG）、胰島素、心鈉素（ANP）、腦鈉素（BNP）水平；心臟彩色多普勒超聲分別測E/A、e/a、S/D、LVEF、DT期?！〗Y(jié)果 A2組BMI較A1、B組均明顯增加（Plt;0.05），A1、B組間差異無統(tǒng)計學意義（Pgt;0.05）。ANP、BNP及DT值在A1、A2組均較B組增高（Plt;0.05），BNP在A2組高于A1組（Plt;0.05），ANP、DT值在A1、A2組間差異均無統(tǒng)計學意義（Pgt;0.05）。E/A、e/a和S/D在A1、A2組均較B組降低（Plt;0.05），A1、A2組間差異均無統(tǒng)計學意義（Pgt;0.05）。A2組患者LVEF較A1、B組均明顯降低（Plt;0.05），A1、B組間差異無統(tǒng)計學意義（Pgt;0.05）。 結(jié)論 隨著胰島素抵抗加重，心肌舒張順應性較差和收縮力下降，伴隨相關激素（心臟利鈉肽）分泌增加，最終產(chǎn)生心功能不全的臨床表現(xiàn)、體征及多普勒超聲心動圖表現(xiàn)?！続bstract】 Objective To investigate the clinical features and related hormone changes of diabetic cardiac insufficiency leaded by insulin resistance in type 2 diabetes mellitus (T2DM). Methods From January to April 2008, 35 patients with T2DM (group A1: HOMA-IRlt;2.69, n=19; group A2: HOMA-IR≥ 2.69, n=16) and 20 subjects without T2DM (group B) were enrolled. The body mass index (BMI), fasting plasma glucose (FPG), insulin (FINS), atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and E/A, e/a, S/D, LVEF and DT stage of all subjects were detected. Results The BMI in group A2 was higher than those in group A1 and group B (Plt;0.05), while the difference between the later two groups was not statistically significant (Pgt;0.05). The ANP, BNP and DT stage were all higher than those in group B (Plt;0.05), the BNP was higher in group A2 than in group A1 (Plt;0.05), while the difference of neither ANP nor DT stage between the later two groups was statistically significant (Pgt;0.05). The values of E/A, e/a and S/D in group A1 and A2 were all lower than those in group B (Plt;0.05), while there were no statistically significant diferences between group A1 and A2 (Pgt;0.05). The values of LVEF of group A1 and A2 were both significantly reduced than that in group B (Plt;0.05), and the values in group A2 were the lowest (Plt;0.05). Conclusion With the aggravating of insulin resistance, myocardial contractility and diastolic function will decline, meanwhile the ANP and BNP secretion will increase, and then the clinical and echocardiographic manifestation will appear.
【摘要】 目的 探討彈性成像在甲狀腺微小癌診斷中的應用價值?！》椒ā』仡櫺苑治鰪?007年12月-2008年4月間經(jīng)病理證實的10例甲狀腺微小癌患者共11個病灶的超聲表現(xiàn)。 結(jié)果 彩色多普勒超聲診斷甲狀腺微小癌8例8個病灶，利用彈性成像技術診斷10例10灶。傳統(tǒng)彩色多普勒超聲對甲狀腺微小癌的診斷率為72.7%；利用彈性成像技術對甲狀腺微小癌的診斷率為90.9%。 結(jié)論 彈性成像技術對于甲狀腺微小癌是對彩色多普勒超聲檢查的有益的補充，能夠顯著提高超聲對甲狀腺微小癌診斷的準確性。【Abstract】 Objective To evaluate the application of US-elastography in diagnosis of thyroid microcacinoma. Methods The images of color ultrasound and ultrasound elastography from 11 lesions of 10 patients with thyroid micro-carcinoma diagnosed via histopathology between December 2007 and April 2008 were retrospectively analyzed. Results Eight patients with eight lesions were found by colour ultrasound and 10 patients with 10 lesions were observed by ultrasound elastography. The diagnosis accurate rate of ultrasonography was about 72.7% and of ultrasound elastography was about 90.0%. Conclusion US-Elastography is a beneficial addition in diagnosis of thyroid microcacinoma by colour ultrasound. It can remarkably develop the accurate rate of the diagnosis of the disease.
【摘要】 目的 探討彩色多普勒超聲對小兒腸系膜淋巴結(jié)炎診斷價值?！》椒ā?1例彩色多普勒超聲檢查診斷為腸系膜淋巴結(jié)炎患兒的淋巴結(jié)大小、數(shù)目及血流情況與33例正常組的彩色多普勒超聲檢查腸系膜淋巴結(jié)的情況進行統(tǒng)計、對比分析?！〗Y(jié)果 71例彩色多普勒超聲診斷為腸系膜淋巴結(jié)炎的患兒中，5例剖腹探查診斷為闌尾炎合并闌尾周圍淋巴結(jié)腫大，5例失訪。余61例患兒淋巴結(jié)大小、同一切面淋巴結(jié)數(shù)目與正常組比較，差異有統(tǒng)計學意義（Plt;0.01），淋巴結(jié)內(nèi)血流情況與正常組比較，差異有統(tǒng)計學意義（Plt;0.05）。 結(jié)論 彩色多普勒超聲在腸系膜淋巴結(jié)炎的診斷中有重要的意義，是臨床診斷小兒腸系膜淋巴結(jié)炎的首選輔助檢查方法之一。
【摘要】 目的 評價彩色多普勒超聲對腎動脈狹窄（ARAS）的診斷指標及準確性?！》椒ā?999年10月-2008年12月對患有高血壓病的58例共113根腎動脈進行彩色多普勒超聲檢查。每例患者均測量腎動脈峰值流速（PSV）與腎內(nèi)段動脈的阻力指數(shù)及腎臟長軸。在雙盲條件下，以患者腎動脈造影、MRI血管造影及CT血管造影為標準，評價彩色多普勒超聲診斷ARAS的診斷指標及準確性?！〗Y(jié)果 彩色多普勒超聲診斷腎動脈狹窄的敏感性為60%，特異性為83%，陽性預測值為83%，陰性預測值為61%?；紓?cè)腎長軸小于健側(cè)腎長軸，患側(cè)腎峰值流速高于健側(cè)腎峰值流速，患側(cè)腎阻力指數(shù)低于健側(cè)腎阻力指數(shù)。 結(jié)論 腎動脈彩色多普勒超聲對于腎動脈狹窄初篩診斷以及評價腎動脈狹窄介入治療后的近、遠期療效，是一種簡便可靠的無創(chuàng)檢查手段。【Abstract】 Objective To evaluate the accuracy and index of color Doppler ultrasonography (CDU) diagnosing renal artery stenosis (RAS).〖WTHZ〗Methods〖WTBZ〗A total of 113 renal arteries of 58 patients with hypertension from October 1999 to December 2008 were examined by CDU. The peak systolic velocity (PSV) of the renal artery, resistant index of interior artery of kidney,and long axis of kidney of each patient were obtained. Under the double-blind condition, accuracy and diagnostic index of CDU for diagnosing RAS were evaluated according to the standard of renal arteriography, magnetic resonance angiography or computerized tomography angiography. Results The sensitivity of CDU for diagnosing RAS was 60%, specificity was 83%, positive predictive value was 83%, and negative predictive value was 61%. Long axis of kidney in patients with RAS was shorter than that in the healthy ones. The PSV in patients with RAS was higher than that in the healthy ones, and the resistant index of section artery of kidney in patients with RAS was lower than that in the healthy ones. Conclusion CDU is an easy and reliable non-invasive examination for early diagnosis and screening of RAS and for evaluating a short-or long-term therapeutic effect.
【摘要】 目的 采用多柔比星（doxorubicin，DOX）制備心肌損傷動物模型，評價各種檢測心功能變化方法的意義。 方法 14只新西蘭大白兔，DOX耳緣靜脈注射，每周3 mg/kg，共10周。分別于給藥前、第4周末及實驗結(jié)束時測定血清肌鈣蛋白Ⅰ（cTnI）和腦鈉肽（BNP）水平，彩色多普勒超聲心動圖檢測心功能變化，并觀察心肌組織病理形態(tài)學改變及心肌細胞凋亡情況?！〗Y(jié)果 使用DOX前后對比，血清cTnI和BNP濃度升高（Plt;0.05）；左室射血分數(shù)（LVEF）和左室短軸縮短率（LVFS）下降（Plt;0.05）；心肌組織病理顯示心肌細胞出現(xiàn)不同程度的空泡變性與水腫，細胞間隙明顯增寬，大量炎性細胞浸潤。心肌細胞凋亡明顯增加?！〗Y(jié)論 結(jié)合心臟超聲檢查和血清cTnI、BNP指標檢測可判斷心肌損傷程度。【Abstract】 Objective To observe the changes of heart function caused by doxorubicin in rabbits. Methods A total of 14 New-Zealand white rabbits were intravenous-injected with doxorubicin with a dosage of 3 mg/kg intravenously once a week, and the accumulative dose was 30 mg/kg. Before the medication and at the 4th and 10th weekend after the medication, the serum levels of cardiac troponin I (cTnI) and brain natriuretic peptide (BNP) were measured; left ventricular ejection function (LVEF) and left ventricular fractional shortening (LVFS) were performed on the rabbits respectively. At the 10th weekend, the pathological changes of cardiac tissue and the apoptosis of myocardial cell were detected. Results The levels of cTnI and BNP significantly increased (Plt;0.05), and the LVEF and LVFS markedly decreased (Plt;0.05) after the administration of doxorubicin. Uneven vacuolar degeneration and edema of cardiocytes could be observed with a wide cell spaces and inflammatory cell infiltration in the histopathological slices. Conclusion The combined application of heart sonography with the detection of the serum levels of cTnI and BNP can evaluate the degree of myocardial damage of the rabbits models very well.
目的:探討乳腺良惡性腫塊二維超聲圖像和彩色多普勒血流狀況,提高乳腺腫塊的超聲診斷符合率。方法:回顧性分析105例乳腺腫塊的二維及彩色多普勒超聲圖像特點。結(jié)果:本組惡性腫塊37例,超聲診斷和疑診惡性腫塊32例,符合率為865%(32/37);良性腫塊68例,超聲診斷良性腫塊58例,符合率為853%(58/68)。乳腺良惡性腫塊在形態(tài)、 邊界、 包膜、 內(nèi)部回聲、 后方回聲、 沙粒樣鈣化、血流形態(tài)分布,血流動力學等方面具有明顯差異。結(jié)論:二維及彩色多普勒超聲對良惡性乳腺腫塊有較高鑒別診斷價值。