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find Keyword "术前诊断" 4 results
  • Eight Cases Review of Obturator Hernia

    目的 探讨闭孔疝的诊断和治疗方法。方法 回顾性分析了我院2001年10月至2009年8月期间收治并经手术证实的8例闭孔疝患者的临床资料。结果 8例均为女性,其中7例是老年、体弱的多产妇,1例是已婚年轻女性。平均年龄74.6岁(46~85岁),平均体重为39.1 kg(34~43 kg),平均生育5胎(1~10胎)。8例患者中5例术前经CT检查确诊而行手术治疗,3例由外院转入者在行急诊剖腹探查术中确诊。7例行坏死小肠切除吻合术,1例行嵌頓小肠复位术。 术后4例出现并发症:1例肺炎、1例切口感染、1例低蛋白水肿、1例为酸中毒和低血钾(死亡)。7例痊愈出院,1例死亡。结论 闭孔疝缺乏特异性表现,对年老体弱的经产妇出现腹痛、呕吐和股部疼痛应想到闭孔疝的可能;CT检查能提高闭孔疝的诊断率。准确的诊断和及时的手术干预是改善闭孔疝患者预后的关键。

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  • Application Value of CT in Preoperative Diagnosis of Omental Torsion

    ObjectiveTo summarize the clinical features and imaging features of CT in the omental torsion, and in order to reduce the misdiagnosis and missed diagnosis rate of imaging features. MethodsThe data of 16 cases of omental torsion (secondary 15 cases, primary 1 case) and 286 cases of acute appendicitis (eliminated the subhepatic and retroperitoneal ectopic appendix) in our hospital from 1998 to 2014 were retrospectively analyzed. ResultsEleven cases of omental torsion suffered from the shifting pain in right lower quadrant. No obvious shifting abdominal pain was observed in other 4 cases whose main manifestations were abdominal tenderness and rebound tenderness around umbilicus. The patient of the remaining 1 case had enclosed mass in the area of left groin with pain and suffered from continuous periumbilical pain. Abdominal spiral CT examination was performed in 16 patients before operation. Increased signal intensity of globular soft tissue, which deviating from McBurney's point, was found at level of distal umbilicus by preoperative spiral CT in 13 cases. One case of omental torsion associated with ncarcerated inguinal hernia was missed. ConclusionsOmental torsion manifests chiefly shifting pain in right lower quadrant, abdominal tenderness, and rebound tenderness around umbilicus. It is easily confused with appendicitis. Abdominal spiral CT should be chosen as a preferred means in preoperative diagnosis of omental torsion.

    Release date:2016-10-25 06:10 Export PDF Favorites Scan
  • Risk assessment of thyroid papillary carcinoma with ultrasound

    ObjectiveTo evaluate the value of preoperative risk assessment of papillary thyroid carcinoma with ultrasound for clinic diagnosis and treatment.MethodsThe data of 400 patients with papillary thyroid carcinoma received operative treatment in 2017 were retrospectively analyzed. Recorded and analyzed the ultrasonic risk assessment and postoperative grading of clinic risk assessment, to evaluate coherence and correlation between them.ResultsThere were 400 lesions with an average size of (12.8±8.5) mm. Among 400 lesions, diameter of 214 lesions less than 10 mm, diameter of 178 lesions were between 10 mm and 40 mm, and diameter of 8 lesions were larger than 40 mm. A total of 242 cases had lymph node metastasis and 309 cases had capsule invasion. Clinical and ultrasoud risk assessment was performed on 400 lesions. There were 224 lesions with low risk of clinical risk stratification vs. 111 lesions with low ultrasonic risk, 148 lesions with intermediate risk of clinical risk stratification vs. 270 lesions with intermediate ultrasonic risk, and 28 lesions with high risk of clinical risk stratification vs. 19 lesions with high ultrasonic risk. The consistency of postoperative recurrence risk stratification and preoperative ultrasound recurrence risk stratification was moderate (κ=0.414, P<0.01). In addition, the consistency between ultrasound examination and clinical lymph node metastasis was poor (κ=0.291, P<0.05), and the consistency of invasion of the capsule was moderate (κ=0.402, P<0.05).ConclusionPre- operative evaluation of recurrence risk grading before thyroid ultrasound, focusing on individualized preoperative assessment, the assessment is more detailed and detailed, and is helpful for follow-up treatment and early screening for recurrence risk.

    Release date:2018-12-13 02:01 Export PDF Favorites Scan
  • 胰腺少见富血供占位病变临床诊治分析

    目的 探讨胰腺少见富血供占位病变的临床特点,为临床该类病变患者的诊治提供参考。 方法 回顾性分析4例胰腺富血供占位病变患者的一般情况、症状体征、辅助检查、影像学检查、手术情况及术后病理结果。 结果 4例患者均无特异性症状和体征,辅助检查无明显异常,影像学检查发现胰腺富血供占位病变而接受治疗。1例诊断胃十二指肠动脉瘤行介入治疗,余3例患者均行胰体尾+脾脏切除术;3例外科手术患者术后病理诊断分别为胰腺内副脾、胰腺微囊型浆液性囊腺瘤和肾透明细胞癌胰腺转移。4例患者术后恢复良好,胰腺内副脾患者合并肝脏占位,行肝脏占位穿刺活检考虑肝脏炎性假瘤。 结论 胰腺少见富血供占位病变术前诊断困难,需结合临床资料及辅助检验结果综合分析,联合多种影像学检查,以提高术前诊断准确率而实施合理的治疗。

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