【摘要】 目的 探索腹部淋巴結結核在多層螺旋CT（multi-layered screw CT，MSCT）掃描中CT值動態變化規律。 方法 2007年1月—2010年8月，收集經診斷性治療或診斷性活檢確診的17例患者腹部淋巴結結核，記錄腫大淋巴結數量、大小、位置，測量興趣淋巴結中心、次中心、邊緣部平掃及注藥后20、60、120、180、360 s的CT值。 結果 共檢測出腫大淋巴結269個，主要分布在肝十二指腸韌帶、門腔間隙、肝胃韌帶、腸系膜根部和腰3平面以上腹主動脈周圍，CT值（49.2±13.6） Hu；強化淋巴結215個，選擇21個興趣淋巴結，測得注藥20、60、120、180、360 s后強化區CT值分別為（67.7±15.3）、（75.2±14.6）、（76.3±18.7）、（75.6±13.4）、（72.6±17.4） Hu。 結論 腹部淋巴結結核動態CT值表明動脈期明顯強化，靜脈期及延時掃描強化值維持在動脈期水平呈平臺樣改變，反映了淋巴結結核慢性感染的病理狀態。【Abstract】 Objective To explore the changing rule of dynamic CT values for abdominal lymph node tuberculosis in multi-layered screw CT (MSCT) multiphasic scanning. Methods Between January 2007 and August 2010, 17 cases of abdominal lymph node tuberculosis confirmed by diagnosis treatment or diagnosis biopsy were retrospectively analyzed. The quantity, size and position of the lymph nodes were recorded, and CT plain scanning values of the interested lymph node center, subcenter, and the margin of the node, and the CT values 20, 60, 120, 180 and 360 seconds after drug administration were also measured. Results Enlargement was found in 269 lymph nodes which were mainly distributed in the liver duodenum ligament, the gate cavity gap, the hepatogastric ligament, the mesentery root and the nodes in retroperitoneal space above the third lumbar vertebra. The average CT value was (49.2±13.6) Hu. A total of 215 lymph nodes had strengthened manifestations, and 21 interested lymph nodes were chosen for the study. The average CT values for lymph nodes with strengthened manifestations 20 ,60, 120, 180, and 360 seconds after drug administration were respectively (67.7±15.3), (75.2±14.6), (76.3±18.7), (75.6±13.4), and (72.6±17.4) Hu. Conclusion Dynamic CT value of abdominal lymph node tuberculosis shows a strengthening in the arterial phase, and the values in the the venous phase and the delayed phase maintain at the arterial phase level, and do not change, which indicates a pathological state of chronic infection of the lymph node tuberculosis.
【摘要】 目的 探討腎鏡結合氣壓彈道碎石治療膀胱結石的臨床療效。 方法 分析2004年9月－2011年3月男性膀胱結石患者87例的臨床資料。結石直徑1.5~6.7 cm，使用腎鏡結合氣壓彈道碎石術治療，統計手術時間、手術并發癥。隨訪3個月，觀察有無尿道狹窄。 結果 所有患者碎石成功，平均手術時間為37 min，無殘留結石，無膀胱穿孔、感染性休克、膀胱大出血等并發癥；術后3個月隨訪，經尿道手術者均未發現尿道狹窄。 結論 腎鏡下氣壓彈道碎石術是治療膀胱結石安全、有效的方法。【Abstract】 Objective To explore the clinical efficacy of pneumatic ballistic lithotripsy via nephroscope in treating patients with bladder stones. Methods We retrospectively analyzed the clinical data of 87 patients with bladder stones from September 2004 to March 2011. The diameter of the stones were ranged from 1.5 to 6.7 cm. The patients underwent peneumatic ballistic lithotripsy via nephroscope. We recorded the operation time and complications, and observed the incidence of urethrostenosis 3 months after the beginning of the follow-up. Results All stones were fragmented and removed successfully. The average operation time was 37 minutes. No residual stone, bladder perforation, infective shock or severe bleeding of the bladder occurred. During the 3-month follow-up, no utethrostenosis occurred. Conclusion Pneumatic ballistic lithotripsy via nephroscope is a safe and efficient technique in treating bladder stones.
