简介:摘要目的讨论自发性蛛网膜下腔出血临床诊断。方法根据患者临床表现结合辅助检查结果进行诊断并鉴别。结论影像学检查突发性头痛为特征性症状,同时突然出现假性脑膜炎,则通常很易诊断。不过,为确定大脑半球和脑干或脑室周围脑脊液的血液,必须急诊做CT扫描。如CT扫描阴性(通常因为SAH较轻或在发作后的几天以上进行CT扫描),或当时当地不能做CT(发作1小时左右),则必须做腰穿检查。
简介:摘要随着近几年对网膜囊切除研究的深入,对横结肠系膜前叶及胰腺被膜癌转移情况的认识日益提高通过最近关于胃癌根治性手术中网膜囊切除的研究进展,本文总结了横结肠系膜前叶及胰腺被膜转移的病理检测方法、转移的危险因素以及两者切除的临床疗效等。目前研究表明对于没有浆膜浸润的胃癌病人最好不进行网膜囊的切除,不少学者亦主张早期胃癌的缩小手术可不切除横结肠系膜前叶及胰腺被膜,但当发生1)术中探查发现肿瘤侵犯横结肠系膜或胰腺被膜;2)肿瘤已穿透浆膜层;3)肿瘤分化程度低;4)术前或术中证实为Ⅲ、Ⅳ期胃癌等情况时可虑行网膜囊的切除
简介:AIM:Toreporttheeffectivenessandsafetyofprimary23-Gauge(G)vitreoretinalsurgeryforrhegmatogenousretinaldetachment(RRD).·METHODS:Inthisretrospectivestudy,49eyesof49consecutivepatientswhounderwentprimary23-Gtransconjunctivalsuturelessvitrectomy(TSV)forRRDbetweenJanuary2007andJuly2009atourinstitutionwereevaluated.·RESULTS:Meanfollow-uptimewas8.9±7.7months(1-28months).Retinalreattachmentwasachievedwithasingleoperationin47(95.9%)of49eyes.Intwoeyes(4.1%),retinalredetachmentduetonewbreakswassuccessfullytreatedwithreoperationusingthe23-GTSVsystem.MeanlogMARvisualacuitywas2.01±0.47preoperativelyand1.3±0.5postoperatively(P<0.001,Pairedt-test).Meanpreoperativeintraocularpressure(IOP)was14.1±2.8mmHg.MeanpostoperativeIOPwas12.3±3.6mmHgat1day,13.1±2.1mmHgat1week,14.3±2.2mmHgat1month.Iatrogenicperipheralretinalbreakwasobservedin1eye(2.0%)intraoperatively.Nosutureswererequiredtoclosethescleralorconjunctivalopenings,andnoeyesrequiredconvertionofsurgeryto20-Gvitrectomy.·CONCLUSION:Primary23-GTSVsystemwasobservedtobeeffectiveandsafeinthetreatmentofRRD.