止血芳酸致过敏性休克1例

止血芳酸引起过敏性休克,临床所见不多,文献报道亦属少见。现将我们临床所见静脉推注止血芳酸引起过敏性休克1例,作一报道。 女,46岁,于1991年10月12日因月经周期紊乱,流血量过多,在本院妇产科诊断为“功能性子宫出血”。给予止血芳酸0.3克加入25％葡萄糖20ml内缓慢静推,约推至10ml时,病人出现胸闷、气急、口唇紫红、烦燥不安、恶心呕吐、四肢厥冷,大汗淋漓、面色苍白,继之神志不清,脉博细弱、血压测不出、双肺2分钟未闻及呼吸音,心音低钝、心率130次/min。立即给以吸氧、去甲肾上腺素1ml,非那根25mg肌注,10％葡萄糖酸     

父子同型输血致血红蛋白尿1例

患儿男，2岁，因中度营养性贫血（RBC2．0×1012／L，Hb61g／L，R．C4％），首次输其父同型鲜血80毫升，输血顺利，输血后约5分钟出现酱油色小便一次，检蛋白（），镜检（－），OBC（），经予地塞米松等治疗，一小时后第2次小便检蛋白（＋），镜检（－），OB（十），3小时第3次小便清，检蛋白（－），镜检（－），OB（－），检血RBC20×1012／L．Hb60g／L，R．C10％，P．C140×10’／L，RBC大小不等，有碎片及有核RBC，直接抗人球蛋白试验（十），冷凝集素试验1。8。远期随访小便（一），系自身免疫性溶血造成。父子同型输血致…     

新利尿合剂治疗急性肾功能衰竭16例

多巴胺、酚妥拉明、山莨菪碱三合用治疗急性肾功能衰竭（下简称急性肾衰）被称为新利尿合剂。作应用此剂治疗急性肾衰16例，取得满意疗效，分析如下。     

多巴酚丁胺心电图与~（99m）Tc－MIBI心肌显像对冠心病诊断价值比较

目的：比较多巴酚丁胺心电图（Ｄｏｂｕ－ＥＣＧ）与￣（９９ｍ）Ｔｃ－ＭＩＢＩ心肌显像（Ｄｏｂｕ－ＥＣＴ）诊断冠心病的价值。方法：对６９例拟诊冠心病而无心肌梗塞患者在行冠状动脉造影时进行多巴酚丁胺心肌显像检查。结果：Ｄｏｂｕ－ＥＣＴ诊断冠心病的敏感性和准确度优于Ｄｏｂｕ－ＥＣＧ（９１．７％对４７．２％，Ｐ＜０．０１８，５．５％对６６．７％，Ｐ＜０．０５），特异性二者之间无差异。诊断冠状动脉单支、双支、三支病变的敏感性Ｄｏｂｕ－ＥＣＴ优于Ｄｏｂｕ－ＥＣＧ。诊断前降支、右冠状动脉的敏感性，Ｄｏｂｕ－ＥＣＴ高于Ｄｏｂｕ－ＥＣＧ。在研究中无一例出现严重副作用。结论：Ｄｏｂｕ－ＥＣＴ对识别冠心病存在与否及冠心病冠脉病变程度和范围均优于Ｄｏｂｕ－ＥＣＧ。     

Detecting residual ischemia and identifying coronary artery disease after myoc ardial infarction using dobutamine technetium-99m-MIBI SPECT

Objective To evaluate dobutamine technetium-99m methoxy isobutyl nitrile (sestamibi) single-photon emission computed tomography (Dobu-ECT) in detecting residual ischemia and identifying coronary vessel disease after myocardial infarction.Methods Sixty-two patients with confirmed myocardial infarction were studied with Dobu-ECT at the time of coronary artery angiography. Dobutamine was administered intravenously in incremental rates from 5 to 40 μg· kg(-1)·min (-1) at 3-minute intervals. At the highest infusion rate, 7.4×10[8] Bq (99m) Tc-MIBI was injected intravenously, and tomographic imaging was performed after one hour. Resting images were taken after 24 hours, with a second dose of (99m)Tc-MIBI.Results The sensitivity of Dobu-ECT in detecting residual ischemia of myocardial infarction was 76%, which was higher than dobutamine electrocardiography (Dobu-ECG). Regardless of the single-, double- or triple-vessel diseases, Dobu-ECT was superior to Dobu-ECG in identifying residual ischemia (56% vs 4%, 86% vs 27%, 100% vs 47%, P<0.01, respectively). The incidence of residual ischemia in patients receiving thrombolytic therapy was 67%, lower than patients without thrombolysis (72%) or those with an old myocardial infarction (94%).But the differences were not statistically significant. Dobu-ECT detected only 56% of ischemias in non-infarct related myocardium. Eighty-two percent of all significantly stenosed vessels were detected with Dobu-ECT, and 84% of patients with multivessel disease could be accurately identified. The sensitivity of Dobu-ECT was significantly greater for detecting severe stenosis over moderate stenosis. The sensitivity for detecting stenosis in the right coronary artery was greater than left anterior descending or left circumflex, but its specificity was lower.Conclusion Dobu-ECT can identify residual ischemia, as well as its location and extent after myocardial infarction. Dobu-ECT can also accurately detect significantly stenosed vessels.     

脑活素治疗新生儿缺氧缺血性脑病26例分析

新生儿缺氧缺血性脑病是新生儿死亡及致残的重要原因。长期以来,对新生儿缺氧缺血性脑病的治疗常限于支持疗法和对症处理疗效不佳。1993～1996年,我们共收治新生儿缺氧缺血性脑病46例,在原支持疗法和对症处理的基础上加用脑活素治疗26例,取得较好疗效,报道如下。     

应用卵巢癌单抗放免显像的临床意义

应用我室制备卵巢上皮癌单抗 COC 183 B_2经~(131)Ⅱ标记后进行45例 RⅡ,30例为术前诊为卵巢癌或可疑者,15例为卵巢上皮癌手术化疗后追踪患者,RII结果与手术病理对照,敏感性达87.5％,特异性达93.1％;如按单抗与癌组织免疫组化染色衡量,则分别为100％及96.7％。追踪治疗后患者,先作第一次手术癌组织与COC183 B_2、PAP染色,RII均与此结果符合。合并有腹水患者先取腹水,用多种单抗进行免疫细胞化学染色,选其阳性反应强的单抗作RII,可提高显像率及准确性。本文提示选择与腹水中癌细胞免疫细胞化学染色,及与癌组织免疫组化染色的单抗来作RII是成功的关键。为临床分期、鉴别诊断及追踪检测等,提供有力的手段。     

~（99m）Tc－MIBI显像用于诊断门静脉高压症的实验研究

作者通过实验性肝硬变大鼠心、肝对￣（９９ｍ）Ｔｃ－ＭＩＢＩ（￣（９９ｍ）Ｔｃ－甲氧基异腈）的显像考察了其诊断门静脉高压症的价值。经直肠或结肠中静脉注入￣（９９ｍ）Ｔｃ－ＭＩＢＩ后定时行心、肝区γ－摄像，由此求得心／肝比（Ｎ／Ｌ）和分流指数（ＳＩ）。结果显示，肝硬变鼠的Ｈ／Ｌ。明显高于正常鼠；直肠给药时Ｈ／Ｌ与自由门静脉压力（ＦＰＰ）的相关性较结肠中静脉给药时为好，说明经直肠给药是可靠的。经直肠给药的肝硬变鼠的Ｈ／Ｌ与ＦＰＰ呈正相关（γ＝０．８３，Ｐ＜０．０１），由回归方程ＦＰＰ（ｋＰａ）＝０．２４＋４．０６（Ｈ／Ｌ）推算的肝硬变大鼠的门静脉压力与实测的ＦＰＰ有良好的相关性（γ＝０．８５，ｐ＜０．０１），表明该方法可用于肝硬变时门静脉压力的预测。