阿昔洛韦治疗小儿水痘80例疗效观察

水痘是幼儿、学龄前和学龄期儿童常见的呼吸道传染病，2002年1—12月在我市造成大流行。我院在2002年1—4月期间诊治的门诊及住院患儿160例，分别采用阿昔洛韦、利巴韦林治疗收到不同的效果，现报道如下。     

硝酸甘油治疗小儿充血性心力衰竭的疗效观察

为了评价硝酸甘油 (NTG)治疗充血性心力衰竭 (CHF)的疗效 ,将125例CHF患儿随机分为两组 ,NTG组 (A组 )75例 ,常规治疗组 (B组 )50例 ,观察两组的临床疗效。NTG组6例患儿在应用小剂量NTG(0.1～0.5) μg/(kg·min)治疗前后 ,应用超声心动图测定肺毛细血管楔压 (PCWP)、肺动脉平均压 (PAMP)、射血分数 (EF)、短轴缩短率 (FS)。结果 :NTG组临床疗效明显优于常规治疗组 ;小剂量NTG明显降低患儿PCWP(P<0.01) ,而对PAMP、EF、FS无明显影响。提示对CHF患儿在常规治疗 (地高辛 卡托普利 利尿剂 )的基础上 ,合用NTG疗效显著 ,而且优于常规治疗组     

黄连素等灌肠治疗小儿腹泻病疗效观察

治疗小儿腹泻病口服药多，小儿口服困难，疗效不理想，我科采用黄连素等灌肠治疗，局部清洁灌肠后用药效果好，现报告如下：     

天一旭泰治疗小儿缺铁性贫血疗效观察

1999年2月～2001年4月，我们在烟台市区及郊区、各县的儿科门诊及儿童保健单位，对临床确诊的374例缺铁性贫血的患儿中的265例以葡萄糖酸亚铁(商品名称：天一旭泰)治疗，另109例以硫酸亚铁冲剂治疗，并进行疗效比较，现将结果报告如下：     

肝素治疗小儿重症肺炎疗效观察(附50例报告)

我院自1998年以来应用肝素治疗重症肺炎取得较好疗效,现分析报告如下。1资料与方法1·1一般资料选择1998年2月~2003年12月的住院患儿100例,均符合小儿肺炎防治方案的诊断标准[1]。随机分为治疗组和对照组:治疗组50例,男26例,女24例,男女之比为1·1:1,其中年龄1~6个月20例(40%),     

黄芪注射液治疗小儿病毒性心肌炎40例疗效观察

笔者应用黄芪注射液治疗小儿病毒性心肌炎，取得较好的疗效，现报告如下。     

赖氨匹林治疗小儿高热疗效观察

高热是儿科急性感染最常见的症状。需要及时退热处理。我们于1999年4—12月应用赖氮匹林治疗小儿高热．效果满意。现报道如下。1临床资料1．1病例选择全部病例均来自我院门诊高热患儿，共138例，年龄4个月～14岁，体温波动在38．5～40℃间，男73例，女65例。病种有：上呼吸道感染79例。支气管肺炎     

硝苯地平治疗226例小儿急性肾炎高血压疗效观察

钙离子拮抗剂在儿科肾性高血压治疗中得到临床重视,我科于1990年3月～1993年6月应用硝苯地平(nifedipine,商品名:心痛定)治疗小儿急性肾炎合并高血压226例,现报告如下。 临床资料 病例随机分为治疗组226例,观察组212例。全部病例均符合小儿急性肾炎合并高血压诊断标准(诸福棠等主编:实用儿科学.第4版.北京:人民卫生出版社     

少感汤治疗小儿急性上呼吸道感染2176例疗效观察

急性上呼吸道感染是临床上最常见的小儿感染性疾病，它累及范围广泛，症状轻重不一，轻者无明显症状，重者可因合并症而死亡。自1995年11月-2005年11月我科应用少感汤结合西医治疗小儿急性上呼吸道感染，疗效较满意。现总结报告如下。     

布地奈德联合博利康尼雾化吸入治疗小儿毛细支气管炎疗效观察

毛细支气管炎(毛支)是婴幼儿常见的下呼吸道感染性疾病,多由呼吸道合胞病毒(RSV)感染所致。流行病学资料表明,75％以上的RSV毛支以后可发展为反复发作的咳嗽和喘息,其与支气管哮喘关系密切。目前对毛支无特效疗法。本文用布地奈德混悬液联合博利康尼溶液通过微量泵雾化吸入辅助治疗30例毛支患儿,现报道如下。     

自体骨髓注射治疗单纯性骨囊肿的影像学变化与临床意义

目的观测自体骨髓注射治疗单纯性骨囊肿的影像学改变，分析其临床意义。方法自体骨髓注射治疗单纯性骨囊肿患儿27例，获随访25例，随访平均3．3年。以CR摄影判定影像学上的疗效；观测术后不同时期X线骨囊肿面积、皮质厚度的变化情况；分术前合并病理骨折组及无病理骨折组，测算术前囊肿纵径／最小皮质厚度，行组间比较。通过三维CT结合X线观察骨囊肿的基本愈合形式。结果1次注射后愈合10例，缺损愈合5例，持续存在7例（含2例无反应），复发3例。除外无反应者，术后3个月病灶内均有不同程度的密度增高；X线骨囊肿面积基本稳定，主要发生在术后649个月（21／23）；X线骨囊肿皮质厚度基本稳定，主要发生在术后9个月～1年（19／23）。除外下肢持重管状骨病变，术前合并病理骨折组及无病理骨折组囊肿纵径与最小皮质厚度比值差异显著。结论自体骨髓注射治疗单纯性骨囊肿术后随访至少1年；该法通过骨皮质增厚，囊腔内骨嵴及骨小梁向心性增生，分割包绕填塞囊腔而逐步愈合。     

纤维蛋白胶对骨骺损伤后骨桥形成的预防作用

目的 利用未成熟大鼠制作胫骨近端骨骺损伤模型,比较不同方法 修复生长板损伤的治疗效果,评价纤维蛋白胶作为一种新型生物材料应用于微创治疗方法 的可行性.方法 实验动物分为4组,A组为未损伤组,作为正常对照;B组为单纯损伤组,按照模型损伤后未予特殊处理;C组为脂肪组织填充治疗组,按照模型损伤后取自体腹股沟区脂肪组织填充损伤区,骨蜡封闭骨洞;D组为纤维蛋白胶填充治疗组,按照模型损伤后以预先配置好的纤维蛋白胶(广州倍绣生物技术有限公司)填充损伤区,骨蜡封闭骨洞.通过组织化学染色观察损伤模型的建立、损伤愈合过程以及骨桥形成情况.取材后先进行显微CT检查,再行组织学检测.比较纤维蛋白胶、脂肪作为填充材料预防治疗大鼠胫骨近端骨骺损伤后骨桥形成的情况,以及大鼠胫骨长度和近端角度的变化.结果 组织学检查显示,纤维蛋白胶和脂肪填充组损伤区域逐渐被纤维组织替代,单纯损伤组损伤区域逐渐被骨桥组织替代.纤维蛋白胶填充治疗组在避免损伤区出现不可逆的骨桥方面,与脂肪填充治疗组效果接近(P>0.05).纤维蛋白胶填充组与单纯损伤组之间存在明显差异(P<0.05),脂肪填充组与单纯损伤组之间存在显著性差异(P<0.01).结论 显微CT可以用于骨骺损伤后骨桥形成的观察研究中.纤维蛋白胶制作来源广泛,术中应用简便,效果与传统的脂肪填充治疗接近,因而推测可能作为一种新的治疗方法 引入临床,预防骨骺损伤后的骨桥形成.     

MR imaging of simple bone cysts in children: not so simple

Objective. The unicameral bone cyst (UBC) is a common cystic bone lesion seen in children. We review and summarize its MR findings, focusing on their appearance following contrast enhancement, and correlating them to known histologic features of UBC. Subjects and methods. A retrospective review of 20 cases (13 boys, 7 girls; age range, 1–17 years; mean age, 8.9) diagnosed as UBC was conducted. Clinical histories, radiographic and MR features, follow-up data, and available pathologic findings were noted. Results. At initial presentation 18 (90 %) of the patients with UBC had a history of acute or remote pathologic fracture. Cysts with history of fracture displayed heterogeneous fluid signals on T1- (n = 9, 50 %), and T2-weighted (n = 15, 83 %) MR images. Gadolinium-enhanced images were obtained in 15 of the 18 UBC cases with history of previous fracture. All showed enhancement with focal, thick peripheral, heterogeneous, or subcortical patterns. Focal nodules of homogeneous enhancement (diameter > 1 cm) within the UBC (n = 5) correlated with areas of ground-glass opacification on plain film. Other interesting MR features were fluid-fluid levels (n = 11), “fallen-leaf” sign (n = 1), soft-tissue changes (n = 2), and detection of septations not seen on plain film (n = 2). Conclusion. UBCs frequently appear complicated on MR imaging, with heterogeneous fluid signals and regions of nodular and thick peripheral enhancement related to previous pathologic fracture and early healing. Received: 27 December 1999 Accepted: 6 March 2000     

彩色超声引导联合聚桂醇灌注治疗小儿单纯性肾囊肿

目的 探讨彩色超声引导联合聚桂醇灌注治疗小儿单纯性肾囊肿临床疗效,寻找小儿单纯性肾囊肿有效的治疗方法及合适的应用药物.方法 回顾2011年5月至2014年10月我院经彩色超声、CTU明确诊断为单纯性肾囊肿患儿51例,其中28例为聚桂醇治疗组,采用彩色超声引导下经皮穿刺并注入聚桂醇,无水乙醇灌洗法23例设为对照组,对比两组不良反应发生情况及治疗后1年两组疗效情况.结果 51例患儿均穿刺注药成功,治疗后3个月、6个月、1年均获彩色超声随访,聚桂醇治疗组治愈率为85.7％,有效率为92.9％,均高于无水乙醇组的60.9％和65.2％,差异均有统计学意义(P＜0.05);聚桂醇治疗组患儿异常哭闹及面红例数均明显较对照组少,差异有统计学意义;聚桂醇治疗组无一例肉眼血尿发生,对照组有6例治疗后出现肉眼血尿,辅助应用止血药物后,均在3d之内消失,差异有统计学意义(P＜0.05);聚桂醇治疗组患儿仅1例出现穿刺后发热,对照组治疗后9例出现发热,差异有统计学意义(P＜0.05);治疗组患儿穿刺点渗血及呕吐例数均较对照组少,差异均有统计学意义(P＜0.05).聚桂醇治疗组二次穿刺例数及手术例数均较无水乙醇组少.结论 彩色超声引导联合聚桂醇灌注治疗小儿单纯性肾囊肿疗效确切、副作用小,应作为小儿单纯性肾囊肿首选治疗方案.     

Uncommon synovial cysts in children

Popliteal synovial cysts (Baker’s cysts) are a common occurrence in children and adults. Synovial cysts in other locations and/or with atypical extension are less common and may be confounded with tumors or other medical conditions. In this article we describe the underlying disease, clinical presentation and clinical course in six children with a sudden onset of paraarticular soft tissue masses or non-specific chronic pain. Ultrasound was the initial imaging method used in all cases; this was supplemented by MRI in three patients. Four children were diagnosed to be suffering from juvenile idiopathic arthritis (JIA), one child from Lyme Arthritis, whereas in one child no underlying disease was identified. Well-demarcated hypoechogenic lesions without signs of perfusion extending from the shoulder (two patients), elbow (one patient), hip (one patient), knee (1) or ankle (one patient) far into the adjacent musculature were detected on ultrasonography. A direct connection to the joint was demonstrated in all cases. All synovial cysts in the five arthritic patients resolved rapidly with medical treatment for arthritis, whereas the cyst persisted in the non-JIA patient. Conclusion: Uncommon synovial cysts occur in particular as a complication of arthritis. Ultrasonography is the initial and follow-up imaging method of choice, which can be supplemented by MRI in unusual cases. Apart from treatment for arthritis, no specific therapeutic interventions were required in the present cases.     

小儿纵隔肠源性囊肿的诊断与治疗

目的：探讨纵隔肠源性囊肿病因、临床诊断及治疗。方法：回顾性分析近20年17例纵隔肠源性囊肿患儿的临床资料。结果：1例为壁内型食道囊肿，16例为纵隔肠源性囊肿，16例中2例同时合并腹腔内的肠重复畸形；临床上多数患儿以呼吸系统症状就诊，12例合并椎体畸形，12例行胸部B超检查，4例行胸部MRI检查，均为边界清晰的囊性肿物，8例行^99TmTc扫描，后纵隔内可见核素^99TmTc浓集灶。结果：分析本组临床资料，得到如下结论：第一，小儿纵隔肠源性囊肿的临床特征有①具有呼吸系统压迫症状，患侧胸廓隆起，呼吸活动度差，呼吸音减弱或消失；②后纵隔囊肿合并椎体畸形；③胸部超声、CT和/或MRI检查，后纵隔存在边缘清楚，内壁光滑的单房性含液囊肿；④^99TmTc扫描发现后纵隔囊肿内有异位的胃肠粘膜。第二，本病的根治方法是手术治疗。     

Congenital chylous ascites: the roles of fibrin glue and CD31

A 6-month-old male infant who presented with abdominal distension and congenital chylous ascites was diagnosed. He was initially refractory to conservative therapy, and then was completely cured with ligation of megalymphatics and fibrin glue application. Immunoperoxidase staining for CD31 on the biopsied peritoneal tissues highlighted the lining cells of lymphatic spaces, which indicated lymphangiectasia.
Conclusion: This case emphasizes the effectiveness of lymphatic ligation of the retroperitoneal megalymphatics in conjunction with fibrin glue application to cure congenital lymphangiectasia.     

Omental cysts: an unusual cause of abdominal distension in children

Congenital cystic lesions arising in the omentum are a rare finding in the paediatric age group. They are difficult to diagnose preoperatively as they have few distinct features; the diagnosis is often confirmed only at lalaparotomy. They are thought to arise due to a developmental abnormality of the lymphatic system. Two cases are presented and the literature reviewed. The treatment of choice is complete resection. Long-term follow-up is unnecessary due to their benign nature.     

Lung hydatic cysts in children: comparison study between giant and non-giant cysts

PURPOSE: The aim of this study is to review our experience in pediatric giant pulmonary hydatid cysts focusing on clinical symptoms, location of the cyst, type of the intervention, postoperative complications and long-term results. METHODS: Between June 2002 and May 2007, 118 children were operated on for hydatid lung cysts. Two groups were defined: Group 1, 32 children with giant hydatid cysts and Group 2, 86 children with non-giant cysts. The statistical significance between the groups was estimated using paired samples t test. RESULTS: The mean age was 11.8 years in G1 and 9.7 years in G2. All of the patients were symptomatic in G1 but only 18% in G2 (P=0.003). The right lower lobe was most frequently involved in both G1 and G2. Surgical parenchymal resection was performed in five patients in G1 (16%) and in 2% in G2 (P=0.033). Postoperative complications in G1 were more significant comparatively to G2 (P=0.003). CONCLUSION: Giant hydatid lung cysts represent a distinct pathology. They affect essentially adolescents and may reach a large size causing parenchymal destruction. Thus, surgical resections are frequently used and postoperative complications rate is high.     

Management of thyroglossal duct cysts in children

BACKGROUND: The recurrence rate of thyroglossal duct cysts removed by Sistrunk or other procedures is 4% and 50%, respectively. The aim of the present study was to explain the reasons for recurrence and misdiagnosis. METHODS: Twenty-seven children underwent surgery for thyroglossal cysts and fistulas during 1989-2000. Age, sex, length of history, presentation, preoperative investigations, operative findings, histopathology of the lesion and length of excised hyoid bone, postoperative complications and length of follow-up were recorded. Statistical analysis was performed using Fisher's exact test with a significance level of P < 0.05. RESULTS: Twenty-three patients were primary referrals and four were secondary referrals having had previous surgery with misdiagnosis. The recurrence rate after a Sistrunk procedure was similar to the rate indicated in the literature (3.7%); however, no related special features could be identified such as inflammation (n = 12), perforation at surgery (n = 7), presentation with fistula (n = 4) or previous drainage of abscess (n = 5) (P > 0.05). CONCLUSION: Misdiagnosis is the most common cause of inadequate and inappropriate surgery, leading to recurrence of the lesion. The authors recommend a Sistrunk procedure for all cases of suspected thyroglossal duct cysts.