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Wysłany: Czw 21:34, 17 Mar 2011
Temat postu: Endoscopy for common bile duct stricture after cho
Endoscopy for common bile duct stricture after cholecystectomy diagnosis and therapeutic value
M, AtomiY. Follow-upofmorethan10yearsaf-terendoscopicsphineterotomyforcholedocholithiasisinyoungpatients [J]. BrJSurg ,1998,85:917-921. [7] to Wang, Wu Tao, Ji being examined,
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, and so on. Hou Aodi cholecystectomy Endoscopic treatment of sphincter dysfunction [J]. Journal of Gastroenterology, 2002,19 (1) :21-23. Age-related delay in diagnosis and treatment of chronic subdural hematoma in three cases the military to spend weeks, often following the Pavilion, and Zhou Jie (1. Taoyuan South Road, Lanzhou Military Region Air Force, retired cadres, Xi'an 710077, China; 2. Lanzhou General Hospital of Lanzhou Military Region Neurosurgery) Keywords: dura mater hematoma; old; diagnosis and treatment in the ring Key words: R651.15 Document code: D old chronic subdural hematoma clinically common, usually more than 3 weeks after head injury began to appear symptoms, misdiagnosis is high, I sent in 2004 in which 3 patients were on preoperative diagnosis and treatment of both Yu-delayed to varying degrees, are as follows. Example 1, M, 7O years old. Numbness of the right side of the scalp for a few days for treatment, physical examination found no abnormalities were observed a few days later go to the higher level hospitals, CT examination revealed chronic subdural hematoma. History by asking the patient a few weeks ago the head had been hit toy bar, have taken no notice. Right cranial roof washing line drilling drainage, postoperative recovery was good. Example 2,
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, F (retired families), 68-year-old, but had cerebral infarction hospitalized in the hospital, was discharged prescribed oral diuretic, vasodilator therapy, nausea, vomiting and other symptoms, preliminary consideration to the drug reaction, given withdrawal treatment, However, no improvement of symptoms. Again into the Lanzhou Military Region, Lanzhou General Hospital head CT examination revealed bilateral parietooccipital chronic subdural hematoma, and another old infarction lesions, cerebral atrophy. Emergency washing line biparietal cranial drill drainage. After a review of head CT subdural fluid change, no reoperation in patients after white line absorption. Example 3, male, aged 72, accidentally hit in the head because of sports equipment, and were not handled. About 1 month later there right side weakness, difficulty walking, unresponsive and other symptoms. CT hospital examination revealed the left side of brain parietooccipital forehead chronic subdural hematoma, skull drilled to give the left temporoparietal rinse drainage, surgery leads to dark red bloody fluid around】 oond. After review of CT, patients with good recovery. Discussion: chronic subdural hematoma more than 3 weeks after head injury symptoms, but also without significant incentive to hematoma, occur in the elderly. Minor head injury in this disease, insidious onset, duration of long duration, no significant early clinical features, coupled with the lack of primary care doctors on the vigilance and awareness of the disease, the common practice of using elderly patients to Received Date: A O1-09 of 2006 Description: Zhou Jun Flower (1972 a), female, physician case report explained, easily misdiagnosed. ... Most patients with chronic subdural hematoma has a slight history of head injury, only a small number of the performance of non-traumatic chronic subdural hematoma. The clinical symptoms mainly chronic increased intracranial pressure, neurological dysfunction and psychiatric symptoms. Older people, dementia, psychosis, and pyramidal tract sign positive for the more easy-to-intracranial tumor or positive pressure hydrocephalus confused. In the clinical suspicion of disease should be as early as possible auxiliary examination, CT examination can confirm the diagnosis, but the retired cadres and other primary health care units generally do not have such a large medical equipment, so on to send patients timely and very important to avoid delays in patients diagnosis and treatment. At present, for the treatment of chronic subdural hematoma drainage method of choice for drilling,
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, or row CT guided hematoma aspiration, results were satisfactory. Whether or craniotomy hole irrigation drainage surgery, there is the possibility of recurrence. Therefore, the need to review after head CT. The prognosis also depends on the treatment of patients is timely,
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, appropriate and supplemented by neurological rehabilitation and guidance can not be ignored. In summary, with the arrival of an aging society, elderly patients with chronic subdural hematoma incidence will increase. In the retired cadres, nursing homes and other primary health care units, due to more elderly people, for a history of head injury, dizziness, headache, nausea,
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, vomiting, sudden vision abnormalities, numbness, movement disorders and other symptoms, should prompt the line head CT examination to rule out intracranial hematoma, can not be taken lightly.
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