目的 探討胃腸道穿孔的多層螺旋CT（MSCT）表現及診斷價值。 方法 收集2010年3月－2011年3月18例經手術證實為胃腸道穿孔患者的臨床及MSCT資料，回顧性分析了胃腸道穿孔及穿孔部位的MSCT表現。 結果 18例患者中，MSCT明確診斷穿孔17例，對穿孔部位準確定位11例。其中術后診斷胃穿孔4例、十二指腸球部穿孔9例、小腸穿孔3例、結腸穿孔1例、闌尾穿孔1例。MSCT表現有腹腔游離氣體，腸壁周圍局限性積氣、腹腔積液及腸袢積液、腸壁增厚、腸腔周圍脂肪間隙密度增高（條紋征）。 結論 MS CT有利于顯示腹腔游離氣體、胃腸道穿孔部位及其腸壁周圍的變化情況，對胃腸道穿孔術前的定性及定位診斷有較明顯的優勢 ，可為臨床提供更多有價值的診斷信息。
Objective To analyze the clinical effect of TINAVI robotic system-assisted pedicle screw internal fixation for thoracolumbar fracture with a Thoracolumbar Injury Classification and Severity Score (TLICS) of 4. Methods A total of 38 patients with TLICS 4 thoracolumbar fracture treated between January 2019 and January 2021 who met the selection criteria of Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital were retrospectively analyzed. According to the results of doctor-patient communication, 18 cases were treated with robot-assisted minimally invasive surgery (robot group), and 20 cases were treated with traditional conservative treatment (non-surgical group). Complications during hospitalization were observed. After discharge, the patients in the two groups were followed up by telephone and outpatient clinic. The Visual Analogue Scale (VAS) score at admission, at discharge, and 3 and 6 months after discharge, and the Oswestry Disability Index (ODI) score 3 and 6 months after discharge were compared between the two groups. Results There were no statistically significant difference in age, sex, body mass index or distribution of injured vertebrae segment between the two groups (P>0.05). No serious complication occurred in any group during hospitalization. The difference in the length of hospital stay between the two groups was not statistically significant (P>0.05). The bed rest in the robot group was shorter than that in the non-surgical group [(4.83±0.92) vs. (43.05±2.70) d, P<0.05]. The VAS scores at discharge (2.50±0.51 vs. 5.05±1.00), 3 months after discharge (1.83±0.71 vs. 3.10±0.72) and 6 months after discharge (1.50±0.51 vs. 1.90±0.79) in the robot group were lower than those in the non-surgical group (P<0.05). The ODI scores 3 months after discharge (21.89±1.41 vs. 30.40±3.00) and 6 months after discharge (10.72±2.37 vs. 12.10±2.29) in the robot group were significantly lower than those in the non-surgical group (P<0.05). Conclusion For patients with TLICS 4 thoracolumbar fracture, the early clinical effect of robot-assisted surgical treatment is better than that of non-surgical treatment.
【摘要】 目的 探討64層螺旋CT尿路造影在上尿路梗阻性病變中的運用及診斷價值。 方法 收集2009年12月—2011年1月132例行螺旋CT尿路造影，并確診為上尿路梗阻病變患者資料，分析其圖像特點并與手術及病理結果對比。 結果 132例患者經臨床及手術病理證實，輸尿管結石31例，先天異常及畸形51例，輸尿管感染性病變16例，尿路腫瘤29例，外源性壓迫3例，腎盂旁囊腫2例；所有患者均顯示良好，與臨床及病理結果基本吻合。 結論 CT尿路造影能多方位清楚顯示病變內部及周圍情況，可準確的顯示、判斷尿路梗阻的原因、性質，是一種對泌尿系疾病診斷極有價值的影像學檢查方法。【Abstract】 Objective To discuss the utilization and diagnostic value of 64-slice spiral CT urography for upper urinary tract obstruction diseases. Methods We collected the clinical data of 132 patients who were diagnosed with upper urinary tract obstruction by 64-slice spiral CT urography between December 2009 and January 2011. We analyzed the imaging features and compared them with surgical and pathological results. Results Confirmed by surgical and pathological results, 132 patients included 31 cases of urethral stone, 51 cases of congenital variant and malformation, 16 cases of ureteral infection, 29 cases of tumors in urinary tract, 3 cases of extraneous compression, and 2 cases of cysts next to the renal pelvis. CT diagnosis for all cases were basically in line with clinical and pathological results. Conclusion CT urography is an extremely valuable imaging method to diagnose the diseases of urinary system. It can display lesions broadly and reveal their inner and peripheral circumstances clearly, thus can help us determine the reasons and natures of the lesions precisely.