目的:探讨甲亢性心脏病的临床特点及131碘治疗的疗效分析。方法:对124例甲心病患者的临床资料及131碘治疗后疗效进行回顾性分析。结果:甲亢患者中甲心病发生率为86%,各年龄段均可发病,但40～60岁年龄段较高;甲亢病程越长甲心病发生率越高;甲心病131碘治疗的治愈率为879%;甲心病心律失常类型较多,以房颤最为多见; 131碘治疗后,各种心律失常复律百分率均大于80%。结论:甲亢患者并发甲心病的发病率与甲亢病程成正相关。早期正确诊断甲心病,可明显提高甲心病的疗效。131碘治疗是目前甲心病的最佳治疗方法。
【摘要】 目的 探讨放射性核素骨显像和血清前列腺特异抗原（PSA），碱性磷酸酶（ALP），骨特异性碱性磷酸酶（BAP）测定在前列腺癌骨转移诊断中的价值。 方法 回顾性分析2006年10月-2009年10月50例前列腺癌（PCa）患者骨显像结果及PSA、ALP、BAP测定结果。 结果 50例Pca患者骨显像阳性率为70.0%。35例Pca骨转移患者分布在PSAgt;20.0 ng/mL时占97.1%，BAPgt;20.1 μg/L时占88.6%，ALPgt;130.0 μg/L时占94.3%。血清PSA、ALP、BAP水平随着放射性核素骨显像分级的增高而逐步增高，呈高度正相关。 结论 放射性核素骨显像仍然是目前诊断PCa骨转移的主要方法；PSA、ALP、BAP亦是重要的辅助诊断指标；PSAgt;20.0 ng/mL时，患者应常规行全身骨显像检查。【Abstract】 Objective To explore the clinical value of radionuclide bone scintigraphy and measurements of serum prostate-specific antigen (PSA), alkaline phosphatase (ALP) and bone-specific alkaline phosphatase (BAP) in the diagnosis of bone metastasis in prostate cancer (PCa) patients from October 2006 to October 2009. Methods The results of bone scintigraphy, serum PSA, ALP and BAP were analyzed retrospectively in 50 PCa patients. Results The positive rate of bone scintigraphy was 70.0% in 50 PCa patients. In 35 patients with PCa bone metastasis, 97.1% of them were PSAgt;20.0 ng/mL, 88.6% were BAPgt;20.1 μg/L, and 94.3% were ALPgt;130.0 μg/L. The serum levels of PSA, ALP and BAP were increased step by step along with the advancement of bone metastatic grading from M0 to M3. They were significantly positively correlated. Conclusion Radionuclide bone scintigraphy is a major method in the diagnosis of bone metastasis in PCa patients currently. PSA, ALP and BAP are also important auxiliary diagnostic markers. Patients with the level of PSAgt;20.0 ng/mL should take a routine whole-body examination of bone scintigraphy.
ObjectiveTo investigate clinical characteristics and surgical treatment of patients with non-malignant esophageal-tracheal/bronchial fistula.?Methods?We retrospectively analyzed clinical data of 12 patients with non-malignant esophageal-tracheal/bronchial fistula who underwent surgical repair in Peking Union Medical College Hospital from January 2002 to October 2011. There were 6 males and 6 females with a mean age of 49.8 years (ranging from 32 to 72 years). There were 7 patients with esophagotracheal fistula，1 patient with esophagobronchial fistula，2 patients with gastro-bronchial fistula after esophagectomy for esophageal cancer，and 2 patients with esophageal diverticulum bronchial fistula. Nine patients underwent surgical repair via right thoracotomy approach，and 3 patients via left thoracotomy approach. Seven patients underwent esophageal fistula and tracheal fistula repair，1 patient underwent esophageal fistula and bronchial fistula repair，2 patients underwent gastric fistula and bronchial fistula repair，1 patient underwent esophagectomy, gastroesophageal anastomosis and left lower lobectomy, and 1 patient underwent esophageal diverticulum repair and left lower lobectomy.?Results?All the patients recovered well from surgery with no perioperative complication or in-hospital death，and resumed oral intake 7-10 days after surgery. Three months to 1 year postoperatively, regular examinations including upper gastroenterography and fibrobronchoscopy found no sign of tracheal/bronchial stenosis or esophageal stenosis，and no patients needed stent implantation or dilatation treatment. All the patients were followed up from 3 months to 10 years and had a good quality of life during follow-up.?Conclusion?Excluding malignant etiology and determining the exact fistula location are key points of clinical diagnosis for esophageal-tracheal/bronchial fistula. Adequate preoperative nutritional support and 1-stage surgical repair can lead to satisfactory clinical outcomes.