【摘要】 目的 探討超聲動態觀察流行性腮腺炎合并睪丸炎的診斷和預后價值。 方法 回顧性分析2008年10月-2010年12月53例流行性腮腺炎合并睪丸炎治療前后的聲像圖特征和臨床治療效果。 結果 全部患者均有腮腺、頜下腺、睪丸、附睪不同程度長大，而腮腺、頜下腺以單側長大為主，睪丸及附睪長大多以單側為主；53例腮腺炎合并睪丸炎經臨床治療15~20 d后，腮腺、睪丸腫痛及自覺癥狀消失，聲像圖恢復正常40例，聲像圖基本恢復正常13例。治療出院后全部患者均獲得遠期超聲觀察隨訪，分別于出院后3~4個月及4~6個月觀察聲像圖均為正常。 結論 超聲動態觀察流行性腮腺炎合并睪丸炎在治療前后聲像圖的改變對其診斷和預后有重要的價值。【Abstract】 Objective To investigate the diagnostic and prognostic value of ultrasonic inspection on epidemic parotitis accompanied by orchitis through observing ultrasonic image changes of the disease before and after treatment. Methods We retrospectively analyzed the ultrasonographic features before and after treatment, and the clinical treatment results of 53 patients with epidemic parotitis accompanied by orchitis between October 2008 and December 2010. Results All patients had different level of increment in their parotid gland, submaxillay gland, testicle or epididymis. Most cases of the increment occurred to unilateral parotid gland and submaxillay gland on the same side, as well as unilateral testicle and unilateral epididymis. After clinical treatment for 15 to 20 days, parotid and testicular swelling and pain, and self-conscious symptoms disappeared. Forty patients returned to normal ultrasonic image, and the ultrasonic images of 13 other patients resumed normal basically. After being discharged, all patients were followed up and ultrasound observation was carried out which showed that 3 to 4 months or 4 to 6 months later, all ultrasonic images were normal. Conclusion Ultrasound dynamic observations before and after treatment have important values to the diagnosis and prognosis of epidemic parotitis accompanied by orchitis.
ObjectiveTo investigate the ultrasonic changes of hepatic veins and splenic veins during various immune stages with different CD4+T lymphocyte count. MethodsFifty AIDS/HIV patients with chronic viral hepatitis treated between January 2010 and October 2013 were designated as the case group, and another 50 patients with simple chronic viral hepatitis were regarded as the controls. For patients in the case group, we observed their ultrasonic changes of hepatic and splenic veins during various immune stages with different CD4+T lymphocyte count. The results of observation and clinical laboratory analysis were compared. ResultsAbnormal ultrasonic changes were detected in the liver in various immune stages based on the CD4+T lymphocyte count, and the main manifestations of these changes included unclear portal and splenic vein distal direction, wide diameter, slowed blood flow velocity, and disappearance of fluctuations of blood flow spectrum; and unclear hepatic vein distal direction, low and three-phase, and negative blood flow spectrum with the disappearance of windows were also detected. There were no statistical differences between the case group and the control group when the CD4+T cell count was over 300/mm3, and a few indexes were significantly different when the CD4+T cell count was between 100 and 200/mm3. However, the differences of almost all indexes were significant when the CD4+T cell count was below 100/mm3. ConclusionPatients with HIV/AIDS combined with chronic viral hepatitis have ultrasonographic abnormalities of intrahepatic and splenic veins, which is more obvious as the CD4+T cell count declines. Overall consideration of intrahepatic vein and splenic vein ultrasonic indicators helps clinical assessment of disease development in patients with HIV/AIDS combined with chronic viral hepatitis.
ObjectiveTo investigate the ultrasonic changes of liver during various immune periods with different number of CD4+ T lymphocytes in HIV/AIDS patients with chronic viral hepatitis. MethodsThe clinical data of 100 patients with chronic viral hepatitis diagnosed between January 2010 and December 2012 were selected. Among them, 50 simple chronic viral hepatitis patients were designated as the control group, and the other 50 HIV/AIDS patients with chronic viral hepatitis were regarded as the experimental group. Ultrasonographic observation was applied on patients of the experimental group according to different immune period based on the number of CD4+ T lymphocytes. Indexes observed included liver size, the edge of liver, capsule of liver and hepatic parenchymal echo. The cross-check analysis was employed between observed results and clinical laboratory results. ResultsAbnormal changes of the experimental group were shown on the ultrasound observation of liver in different CD4+ T lymphocyte count immune periods, including enlargement of the liver, slightly blunt liver margin, slightly thick capsule, dense and uniform, slightly rough and not so uniform, or rough and not uniform hepatic parenchymal echo. There was no significant difference in ultrasonic changes of liver between the two groups when the CD4+ T cell number was over 300/mm3. However, the difference was significant when the CD4+ T cell number was below 100/mm3. ConclusionLiver abnormalities become more obvious as CD4+ T cell count decreases in HIV/AIDS patients with chronic viral hepatitis. Comprehensive considerations of various liver ultrasound indicators are helpful in clinical evaluation of HIV/AIDS patients with chronic viral hepatitis.