摘要:目的:應用區域阻抗法測定慢性阻塞性肺疾病（COPD）患者的肺血流灌注及肺通氣分布的變化,與放射性核素肺顯像方法比較,探討肺區域阻抗方法的臨床應用價值。 方法: 測定對象為18例中重度COPD患者,均為男性,平均年齡63.8歲,應用肺區域阻抗法及放射性核素法,分別測定肺血流灌注及肺通氣的分布。〖HTH〗結果〖HTSS〗: 本研究發現肺區域阻抗法在測定肺血流灌注分布方面,僅在左下肺區域高于核素法測得的數值(Plt;0.05),余肺區測定結果相近,無顯著差異。在肺通氣的測定方面,阻抗法所得數值與核素法測得的數值有一定的不同,在左上、右上區域高于核素法測得的數值,在左中肺區測得的數值低于核素法測得的數值(Plt;0.05),余肺區測定結果相近,無顯著差異。結論: 雖然目前區域阻抗方法暫不能取代放射性核素的測定,但作為一種輔助手段,可簡便、快速了解肺內的通氣、血流等生理病理改變。Abstract: Objective: To evaluate the clinical capability of regional electric impedance pneumograph and scintigraphy in measurement of pulmonary perfusion and ventilation in patients with COPD. Methods: Thirtytwo patients with different respiratory diseases underwent regional electric impedance pneumograph and scintigraphy, the pulmonary perfusion and ventilation were obtained and recorded. Results:The pulmonary perfusion results got by regional electric impedance pneumograph in the left lower region was lower than the results measured by scintigraphy, there were significant difference (Plt;0.05), and no difference in other pulmonary region. The pulmonary ventilation results got by regional electric impedance pneumograph in the both upper region were higher and in the left middle region were lower than the results measured by scintigraphy, there were significant difference(Plt;0.05), and no difference in other pulmonary region. Conclusion:The result got by regional electric impedance pneumograph could not replace the result got by scintigraphy at present, but this is a quick, simple,and convenient measurement to get parameter of the pulmonary perfusion and ventilation.
目的 探討超聲、CT與99Tcm-甲氧基異丁基異腈（MIBI）核素掃描在原發性甲狀旁腺功能亢進癥（PHPT）中的診斷價值及其漏診原因。方法 回顧性分析中國醫科大學附屬盛京醫院普外科2003年1月至2012年8月期間行手術治療的69例PHPT患者的臨床資料。結果 術后經病理學檢查證實，69例患者共76個病灶，其中甲狀旁腺腺瘤58例（60個病灶），甲狀旁腺增生7例（11個病灶），甲狀旁腺腺癌4例（5個病灶）。超聲、CT與99Tcm-MIBI核素掃描的靈敏度分別為81.94% （59/72）、61.76% （21/34）及69.57% （16/23），準確性分別為78.67%（59/75）、61.76% （21/34）及66.67% （16/24）；陽性預測值分別為95.16% （59/62）、100% （21/21）及94.12% （16/17）。僅超聲與CT靈敏度的差異有統計學意義（P=0.03），3種檢查的其他相應指標比較差異均無統計學意義（P＞0.05）。結論 超聲與99Tcm-MIBI核素掃描互補，而CT對診斷甲狀旁腺病灶的幫助不大，推薦術前常規行超聲與99Tcm-MIBI核素掃描兩項檢查。