ECT检查基本常识

ECT检查基本常识 来源: 编辑: 录入时间:2008年6月14日 浏览量:1878 1、SPECT都能检查什么 我科常规开展的SPECT检查项目有如下表所示: 显像检查病人需要做哪些准备, 注射显像剂后，建议病人多饮水，一般在注射后两小时内饮水约500, 显 像 项 目 主 要 临 床 应 用 显 像 剂 检查前准备 预约 全身骨显像 恶性肿瘤骨转移;代谢性骨病;应力性骨折 MDP 无 无 99m甲状腺显像 结节功能判定;甲炎;异位甲状腺; Tc 无 无 131131I全身显像 甲癌及转移灶 I 空腹 无 甲状腺肿瘤阳性显像 分化型甲癌诊断 MIBI 无 无 运动,静息心肌灌注显像 心肌缺血;心肌炎;冠脉狭窄灌注受损范围及疗MIBI 空腹 无 效; 外科术前评价心功能及血流灌注; 腺苷负荷心肌灌注显像 心肌缺血;冠脉狭窄灌注受损范围及疗效; MIBI 空腹 无 外科术前评价心功能及血流灌注; 双肾动态显像 分肾形态功能;分肾GFR测定;化疗肾功能监测;DTPA 饮水、排尿 无 肾移植监测; 肝血池断层显像 肝血管瘤特异性鉴别诊断; PYP 空腹 无 消化道出血显像 活动性消化道出血定位诊断; PYP 空腹 无 99m麦克尔憩室显像 小儿Meckel’s憩室定位诊断 Tc 空腹 无 甲状旁腺显像 甲状旁腺腺瘤定位诊断 MIBI 无 无 肺灌注,通气显像 肺栓塞,COPD DTPA 空腹 有 MAA 131131I,MIBG全身显像 肾上腺及异位嗜铬细胞瘤 I-MIBG 封闭甲状有 腺， 清洁肠道 骨髓显像 全身功能性骨髓分布 SC 无 无 淋巴显像 上、下肢淋巴肿 AS 无 有 下肢静脉显像 下肢静脉通畅情况、下肢肿 MAA 无 无 1000ml，排尿时应防止尿液污染衣裤及身体，如果发现污染应及时更换污for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 染的衣服，并将污染皮肤局部清洗后再做检查。检查前排尿，同时摘除身体上的金属物品如项链、钥匙、硬币以防影响检查结果。如果病人近日内在放射科检查时使用了钡剂应将其排净后再约检查。 我科全身骨显像检查无需预约，一般上午9-11点注射显像剂，下午检查， 3、肿瘤病人怀疑有骨转移 怎么办, 有些肿瘤很容易转移到骨骼，形成骨转移癌，如乳腺癌、肺癌、前列腺癌等，因此早期诊断骨转移，对患有这些肿瘤病人的治疗的制定以及骨转移的治疗效果的好坏非常重要。核医学的全身骨显像是首选的诊断项目，目前在临床上用得最普遍，它具有以下显著的优点:?、比X线早发现骨转移病灶3-6个月;?、一次检查可以看到全身是否有病变;?、检查安全、简便、无创伤性、无痛苦。肿瘤病人应定期检查全身骨显像，特别是自感骨痛时，应立即做骨显像检查，看看是否有骨转移。 4、恶性肿瘤病人术前建议做全身骨显像检查, 对于大多数确诊为骨外恶性肿瘤的病人，尤其是一些容易早期转移到骨的肿瘤，如乳腺癌、肺癌、胃癌、甲状腺癌、前列腺癌、直肠癌等，不管有无骨痛症状，都应该在术前进行骨显像检查，了解有无骨转移，以决定正确的治疗方案。对于一些不容易发生骨转移的肿瘤，要根据医生的判断决定进行骨显像的时机。 5、为什么肿瘤患者不要等到出现骨痛了才去做骨显像检查, 对于上述最常发生骨转移的恶性肿瘤患者，一旦出现骨痛时，大家都能想到要做骨显像，看看是否真的发生了骨转移。但对于没有骨痛的病人有必要做骨显像吗,回答是仍然有必要的。许多病人发生骨转移并不一定出现骨痛，尤其是发生骨转移的早期。因此在原发肿瘤发病的前几年，不要等到出现骨痛时才想到进行骨显像检查。 6、骨显像有问题都是骨转移吗, 绝大多数骨转移的病灶是多发的，单发转移比较少见，加上一些良性骨骼疾病也可以表现为骨显像的异常。所以对于单发病灶，骨显像的鉴别有一定困难，比如常见于创伤所致的骨折;各种炎症如骨髓炎、骨脓肿等;良性骨肿瘤如骨样骨瘤、骨囊肿、骨软骨瘤;一些关节炎也可以出现异常表现，如退行性骨关节病、类风湿关节炎等。此外在一些骨外的软组织也可以摄取骨显像剂。总之当肿瘤病人骨显像出现异常尤其是单发的局限性异常时不要过于紧张，医生要结合病史及相关影像学以及骨显像的不同表现综合，做出正确的判断。即便发生了骨转移，也可以用核素进行治疗。 7、心肌显像要让冠心病患者避免不幸 对于已诊断为冠心病的患者，核素心肌灌注显像可以帮助评估您的预后状况及估测您的危险度。即:如果您的心肌灌注显像正常，预示一年内心脏事件(心肌梗死、心脏猝死等)的发生几率小于1,，说明预后良好，for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 是比较安全的。如果心肌灌注显像不正常，根据不正常心肌的范围和严重程度，可以预示一年内心脏事件的发生率有多高，从而采取相应的措施，可以避免和减少不幸的发生。 8(心肌显像能帮助冠心病患者选择治疗方法 核素心肌显像可以帮您确定治疗方案。即:如果您的心肌灌注显像正常，首选内科药物治疗;如果有心肌缺血，就应进行冠脉支架术或冠脉搭桥术。 9(放过支架或做过搭桥手术的患者可不是一劳永逸 首先核素心肌灌注显像可以评价疗效;由于这些治疗后的病人会出现再狭窄，核素心肌灌注显像可以看有无新的心肌缺血出现。 10(增加心脏负荷，让心肌缺血无处藏身 一般情况下冠状动脉即使狭窄达到70-80,，静息状况下可能不表现出心肌缺血，只有当心脏耗氧量增加即负荷(运动、劳累、情绪激动等)情况下心肌缺血才表现出来。所以为了准确诊断冠心病心肌缺血，在核素心肌灌注显像时要做负荷试验。 11(心肌显像为何要增加心脏负荷，负荷试验有哪些, 负荷试验分为运动负荷和药物负荷试验两种。使患者处于心脏高负荷状态的目的是使正常心肌和缺血心肌的差异加大，就可通过显像把轻度缺血心肌找出来，以得到准确的诊断。 12(心肌显像时患者应注意什么, 受检查者应注意:进行显像检查当日空腹或吃少量素食，检查前1-2日停用扩张血管药物和?受体阻滞剂，检查当日携带油煎鸡蛋二个、牛奶一袋等脂肪餐到核医学科;患有支气管哮喘者不建议做药物负荷试验(腺苷、潘生丁)，请提前告知医生。 13(如何判断缺血心肌还能否恢复, 心肌梗死灶内的存活心肌处于缺血状态，其摄取葡萄糖的能力提高。核素心肌代谢显像就是通过探测心肌梗死区内有无摄取葡萄糖的心肌细胞，准确判断心肌梗死区内有无存活心肌。而只有存活的心肌，通过各种导管等治疗恢复血流才有可能恢复心脏功能;如果没有存活心肌，再怎么恢复血流也不会让那部分心肌复活，也就不会恢复心脏功能。临床上把核医学18F-FDG心肌代谢显像是判断心肌存活的“金标准”。 14(心肌显像和CT及造影有什么不同, 核素心肌显像和多排CT及冠状动脉造影均可用于诊断冠心病。核素心肌灌注显像主要显示心肌有无缺血，心肌细胞功能是否正常。而多排CT和冠状动脉造影主要显示冠状动脉有无斑块、钙化及狭窄。 打个比方说:冠状动脉好比灌溉的水渠，心肌好比水稻，农民更关心的是水稻的长势，如果水稻长势好，说明养料和水分供给充足，农民就不for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 需要去修水渠;一旦哪块稻田里的水稻出现枯萎，说明这块稻田缺乏养分，农民只需要去修理供应这块稻田的水渠就可以了，而不必要修理全部地水渠。 因此，核素心肌灌注显像就是观察水稻的长势(心肌有无缺血)，而多排CT及冠状动脉造影是观察水渠是否有堵塞(水渠有无阻塞)。 15、甲状腺显像在临床上有何意义 甲状腺疾病在内分泌系统的疾病中是一种常见的多发的病种，在对它的诊断和治疗过程中要用到多种核医学的方法，其中常用的直观的方法就是甲状腺显像，它在临床上有以下诊断意义: (1) 当你发现颈部甲状腺处有肿块时，甲状腺显像可以告诉你肿块的功能状态，一般有热结节、冷结节、温结节等情况。 (2) 异位甲状腺的诊断 (3)甲状腺癌转移灶的寻找 (4)甲状腺炎诊断 16(简便而准确的诊断肺栓塞方法 核素肺通气,灌注显像诊断肺栓赛，包括肺灌注显像和肺通气显像。 核素肺灌注显像是:通过静脉注射少量放射性蛋白颗粒，其随血流进入肺动脉，并暂时停留在肺毛细血管中，通过特殊的显像设备(SPECT)就可以发现肺动脉及分支阻塞而造成局部血流没有分布。核素肺灌注显像可以准确的判断肺动脉及分支堵塞的部位、范围和程度。 核素肺通气显像是:患者通过口/鼻吸入微量放射性气体，其暂时沉积在支气管、细支气管、肺泡内，通过特殊的显像设备(SPECT)就可以显示气道通畅情况。 17(既能了解肾功能又能了解尿路阻塞的肾动态显像 利用肾图或肾动态显像可以了解肾脏的功能以及肾功能受损程度，也可以判断尿路是否存在梗阻。肾动态显像还能够计算出肾小球滤过率(GFR)或肾有效血浆流量(ERPF)。GFR 和ERPF是两个很重要的判断肾功能的参数值。 18(抽血化验肾功能与核医学方法有什么不同, 肾图和肾动态显像都是利用同位素示踪技术的原理观察肾脏和尿路情况的。所用的示踪药物从泌尿系统排泄，其通过肾脏和尿路的过程反映了尿液生成和排出的过程。其所得到的信息更符合生理状态下泌尿系统的状况，结果也就更准确。其定量指标还非常适合临床及时动态观察肾功能变for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 化情况。另外，临床常用的一些肾功能实验室检测方法只能得到两只肾脏总和的功能情况，无法了解每个肾脏的具体情况。而肾图和肾动态显像能够观察和判断每只肾脏各自的功能和每侧尿路的情况，这一优势在临床上非常有价值。 19(肾动态显像主要的检查步骤有哪些, 进行肾动态显像的主要步骤有: (1)显像开始前，需饮水300,500ml; (2)检查前排尿，测量身高、体重; (3)静脉注射显像剂同时开始检查，受检者身体保持不动，连续采集图像约20分钟; (4)如果需要，在连续采集结束后还可以加做肾脏侧位像和排尿后的肾脏影像。 ECT检查让病灶无处藏身 您了解ECT检查吗, ECT是发射型计算机断层显像的简称，是继CT之后在临床上应用的一种先进的医疗设备。它分为单光子发射型计算机断层显像(SPECT)和正电子发射型计算机断层显像(PET)。ECT检查是利用特定的显像剂对某种组织或脏器进行选择性定位并能对疾病进行诊断的一种医学影像检查。与CT、X线摄片等放射学检查不同的是，ECT检查利用的放射线不是来源于检查设备，而是来自特定的显像剂。具体地说，ECT是检测注入人体内的放射性核素发射出的光子，以组织器官吸收放射性核素浓度的高低和变化作为重建图像的参数，根据放射性药物在组织器官内的分布重建图像，以血流、功能、代谢的变化作为诊断依据。当疾病早期病变组织结构尚未破坏、密度变化不大而只是血流、功能、代谢发生改变时，显像剂在该部位的聚集就会发生相应的改变，在体外利用ECT采集将病变以图像方式记录下来，医生就可依据图像变化对疾病做for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 出早期诊断。 ECT检查的结果对医生制定有针对性的治疗方案有着非常重要的意义。比如:作为肺癌等易发生远端转移的恶性肿瘤的治疗前分期检查，骨显像是常规检查之一，若肺癌治疗前患者的骨显像检查显示患者有骨转移，其临床分期已达IV期，首选治疗方案不是外科手术切除，而是全身化疗。再如:乳腺癌患者前哨淋巴结显像，早期乳癌患者通过核医学前哨淋巴结示踪检查配合外科前哨淋巴结活检术可以有针对性地选择治疗方案:如果活检切下的前哨淋巴结没有癌转移(则可选择“保乳术”，免去腋窝淋巴结清扫，在保证疗效的前提下(可有效提高患者生活质量。 ECT检查的部位及特点 1、骨显像扫描:ECT是目前唯一可实现一次扫描完成全身骨检查的影像设备，可早于X线3—6个月发现骨转移灶，同时对原发骨肿瘤的诊断、骨痛的筛查及预后的判断都有很大的帮助。 2、心肌灌注显像:主要观察心肌供血情况，诊断适应症包括:冠心病、心肌缺血的早期诊断，急性心梗的诊断，心肌缺血治疗后的效果评价，心肌病和心肌炎的辅助诊断，评估心肌细胞的活性。 3、泌尿系统:肾图和肾小球滤过率的测定，诊断肾血管性高血压，分肾功能的判断，移植肾成活与排泄反应的观察，尿路梗阻的诊断。 4、内分泌系统:了解甲状腺位置、形态、大小及功能状态，异位甲状腺的诊断，寻找甲状腺癌转移灶及疗效评价，了解甲状腺术后残余组织的再生、修复情况，甲状腺结节的功能及良恶性的判断。 5、脑血流显像:短暂性脑缺血及可逆性脑缺血的诊断，阿尔茨海默病的诊断(AD)，脑肿瘤术后复发与坏死灶的鉴别，癫痫灶的定位。 6、肿瘤代谢显像:对甲状腺及乳腺肿瘤的诊断定性有很大意义。 7、异位胃粘膜显像:消化道出血的诊断及定位。 for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 8、唾液腺的功能显像:评价唾液腺功能，诊断干燥综合征、及唾液腺的占位等。 ECT检查的优点 1、图像清晰:成像清晰，后处理软件强大，配套准直器齐全、完备，对临床诊断、肿瘤病程分期、治疗方案拟订、疗效随访、预后评估均有很大实用价值。 2、安全可靠:根据不同的部位，ECT可做动态、静态，全身、局部检查，门控电路心脏功能显像检查以及各种断面显像，对人体无损害，可以多次重复检查。 3、检查范围广:检查者完全处于生理状态下，更直观地显示脏器的形态、位置、大小，可动态观察脏器血流、功能变化，能重建横断面、冠状面、矢状面图像，确定脏器内有无肿瘤存在，其准确位置、大小、范围如何，血流供应，功能及组织形态有无变化，人体全身骨骼及各种脏器都可以用ECT检查。 咨询热线: 2028821 病例摘要: 病例一:一位近50岁的男性患者～开始腰痛～就诊多家医院～经药物、按摩等方法治疗均不见好转～后发展为全身疼痛来我院做ECT全身骨检查。结果诊断为全身多发骨转移癌～进一步检查发现是由肺癌转移而来。 病例二:一位46岁的女性患者～心前区不适～心电图示有早室性早搏～心情非常紧张～怕患上了冠心病～做ECT心肌血流灌注断层显像～结果显示心肌血流灌注良好。随访至今患者冠状动脉供血良好～无冠心病征像。 图说:国际领先设备飞利浦ECT机 for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the wow gold wow gold wow gold wow gold aion gold aion kina seo seo 关注老年心力衰竭 干部外宾病房副主任 副主任医师 医学硕士 金明磊 心力衰竭就是由于心脏功能异常不能满足身体各组织器官对于心脏泵血的需求而引起的一系列临床症状。该病是老年人的常见病，并已成为全球的第一健康杀手。据国外统计数据显示，慢性心力衰竭患病率约为1.5%—2%，65岁以上的老年人高达6%—10%，心衰患者中大于60岁的老年患者占50%以上。近年来我国心力衰竭的发 病率与国外近似，患者超过1100万。 哪些疾病可导致老年心力衰竭 心力衰竭是各种心血管疾病进展的最后阶段。根据国内调查结果显示，慢性心力衰竭住院病例主要病因为冠心病、高血压性心脏病、风湿性心脏病、肺源性心脏病、扩张型心肌病和先天性心脏病，近年来由老年心脏瓣膜病、糖尿病心肌病、甲状腺功能亢进、慢性贫血引起的心力衰竭也逐年增多。 在老年心力衰竭中，两种或两种以上心脏病共存的高达65%，以冠心病合并高血压性心脏病、冠心病合并肺心病多见，其中一种心脏病为引起心衰的主要原因，另一种则参与和促进心衰的发生、发展。 哪些因素可诱发老年心力衰竭 1、感染:尤其是呼吸道感染，患肺炎的老年人9% for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 死于心衰。2、心肌缺血:心绞痛、无症状心肌缺血、心肌梗死均可诱发心衰。3、心律失常:如心房颤动是最常见的诱发心衰的心律失常。4、药物影响:如某些抗心律失常药、麻醉药、抗肿瘤药物、皮质激素、非甾体类抗炎药等均可诱发或加重心衰。另外，体力过劳、精神压力过重、情绪激动及环境、气候的急剧变化等均可诱发心衰。 如何识别老年心力衰竭 老年心力衰竭的表现多不典型，常隐匿发病，如果出现以下症状，应尽早到医院就医:1、稍活动或劳动即感心慌、胸闷、气促。2、尿量减少，短时间内体重明显增加，或白天尿少、夜尿增多。3、卧位性干咳，病人站立或坐位时不出现咳嗽，躺平后即出现干咳，说明肺部已明显充血或淤血。4、夜间突然憋醒或伴有喘息，睡眠后大约1—2小时，突然憋醒或伴有呼吸急促或喘息，坐起或起床后症状很快消失。5、不能完全平卧或平睡，平卧后即感到胸闷气短，且需垫高枕头或取半卧位才感舒适。6、咳痰，开始吐白色痰，量比较少，然后吐大量白色泡沫痰或洗肉水样痰，并伴有口唇或面色青紫，大汗淋漓喘息。7、不少老年病人常出现精神症状，如心情烦躁、焦虑或有恐惧感，有的甚至出现精神失常、嗜睡昏迷。8、全身静脉回流不畅或出现静脉淤血情况，如颈部血管(静脉)明显充盈或怒张，肝脾肿大，下肢或全身出现浮肿，常伴有食欲不振、腹胀、消化不良、腹泻等。即使确诊为心力衰竭也不要恐惧，在专科医生的帮助下，通过病因防治、去除诱因、改善生活方式并配合科学的药物治疗，心力衰竭是可防可控的。 出诊时间:每周二、五上午 健康热线:2028970 2028799 wow gold wow gold wow gold for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the wow gold aion gold aion kina seo seo , 上一篇文章 相关文章列表 ? 标题 没有相关文章 ECT检查基本常识 for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 1、SPECT都能检查什么 我科常规开展的SPECT检查项目有如下表所示: 显 像 项 目 主 要 临 床 应 用 显 像 剂 检查前准备 预约 全身骨显像 恶性肿瘤骨转移;代谢性骨病;应力性骨折 MDP 无 无 99m甲状腺显像 结节功能判定;甲炎;异位甲状腺; Tc 无 无 131131I全身显像 甲癌及转移灶 I 空腹 无 甲状腺肿瘤阳性显像 分化型甲癌诊断 MIBI 无 无 运动,静息心肌灌注显像 心肌缺血;心肌炎;冠脉狭窄灌注受损范围及疗效; MIBI 空腹 无 外科术前评价心功能及血流灌注; 腺苷负荷心肌灌注显像 心肌缺血;冠脉狭窄灌注受损范围及疗效; MIBI 空腹 无 外科术前评价心功能及血流灌注; 双肾动态显像 分肾形态功能;分肾GFR测定;化疗肾功能监测;肾DTPA 饮水、排尿 无 移植监测; 肝血池断层显像 肝血管瘤特异性鉴别诊断; PYP 空腹 无 消化道出血显像 活动性消化道出血定位诊断; PYP 空腹 无 99m麦克尔憩室显像 小儿Meckel’s憩室定位诊断 Tc 空腹 无 甲状旁腺显像 甲状旁腺腺瘤定位诊断 MIBI 无 无 肺灌注,通气显像 肺栓塞,COPD DTPA 空腹 有 2、骨显像检查病人需要做哪些MAA 准备, 131131I,MIBG全身显像 肾上腺及异位嗜铬细胞瘤 I-MIBG 封闭甲状腺， 有 注射显像剂后，建议病人多清洁肠道 饮水，一般在注射后两小时内饮 骨髓显像 全身功能性骨髓分布 SC 无 无 水约500,1000ml，排尿时应防 止尿液污染衣裤及身体，如果发 现污染应及时更换污染的衣服， 并将污染皮肤局部清洗后再做 检查。检查前排尿，同时摘除身 体上的金属物品如项链、钥匙、 硬币以防影响检查结果。如果病 人近日内在放射科检查时使用 淋巴显像 上、下肢淋巴肿 AS 无 有 了钡剂应将其排净后再约检查。 下肢静脉显像 下肢静脉通畅情况、下肢肿 MAA 无 无 我科全身骨显像检查无需前哨淋巴结显像 乳癌前哨淋巴结定位显像 SC 无 有 预约，一般上午9-11点注射显像剂，下午检查， for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 3、肿瘤病人怀疑有骨转移 怎么办, 有些肿瘤很容易转移到骨骼，形成骨转移癌，如乳腺癌、肺癌、前列腺癌等，因此早期诊断骨转移，对患有这些肿瘤病人的治疗方案的制定以及骨转移的治疗效果的好坏非常重要。核医学的全身骨显像是首选的诊断项目，目前在临床上用得最普遍，它具有以下显著的优点:?、比X线早发现骨转移病灶3-6个月;?、一次检查可以看到全身是否有病变;?、检查安全、简便、无创伤性、无痛苦。肿瘤病人应定期检查全身骨显像，特别是自感骨痛时，应立即做骨显像检查，看看是否有骨转移。 4、恶性肿瘤病人术前建议做全身骨显像检查, 对于大多数确诊为骨外恶性肿瘤的病人，尤其是一些容易早期转移到骨的肿瘤，如乳腺癌、肺癌、胃癌、甲状腺癌、前列腺癌、直肠癌等，不管有无骨痛症状，都应该在术前进行骨显像检查，了解有无骨转移，以决定正确的治疗方案。对于一些不容易发生骨转移的肿瘤，要根据医生的判断决定进行骨显像的时机。 5、为什么肿瘤患者不要等到出现骨痛了才去做骨显像检查, 对于上述最常发生骨转移的恶性肿瘤患者，一旦出现骨痛时，大家都能想到要做骨显像，看看是否真的发生了骨转移。但对于没有骨痛的病人有必要做骨显像吗,回答是仍然有必要的。许多病人发生骨转移并不一定出现骨痛，尤其是发生骨转移的早期。因此在原发肿瘤发病的前几年，不要等到出现骨痛时才想到进行骨显像检查。 6、骨显像有问题都是骨转移吗, 绝大多数骨转移的病灶是多发的，单发转移比较少见，加上一些良性骨骼疾病也可以表现为骨显像的异常。所以对于单发病灶，骨显像的鉴别有一定困难，比如常见于创伤所致的骨折;各种炎症如骨髓炎、骨脓肿等;良性骨肿瘤如骨样骨瘤、骨囊肿、骨软骨瘤;一些关节炎也可以出现异常表现，如退行性骨关节病、类风湿关节炎等。此外在一些骨外的软组织也可以摄取骨显像剂。总之当肿瘤病人骨显像出现异常尤其是单发的局限性异常时不要过于紧张，医生要结合病史及相关影像学资料以及骨显像的不同表现综合分析，做出正确的判断。即便发生了骨转移，也可以用核素进行治疗。 7、心肌显像要让冠心病患者避免不幸 对于已诊断为冠心病的患者，核素心肌灌注显像可以帮助评估您的预后状况及估测您的危险度。即:如果您的心肌灌注显像正常，预示一年内心脏事件(心肌梗死、心脏猝死等)的发生几率小于1,，说明预后良好，是比较安全的。如果心肌灌注显像不正常，根据不正常心肌的范围和严重程度，可以预示一年内心脏事件的发生率有多高，从而采取相应的措施，可以避免和减少不幸的发生。 8(心肌显像能帮助冠心病患者选择治疗方法 核素心肌显像可以帮您确定治疗方案。即:如果您的心肌灌注显像正常，首选内科药物治疗;如果有心肌缺血，就应进行冠脉支架术或冠脉搭桥术。 9(放过支架或做过搭桥手术的患者可不是一劳永逸 首先核素心肌灌注显像可以评价疗效;由于这些治疗后的病人会出现再狭窄，核素心肌灌注显像可以看有无新的心肌缺血出现。 10(增加心脏负荷，让心肌缺血无处藏身 一般情况下冠状动脉即使狭窄达到70-80,，静息状况下可能不表现出心肌缺血，只有当心脏耗氧量增加即负荷(运动、劳累、情绪激动等)情况下心肌缺血才表现出来。所以为了准确诊断冠心病心肌缺血，在核素心肌灌注显像时要做负荷试验。 11(心肌显像为何要增加心脏负荷，负荷试验有哪些, 负荷试验分为运动负荷和药物负荷试验两种。使患者处于心脏高负荷状态的目的是使正常心肌和缺血心肌 for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 的差异加大，就可通过显像把轻度缺血心肌找出来，以得到准确的诊断。 12(心肌显像时患者应注意什么, 受检查者应注意:进行显像检查当日空腹或吃少量素食，检查前1-2日停用扩张血管药物和?受体阻滞剂，检查当日携带油煎鸡蛋二个、牛奶一袋等脂肪餐到核医学科;患有支气管哮喘者不建议做药物负荷试验(腺苷、潘生丁)，请提前告知医生。 13(如何判断缺血心肌还能否恢复, 心肌梗死灶内的存活心肌处于缺血状态，其摄取葡萄糖的能力提高。核素心肌代谢显像就是通过探测心肌梗死区内有无摄取葡萄糖的心肌细胞，准确判断心肌梗死区内有无存活心肌。而只有存活的心肌，通过各种导管等治疗恢复血流才有可能恢复心脏功能;如果没有存活心肌，再怎么恢复血流也不会让那部分心肌复活，也就不会恢复心脏功能。临床上把核医学18F-FDG心肌代谢显像是判断心肌存活的“金标准”。 14(心肌显像和CT及造影有什么不同, 核素心肌显像和多排CT及冠状动脉造影均可用于诊断冠心病。核素心肌灌注显像主要显示心肌有无缺血，心肌细胞功能是否正常。而多排CT和冠状动脉造影主要显示冠状动脉有无斑块、钙化及狭窄。 打个比方说:冠状动脉好比灌溉的水渠，心肌好比水稻，农民更关心的是水稻的长势，如果水稻长势好，说明养料和水分供给充足，农民就不需要去修水渠;一旦哪块稻田里的水稻出现枯萎，说明这块稻田缺乏养分，农民只需要去修理供应这块稻田的水渠就可以了，而不必要修理全部地水渠。 因此，核素心肌灌注显像就是观察水稻的长势(心肌有无缺血)，而多排CT及冠状动脉造影是观察水渠是否有堵塞(水渠有无阻塞)。 15、甲状腺显像在临床上有何意义 甲状腺疾病在内分泌系统的疾病中是一种常见的多发的病种，在对它的诊断和治疗过程中要用到多种核医学的方法，其中常用的直观的方法就是甲状腺显像，它在临床上有以下诊断意义: (1) 当你发现颈部甲状腺处有肿块时，甲状腺显像可以告诉你肿块的功能状态，一般有热结节、冷结节、温结节等情况。 (2) 异位甲状腺的诊断 (3)甲状腺癌转移灶的寻找 (4)甲状腺炎诊断 16(简便而准确的诊断肺栓塞方法 核素肺通气,灌注显像诊断肺栓赛，包括肺灌注显像和肺通气显像。 核素肺灌注显像是:通过静脉注射少量放射性蛋白颗粒，其随血流进入肺动脉，并暂时停留在肺毛细血管中，通过特殊的显像设备(SPECT)就可以发现肺动脉及分支阻塞而造成局部血流没有分布。核素肺灌注显像可以准确的判断肺动脉及分支堵塞的部位、范围和程度。 核素肺通气显像是:患者通过口/鼻吸入微量放射性气体，其暂时沉积在支气管、细支气管、肺泡内，通过 for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the 特殊的显像设备(SPECT)就可以显示气道通畅情况。 17(既能了解肾功能又能了解尿路阻塞的肾动态显像 利用肾图或肾动态显像可以了解肾脏的功能以及肾功能受损程度，也可以判断尿路是否存在梗阻。肾动态显像还能够计算出肾小球滤过率(GFR)或肾有效血浆流量(ERPF)。GFR 和ERPF是两个很重要的判断肾功能的参数值。 18(抽血化验肾功能与核医学方法有什么不同, 肾图和肾动态显像都是利用同位素示踪技术的原理观察肾脏和尿路情况的。所用的示踪药物从泌尿系统排泄，其通过肾脏和尿路的过程反映了尿液生成和排出的过程。其所得到的信息更符合生理状态下泌尿系统的状况，结果也就更准确。其定量指标还非常适合临床及时动态观察肾功能变化情况。另外，临床常用的一些肾功能实验室检测方法只能得到两只肾脏总和的功能情况，无法了解每个肾脏的具体情况。而肾图和肾动态显像能够观察和判断每只肾脏各自的功能和每侧尿路的情况，这一优势在临床上非常有价值。 19(肾动态显像主要的检查步骤有哪些, 进行肾动态显像的主要步骤有: (1)显像开始前，需饮水300,500ml; (2)检查前排尿，测量身高、体重; (3)静脉注射显像剂同时开始检查，受检者身体保持不动，连续采集图像约20分钟; (4)如果需要，在连续采集结束后还可以加做肾脏侧位像和排尿后的肾脏影像。 for more than 60 years of rural senior party member care funds; System of regulating the activities of grass-roots party organizations, and enhance the sense of belonging of grass-roots party members; Hold fast to implement "red credit", "red stake" two major project opportunities, strive to explore new ways of development of village collective economy, rural collective economy achieve breakthrough; A progress review by the Secretary of the party work of grass-roots party organizations, strengthens the responsibility of grasping party building, Party Secretary. Second, strengthening the construction of clean and honest Government and fight against corruption. Seriously implement the honest responsibility, actively carry out the independent Commission against corruption interview system, increase the leadership and the day-to-day supervision of party members and cadres at all levels, strengthen the not Winds of special treatment, treatment of "laid-back luxury and arrogance" and "three-pronged" problem, non-gang, national public officers, serving in leadership positions is not land, above-standard equipped with buses and cars for private purposes, and recreational city of gifts, hospitality, luxury and waste, "emptied the rating" special rectification work. Adhere to the rot will be punishing, corrupt Su, and 1 village, 4 disciplinary administrative cadres and workers. Three is to strengthen peace to create a work. Strengthen source management, adhere to prevention, focusing on prevention. Carry out the "big reception, big tour" campaign, petitioning for the cadres of the