目的:探讨大肠癌致肠梗阻的诊断和手术方法。方法:回顾分析2002～2008年间65例结直肠癌致肠梗阻病例的外科治疗资料。结果:术后出现并发症9例,切口感染6例,腹腔感染2例,吻合口瘘1例。结论:结直肠癌致肠梗阻应争取Ⅰ期切除吻合。合理选择手术方式,做好术中结肠灌洗和围手术期治疗是手术成功关键。
Objective To investigate the causes of failure of the primary vitrectomy,sum up the experience for secondary vitreous surgery and improve the success rate of primary vitrectomy for complicated retinal detachment． Methods The records of a consecutive series of 60 patients(65 eyes)that underwent secondary vitreous surgery between 1997 to 1998 were retrospectively reviewed.The age of patient ranged from 9 to 63 years(mean 36),and the followup period ranged from 3 to 18 months(mean 10.5 months). Results The main causes of failure of the primary vitrectomy were postoperative recurrence of proliferative vitreoretinopathy(PVR),unwell closed retinal breaks,and intra-and postoperative complications.In 46 of 65 eyes the retina was reattached after secondary vitreous surgery(70．1%)．Postoperatively,31 eyes (47.7%) had a visual acuity(VA)improved,16 eyes(24.6%)had a VA unchanged,and 18eyes(27.7%)had a VA reduced．Fifteen eyes(23.1%)had a VA of ge;0.05 and the best VA was 0.4．Thirty-nine eyes were followed-up from 3 to 18 months(mean 10.5)．In 35 of 39 eyes,the retina was reattached(89.7%),26 eyes(40%)had a VA of ge;0.05,and 7 eyes(10.7%)were hypotonic. Conclusions The keys to the success of secondary vitreous surgery are to restore the mobility for retina by eliminating the PVR completely,and avoid intraoperative complicattions by choosing the appropriate closure procedure for retinal breaks and the suitable intraocular tamponades. (Chin J Ocul Fundus Dis,20000,16:24-26)
目的：探讨腹腔镜检查对胃癌分期的价值。方法: 2007 年1月至2007 年11 月收治的胃癌患者14 例胃癌患者在全麻下行腹腔镜检查。结果: 腹腔镜T分期与术后病理检查结果符合率为92.9％，术前临床T分期与术后病理检查结果符合率为64.3%。腹腔镜分期显著优于临床分期Plt;0.05。在14例术前临床分期均未发现腹膜转移的病例中，腹腔镜探查发现有腹膜转移（P1-P3）者4例，腹腔镜对腹膜转移的评估显著优于临床分期P lt;0.05。结论: 腹腔镜可作为常规检查手段的一种补充，能对进展期胃癌进行准确的诊断和分期，有助于手术决策制定及估计治疗结果与预后，避免不必要的剖腹探查。
摘要:目的:探讨左半结肠癌合并肠梗阻Ⅰ期手术切除肠吻合的方法和注意事项。〖HTH〗方法:〖HTSS〗分析36例左半结肠癌合并肠梗阻患者Ⅰ期行手术切除肠吻合手术及术后恢复情况。结果:36例左半结肠癌并肠梗阻患者,Ⅰ期手术切除、肠吻合无一例吻合口瘘,术后恢复良好。〖HTH〗结论:〖HTSS〗只要围手术期、术中处理得当,左半结肠癌合并肠梗阻患者选择Ⅰ期手术切除肠吻合,可以减少患者痛苦、节约医疗费用,同时也是安全的。
目的:探讨胆总管结石致急性梗阻性黄疸手术治疗的效果。方法:回顾分析72例手术治疗胆总管结石致急性梗阻性黄疸患者的临床资料。结果:术后死亡3例。随访3~6年,效果优良者62例。3例胆总管T管引流术后3年复发肝胆管结石。结论:对该病的治疗术前应尽量做全面辅助检查,明确结石的部位及大小,胆管的形态及位置。根据病情确定手术时机和方式,对保证患者安全,减少术后并发症,提高治愈率有重要意义。
摘要:目的: 探讨自发性食管破裂的诊断和治疗经验。 方法 :对我院1996年2月至2009年8月收治的8例自发性食管破裂患者的诊断和治疗作回顾性分析。 结果 :全组患者7例行手术治疗,1例行保守治疗。6例患者行修补手术,其中4例行分层缝合,2例行全层缝合。1例行食管切除胃食管吻合术。本组痊愈7例,死亡1例。 结论 :早期诊断和早期治疗是自发性食管破裂的治疗原则。确诊患者,若病情允许,应首选手术治疗。Abstract: Objective: To explore the clinical diagnosis and treatment of spontaneous esophageal rupture. Methods :The clinical features, diagnosis and surgical treatment of 8 patients with spontaneous esophageal rupture were retrospectively reviewed. Results :There were 7 cases treated by surgical therapy and 1 case for conservative treatment. 6 cases were treated by surgical repair including 4 cases of layered suture and 2 cases of singlelayer suture. 1 case was treated by esophagus resection and gastroesophagostomy. In the whole group, 7 cases were cured and 1 case died. Conclusion :The therapeutic principle of spontaneous esophageal rupture are early diagnosis and early treatment. For diagnosed patient, surgical procedure is the first choice if condition permitted.