高频电灼加留置硅胶管治疗泪小管阻塞

目的 探讨高频电灼联合硅胶管植入术治疗泪小(总)管阻寨的适应证,手术方法和临床疗效.方法 对2年来行高频电灼联合硅胶管植入术治疗的泪道阻塞62例(68只眼),进行回顾性分析.结果 62例(68只眼)泪小(总)管阻塞有效率达88.2%.结论 高频电灼联合硅胶管植入术治疗泪小(总)管阻塞具有成功率高,操作简便,并发症少,经济,损伤小和美观等优点,具有临床适用价值.     

肝内型重症急性胆管炎32例诊治分析

目的探讨肝内型重症急性胆管炎(ACST)的诊治经验。方法总结2001—2006年重庆三峡中心医院收治的32例肝内型重症急性胆管炎病人的临床资料。结果5例经保守治疗缓解后行择期手术,2例经PTCD治疗缓解后行择期手术,25例行急诊手术;术后2例死亡,其余病人均达到解除梗阻、通畅引流的目的。结论肝内型ACST的梗阻部位影响病人的临床表现及预后,大多数病人需要作急诊手术,应根据梗阻部位来选择合适的治疗方式。     

Internal hernia complications of gastric bypass surgery in the acute setting: spectrum of imaging findings

Bariatric surgery is increasingly becoming an option for the treatment of morbid obesity. Patients who have undergone gastric bypass surgery have varied post-surgical complications which present acutely in the emergency medical setting, particularly internal hernias. It may be difficult to identify an internal hernia in the absence of intestinal obstruction. This article will review the various types of imaging presentations to highlight the complexity of making a radiographic diagnosis. Recognition of internal hernia as the cause of intermittent or acute abdominal pain symptoms in these patients in the emergency setting can prompt immediate surgical intervention, thus avoiding life-threatening outcomes.     

创伤骨折患者急性应激障碍的干预对策

目的了解创伤骨折后急性应激障碍的发生发展规律并探讨干预对策。方法将1000例创伤骨折患者随机分为试验组和对照组各500例，在2组患者均接受常规治疗和护理的基础上，对试验组施以应激干预，分别于入院第2天和第9天对2组患者进行SCL-90、HAMA、HAMD的问卷调查，并对所得数据进行统计分析。结果2组患者住院第2天心理障碍程度比较无显著差异，住院第9天心理障碍程度比较差异有统计学意义（P〈0．05）。结论应激干预对策可显著减轻或消除创伤骨折患者应激障碍，提高心理健康水平。     

Closed loop obstruction: Diagnosis by enteroclysis

The diagnosis of closed loop obstruction was made by enteroclysis in 5 patients. In each case barium outlined the involved loop, and related segments of marked narrowing were identified as the neck of the closed loop. The findings prompted early surgical intervention, and adhesive bands causing closed loop obstruction were confirmed in all 5 patients.     

大鼠膀胱出口梗阻模型的建立及其尿动力学检测

目的 :建立大鼠下尿路梗阻引起逼尿肌不稳定 (DI)的模型。方法 :成年雌性大鼠会阴部尿道结扎 ,6周后耻骨上膀胱造瘘 ,行充盈性膀胱测压 ,观察容量、压力变化及DI的发生情况。结果 :实验组DI发生率 3 5 1% ,对照组无DI ,两组膀胱最大容量和最大压力有统计学意义 (P <0 0 1)。结论 :会阴部尿道结扎 ,膀胱造瘘 ,充盈性膀胱测压是建立大鼠下尿路梗阻引起DI模型的合适方法     

Ultrasonic Demonstration of Anicteric Biliary Obstruction

25 non jaundiced patients with dilatation of the biliary tree are presented. In 22 of these cases the cause of obstruction was shown either by ultrasound alone, on radionuclide (RN) study or at endoscopic retrograde cholangiography (ERCP) and was subsequently proven at surgery. In 2 cases ultrasound showed dilatation of the common duct, which was proved to be non-obstructive dilatation on ERCP. One patient had multiple benign hepatic cysts with intrahepatic biliary dilatation and was not subjected to surgery. Twenty out of 23 patients with obstructive dilatation showed a variable rise in serum alkaline phosphatase. Bile duct size did not show any correlation with serum alkaline phosphatase levels. It is stressed that ultrasound is a more sensitive indicator of obstructive biliary disease than clinical and biochemical parameters.     

Use of the distal double-slit valve system in children with hydrocephalus

Shunts with distal slit valves have been in use for almost three decades for children with hydrocephalus. Drawbacks of this device include shunt obstruction, infection and overdrainage. Onepiece shunts have been used widely for ventriculoperitoneal insertion because they are easy to place, do not need manipulation of connecting parts during surgery and rarely disconnect. Disadvantages of these shunts, however, include a relatively higher risk of distal obstruction than with the open-ended peritoneal tube and a tendency for overdrainage. With these disadvantages in mind, we hypothesized that using double-distal-slit valves could increase the survival rate of the shunt. For the past 2 years we have been using a one-piece shunt with double-distal-slit valves and an elliptical reservoir under a strict protocol. The study showed the following. (1) Among the children operated on 30.3% required shunt revisions (0.9 revisions per patient). Children with intraventricular hemorrhage-posthermorrhagic hydrocephalus had a three times higher risk of shunt revision than children with posttraumatic hydrocephalus (55.4% vs 18.8%). (2) The so-called slit-ventricle syndrome was observed in only 4 children (8.5%), who subsequently required surgical attention. Most of the children with other forms of the overdrainage phenomenon continued to do well without clinical problems. (3) Of the 155 children, 7 (4.5%) experienced infections after the initial shunt installation. (4) Of the 136 shunt revisions, 90.4% (123 procedures) were related to obstruction. Distal obstruction (47.1%) was more frequent than proximal obstruction (36.6%). (5) In 8 children, the shunt was still working through the proximal set of valves when the distal set of valves was completely obstructed. Although a perfect shunt has not yet been developed, the shunt with a double-distal-slit valve is effective in the treatment of children with hydrocephalus and could increase shunt survival time.Presented at the Consensus Conference: Hydrocephalus '92, Assisi, Italy, 26–30 April 1992     

结肠癌并肠梗阻的外科治疗

报道结肠癌并肠梗阻５５例，占同期结肠癌的５３．４％。右侧结肠占８３．３％，与国内外文献均不一致。Ｃ、Ｄ期占７４．５％。急症手术２７例，一期切除率４８．１％，一期切除组手术死亡率及吻合口瘘发生率均为７．７％。作者认为对结肠癌并肠梗阻急症手术者只要病人情况允许，病灶尚能切除者应以一期切除为首选。     

A study of 272 cases of endoscopic dacryocystorhinostomy

272 Patients with obstruction in nasolacrimal duct were treated by endoscopic nacryocystorhinostomy (DCR). The results were compared with that of external DCR and Endoscopic DCR without stent. In our study Endoscopic DCR with stening had better results. Endoscopic DCR with stenting has several advantages over the more conventional external approach and Endoscopic DCR without stenting. Results at 4 years of follow up have been good that is 98.6% patients were relieved of symptoms completely.