瘤段骨截除人工关节置换术治疗膝部骨巨细胞瘤35例

骨巨细胞瘤在骨肿瘤中比较常见，且以股骨下端和胜骨上端多发。我们所见35例中，股骨下端22例，医骨上端13例，占骨巨细胞瘤总数的50％以上。这些膝部骨巨细胞瘤，如果不彻底切除合理修补，必将造成终生残废。为此国内早在50年代末开始研制人工膝关节，60年代应用于临床，70年代几经改进终于制成了铰链式全膝人工关节。本院自1983年～1996年间已为35例膝部骨巨细胞瘤的情例行瘤段截除全膝人工关节置换术，疗效满意，现报告如下。1资料与方法1．1临床资料本组35例，男20例，女15例，年龄最小者24岁，最大者57岁，平均年龄35岁。部位：股骨下…     

用带环造瘘术治疗舌下腺囊肿

用带环造瘘术治疗舌下腺囊肿杭州市第一人民医院口腔科莫关浩舌下腺囊肿是口腔科最常见的疾病之一，治疗方法较多，有手术治疗［１］和非手术治疗。本文作者采用带环造瘘术对３０例舌下型舌下腺囊肿进行了治疗，获得了较满意效果，现总结报道如下。临床资料及方法１一般资...     

卵巢颗粒细胞瘤20例临床分析

颗粒细胞瘤是最常见的一种卵巢性索间质肿瘤，具有分泌雌激素的特点，被认为是低度恶性肿瘤，预后一般较好，但有晚期复发或转移倾向。作者收集1985～1992年间我院收治的卵巢颗粒细胞瘤20例进行分析和讨论。临床资料ZO例发病年龄为17～69岁，平均42．5岁。左侧9例，右侧8例，双     

嗜铬细胞瘤切除术20例麻醉护理配合

2004年1月～2006年12月，我院对20例嗜铬细胞瘤切除术患者术前实施麻醉，经充分准备与密切配合，效果满意。现将护理配合报告如下。     

神经内镜治疗脑室内病变

目的探讨脑室内病变的神经内镜治疗。方法应用神经内镜对68例脑室内病变进行治疗,其中松果体区肿瘤16例,囊性颅咽管瘤15例,丘脑肿瘤14例,脑室内囊肿16例,侵及室管膜下的胼胝体肿瘤3例,侧脑室脉络丛乳头状瘤2例,侧脑室猪囊尾蚴病1例,侧脑室内分流管脱落1例。结果随访17～69个月,56例有效,12例死于肿瘤扩散。无严重并发症。结论对脑室内病变选择性应用神经内镜治疗安全、有效。     

肾上腺组合性嗜铬细胞瘤四例报告及文献复习

Objective To discuss the clinical characteristics and management principles of com-posite pheochromoeytoma of adrenal gland (pheochromocytoma-ganglioneuroma). Methods Four cases of composite tumor of adrenal gland diagnosed pathologically were reviewed. All the cases were male, aged 37 to 62 years;three of them had the history of hypertension, one of them accompanied with paroxysmal palpitation, while one case was asymptomatic. Computerized tomography and ultra-sonography showed single tumor in adrenal, the diameter was about 2.5、3.8、6.3、15cm respectively. Two cases showed positive results in 131Ⅰ-metaiodobenzylguanidine (MIBG) scintigraphy. One case showed positive result in 99Tcm-hydrazinonicotinamide-3trysinoctreotide (HTOC) scintigraphy. Twenty-four hours urinary catecholamine examination revealed the average of norepinephrine, epi-nephrine and dopamine were (196.1±92.2)nmol/24 h, (26.6±8.9)nmol/24 h, (1957.9±913.5) nmol/24 h respectively. Two cases were at a little elevated level and the others with normal. All cases were managed with α-adrenergic receptor blocker preoperatively for 2-4 weeks. Results Tumor re-section was performed in all 4 cases, and 3 cases by retroperitoneal laparoscopy, one by open surgery. All 4 cases were diagnosed as composite pheochromocytoma of adrenal (Pheochromocytoma-gangli-oneuroma) by pathology. All patients had no evidence of recurrence or metastasis during follow-up from 15 to 38 months. Two of three cases with hypertension reverted to normotensive. Conclusions Composite pheochromocytoma of adrenal is rare, difficult to be diagnosed preoperatively. Except mild in eatecholamine secretion, which clinical manifestations are similar to pheochromocytoma. Pheochro-mocytoma-ganglioneuroma is no apparent tendency for aggressive behaviors, the results of surgical management are favorable.     

后腹腔镜手术治疗嗜铬细胞瘤

目的探讨后腹腔镜手术治疗嗜铬细胞瘤的适应证及手术安全性. 方法采用后腹腔镜手术治疗肾上腺嗜铬细胞瘤患者15例(双侧2例),腹主动脉旁嗜铬细胞瘤1例.对照组为开放手术治疗的肾上腺嗜铬细胞瘤16例,腹主动脉旁嗜铬细胞瘤1例.结果后腹腔镜手术组16例患者行后腹腔镜手术18例次,17例次取得成功,1例因术中出血改行开放手术.肿瘤最大径2.0～6.5(3.8±1.6)cm.手术时间45～150(85±31)min,出血量10～100(32±22)ml.术后吗啡用量0～40(12.5±7.8)mg;术后恢复进食时间1～3(1.8±0.7)d;下床活动时间2～3(2.3±0.5)d;术后住院时间4～9(6.5±1.3)d.开放手术组肿瘤最大径1.5～6.0(4.3±1.3)cm.手术时间90～240(155±39)min,出血量50～600(273±105)ml,9例输血.术后吗啡用量10～120(61±24)mg;术后恢复进食时间2～4(2.9±0.5)d;术后下床活动时间3～6(4.8±0.7)d;术后住院时间8～11(8.8±0.9)d.结论对于有一定腹腔镜手术经验者,后腹腔镜手术并不增加嗜铬细胞瘤手术的危险性,且具有手术时间短、出血少、创伤小、疼痛轻、康复快等优点.该法有望成为治疗肾上腺嗜铬细胞瘤的首选手术方法.