精索静脉曲张患者精索静脉和外周血睾酮水平的对照研究

目的：探讨精索静脉血张患者血浆睾酮水平的变化及其机制。方法：对25例精索静脉曲张患者与22例腹股沟斜疝患者精索静脉和外周血睾酮水平进行对照研究。结果：精索静脉曲张组外周血睾酮浓度与腹股沟斜疝组无差别（P＞0．05），而精索静脉血睾酮浓度两组则有明显差异，精索静脉曲张组精索静脉血中睾酮浓度较腹股沟斜疝组低（P＜0．05）。结论：多种因素可影响外周血睾酮浓度，使其难以准确地反映睾丸分泌睾酮的实际水平，而精索静脉血中的睾酮浓度则能较为直接地反映睾丸的睾酮分泌能力。     

窒息鼠脑组织型纤溶酶原激活物活性变化与脑水肿的关系

目的：探讨窒息对鼠脑分泌组织型纤溶酶原激活物（TPA）的影响与脑水肿的关系。方法：通过“延迟剖宫产术”致胎鼠宫内窘迫，实验分空白对照组，窒息15min组，窒息30min组，窒息15min复氧30min组，窒息30min复氧30min五个实验组，每组各取8例测试脑组织TAP的活性及含水量，结果：窒息后鼠脑TPA活性与含水量均升高（P＜0．01），结论：窒息可致TAP活性增高，同时发生脑水肿，高活性的TPA可能是脑缺氧缺血致不可逆神经元损伤的一个重要媒介。     

无创伤性测定门静脉压力与肝血流二法联合应用研究肝硬化的价值

目的　为临床研究肝硬化提供有价值的手段。方法　采用99mTc -RBC测定 93例肝硬化患者肝血流 ,选择峰时 (Tmax) ,半廓清时 (T1/2 )、廓清率 (K值 )、肝血流 (LBF)等作为观察指标 ,与正常对照组比较 ;同时用99mTc-MIBI经直肠给药测定其中 5 4例患者门静脉压力 (PVP) ,以心 /肝 (H/L)比值作为分流指数。结果　肝硬化组Tmax、T1/2 、K及LBF分别为 1.2 6± 0 .99(93)min、5 .75± 3.38(93)min、0 .15 4± 0 .116 (93)及 0 .6 10± 0 .2 89(93)L/min ,除Tmax外 ,与对照组均有非常显著性差异 ;Child -A、B、C级各组之间 (除Tmax外 )也均有非常显著性差异或显著性差异 ;Child -A、B、C级各组H/L分别为 0 .49± 0 .18(2 1)、0 .6 9± 0 .16 (15 )、0 .91± 0 .2 1(18) ;PVP分别为 2 .2 2± 0 .5 7(2 1)kPa、2 .85± 0 .38(15 )kPa及 3.5 4± 0 .6 5 (18)kPa。而对照组的H/L及PVP分别为 0 .30± 0 .12 (16 )及 1.6 1± 0 .38(16 )kPa。Child -A、B、C级各组分别与对照组及各组之间比较 ,除Child -B与C级组PVP无显著性差异 (P >0 .0 5 )外 ,其余均有非常显著性差异 (P <0 .0 1)及显著性差异 (P <0 .0 5 )。结论　本法测定肝血流及门脉压力方便 ,无创伤 ,对分析病情 ,判断疗效 ,指导制订治疗方案 ,估计预后等均有较     

自体大隐静脉移植治疗周围血管损伤22例分析

目的：探讨周围血管损伤自全大隐静脉移植治疗的方法。适应证和治疗效果。方法：回顾性分析22例周围血管损伤自体大隐静脉移植治疗的临床资料，并阐述了术中注意事项，提出最佳手术时机及预后情况。结果：22例均采用自体大隐静脉移植，痊愈19例（86.4%)。截肢3例（13.6%），22例患者无死亡，随访2-9年，20例肢体功能恢复满意，2例移植段狭窄，但肢体功能良好。结论：自体大隐静脉移植是治疗周围血管损伤行之有效的方法之一。血管吻合的时间应在24h以内，最佳为8h以内。     

7例睾丸静脉和2例卵巢静脉变异的解剖学研究

目的：了解睾丸静脉和卵巢静脉的变异。方法：观测了73具（146侧）成人尸体（男58，女15）两种静脉的形态结构。结果：发现两种静脉有变异者7例，其中睾丸静脉5例，卵巢静脉2例，另外，作者还对变异与国内文献作了比较。结论：本研究为探讨睾丸静脉和卵巢静脉曲张发生原因及治疗等提供解剖学资料。     

介入联合手术治疗门静脉血栓形成7例

目的 评价介入联合手术治疗门静脉血栓形成的疗效。方法 对7例术前确诊为门静脉血栓形成者行开腹经肠系膜上静脉的门静脉内手术取栓、局部溶栓和门静脉狭窄/闭塞段球囊扩张、内支架置入术。2例因小肠坏死、1例因肠腔明显狭窄而同时行部分小肠切除术。结果 7例均治疗成功。术前腹痛、腹胀及消化道症状消失,腹水基本消失。随访3～24个月,平均16个月,均健在,无消化道出血。多普勒超声复查显示门静脉血流通畅。结论 介入联合手术是治疗门静脉血栓形成的安全、有效方法。     

Partial Portal Vein Ligation Plus Thioacetamide: A Method to Obtain a New Model of Cirrhosis and Chronic Portal Hypertension in the Rat

To obtain a new model of chronic portal hypertension in the rat, two classical methods to produce portal hypertension, partial portal vein ligation and the oral administration of thioacetamide (TAA), have been combined. Male Wistar rats were divided into four groups: 1 (control; n?=?10), 2 [triple partial portal vein ligation (TPVL); n?=?9], 3 (TAA; n?=?11), and 4 (TPVL plus TAA; n?=?9). After 3 months, portal pressure, types of portosystemic collateral circulation, laboratory hepatic function tests (aspartate aminotransferase, alanine aminotransferase, bilirubin, alkaline phosphatase, and gamma-glutamyl transpeptidase) and liver histology were studied. The animals belonging to group 2 (TPVL) developed extrahepatic portosystemic collateral circulation, associated with mesenteric venous vasculopathy without hepatic destructurization or portal hypertension. Animals from group 3 (TAA) developed cirrhosis and portal hypertension but not extrahepatic portosystemic collateral circulation, or mesenteric venous vasculopathy. Finally, the animals from group 4 (TPVL?+?TAA) developed cirrhosis, portal hypertension, portosystemic collateral circulation, and mesenteric venous vasculopathy. The association of TPVL and TAA can be used to obtain a model of chronic portal hypertension in the rat that includes all the alterations that patients with hepatic cirrhosis usually have. This could, therefore, prove to be a useful tool to study the pathophysiological mechanisms involved in these alterations.     

经大隐静脉穿刺置管溶栓治疗急性期髂股静脉血栓形成

目的:探讨经大隐静脉入路置管溶栓治疗髂股静脉血栓形成的应用价值。方法:对18例急性期髂股静脉血栓形成的患者在下腔静脉滤器植入术前提下,经大隐静脉入路置管溶栓治疗。结果:18例患者经大隐静脉穿刺成功置管,技术成功率为100%,治疗有效率为100%。置管期间无不良反应及并发症发生;平均住院时间为12.5d。结论:经大隐静脉入路置管溶栓介入治疗急性期髂股静脉血栓操作简便,经济实用,安全有效。     

Traumatic Injury of the Superior Mesenteric Vein: Ligate,Repair or Shunt?

Abstract We report a case of SMV injury in a critically ill patient. The patient was a 19-year-old woman involved in a motor vehicle collision. Her injuries included grade II splenic and renal lacerations, devascularized and lacerated right and transverse colon, a transected transverse mesocolon, a massive shear injury of her abdominal wall, and two partial SMV transections. At initial damage control laparotomy, the SMV was ligated, the devascularized bowel resected and a temporary abdominal closure applied. At re-operation, a mesocaval shunt using saphenous vein was employed. The shunt failed and the patient required a saphenous vein jump graft. Although visceral vascular injuries are rare, ligation of the SMV in a damage control situation is acceptable. This case study is the first to discuss appropriate treatment when interruption to a patient's collateral visceral venous drainage limits the surgeon’s ability to ligate. In these situations, bypass shunts may be successful.