Background: Stomal stenosis (SS) and marginal ulcer (MU) are reported to occur in 9-20% and 2-13%, respectively, of patients
undergoing gastric bypass for morbid obesity. It is hypothesized that decreasing tension on the gastrojejunostomy by performing
limited small bowel resection (SBR) would decrease ischemia, thereby decreasing the likelihood of SS and MU. Methods: A retrospective
review of 150 consecutive gastric bypass patients operated by one surgeon from 1993 to 1996 was performed. The incidence of
SS and MU was compared in patients with and without SBR. Results: The overall rate of SS was 24.0% and that of MU was 9.3%:
the incidence of both was 2.0%. The incidence of SS in patients without SBR was 26.9% and with SBR was 19.6%. The incidence
of MU in patients without SBR was 8.9% and with SBR was 9.8%. Neither result was statistically significant by Fisher's exact
test. Conclusion: There is a trend towards a decrease in the incidence of SS in gastric bypass patients with concomitant SBR
although this did not reach clinical significance. 相似文献
For its peripheral vascular dilating effect and platelet agglutination inhibitory activity, prostaglandin E1 is used in the treatment of diseases which are likely to cause peripheral circulatory failure or thrombus. In Japan, lipo-PGE1, which was developed to give it a target-directed nature by modifying the conventional PGE1, has been used and found to be useful in clinical practice. In this report, we attempt to describe the clinical benefits of lipo-PGE1 focusing on the diseases which have been approved for its indications. 相似文献
The objective of this study was to assess the effects of ascorbic acid supplementation, 500 mg twice daily in the treatment of pressure ulcers as an adjunct to standardized treatment.
The design consisted of a multicenter blinded randomized trial. The control group received 10 mg of ascorbic acid twice daily.
Patients from 11 nursing homes and 1 hospital participated.
Main outcome measures included wound survival, healing rates of wound surfaces, and clinimetric changes over 12 weeks.
Eighty-eight patients were randomized. Intention-to-treat analysis showed that the wound closure probability per unit time (i.e., the closure rate) was not higher in the intervention group than in the control group (Cox hazard ratio of 0.78 [90% precision interval, 0.44–1.39]). Mean absolute healing rates were 0.21 and 0.27 cm2/week in the intervention and control group, respectively (PI of the adjusted difference: −0.17 to 0.13). Relative healing rates and healing velocities did not show favorable results of ascorbic acid supplementation, either. A panel scored slides of the ulcers with a report mark between 1 (bad) and 10 (excellent). The improvement was 0.45 and 0.72 points per week in the intervention and control group, respectively (PI of the adjusted difference: −0.50 to 0.20). With another clinimetric index we could not show any differences, either.
These data do not support the idea that ascorbic acid supplementation (500 vs. 10 mg twice daily) speeds up the healing of pressure ulcers. 相似文献