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101.
A. Emmermann C. Zornig D. M. Lloyd M. Peiper C. Bloechle C. E. Broelsch 《Surgical endoscopy》1997,11(7):734-736
Background: Between 1991 and November 1994, 18 patients with large, solitary, nonparasitic liver cysts underwent laparoscopic deroofing;
the last 13 of them also received an omental transposition flap in addition.
Methods: Using three to four trocars, the cystic contents were first aspirated, and the cyst derooted widely using diathermia. An
omental transposition flap was fashioned and stapled into the cyst cavity itself.
Results: Postoperative complications included one case of pulmonary atelectasis. Another patient developed a subhepatic bile collection
which was aspirated percutaneously. On average, patients were discharged on the 4th (2–14) postoperative day. Follow-up was
performed with abdominal ultrasound for 2–43 months (mean 19 months). There were two early cyst recurrences, both in cases
without an omental transposition flap (overall recurrence rate, 11%; in patients with omental flap, 0).
Conclusions: Deroofing in combination with an omental transposition flap is a safe and effective therapy for symptomatic solitary liver
cysts and can be performed using minimal-access surgical techniques.
Received: 19 January 1996/Accepted: 26 August 1996 相似文献
102.
对126列原发性肝癌与37例转移性肝癌介入治疗前均进行了B超、CT与数字减影血管造影(DSA)检查。DSA显示原发性肝癌多数血供丰富,而转移性肝癌以少血供者为主;CT显示小病灶的敏感性稍差,病灶的密度和均匀性与血供多少有一定关系,但特异性不高,而病灶的增强次应与血供关系密切,多血供者中95%有显示的增强效应,少血供者仅占4.7%;B超所示病灶的回声高低与血供亦有一定关系,但特异性稍差。结果表明,D 相似文献
103.
104.
小鼠原位脂肪肝移植模型的建立 总被引:2,自引:1,他引:1
目的 建立了ob/ob小鼠脂肪肝移植模型 ,探讨保证建模成功的关键因素。方法 采用小鼠非动脉化肝移植技术 ,5~ 7周肥胖小鼠为供体 ,正常小鼠为受体 ,双袖套法行原位肝移植。受体肝组织行HE染色和油红O染色 ,血清ALT、AST水平检测采用常规生化分析法。结果非脂肪肝移植组 (lean to lean)受体长期存活率 (n =10 )为 70 % ,脂肪肝移植组 (ob/obtoagematchedlean)受体存活率为 0 (n =10 ) ,差异有显著性 (P <0 .0 5 )。脂肪肝移植给体积相当的正常小鼠 ,其短期存活率为 3 0 % (n =10 ) ,所有小鼠术后存活并苏醒 ,但均未超过 2 4h。脂肪肝移植受体ALT水平为 (62 85± 2 93 7)U /L ,AST为 (5 812± 2 942 )U /L ;而正常小鼠移植组ALT与AST水平分别为 (5 96± 114 )U /L ,(1796± 870 )U/L ,差异有显著性 (P <0 .0 5 ) ,组织学检测显示大量胆管中央凝固性坏死伴出血。结论 该模型的成功建立为我们提供了一种新的肝原发性肝无功能移植模型 ,为脂肪肝移植后脂肪肝细胞受损的机制研究奠定了基础。 相似文献
105.
肝腺瘤的影像学诊断 总被引:5,自引:1,他引:4
目的探讨影像学(US、CT、MRI及DSA)诊断肝腺瘤的价值。方法回顾性分析经手术、病理证实的11例肝腺瘤的影像学表现,其中11例行US和CT检查(有1例行CT灌注成像,CTP),5例行MRI扫描,4例行DSA检查,并与手术病理所见对照。结果11例肝腺瘤均为单发肿块,无肝硬化背景,直径2.0~10.0cm。影像学表现:US检查,10例呈稍低或不均匀稍强回声,边界清晰,6例见低回声晕,彩色多普勒显示肿块内有较丰富的血流;CT检查,10例为稍低或等密度,8/10例动脉期全瘤明显强化,门脉期轻度强化,延迟期呈等密度,1例平扫和延迟期呈等密度,动脉期中度强化,门脉期轻度强化,误诊为血管瘤。1/11例CT灌注成像(CTP)检查,肝动脉灌注量(HAP)=1.08ml/(min.ml),门静脉灌注量(PVP)=0.19ml/(min.ml),肝动脉灌注指数(HPI)=0.85,各参数值与肝癌均有明显不同;MRI检查,5例肝腺瘤均能显示完整包膜,T1WI上2例稍高于肝脏信号,1例呈等信号,2例为稍低信号,T2WI上5例均表现为以稍高信号为主的混杂信号,脂肪抑制像(STIR)1例呈略低信号,4例信号与T2WI相似,行增强扫描的4例病灶动脉期显著强化,门脉期强化减退,平衡期呈等信号。DSA检查,3/4例病灶见粗细不均的异常血管影,实质期可见肿瘤染色表现。结论肝腺瘤的US和DSA表现均缺乏特异性,CT、MRI则具有一定的特点。CTP对肝腺瘤可能具有诊断和鉴别诊断价值。 相似文献
106.
107.
2型糖尿病并脂肪肝与血脂紊乱的关系探讨 总被引:2,自引:0,他引:2
目的 探讨 2型糖尿病并脂肪肝患者与脂代谢紊乱之间的关系。方法 对 60例 2型糖尿病并脂肪肝和 5 2例 2型糖尿病不并有脂肪肝病例的血脂谱 ,空腹血糖 (FPG ) ,餐后 2小时血糖 ( 2hPG) ,空腹胰岛素 (FINS)进行测定 ,计算体重指数 (BMI)及胰岛素敏感指数 (ISI)。结果 2型糖尿病并脂肪肝与不并脂肪肝相比 ,甘油三脂 (TG) ,低密度脂蛋白胆固醇 (LDL -C) ,FINS均升高 (P <0 .0 5 ,P <0 .0 1) ,而ISI明显降低 (P <0 .0 1)、脂蛋白a(Lp(a)降低(P <0 .0 5 )。结论 2型糖尿病并脂肪肝比不并脂肪肝者存在明显脂代谢紊乱及胰岛素抵抗 相似文献
108.
Objective: To study the calcium channel reaction of human Leydig cells induced by hCG/ATP at different extracellular calcium ion concentrations. Methods: The Leydig cell calcium ion concentration was examined with laser confocal microscope, when the cells were stimulated with hCG/ATP at different extracellular calcium contrations. Results: With calcium-containing extracellular fluid, the Leydig cells were sensitive to hCG stimulation and when the extracellular fluid was calcium-free, the Leydig cells did not respond to the stimulation. However, the Leydig cells did respond to ATP stimulation no matter the extracellular fluid contained calcium or not. Conclusion: In human Leydig cells, there are calcium channels sensitive to hCG and ATP. The extracellular calcium ion concentration plays an important role in the regulation of Leydig cell metabolism by hCG/ATP. 相似文献
109.
朱君华 《浙江中医药大学学报》2007,31(3):339-339,341
[目的]探讨脂必妥胶囊联合疏肝健脾、化痰祛瘀中药治疗脂肪肝的临床疗效。[方法]将45例脂肪肝患者随机分为两组,治疗组25例,使用脂必妥胶囊联合疏肝健脾、化痰祛瘀中药治疗3月;对照组20例,单用脂必妥胶囊治疗3月,观察患者治疗前后血清丙氨酸转氨酶(ALT)、甘油三酯(TG)、血清总胆固醇(TC)的变化。[结果]治疗组总有效率为84.0%,而对照组仅70.0%;治疗组TG、TC治疗后下降明显;治疗后与对照组治疗后比较也下降明显。[结论]脂必妥胶囊联合疏肝健脾、化痰祛瘀中药治疗脂肪肝是一种有效的方法。 相似文献
110.
Update on ascites and hepatorenal syndrome 总被引:5,自引:0,他引:5
P. Gentilini F. Vizzutti A. Gentilini M. Zipoli M. Foschi R. G. Romanelli 《Digestive and liver disease》2002,34(8):592-605
Ascites is the most common complication occurring during liver cirrhosis. Even if a significant decrease in renal clearance may be observed in the first step of chronic active liver disease, renal impairment, at times complicated by the typical signs of hepatorenal syndrome, occurs only in patients with ascites, especially when tense and refractory. Experimental and clinical data seem to suggest a primary sodium and water retention in the pathogenesis of ascites, in the presence of an intrahepatic increase of hydrostatic pressure, which, by itself, physiologically occurs during digestion. Abnormal sodium and water handling leads to plasma volume expansion, followed by decreased peripheral vascular resistance and increased cardiac output. This second step is in agreement with the peripheral arterial vasodilation hypothesis, depicted by an increase in total blood volume, but with a decreased effective arterial blood volume. This discrepancy leads to the activation of the sympathetic nervous and renin-angiotensin-aldosterone systems associated with the progressive activation of the renal autacoid systems, especially, that of the arachidonic acid. During advanced cirrhosis, renal impairment becomes more sustained and renal autacoid vasodilating substances are less available, possibly due to a progressive exhaustion of these systems. At the same time ascites becomes refractory inasmuch as it is no longer responsive to diuretic treatment. Various pathogenetic mechanisms leading to refractory ascites are mentioned. Finally, several treatment approaches to overcome the reduced effectiveness of diuretic therapy are cited. Paracentesis, together with simultaneous administration of human albumin or other plasma expanders is the main common approach to treat refractory ascites and to avoid a further decrease in renal failure. Other effective tools are: administration of terlipressin together with albumin, implantation of the Le Veen shunt, surgical porto-systemic shunting or transjugular intrahepatic portosystemic stent-shunt, or orthotopic liver transplantation, according to the conditions of the individual patient. 相似文献