胃肠吻合口溃疡再手术体会

本院于１９８７年～１９９７年共收治胃肠吻合口溃疡５６例。其中经胃泌素测定及ＣＴ等检查证实胃泌素瘤３例,３３例经内科治疗,症状得到控制,２０例再手术效果满意。本文就再手术治疗２０例吻合口溃疡总结如下。１临床资料１．１一般资料：２０例患者中男１８例,女２...     

老年活体供肾移植术后供者安全性及受者移植效果的分析

Objective To investigate the safety for donors and the effectiveness for recipients of living-related donor (LRD) kidney transplantation from elder donors. Methods 251 cases of LRD kidney transplantation were reviewed. According to the age of LRDs, the patients were divided into 2 groups:≥55 years group (group A) and <55 years (group B). The parameters studied included serum creatinine (Cr), glomerular filtration rate (GFR), creatinine clearance (Ccr), perioperative complications, average hospital stay, and acute rejection rate of LRDs and recipients were compared. Results (1)There was no significant difference in serum Cr between groups A and B at different time points (P>0.05). (2)There was no significant difference in Ccr between two groups pre-donation (P = 0.45). But at the 10th day after the donor nephrectomy, Ccr level in group A was significant lower than in group B (P<0.01). (3)Total GFR pre-donation, remaining renal GFR, and remaining renal GFR on the day 10 after donation had no significant difference in both groups A and B (P>0.05). Remaining renal GFR on the day 10 before and after donation had no significant difference in group A (P>0.05), but on the day 10 after donation that was significantly increased in group B as compared with that pre-donation (P<0.01). (4) The serum Cr of recipients at different time points after transplantation had no significant difference between two groups (P>0.05). (5) The mean hospital stay after donation of LRDs and recipients had no significant difference between two groups. (6) The incidence of recipients" acute rejection was 6.50 % (5/77) in group A, and 5.75%(10/174) in group B within 6 months after operation (P = 0.95). Conclusion Transplantations performed from the elderly donors will yield similar results from younger donors if the eider donors are evaluated or assessed as the standards.     

“三七九味方”治疗热证吐血

“三七九味方”治疗热证吐血吉林省通化县中医院（１３４１０２）边军伟长白山民间秘方研究所（１３４１０２）王奂实，王爽，王科主题词呕血／中医药疗法，胃热／中医药疗法热证吐血，是中医内科的常见多发病，在现代医学中属于上消化道出血。临床主要特征是吐血，血鲜红...     

吴茱萸碱刺激的负载脊髓匀浆蛋白DCs促进小鼠脊髓损伤的修复

目的探讨吴茱萸碱(evodiamine,EVO)刺激的负载脊髓匀浆蛋白(homogenate protein of spinal cord,hp)树突状细胞(hpDCevo)对小鼠脊髓损伤(spinal cord injury,SCI)的促修复作用及其机制。方法SCI后24 h给予治疗,随机分6组:分别腹腔注射PBS、EVO、未成熟DC(DCs)、经EVO刺激的DCs(DCevo)、负载hp的DC(hpDC)、hpDCevo。利用BMS功能评分及组织病理学方法,观察hpDCevo对小鼠脊髓损伤神经功能恢复和局部瘢痕等病理学改变的影响。ELISA法测定SCI损伤局部组织和T细胞培养上清中的脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、神经营养因子-3(Neurotrophin-3,NT-3)、白介素-12(interleukin-12,IL-12)、粒-巨噬细胞集落刺激因子(granulocyte-macrophage colonystimulating factor,GM-CSF)的含量。结果注射后第84天,hpDCevo组BMS评分明显高于hpDC组和其...     

成人肱骨远端粉碎性骨折13例治疗体会

自2005～2008年,我院共收治肱骨远端粉碎骨折13例,采用尺骨鹰嘴截骨及Y型钢板内固定,疗效满意,现报告如下：     

临床医学8年制学生学习问卷调查与分析

为保证8年制的教育质量,我们从2004年开始对414名8年制学生的心理状态及学生对教学管理、教学效果的反馈等方面进行了调查,以便及时发现办学过程中的问题,从而制定相应的改革措施,更好地完善8年制医学教育这项创新工程。     

记忆合金环抱器内固定治疗创伤性连枷胸56例

胸部创伤所致多处肋骨骨折是一种严重的胸部损伤,不论平时或战时均常见.多根多处肋骨骨折造成胸壁软化,形成浮动胸壁,亦称为连枷胸.连枷胸所致反常呼吸导致纵隔摆动,严重影响呼吸循环功能,且多合并心、肺挫裂伤、血气胸、失血性休克及急性呼吸衰竭,如救治不及时或处理不当,极易造成患者死亡.     

高压气体致食管破裂及血气胸一例

[病例]男,49岁.因吹吸高压氧瓶阀门后出现胸痛、气短、咯血,伴呕吐1 h人院.患者左胸及胸骨后疼痛较剧,少量咯血、色鲜红,呕吐物为胃内容物.查体:呼吸34/min,短促、费力,心率120/min,端坐位,口唇发绀,球结膜充血,头颈部及前胸皮肤广泛紫红色出血点,颈部及胸部皮下可触及捻发感,左胸语颤减弱,叩诊鼓音,左肺呼吸音减弱,两肺布满湿啰音.心电图提示窦性心动过速;x线胸部平片提示左侧胸腔积液、积气,以积气为主,纵隔及颈胸部皮下气肿.     

记忆合金环抱器内固定治疗创伤性连枷胸56例

胸部创伤所致多处肋骨骨折是一种严重的胸部损伤,不论平时或战时均常见.多根多处肋骨骨折造成胸壁软化,形成浮动胸壁,亦称为连枷胸.连枷胸所致反常呼吸导致纵隔摆动,严重影响呼吸循环功能,且多合并心、肺挫裂伤、血气胸、失血性休克及急性呼吸衰竭,如救治不及时或处理不当,极易造成患者死亡.     

单支与多支移植肾动脉的移植效果观察

目的 比较单支与多支移植肾供肾动脉的移植效果.方法 根据供肾动脉的支数将患者分为3组,A组为单支肾动脉组(251例);B组为2支肾动脉组(12例),但有1支动脉直径<2 mm或估计供血区域<10%.将该动脉结扎(上极动脉);C组为2支或2支以上肾动脉组(35例).分别观察记录3组患者的手术时间、术中失血量、术后并发症以及术后肾功能情况.结果 A、B两组的手术时间较C组短,但差异无统计学意义(均P>0.05).3组的失血最差异无统计学意义(均P>0.05).3组患者术后的肌酐差异无统计学意义(均P>0.05).A组有7.6%(19/251)出现术后并发症;B组有2例出现肾功延迟恢复,无其他并发症,并发症发生率为16.7%(2/12);C组有11.4%(4/35)出现并发症.术后各组1年人/肾存活率差异无统计学意义(P>0.05).结论 单支与多支移植肾供肾动脉组之间比较,除手术时间略长外,在术中失血量、术后并发症、术后肾功能情况、术后急性排斥反应发生率、术后1年人/肾存活率方面均无明显差异.提高血管重建吻合技术是减少多支供肾动脉术后并发症,提高移植肾存活率的关键.