先天性胃壁肌层缺损诊治体会

目的 探讨提高新生儿先天性胃壁肌层缺损治愈率的方法。方法 总结分析近年来收治的本症11例患儿(均经过病理检验证实)的临床及相关资料。结果 11例患儿中，8例存活，其中7例为近十年的病例。1例死亡，2例放弃治疗，均为十年以前的病例。在存活者中，经追踪观察及消化道造影检查，残胃有明显代偿性生长，患儿生长发育未受到明显的影响。结论 早期发现、及时手术、控制感染、术后营养、支持治疗，其预后良好。     

Airway troubles related to the double-lumen endobronchial tube in thoracic surgery

Purpose Several case reports indicate critical respiratory complications in relation to the double-lumen endobronchial tube (DLT). A prospective survey for the airway problems in using the DLT is presented. Methods One hundred adult patients undergoing thoracotomy for lung cancer were investigated. Tube malposition and airway obstruction were searched using a fiber-optic scope. The endobronchial cuff was positioned just below the trachcal carina while the trachea was intubated with a DLT (Rüsch). The distances of displacement, from the tracheal carina to the bronchial cuff, were measured during anesthesia using an epidural catheter, which had marks every 5 mm. The distances for correcting the tube position were measured at both the bronchial cuff and the level of the teethPaO₂,PaCO₂ andSPO₂ were also measured. Results Malposition (displacement over 5 mm from the correct position) was found in 42 patients, and 40 of them were in a withdrawal direction, occurring at the postural change and during one-lung ventilation, especially during manipulation of the lung hilum. Correcting distances at the level of the teeth were 15.3–3-times longer than those at the bronchial cuff. Airway deformities and gradual withdrawal of the bronchial cuff were found in association with surgical manipulation. Obstruction occurred at the tips of the tracheal tube in four patients and the bronchial tube in six patients, and at the tip of both in two patients. Hypoxemia (PaO₂<60 mmHg) occurred in four patients and hypercapnea (PaCO₂>60 mm Hg) in two patients. Conclusion Most of the DLT obstructions were associated with withdrawal malposition. Great attention to DLT displacement and airway deformity is advised.     

未破裂期输卵管妊娠介入治疗术的护理配合

目的 :根据 14例未破裂期输卵管妊娠病人在介入治疗过程中的护理配合 ,提出术前、术中、术后的护理配合是介入治疗成功的重要环节。方法 :14例病人中 ,7例采用经阴道输卵管孕囊内药物注射方式 ,7例采用经健侧股动脉穿刺子宫动脉内插管灌注栓塞方式。结果 :全部病例均获得满意的疗效。结论 :随着介入技术的应用和普及 ,对护理工作提出了更高的要求 ,总结经验、完善新技术条件下的护理配合 ,是摆在护理工作者面前的一项新任务     

甾体避孕药不增加血栓栓塞性疾病危险(病例对照研究)

本文采用1:3病例对照研究方法,对甾体避孕药的使用与血栓栓塞性疾病(急性心肌梗塞、脑栓塞、脑血栓形成和深静脉血栓形成)间的关联进行多因素分析。结果提示在我国广泛应用的甾体避孕药(主要为国产Ⅰ号避孕药)并不增加血栓栓塞性疾病的危险性。用药和停药时间的长短与血栓栓塞性疾病的发生无关,并与高血压病之间亦不存在协同作用。     

Segmental Uterine Horn Replacement in the Rat Using a Biodegradable Microporous Synthetic Tube

To investigate the possible use of a biodegradable microporous synthetic tube for fallopian tube replacement, polyetherurethane/poly-L-lactide (PU/PLLA) grafts in the uterine horn of the rat were studied and their patency and healing characteristics compared with those of nonbiodegradable polytetrafluoroethylene (PTFE; Teflon) grafts as well as with those of reanastomosed uterine horns. Regarding the healing characteristics, the PU/PLLA grafts were superior to the PTFE graft, as was indicated by the regeneration of endometrium and the extensive perigraft tissue ingrowth. However, the graft/uterine anastomoses of the PU/PLLA and PTFE grafts became obstructed by a plug of mucosal folds, all reanastomosed, uterine horns in the control experiments remaining open. In conclusion, although biodegradable microporous PU/PLLA uterine horn grafts have better healing characteristics than PTFE grafts, they easily obstruct at the graft/uterine junction. Mucosal suturing and/or the use of splints may contribute to the feasibility of biodegradable microporous artificial fallopian tubes in tubal surgery.