脾切除贲门周围血管离断术后肝脏血流动力学和储备功能的变化

Objective To observe changes of hepatic hemodynamics and hepatic functional reserve after splenectomy and periesophagogastric devascularization. Methods From July 2006 to August 2007, thirty patients with portal hypertension caused by hepatitis B cirrhosis underwent splenectomy and periesophagogastric devascuiarization. The PVPG (portal venous pressure gradient) was measured by inductor continually during operation. The HAF (hepatic artery flow), PVF (portal venours flow) and hepatic arterial RI(resistant index) were measured with Doppler sonography. The EHBF(effective hepatic blood flow) and ICGR15 (indocyaninegreen retention rate at 15 minutes) were obtained respectively by indocyaninegreen clearance test before and after the operation. Results PVPG after laparotomy (19±4) mm Hg, ligating the splenic artery(14±4) mm Hg, splenectomy(14±3)mm Hg and periesophagogastric devascularization (12±4) mm Hg showed a tendency to decrease progressively. The PVF decreased [from (42±14) ml/s to (16±8) ml/s] and HAF increased in compensation after operation. The EHBF increased [from (0.48±0.10) L/min to (0.56±0.10) L/min], and the ICGR15 decreased (from 23%±8% to 18%±4%) postoperatively. Conclusion After splenectomy and periesophagogastric devascularization, the hepatic functional reserve improves at least in a short term notwithstanding the decrease of PVPG and PVF.     

圆形分布法在传染病流行病学调查中的应用

在传染病的发生过程中,某些疾病存在着明显的季节性,如呼吸道传染病、消化道传染病等,这些呈季节性变动的资料可通过三角函数变换,使原始数据成为线性资料.本文以长春市1990、1991、1992年细菌性痢疾(以下简菌痢)各月发病为例用圆形分布法进行统计分析,以了解细菌性痢疾发病高峰的集中时间和流行期,从而为传染病监测和防治工作提供科学依据.     

果胶对飞行人员血脂水平的影响

旨在探讨预防飞行人员高脂血症的途径。17名健康飞行人员,每天服果胶胶囊12粒,共4.8g果胶,连服21天。实验后血清甘油三酯水平(0.45±0.17mmol/L)较实验前(0.56±0.29mmol/L)降低,两者比较有显著性差异(P<0.05),实验前后高密度脂蛋白胆固醇、血清总胆固醇无显著性变化。     

常温下连续阻断半肝血流60 min在乙肝肝硬变患者肝切除术中的应用

目的评价常温下连续阻断半肝血流60min行不规则肝切除术对乙肝肝硬变患者剩余肝脏安全性的影响。方法回顾性分析1995年1月至2006年12月在华西医院施行半肝血流阻断肝切除术的232例乙肝肝硬变伴有肝细胞癌患者的临床资料。依据半肝血流阻断时间将患者分成3组：〈60min组、60～90min组和〉90min组;分析3组患者术中的出血量、输血量、肝脏功能和术后并发症发生情况。结果3组术后并发症发生情况比较差异无统计学意义（P〉0.05）。3组患者的AST、ALT、PT和总胆红素水平在术后第1和3d较术前均显著升高（P〈0.05）,于术后第7d则明显下降并接近术前水平;白蛋白水平和血小板计数在术后第1d较术前均显著下降（P〈0.05）,于术后第3和7d则明显升高并接近术前水平。〉90min组的住院时间、ALT和AST水平均高于〈60min组和60～90min组（P〈0.05）,而后2组间差异则无统计学意义（P〉0.05）。结论半肝血流阻断法在乙肝肝硬变不规则肝切除术中具有可行性和一定的安全性;当半肝血流阻断时间〉90min时,使用该方法应慎重。     

老年腰椎间盘突出症的手术治疗策略

<正>老年腰椎间盘突出症(Lumber Disc Hernation,LDH)是指发生在65岁以上者的LDH。随着我国社会老龄化进程的加快,老年LDH患者数量呈逐年上升趋势。本研究就近年来老年LDH的临床手术治疗及科研进展文献作一综述,以期阐明老年腰椎间盘突出症的特点及手术治疗老年腰椎间盘突出症的机制,为老年腰椎间盘突出症的手术治疗提供参考。     

脾切除贲门周围血管离断术后肝脏血流动力学和储备功能的变化

Objective To observe changes of hepatic hemodynamics and hepatic functional reserve after splenectomy and periesophagogastric devascularization. Methods From July 2006 to August 2007, thirty patients with portal hypertension caused by hepatitis B cirrhosis underwent splenectomy and periesophagogastric devascuiarization. The PVPG (portal venous pressure gradient) was measured by inductor continually during operation. The HAF (hepatic artery flow), PVF (portal venours flow) and hepatic arterial RI(resistant index) were measured with Doppler sonography. The EHBF(effective hepatic blood flow) and ICGR15 (indocyaninegreen retention rate at 15 minutes) were obtained respectively by indocyaninegreen clearance test before and after the operation. Results PVPG after laparotomy (19±4) mm Hg, ligating the splenic artery(14±4) mm Hg, splenectomy(14±3)mm Hg and periesophagogastric devascularization (12±4) mm Hg showed a tendency to decrease progressively. The PVF decreased [from (42±14) ml/s to (16±8) ml/s] and HAF increased in compensation after operation. The EHBF increased [from (0.48±0.10) L/min to (0.56±0.10) L/min], and the ICGR15 decreased (from 23%±8% to 18%±4%) postoperatively. Conclusion After splenectomy and periesophagogastric devascularization, the hepatic functional reserve improves at least in a short term notwithstanding the decrease of PVPG and PVF.     

脾切除贲门周围血管离断术后肝脏血流动力学和储备功能的变化

Objective To observe changes of hepatic hemodynamics and hepatic functional reserve after splenectomy and periesophagogastric devascularization. Methods From July 2006 to August 2007, thirty patients with portal hypertension caused by hepatitis B cirrhosis underwent splenectomy and periesophagogastric devascuiarization. The PVPG (portal venous pressure gradient) was measured by inductor continually during operation. The HAF (hepatic artery flow), PVF (portal venours flow) and hepatic arterial RI(resistant index) were measured with Doppler sonography. The EHBF(effective hepatic blood flow) and ICGR15 (indocyaninegreen retention rate at 15 minutes) were obtained respectively by indocyaninegreen clearance test before and after the operation. Results PVPG after laparotomy (19±4) mm Hg, ligating the splenic artery(14±4) mm Hg, splenectomy(14±3)mm Hg and periesophagogastric devascularization (12±4) mm Hg showed a tendency to decrease progressively. The PVF decreased [from (42±14) ml/s to (16±8) ml/s] and HAF increased in compensation after operation. The EHBF increased [from (0.48±0.10) L/min to (0.56±0.10) L/min], and the ICGR15 decreased (from 23%±8% to 18%±4%) postoperatively. Conclusion After splenectomy and periesophagogastric devascularization, the hepatic functional reserve improves at least in a short term notwithstanding the decrease of PVPG and PVF.     

空军某医院死亡病例医院感染调查及危险因素分析

本文采用回顾性调查的方法,对空军某医院470例死亡病例的医院感染情况作了报道,并分析了有关的危险因素。470例中发生医院感染的共有117例(24.89％),其中因医院感染直接造成死亡的51例(43.59％)。并按不同科室。原有疾病种类。感染部位,病原体种类等分别调查了医院感染情况。其主要危险因素为:滥用抗生素、应用肾上腺皮质激素、住院时间长、年龄大等。OR值分别为10.30、4.32、3.72、2.07,X~2 检验与95％CL值均有显著性意义。     

IL-2对慢性肝病HBV血清标志物的疗效观察

有关文献报道HBV所致的慢性活动性肝炎患者血清白细胞介素-2(IL-2)活性显著低下,其活性降低程度与HBV的复制有关。有人应用IL-2治疗慢性乙型肝炎也证实了其对HBV有抑制作用。本文应用IL-2治疗31例慢性乙型肝炎,观察IL-2对慢性肝病HBV血清学复制指标之一HBeAg及其它标志物的影响,报道如下:1 临床资料1.1 病例选择 实验组31例,年龄15岁～66岁,平均38岁,其中慢活肝9例,慢迁肝22例。对照