肝硬化门脉高压症与消化道内分泌的有关问题(文献综述)

导言肝硬化门脉高压症是外科中常见的一个疾病,治疗上比较困难,人们对其发病机理的认识也还不十分清楚.多年来,对于门脉高压症发病机理的研究工作,多限于血流动力学的观察,如压力、流量、阻力等等.对于发病机理的认识大致有两个阶段;自从1928年McIndoe提出肝内纤维结缔组织增生,压迫肝内小静脉及肝窦,致使门脉血流受阻,造成门脉压增高以后,Whipple等对此理论进一步加以说明,形成了所谓的"被动瘀血"的理论.直到最近新版的克氏外科学一书中Orloff还是引用了这一理论做为门脉高压症经典的发病机理.但是,自五十年代以后,人们经过对门脉高压症血流动力学的大量研究及临床观察,对这一理论产生了怀疑.人们发现有的肝硬化门脉高压症病人     

NONSPECIFIC THYROIDITIS

A clinical and pathological study was made on 53 cases of nonspecific thyroiditis operated on from 1962 through 1982. These included 36 Hashi. moto's disease, 7 Riedel's disease and 10 giant cell thyroiditis. There was no operative mortality or serious complication. With Hashimoto's disease, postoperative hypothyroidism occurred in 23 patients (63.9%) and the degree of lymphocytic infiltration of the thyroid appeared to be a more important factor relating to the occurrence of postoperative hypothyroidism rather than the amount of thyroid tissue resected. In mild Iymphocytic infiltration hypothyroidism did not appear when resection was limited to less than 50%. Therefore, intraoperative frozen section biopsy is beneficial not only for diagnosis but also for the choice of a proper opera- tive procedure. An association of Hashimoto's disease with hyperthyroidism was found in 10 cases. There were 3 clinical types of such association: Symptoms of hyperthyroidism preceded thyroiditis; thyroiditis occurred first and then the symptoms of hyperthyroidism; and both disorders occurred simul- taneously. As thyroiditis is generally considered an autoimmune disease, whether these three clinical types are different stages of the autoimmune reaction needs further investigation.     

脾肾静脉分流术治疗门脉高压症140例远期疗效观察

门脉高压症是我国常见多发病之一,北方地区的患者,绝大多数继发于结节性、坏死后性肝硬变。本病予后较差,多数病人在不长的时间内可死于急性上消化道出血或肝功能衰竭。1945年,首先由Whipple Blakemore和Lord报告了应用门静脉——下腔静脉分流术(简称门腔分流术)。1947年,Linton等人报告了应用脾切除脾肾静脉分流术(简称脾肾分流术)治疗门脉高压症以来,分流术已为各国普遍采用。1952年,我国首先由上海     

外科病人手术前后正确处理的重要性

手术是治疗外科疾病的一个重要手段。手术的操作技术正确与否直接影响到治疗效果,多受到外科医生的重视。然而,手术前后处理对疗效的影响却易被忽略或未受到应有的重视。临床上有时会遇到这样的情况:一个疑难或复杂的病例经过手术治疗后,病人顺利地得到恢复;而另一个病情比较单纯的病例术后反而会出现某些意外的并发症,导致治疗失败。譬如一个Sheehan氏综合征合并门脉高压症的病人发生食管静脉曲张破裂出血,处于肝昏迷前期,由于手术前后处理适当,病人经急症分流,术后顺利恢复。另一个遗疡病穿孔的病人,由于术前准备不够充     

胃手术后胆汁逆流问题

胃部分切除术和迷走神经切断并附加各种引流术破坏了幽门管的功能,引起碱性十二指肠液逆流问题,日益受到临床的重视。自应用不加引流的高选择性迷走神经切断术(简称HSV)以来,认为保留了幽门括约肌的功能,胆汁性呕吐发生率已明显下降,但胆汁逆流情况尚不清楚。     

休克

休克为一临床常见病症,各家研究颇多,但由于对本症生理、病理所得仍嫌不足,故尚难做出确切定义。目前,大体上可以认为休克是由于各种不同原因所引起一个临床症候羣,是身体中枢神经系统对损伤(包括肉体的和精神的)反应的结果;它的主要临床表现是血压降低,它的基本生理变化是由于血管容积与血循环量之间的差     

乳癌根治術与擴大根治術的療效比较

乳癌根治术在我国已经沿用多年,近年来扩大根治术又在开展。为了了解两种手术的疗效,本文分析1951年至1960年间,国内十个城市(北京、上海、天津、青岛、广州、杭州、武汉、长春、石家庄、兰州),乳癌患者共2573例,这些病例皆经病理检查证实。     

LONG-TERM RESULTS IN SURGICAL TREATMENT OF CROHN''S DISEASE

55 patients (24 were male and 31 female; age range 12-'75 years) with Crohn's disease were treated surgically. The lesions were single in 32 (58.2%) and multiple in 23 (41.8To). The distribu- tion was: the small intestine, 26 patients (48.2'70); the colon 20 (35.7%); and both 9 (16.170). Most patients were opera.te{l upon fo;r a.cute abdo- minal pain, intestinal obstruction, abdominal mass and intestinal bleeding. Five patients (9.1%) died during ho.spitalizatioin, 49 were followed up for 0.5 t0 32 years;. Clinical cure was obtained in 22 (54.6To) of the resection group and in 4 (30.7%) of the nonresection group. Indications for surgical treatment are described and com- plications discussed.     

重视胃癌的临床诊治

我国胃癌的发病率在世界上不是最高的地区,比不上日本或南美一些国家,也低于欧洲诸国,但它却是我国最常见的恶性肿瘤之一。根据七十年代的调查,我国胃癌的年龄调整死亡率每10万人口男性为20.93,女性为10.16,都居于恶性肿瘤的第一位。恶性肿瘤是我国人口主要死因之一,在男性仅次于呼吸系病,居第二位;在女性又次于心血管病居第三位。因此胃癌是危害我国人民健康的一个重要疾病而应予以更多的重视。目前我国对胃癌的临床诊治水平还不能说是令人满意的。从国内文献资料来看,纤维内窥镜检出的胃癌中,早期胃癌的比例只占7.3%。在大数量病例的分析中,Ⅰ期胃癌也只占根治切除病例中的7.5%,而能得到根治切除的又只占就诊病例的23%。说明我国在胃癌的早诊和早治方面还存在着问题。从远期疗效来看,胃癌切除术后的五年生存率为20.8%,如将姑息