带蒂大网膜填塞治疗巨大肝包虫囊肿44例

我院1981年12月～1996年12月，对高原地区44例囊壁坚厚，不易塌陷，囊腔直径大于5cm的肝包虫患者采取“内囊摘除带血管蒂大网膜填塞法”为主要手段治疗，取得满意效果。1临床资料．1一般情况本组44例，男35例，女9例；年龄24～60岁，平均372岁。以石上腹隐痛不适，伴腹胀、恶心、呕吐等就诊。病史2～4．5年。43例有牧区居住史，l例末去过牧区，但有牲畜接触史。包虫抗体间接血凝试验均阳性，B超肝内均可探及有囊壁的液性暗区，单发于肝右叶39例，肝左叶4例，左叶、右叶均有一囊胜1例。包囊最小4．7cmX56cm，最大74cmX85cm，平均65cmX78cm…     

肾脏裂伤（带蒂大网膜片包肾的动物实验）

用14只杂交狗进行实验观察。动物平均分成2组。一组以左半带蒂大网膜片包裹受伤之肾，男一组用肠线捆缚，作为对照。术后1个月（各2只）、3个月（各2只）和6个月（各3只）分别将伤肾切除，进行组织病理学观察。肾切除对．网膜组肾脏与周围组织粘连轻，3只动物的大网膜片在肾表面形成一光滑薄膜。肠线组肾脏体积明显缩小，术后6个月比原先缩小52％。但两组病理改变所见相似。尽管如此，网膜组还是优于肠线组。     

大网膜带蒂移植治疗慢性脓胸6例的体会

1988年以来，我们共收治了虽经适当治疗，但经久不愈的慢性脓胸6例。采用大网膜带蒂移植脓腔，取得了令人满意的效果。临床资料本组6例，男5例，女1例。年龄28～56岁。左、右侧各3例，病程6～42个月，平均19个月。其中4例为结核性脓胸；1例为右肺巨大囊肿合并支气管胸膜疾，在外院行右全肺切除后感染17个月未愈；l例为主主支气管异物肉芽肿，外院按肺癌行左肺全切后感染42个月未愈；1例合并支气管胸膜接，均经过长时间消炎或抗涛，反复胸穿，闭式引流；2例行胸膜剥脱，均告失败。本组治疗方法为病灶清除，移植带蒂大网膜固定充填脓腔，术后…     

带蒂大网膜移植治疗胸段食管穿孔8例

自 1994年以来 ,我们用带蒂大网膜移植术治疗胸段食管创伤穿孔 8例 ,收到了良好的效果。1　临床资料1 1　一般情况　 8例中 ,男 6例 ,女 2例 ;年龄 16 58岁 ,平均 30 2岁。右侧穿孔 5例 ,左侧 3例 ,裂口长2 0 7 5ｃｍ。上段 2例 ,中段 4例 ,下段 2例。受伤至手术时间 6ｈ12ｄ。 2 4ｈ内手术 1例 ,余 7例均延误诊治 ,延误诊治率 87 5%。 8例术前均经口服亚甲蓝后胸腔闭式引流液变蓝色及口服碘水造影明确诊断。刀刺伤 1例 ,手术损伤 2例 ,钝性伤 5例。均有剧烈胸痛 ,伴明显呼吸困难 6例 ,伴腹部压痛、板状腹 2例 ,伴创伤失血性休克 1例。Ｘ…     

前房穿刺在角膜全层裂伤修补术中的应用

目的：探讨前房穿刺术在角膜全层裂伤修补术中应用的方法及结果。方法：将1995至1998年复杂性角膜裂伤分为A、B两组。A组：常规缝合，由创口或辅助切口恢复前房及解除前粘连；B组：缝合时常规行前房穿刺术，由穿刺口恢复前房及解除前粘连。结果：术中器械进入前房次数≥2次；A组28上,B组3眼；后弹力层剥脱：A组6眼，B组1眼；缝线松驰、创口漏水：A组7眼，B组0眼；术后虹膜前粘连：A组12眼，B组12眼，P＜0．01。结论：角膜全层裂伤修复术中应用前房穿刺术安全有效。     

大网膜在肝外伤手术中的应用

评价大网膜在肝外伤术中应用的方法及价值.应用大网膜时必须对肝创面彻底清创,严格结扎血管、胆管.大网膜填塞有一定的压力,盲目大网膜填塞易再出血,应慎用.     

带蒂颞深筋膜瓣在颅脑损伤后颅骨修补中的应用

我科自 1996年 7月起在重型颅脑损伤患者行颞肌下减压术时 ,采用带蒂颞深筋膜瓣修复张力性硬脑膜缺损 ,至2 0 0 1年 8月有 12 4例患者再次行颅骨修补术 ,效果满意。报告如下。临床资料　 (1)一般资料 :本组男89例 ,女 3 5例 ;年龄 15～ 69岁 ,平均 47.3岁。 (2 )手术方法 :在行颞肌下减压术时均采用带蒂颞深筋膜瓣修复张力性硬脑膜缺损。减压骨窗部位为双侧额颞部 ,颅骨缺损面积最小 5.0 × 5.0 ,最大 10 × 12 。颅骨修补手术时间 :脑外伤术后切口愈合 3～ 10个月 ,平均 4个月。修补材料选用钛网片。手术按原开颅切口入路 ,分离颅骨缺…     

网膜填塞在肝包虫病术中的应用32例

肝包虫病(Echinococcus cyst of the livet)又称肝棘球蚴病,是由犬绦虫(棘球绦虫)的幼虫(棘球蚴)侵入肝脏后引起的一种囊性病变。在我国西北及西南畜牧区常见。其手术方式多样,其中以传统术式-肝包虫内囊摘除,外囊内翻缝闭术为临床常用。我院自1998年8月-2000年8月共行肝包虫手术48例,其中行肝包虫开窗及网膜填塞术32例,取得了满意效果,现报告如下。     

Primary tumours of the greater omentum

Primary tumours of the greater omentum are very rare. Ultrasound allows the detection and characterization of such lesions, but determination of their precise anatomical location is usually difficult by US. Computed tomography determines the omental origin of the tumour. Thus,when US reveals an abdominal tumour of unknown origin, the possibility of an omental tumour, although rare, must be kept in mind and CT should be performed. Received 3 October 1997; Revision received 4 March 1998; Accepted 5 March 1998     

Cystic mesothelioma of the greater omentum]

Peritoneal cystic mesothelioma is very rare clinical entity, and only a few cases situated on the greater omentum are described. The authors here presented two cases of the greater omentum cystic mesothelioma that were diagnosed in 260,000 adult patients hospitalized for the first time, during the fifteen year period. Cystic tumor of 30 cm in diameter was found in a 78 years old male patient, and the second one was 35 cm in diameter in female patient 56 years old. Symptomatology was not characteristic. Peritoneal pseudocyst or parasitic, lymphogen, urogenital, enteric or dermoid cyst origin was preoperatively excluded, and correct diagnosis was established upon the operative findings and immuno-histochemical investigations. In both cases keratin and vimentin were clearly positive in tumor cells, but other markers were negative (EMA, Actin, S-100, NSE, chromogranin and sinoptophysin). Cystic mesothelioma was not infiltrative and surgical treatment was simple and successful.     

脾全切大网膜包肺术治疗门脉高压症的临床分析(附8例报告)

目的：探讨门脉高压症脾全切大网膜包肺术术式，并与黄凤瑞脾大部切除肺包脾并大网膜包肺术比较。方法：对8例门脉高压症患者行脾全切大网膜包肺术治疗，并观察其临床效果。结果：本组患者经随访1年～3年，均无术后再出血。术后4个月钡察复查，1例轻度食道静脉曲张者已完全消失；5例中度曲张者，有4例完全消失，1例减轻；2例重度曲张者明显减轻。腹水消失，肺功能改善，白细胞上升，生活质量提高。结论：论术式具有操作简单，术后恢复快、并发症少，而与黄凤瑞术式疗效相同等优点，值得临床推广。     

X-ray computed tomography in pathology of the greater omentum

CT examinations were reviewed in 19 patients with proved omental lesions (15 metastases, 1 lymphoma, 1 benign mesothelioma, 1 echinococcosis and 1 tuberculosis). Four distinct but aspecific patterns of omental pathology were identified with CT: omental caking; finely infiltrated fat with a "smudged" appearance; discrete nodules; cystic masses. CT is the most reliable radiographic technique to routinely evaluate omental lesions.     

Idiopathic segmental infarction of the greater omentum diagnosed by unenhanced multidetector-row CT and treated successfully by laparoscopy

Idiopathic segmental infarction of the greater omentum is a rare disorder presenting with nonspecific clinical symptoms that may mimic a variety of acute abdominal conditions. We describe the diagnosis and treatment of two patients who had idiopathic infarction of the greater omentum and presented with localized abdominal pain, mimicking acute cholecystitis and acute diverticulitis, respectively. Patients underwent unenhanced multidetector-row computed tomography (CT) examination, which demonstrated the characteristic features of omental infarction, consisting of a heterogeneous density fatty mass, containing hyperattenuating streaks, located in the greater omentum, between the anterior abdominal wall and the colon; a moderate amount of free peritoneal fluid was also present. There were no other pathological abdominal findings. Giving persisting and worsening symptoms, both patients underwent laparoscopy with resection of the necrotic portion of the omentum. Pathology confirmed the preoperative diagnosis. Unenhanced CT allows us to obtain a reliable diagnosis of omental infarction in patients with acute abdominal pain and may help in selecting the appropriate medical or surgical therapy.     

原发性大网膜扭转伴梗死一例

患者男,30岁.无明显诱因出现腹胀、右下腹痛并渐进性加重2 d,伴恶心及低热.体检:体温38℃,肠鸣音减弱,腹肌紧张,右下腹压痛及反跳痛,Murphy征阴性,腹部未扪及包块,肋脊角无压痛.实验室检查:白细胞升高至19.8×109/L,中性粒细胞百分比为83.4%.     

Primary leiomyosarcoma of the greater omentum: CT findings

Three cases of primary leiomyosarcoma arising from the greater omentum are described. On CT the tumors were multilobulated, flat, and pancake-like, with enhancing solid and multicystic densities. The masses in all cases were located in the most anterior part of peritoneal cavity. These CT findings are useful in the preoperative diagnosis of omental leiomyosarcoma.     

CT diagnosis of primary torsion of greater omentum

The etiology of primary volvulus of the omentum in the absence of other intraabdominal pathology remains obscure. Abdominal pain and tenderness are always present. Computed tomography demonstrates an abdominal mass composed of fatty and fibrous folds. Characteristic for a torsion is the concentric distribution of the fibrous folds at the site of torsion.