术后早期炎性肠梗阻64例诊治分析

目的 探讨术后早期炎性肠梗阻的临床特点及处理方法。方法 分析64例术后早期炎性肠梗阻的病例资料。结果 64例均行禁食、胃肠减压、应用生长抑素、肠外营养等支持治疗，平均治愈时间13.5d，无一例再手术。结论 术后早期炎性肠梗阻多发性于术后5-15d，可表现为典型的肠梗阻征象，多由小肠无菌性炎症致广泛肠粘连所致，多数病例采用保守疗法可治愈。     

术后早期炎性肠梗阻18例诊治分析

目的 探讨术后早期炎性肠梗阻的临床特点及处理方法.方法 分析18例术后早期炎性肠梗阻的临床特点及治疗结果.结果 18例均胃肠减压,应用生长抑素、肠外营养等支持疗法,平均治愈时间为17 d,1例因"切口裂开"再手术并发小肠瘘.结论 术后炎性肠梗阻多发生在术后5～7 d,可表现为典型的肠梗阻体征,多由小肠无菌性炎症致广泛肠粘连引起,多数病例采用保守疗法可治愈.     

术后早期炎性肠梗阻的诊断与治疗

目的 探讨术后早期炎性肠梗阻的特点和诊断，治疗原则。方法 分析近期经治的术后早期炎性肠梗阻23例。结果 23例病人均经胃肠减压，应用生长抑素，肾上腺皮质激素及肠外营养等治疗后痊愈，平均治愈时间13.2天，无一例再手术引起；（3）症状以腹胀为主，腹痛相对较轻；（4）很少发生肠绞窄。（5）最好先试行保守治疗2-4周，多数有效。     

术后早期炎性肠梗阻32例临床分析

目的 探讨术后早期炎性肠梗阻的诊断和治疗方法.方法 对32例术后早期炎性肠梗阻的临床特点和治疗方法进行回顾性分析.结果 32例患者均经胃肠减压、应用生长抑素、肾上腺皮质激素、肠外营养、抗生素等方法治愈,平均住院时间15d,无一例肠坏死.结论 术后早期炎性肠梗阻的特点①发生于腹部手术后早期.②症状以腹胀为主,疼痛相对轻,部分患者排便、排气,体征典型,但较少发生绞窄.③保守治疗大多有效,过程中应严密观察,如出现肠坏死、腹膜炎时及时中转手术.     

术后早期炎性肠梗阻13例诊治体会

目的总结术后早期炎性肠梗阻的诊治经验。方法回顾13例炎性肠梗阻病人的治疗方法，包括禁食，胃肠减压，全肠外营养，生长抑素和糖皮质激素的应用，中医治疗。结果13例病人中12例治愈，平均治疗时间28d，一例治疗三周后转入上级医院。结论采用非手术治疗术后早期炎性肠梗阻效果满意，并发症少，安全。     

术后早期炎性肠梗阻67例诊治分析

目的 探讨术后早期炎性肠梗阻(EPISBO)的诊断和治疗方法.方法 回顾性分析2000年1月至2007年10月收治的67例EPISBO的临床资料.结果 有64例经非手术治疗治愈;3例经非手术治疗5～7 d后中转手术,2例治愈,1例发生肠瘘后死亡.结论 术后早期炎性肠梗阻好发于腹腔污染重或创伤大的腹部手术,多发生于术后3周以内,有典型的肠梗阻症状和体征,诊断主要依靠病史、体征及腹部X线、CT检查,应先采取非手术治疗,要严格掌握再手术适应证.     

胃肠穿孔术后早期炎性肠梗阻诊治体会

目的探讨胃肠穿孔术后早期炎性肠梗阻的诊断、预防和治疗措施。方法回顾性分析我院2004年1月至2009年1月收治的25例胃肠穿孔术后早期炎性肠梗阻患者病例,全部患者予以持续胃肠减压、营养支持、中药外敷等保守治疗措施,观察治疗效果和病员愈后回访结果。结果25例患者中,22例经保守治疗,痊愈出院;另外3例行剖腹探查术,手术治疗后痊愈。结论胃肠穿孔术后早期炎性肠梗阻患者通过综合治疗能够明显改善术后早期炎性肠梗阻的临床症状、维持患者的营养状况及内环境稳定,促进肠道功能恢复,从而有效地治疗术后早期炎性肠梗阻,避免患者再次手术。     

腹部术后早期炎性肠梗阻的诊治

目的 探讨腹部手术后早期炎性肠梗阻的诊断及治疗.方法 回顾性分析腹部手术后早期炎性肠梗阻22例.结果 22例患者经胃肠减压、营养支持及使用生长抑素、肾上腺皮质激素等综合保守治疗,所有患者均治愈.结论 早期炎性肠梗阻宜采用非手术治疗.     

奥曲肽联合乌司他丁治疗术后早期炎性肠梗阻疗效观察

术后早期炎性肠梗阻(early postoperative inflammatory ileus)是腹部手术后较常见的一种并发症,目前认为,内毒素(LPS)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)在术后早期炎性肠梗阻的疾病进程中发挥了重要作用[1-3]。本文采用奥曲肽和乌司他丁联合治疗术后早期炎性肠梗阻,通过观察治疗后患者体内LPS、IL-6、TNF-α、hs-CRP及临床症状的变化,探讨奥曲肽和乌司他丁联合治疗术后早期炎性肠梗阻的临床疗效及可能机制,现报道如下。     

术后早期炎性肠梗阻17例临床分析

目的:探讨术后早期炎症性肠梗阻的临床特点、诊断、治疗方法.方法:对17例术后早期炎症性肠梗阻病人的临床资料进行回顾性分析.结果:本组患者经非手术治疗,均痊愈出院.结论:非手术治疗早期炎症性肠梗阻是安全、有效的.     

Study of clinical profile and antibiotic response in typhoid fever

The objective of the present study is to evaluate the clinical profile and pattern of various drugs used in the treatment of typhoid fever. A retrospective analysis of adult patients suffering from typhoid fever was done at Kasturba Medical College hospital, Attavar during the year 1999-2001. Diagnosis of patients was based on clinical features, widal test and blood culture. The sensitivity pattern of isolates from blood culture was recorded. The mode of presentation, clinical course, treatment history, laboratory investigations reports, antibiotic administered, response to therapy and the complications were recorded. Total number of 44 cases of typhoid fever were studied. Out of these 21(47.7%) were males and 23(52.3%) were females. Average age of presentation was 23.9 years. Average duration of hospital stay was 10.8 days. Fever was present in all patients. Resistance of S. typhi to amoxicillin, chloramphenicol, ampicillin and co-trimoxazole were significantly high. Ciprofloxacin also showed resistance in 18.1% of cases. Sensitivity to cephalosporin was 100% in our study. Ciprofloxacin was the most commonly used antibiotic in our study (23 patients). Chloramphenicol alone was used in 2 patients and in 3 patients it was given after 6 days of ciprofloxacin treatment. Third generation cephalosporins (ceftriaxone) alone were used in 16 patients. Indiscriminate use of drugs in typhoid fever should be discouraged. Appropriate antibiotic as indicated by sensitivity tests should be employed to prevent the development of resistant strains of S. typhi.     

气管支气管损伤的外科治疗

目的探讨严重胸部损伤中气管、支气管损伤的及时诊断和治疗方法。方法回顾分析23例气管支气管损伤的临床特点、损伤部位、及时诊断和治疗的方法。结果4例叶支气管断裂行肺叶切除术，1例左主支气管完全断裂行切除左全肺，另1例左主支气管完全断裂行左全肺切除。剩余17例，3例气管膜部裂伤经保守治疗痊愈，14例气管支气管损伤者手术治疗修补断裂的气管支气管，术后复查胸片肺膨胀均良好。全组23例无死亡，术后无支气管胸膜瘘发生，均痊愈出院。结论严重胸部创伤的患者通常伴有气管或支气管损伤。如不能及时明确诊断，极易导致管腔狭窄或闭锁，影响患者肺功能。纤维支气管镜检查是尽早明确气管支气管损伤诊断和损伤部位的有效方法。     

成人前列腺肉瘤15例临床病理分析

目的 分析和总结成人前列腺肉瘤的临床和病理特征,以提高对前列腺肉瘤的认识和诊断水平.方法 收集15例前列腺肉瘤患者的临床和病理资料,对标本进行病理形态学观察,免疫组织化学采用EnVision法染色.并对治疗和预后进行总结分析.结果 患者发病年龄22～77岁,平均46.3岁;多数以排尿困难就诊,并且直肠指检和影像学可发现占位体积较大;15例前列腺肉瘤中,平滑肌肉瘤6例,胚胎性横纹肌肉瘤6例,纤维肉瘤3例.随访12例,其中7例术后9 ～360 d死亡,尚存5例随访2～24个月,其中3例目前出现肿瘤复发.结论前列腺肉瘤罕见,发病年龄偏早,尿路症状出现较快,血清中前列腺特异性抗原水平正常或偏低,占位效应明显,预后差.最终诊断依靠HE形态和免疫组织化学的表达.     

小儿后颅窝迟发性血肿23例诊治体会

目的探讨小儿外伤性迟发性后颅窝血肿的临床特征、诊断和治疗。方法回顾性分析我院2002年1月至2012年01月收治的23例小儿外伤性后颅窝血肿的临床资料。结果本组小脑硬膜外血肿11例(3例血肿骑跨幕上),占47.82%,小脑硬膜下血肿6例,占26.08%.,小脑半球血肿4例,其中伴阻塞性脑积水2例,第四脑室内出血2例。6例行非手术治疗,全部治愈;18例行后颅窝血肿清除术(其中有1例为非手术治疗的中转手术),17例治愈,1例死亡,死亡率4.34%。结论小儿外伤性迟发性后颅窝血肿病情隐蔽,早期诊断、及时发现及选择恰当的治疗方案是抢救成功的关键。     

11q23异常恶性血液病的临床和细胞遗传学研究

目的 评估１１ｑ２３异常与恶性血液病的临床,血液学和预后的相互联系。方法 采用骨髓直接法和（或）培养法制备色体标本,用Ｒ显带技术,对６０００例恶性血液病进行核型分析。结果 ６０００例恶性血液病中发现２８例有１１ｑ２３异常,发生率为０．４７％。异常类型有７种：ｔ（４;１１）（ｑ２１;ｑ２３）１０例;ｔ（１１;１９）（ｑ２３;ｐ１３）５例;ｔ（９;１１）（ｐ１２;ｑ２３）２例;ｔ（１０;１１）（ｐ１５     

急性下肢深静脉血栓形成74例治疗分析

目的：观察下肢深静脉血栓形成（DVT）患者药物间接导向溶栓和手术取栓的疗效,为DVT的治疗提供参考依据.方法：下肢（DVT）患者共74例.发病＜7 d 45例中,手术治疗23例（手术组）,药物溶栓治疗22例（药物组1）;发病＞7d 29例（药物组2）均采用药物溶栓法治疗.手术组23例,采用Fogarty导管取栓;药物治疗51例采用尿激酶间接导向溶栓治疗.结果：手术取栓23例,15例发病时间＜3 d者,临床治愈率为93.3%,显效率为6.7%;另8例发病3～7 d者中,临床治愈率为50%,显效率为37.5%;不同发病时间疗效差异有统计学意义（P＜0.05）.药物溶栓组51例,临床治愈率为23.5%,显效率为41.2%,进步率为35.3%,不同发病时间之间疗效比较,差异有统计学意义（P＜0.05）.手术组与药物组1疗效比较,差异有统计学意义（P＜0.05）.药物组发生血栓形成后综合征35.3%（18/51）,手术组为21.7%（5/23）.结论：治疗时机和方法均会影响疗效,治疗时间较早疗效越好;发病7 d内手术取栓疗效优于药物溶栓.     

Risk factors for and clinical implications of mixed Candida/bacterial bloodstream infections

Mixed Candida/bacterial bloodstream infections (BSIs) have been reported to occur in more than 23% of all episodes of candidaemia. However, the clinical implications of mixed Candida/bacterial BSIs are not well known. We performed a retrospective case-control study of all consecutive patients with candidaemia over a 5-year period to determine the risk factors for and clinical outcomes of mixed Candida/bacterial BSIs (cases) compared with monomicrobial candidaemia (controls). Thirty-seven (29%) out of 126 patients with candidaemia met the criteria for cases. Coagulase-negative staphylococci were the predominant bacteria (23%) in cases. In multivariate analysis, duration of previous hospital stay >7 weeks (odds ratio (OR), 2.86; 95% confidence interval (CI), 1.09–7.53), prior antibiotic therapy ≥7 days (OR, 0.33; 95% CI, 0.14–0.82) and septic shock at the time of candidaemia (OR, 2.60; 95% CI, 1.14–5.93) were significantly associated with cases. Documented clearance of candidaemia within 3 days after initiation of antifungal therapy was less frequent in cases (63% vs. 84%; p = 0.035). The difference in the rate of treatment failure at 2 weeks was not significant between cases (68%) and controls (62%; p = 0.55). The crude mortality at 6 weeks and survival through 100 days did not differ between the two patient groups (p = 0.56 and p = 0.80, respectively). Mixed Candida/bacterial BSIs showed a lower clearance rate of candidaemia during the early period of antifungal therapy, although the treatment response and survival rate were similar regardless of concurrent bacteraemia. Further studies on the clinical relevance of species-specific Candida-bacterial interactions are needed.     

Demographic, clinical and therapeutic features of adult visceral leishmaniasis at the Rabta hospital in Tunis (tunisia) from 1983 to 2002

The purpose of this study was to evaluate in a retrospective analysis, cases of Mediterranean visceral leishmaniasis (VL) diagnosed in adults during a 20-year period in a department of infectious diseases. Demographic data, clinical and laboratory features and therapeutic findings were considered. During the study period, 22 cases of VL were diagnosed, and 6 (27%) were associated with HIV infection. Fever and splenomegaly were observed in all cases. Anaemia was constant. The anti-leishmanial IF titer was positive among 21 patients (95%). Smears from bone marrow aspiration were positive at microscopy in 95% of cases. Zymodeme analysis was carried out in nine isolates. L. infantum zymodeme MON-1 was characterized in all cases. Seventeen patients (77%) received meglumine antimoniate (MA) (20 mg SbV/kg per day) and 5 (23%) patients amphotericin B (AB) (0.5-1 mg/kg per day) for an average period of 25 days (10-49 days). Adverse events occurred in 7 patients (32%), among them 4 received AB. Clinical cure was achieved with success in 21 patients (95%). After a successful MA treatment of the initial episode, VL relapse was observed in one HIV-positive patient. Only one HIV-positive patient died from neurological disorders. VL is rare in adults. However, its incidence is increasing everywhere in the world, because of HIV-related cases. Its prognosis depends on the precocity of diagnosis and treatment.