金黄散局部外敷治疗宫颈癌根治术后淋巴囊肿效果观察

目的 观察金黄散治疗宫颈癌根治术后淋巴囊肿的疗效。方法 对119例宫颈癌根治术后淋巴囊肿的患者采用蜂蜜调和金黄散局部外敷。结果 119例患者中治愈72例，占60．50％；有效45例，占37．82％；无效2例，占1．68％，总有效率98．32％。结论 金黄散治疗宫颈癌根治术后淋巴囊肿效果较好。     

75%乙醇联合如意金黄散外敷治疗静脉炎

目的探讨75%乙醇联合如意金黄散外敷治疗PICC置管所致顽固性静脉炎的效果。方法将64例因PICC置管所致顽固性静脉炎患者随机分为对照组和观察组各32例。对照组局部以蜂蜜调制的如意金黄散外敷治疗,观察组先用75%乙醇湿敷10min,再用如意金黄散外敷。结果观察组治疗效果显著优于对照组(P0.05),治愈时间显著缩短(P0.01)。结论 75%乙醇联合如意金黄散外敷治疗PICC置管所致顽固性静脉炎效果显著,且可缩短治疗时间。     

金黄散外敷联合热疗治疗百白破疫苗接种所致硬结疗效观察

目的 观察金黄散外敷联合热疗治疗百白破疫苗接种所致硬结的治疗效果。方法 将78例百白破注射引起局部硬结的儿童随机分为对照组（38例）和观察组（40例）。对照组按常规用热水袋热敷局部，观察组采用金黄散外敷联合热疗治疗。结果 观察组治疗效果显著优于对照组（P〈0．05）。结论 中药金黄散外敷加热疗治疗百白破疫苗接种所致的硬结，可有效地控制硬结的发生和发展，最终消肿散结。     

金黄散外敷用于胺碘酮致静脉炎

胺碘酮是苯比呋喃类的一种衍生物，属于第Ⅲ类抗心律失常制剂。但胺碘酮对血管刺激性大，直接外周静脉途径给药会引起浅表静脉炎。我科2005年7月至2006年7月采用金黄散外敷治疗胺碘酮静脉输注致局部不良反应，取得了满意效果，报告如下。     

75％乙醇联合如意金黄散外敷治疗静脉炎

目的探讨75％乙醇联合如意金黄散外敷治疗PICC置管所致顽固性静脉炎的效果。方法将64例因PICC置管所致顽固性静脉炎患者随机分为对照组和观察组各32例。对照组局部以蜂蜜调制的如意金黄散外敷治疗,观察组先用75％乙醇湿敷10min,再用如意金黄散外敷。结果观察组治疗效果显著优于对照组（P〈0．05）,治愈时间显著缩短（P〈0．01）。结论75％乙醇联合如意金黄散外敷治疗PICC置管所致顽固性静脉炎效果显著,且可缩短治疗时间。     

金黄散外敷用于胺碘酮致静脉炎

胺碘酮是苯比呋喃类的一种衍生物,属于第Ⅲ类抗心律失常制剂.但胺碘酮对血管刺激性大,直接外周静脉途径给药会引起浅表静脉炎.我科2005年7月至2006年7月采用金黄散外敷治疗胺碘酮静脉输注致局部不良反应,取得了满意效果,报告如下.     

如意金黄散加蜂蜜外敷治疗小儿PICC并发静脉炎的疗效观察

目的:观察如意金黄散加蜂蜜外敷治疗小儿PICC并发静脉炎的临床效果。方法:本组将我科2009年5月～2011年1月置入的60例小儿PICC作为研究对象,置管后发生静脉炎9例,用如意金黄散加蜂蜜调制成稀糊状外敷于红肿处,观察疗效。结果:PICC置入后发生静脉炎的9例患儿经如意金黄散加蜂蜜外敷治疗3～5天后静脉炎均痊愈,无不良反应,无拔管现象。取得了满意疗效。结论:如意金黄散加蜂蜜外敷治疗小儿PICC并发静脉炎使用方便,值得推广。     

金黄膏外敷治疗带状疱疹效果观察

将带状疱疹患者随机均分为观察组和对照组.对照组采用常规抗病毒(阿昔洛韦)治疗,观察组在此基础上局部外敷金黄膏.结果观察组总有效率显著高于对照组(P<0.05).提示应用中药外敷可提高带状疱疹治疗效果.     

金黄散外敷联合热疗治疗百白破疫苗接种所致硬结疗效观察

目的 观察金黄散外敷联合热疗治疗百白破疫苗接种所致硬结的治疗效果.方法 将78例百白破注射引起局部硬结的儿童随机分为对照组(38例)和观察组(40例).对照组按常规用热水袋热敷局部,观察组采用金黄散外敷联合热疗治疗.结果 观察组治疗效果显著优于对照组(P＜0.05).结论 中药金黄散外敷加热疗治疗百白破疫苗接种所致的硬结,可有效地控制硬结的发生和发展,最终消肿散结.     

金黄散治疗化疗静脉炎临床疗效的观察与护理

目的:观察金黄散治疗化疗后静脉炎疗效.方法:化疗后所致静脉炎62例,随机分为研究组(32例)及对照组(30例).研究组将如意金黄散调成糊状局部外涂.对照组使用50％硫酸镁湿敷.观察两组疗效.结果:两者之间差异有统计学意义(P＜0.05).结论:金黄散治疗化疗后静脉炎治愈率高,价格便宜,使用方便,无明显毒副作用,值得临床推广使用.     

Late Recurrence After Radical Resection of Esophageal Cancer

Background

Approximately 10–20 % of esophageal cancer patients in whom recurrence is diagnosed experience late recurrence beyond 2 years after esophagectomy. However, the risk of late recurrence is still unclear. The aim of this study was to identify the risk factors of late recurrence for appropriate postoperative surveillance.

Methods

A total of 447 patients underwent radical esophagectomy and reconstruction for esophageal cancer from 2005 to 2014. Patients who had recurrence beyond 2 years after esophagectomy were defined as the late recurrence group and the remaining patients with recurrence as the early recurrence group. A comparison of the clinicopathological factors and prognosis was performed between patients with early recurrence, late recurrence, and no recurrence.

Results

Recurrences were recognized in 117(26.2 %) of the 447 patients. Recurrence was diagnosed within 2 years after surgery in 103 patients (88.0 %) and after 2 years in 14 patients (12.0 %). Patients with late recurrence showed a favorable prognosis compared with those with early recurrence (P = 0.0131), and late recurrence was an independent factor associated with a favorable prognosis after recurrence (HR 0.199, P = 0.025). In the comparison between patients with late recurrence and those with no recurrence who had a minimal recurrence-free survival of 2 years, pathological lymph node metastasis at esophagectomy was found to be an independent predictor of late recurrence (HR 7.296, P = 0.043).

Conclusions

Pathological lymph node metastasis at esophagectomy is a risk factor of late recurrence for esophageal cancer, and a close, lifelong follow-up is recommended for such patients.

     

气囊导尿管在食管癌术后颈部吻合口瘘中的应用

目的缩短食管癌术后颈部吻合口瘘患者瘘口愈合时间,减轻患者痛苦。方法将28例食管癌切除颈部吻合术后吻合口瘘患者随机分为对照组13例,观察组15例。对照组实施传统换药处理,观察组应用气囊导尿管沿瘘口走向置入食管内加换药处理。比较两组吻合口瘘愈合时间、住院时间及住院费用。结果观察组较对照组瘘口愈合时间及住院时间显著缩短,住院费用显著减少(均P<0.01)。结论气囊导尿管用于食管癌术后颈部吻合口瘘,可保证患者经口进食,促进瘘口愈合。     

气囊导尿管在食管癌术后颈部吻合口瘘中的应用

目的缩短食管癌术后颈部吻合口瘘患者瘘口愈合时间，减轻患者痛苦。方法将28例食管癌切除颈部吻合术后吻合口瘘患者随机分为对照组13例，观察组15例。对照组实施传统换药处理，观察组应用气囊导尿管沿瘘口走向置入食管内加换药处理。比较两组吻合口瘘愈合时间、住院时间及住院费用。结果观察组较对照组瘘口愈合时间及住院时间显著缩短，住院费用显著减少（均P〈0．01）。结论气囊导尿管用于食管癌术后颈部吻合口瘘，可保证患者经口进食，促进瘘口愈合。     

双向腔静脉-肺动脉吻合术的手术配合

目的 探讨0．5％甲硝唑、庆太霉素加入0．9％氯化钠溶液膀胱冲洗预防宫颈癌术后留置尿管感染的临床效果。方法 宫颈癌（Ⅰb～Ⅱa期）根治术后留置尿管患者97例，随机分为观察组（49例）和对照组（48例），观察组术后用0．5％碘伏棉球会阴擦洗。2次／d，并于第5天开始每天上午予0．5％甲硝唑0.5g、下午予庆大霉素16万U膀胱冲洗；对照组术后用0．1％苯扎溴铵棉球会阴擦洗，2次／d，并于第5天开始予0．02％呋喃西林250ml膀胱冲洗，2次／d。观察两组惠者置尿管后3、7、10d中段尿培养细菌阳性率。结果 观察组置尿管后3、7、10d尿路感染率显著低于对照组（P〈0．05。P〈0．01）。结论 甲硝唑与庆大霉素膀胱冲洗可以有效预防或减少宫颈癌根治术后留置尿管患者尿路感染的发生。     

甲硝唑与庆大霉素预防宫颈癌根治术后尿路感染的临床观察

目的探讨0.5%甲硝唑、庆大霉素加入0.9%氯化钠溶液膀胱冲洗预防宫颈癌术后留置尿管感染的临床效果.方法宫颈癌(Ⅰ b～Ⅱa期)根治术后留置尿管患者97例,随机分为观察组(49例)和对照组(48例),观察组术后用0.5%碘伏棉球会阴擦洗,2次/d,并于第5天开始每天上午予0.5%甲硝唑0.5g、下午予庆大霉素16万U膀胱冲洗;对照组术后用0.1%苯扎溴铵棉球会阴擦洗,2次/d,并于第5天开始予0.02%呋喃西林250 ml膀胱冲洗,2次/d.观察两组患者置尿管后3、7、10 d中段尿培养细菌阳性率.结果观察组置尿管后3、7、10 d尿路感染率显著低于对照组(P＜0.05,P＜0.01).结论甲硝唑与庆大霉素膀胱冲洗可以有效预防或减少宫颈癌根治术后留置尿管患者尿路感染的发生.     

气囊压迫止血在冠状动脉介入诊疗术后的应用

目的探讨经腹经膈肌裂孔根治近侧部进展期胃癌患者的术后护理方法。方法对41例采用该手术方法的患者术后行呼吸道护理，引流管护理，营养支持护理以及并发症的观察与护理等。结果41例无死亡病例，其中1例术后5d发生吻合口瘘，经保守治疗瘘口愈合，术后61d出院。另1例术后2d自行拔除鼻空肠管，经全胃肠外营养支持至经口进食。结论合理有效的术后护理是经腹经膈肌裂孔途径治疗累及食管下段的近侧部进展期胃癌成功的重要保证.     

经腹经膈肌裂孔根治近侧部进展期胃癌的术后护理

目的 探讨经腹经膈肌裂孔根治近侧部进展期胃癌患者的术后护理方法.方法 对41例采用该手术方法的患者术后行呼吸道护理,引流管护理,营养支持护理以及并发症的观察与护理等.结果 41例无死亡病例,其中1例术后5d发生吻合口瘘,经保守治疗瘘口愈合,术后61 d出院.另1例术后2 d自行拔除鼻空肠管,经全胃肠外营养支持至经口进食.结论 合理有效的术后护理是经腹经膈肌裂孔途径治疗累及食管下段的近侧部进展期胃癌成功的重要保证.     

Comparison of Laparoscopic-Assisted Radical Vaginal Hysterectomy and Laparoscopic Radical Hysterectomy in the Treatment of Cervical Cancer

Background

The aim of this study was to compare the surgical and oncologic outcomes of laparoscopic-assisted radical vaginal hysterectomy (LARVH) with that of laparoscopic radical hysterectomy (LRH) for early-stage cervical cancer.

Methods

Patients affected by invasive cervical cancer (FIGO stage I?CIIA) who had received LARVH (n?=?89) in our institute between September 2004 and December 2010 were compared with patients treated by LRH (n?=?105) during the same period. All patient information, surgical and pathological data, and oncological results were prospectively collected. Patients undergoing abdominal radical hysterectomy (ARH) were included for comparison of safety, morbidity, and recurrence rate.

Results

The mean estimated blood loss (EBL) and return of bowel activity were significantly reduced in the LRH group compared with the LARVH group (p?=?.011 and p?=?.002, respectively). Intraoperative complications occurred in 10 patients (11.2?%) in the LARVH group, 6 (5.7?%) in the LRH group, and 3 (3.0?%) in the ARH group. Forest plot analyses of the previous studies showed higher incidence of intraoperative complication in the LARVH group than in LRH group (p?=?.02). Despite the similar overall recurrence rate, stump recurrence seems to be high in the LRH group in the forest plot analysis of previous studies (p?=?0.08).

Conclusions

Both LARVH and LRH are safe and effective therapeutic procedures for the management of early-stage cervical cancer, although LRH is characterized by less blood loss and shorter bowel recovery time. Possible higher stump recurrence in the LRH should be further evaluated.     

Radical Resection After IORT-Containing Multimodality Treatment is the Most Important Determinant for Outcome in Patients Treated for Locally Recurrent Rectal Cancer

Background  The optimal treatment for locally recurrent rectal cancer (LRRC) is still a matter of debate. This study assessed the outcome of LRRC patients treated with multimodality treatment, consisting of neoadjuvant radio (chemo-) therapy, extended resection, and intraoperative radiotherapy. Methods  One hundred and forty-seven consecutive patients with LRRC who underwent treatment between 1994 and 2006 were studied. The prognostic values of patient-, tumor- and treatment-related characteristics were tested with uni- and multivariate analysis. Results  Median overall survival was 28 months (range 0-146 months). Five-year overall, disease-free, and metastasis-free survival and local control (OS, DFS, MFS, and LC respectively) were 31.5%, 34.1%, 49.5% and 54.1% respectively. Radical resection (R0) was obtained in 84 patients (57.2%), microscopically irradical resection (R1) in 34 patients (23.1%), and macroscopically irradical resection (R2) in 29 patients (19.7%). For patients with a radical resection median OS was 59 months and the 5-year OS, DFS, MFS, and LC were 48.4%, 52.3%, 65.5% and 68.9%, respectively. Radical resection was significantly correlated with improved OS, DFS, and LC (P < 0.001). Patients who received re-irradiation or full-course radiotherapy survived significantly longer (P = 0.043) and longer without local recurrence (P = 0.038) or metastasis (P < 0.001) compared to patients who were not re-irradiated. Conclusions  Radical resection is the most significant predictor of improved survival in patients with LRRC. Neoadjuvant radio (chemo-) therapy is the best option in order to realize a radical resection. Re-irradiation is feasible in patients who already received irradiation as part of the primary rectal cancer treatment.