蓝色橡皮大疱痣综合征手术一例

患者,男,31岁。因全身多发性血管瘤及血肿,并便血、贫血31年,症状加重11年于2006年4月16日入院。患者出生时即发现全身多发性血管瘤及血肿,便血、贫血。因贫血较重需每2年输血1次。输血前血红蛋白最低达20g/L,输血后血红蛋白多在80g/L左右。23岁行唇部及右颈部血管瘤切除术。无类似家族史。体检：重度贫血貌,全身皮肤散在米粒至黄豆大小的血管瘤和血肿及淤斑。血管瘤呈黑蓝色、斑块状,压之不褪色,部分为乳头状可压缩的黑蓝色囊性血管瘤。[第一段]     

1例蓝色橡皮疱痣综合征内镜下治疗的护理配合

对1例蓝色橡皮疱痣综合征患者,采取内镜下曲张静脉套扎、硬化治疗及黏膜剥离术治疗,配合术前耐心细致的心理护理、术中对不同治疗方法的准确配合及术后休息、饮食及用药护理,食管、胃及结肠共11处病变均治疗成功。提示蓝色橡皮疱痣综合征内镜下治疗安全性高、并发症少,科学、有效的护理配合是治疗成功的保障。     

国内蓝色橡皮疱痣综合征的诊治现状

目的 汇总分析国内蓝色橡皮疱痣综合征的文献,探讨中国患者蓝色橡皮疱痣综合征临床特点和诊治策略.方法 在中国期刊全文数据库、万方数据库及维普中文科技期刊数据库中检索,提取符合要求的文献进行总结分析.结果 50例患者纳入研究,其中男性31例,女性19例.100％出现皮肤血管瘤,其他主要临床症状:黑便35例(70％),便血13例(26％),头晕心悸35例(70％).胃镜检查48例,发现胃血管瘤40例(40/48,83.33％);结肠镜检查41例,发现结肠血管瘤30例(30/41,73.17％);小肠检查25例,发现小肠血管瘤23例(23/25,92％).单纯药物支持治疗14例;单纯内镜治疗12例患者,所有单纯内镜下治疗病变均局限于胃及结肠;单纯手术治疗16例;2例为腹腔镜联合内镜下治疗.结论 蓝色橡皮疱痣综合征是罕见的疾病.在中国患者中,皮肤和消化道是常累及的部位.对小肠部位的检查应作为常规检查.有效的治疗方法尚需要进一步研究.     

蓝色橡皮大疱痣综合征一例报道

病人:男性,31岁。因全身多发性血管瘤及血肿、便血、贫血31年,加重11年入院。病人贫血较重,需周期性输血,输血周期约每2年1次。输血前Hb最低达20g/L,输血后Hb多在80g/L左右。病人出生时即被发现全身多发性血管瘤及血肿,便血,贫血。体检:重度贫血貌。全身皮肤散在米粒至黄豆大小的血管瘤,血肿,淤斑。血管瘤呈黑蓝色,斑块状,压之不褪色,部分为乳头状可压缩的黑蓝色囊性血管瘤。实验室检查:血常规:WBC1.7×109/L,E0.006,N0.66,L0.28,RBC0.82×1012/L,Hb15.0g/L,PLT67×109/L。大便潜血(+++)。染色体检查无异常。CT检查:下胸部皮下、…     

蓝色橡皮疱痣综合征引起肠套叠一例

患者．男,19岁。因“反复上腹部胀痛半年余,加重1周”于2011年8月6日入院。患者半年来反复出现上腹部胀痛,伴有反酸、嗳气．无呕血．1周来间断性解黑便,每天一次,量约100g。既往史：出生时波发现有肩胛区一皮肤隆起．逐渐增大．15年前行手术切除,病理为海绵状血管瘤：后逐渐发现全身多处出现小血管瘤,     

1例新生儿大疱表皮松解症的护理

新生儿大疱表皮松解症是一罕见的皮肤病,病因尚未明确,皮损表现为红斑、水疱、表皮松解、破溃及结痂。由于皮损严重,范围广,极易引起诸多并发症,特别是败血症等全身感染,严重威协患儿生命,护理难度较大。我院收治1例,现介绍如下: 病例简介男,50天,因出生后全身红斑、水疱、渗液、结痂,以大疱表皮松解症(营养不良型)收入院。体温37.5℃,心率140次/分,呼吸20次/分,营养较差,全身散在分布大小不等的红斑水疱,部分水疱破溃,有黄色渗液,上覆淡黄色痂皮,部分痂下积脓,有臭味,颈、臀部大片红斑,糜烂,尼氏征阴     

腹腔镜联合内镜治疗肝外胆管结石610例

目的 探讨腹腔镜、胆道镜、十二指肠镜联合治疗肝外胆管结石的疗效和技巧.方法 回顾性分析1997年9月至2007年1月采用腹腔镜、胆道镜、十二指肠镜联合治疗610例肝外胆管结石患者的临床资料.单纯胆管结石行ERCP、EST;胆囊结石合并胆总管结石采用腹腔镜联合十二指肠镜、腹腔镜联合胆道镜、三镜联合治疗.结果 610例中成功施行589例,成功率为96.6%.住院时间7～28 d,平均13 d.无胆漏、十二指肠漏、十二指肠乳头出血、急性胆管炎等与内镜操作有关的严重并发症发生.411例随访1～3年,平均13个月,无胆管结石复发及其他并发症发生.结论 单纯胆管结石行ERCP、EST,胆囊结石合并胆总管结石采用腹腔镜联合内镜治疗,效果较好,无内镜相关并发症发生.     

老年重症糖尿病性大疱病患者的护理

目的探讨糖尿病性重症大疱病患者的护理方法。方法在胰岛素强化治疗控制血糖的基础上,针对糖尿病性重症大疱病患者的心理、生理特点,对患者进行健康教育、局部护理、饮食护理、血糖监测和病情观察,总结护理经验。结果 13例重症糖尿病性大疱病患者,无1例发生继发感染、溃疡,大疱逐渐消退,均痊愈出院。结论对老年重症糖尿病性大疱病患者做好局部护理、密切监测血糖、合理饮食,可减少并发症,改善患者生活质量。     

1例重症大疱表皮松解型药疹患儿的护理体会

目的:通过报道1例年龄小、病情重,家属无任何医学知识的重症大疱表皮松解型药疹患儿的护理,经过总结该类患者的护理经验;方法:采取抗过敏、营养支持、保护创面、预防感染等护理处理;结果:治疗护理取得满意疗效,患儿痊愈出院;结论:在护理该名患儿时,集中了皮肤科、儿科、消化内科的护理力量,成功治愈该患儿是多科护理合作的体现.     

腹腔镜与内镜联合技术治疗胃肠疾病

In recent years, the concept of minimally invasive surgery has become accepted by the surgical community, though there are limitations in locating small gastrointestinal tumors when laparoscopy is used alone. Meanwhile, endoscopy is an excellent tool for locating these small tumors, though one must take extreme care to avoid hollow viscus perforation. Combination of laparoscopy and gastroduodenoscopy has extensive application in the resection of gastrointestinal stromal tumors, sessile gastric polyps and early gastrointestinal carcinoma. During laparoscopic operation, the endoscopist can help to locate the tumor or polyp. Endoscopy can also help to determine whether or not the tumor or polyp has been resected completely. In performing traditional laparoscopic colectomy for left-sided colonic tumors, specimen retrieval necessitates a mini-incision which is often the cause of postoperative pain, wound infection, and other pain-related complications. The combination of laparoscopy with transanal endoscopic microsurgery is feasible for selected patients with left-sided colonic tumors, and complications related to mini-incision can be avoided completely. Combination of laparoscopy and gastrointestinal endoscopy also benefits patients with acute bowel obstruction prior surgical operation. With the help of perineum-bowel tube, sigmoidoscopic technique can relieve acute bowel obstruction, so that these patients may have chance for laparoscopic operation. In summary, this hybrid approach can not only decrease surgical incisions, but also avoid some of the surgical risks of emergent operations.     

Anesthetic experience of a patient with blue rubber bleb nevus syndrome

We report an anesthetic experience of a 63-year-old female patient with blue rubber bleb nevus syndrome who underwent an open reduction of the fracture of the right femur. The syndrome is characterized by bluish nevus scattered throughout the skin of the whole body and angiomas of the gastrointestional tract causing serious bleeding. Anesthesia was induced with thiopental followed by intravenous injection of succinylcholine chloride and maintained with neuroleptanesthesia in nitorous oxide and oxygen. The course of anesthesia and emergence from anesthesia were uneventful. Anesthetic management of patients with blue rubber bleb nevus syndrome was also discussed.     

Blue rubber bleb nevus syndrome

Blue rubber bleb nevus syndrome, an uncommon condition, is manifested by gastrointestinal and skin hemangiomas and gastrointestinal hemorrhage causing anemia. The authors report a unique case of the syndrome in association with a congenital cardiac malformation. A 26-year-old woman presented with iron-deficiency anemia after the birth of her first child. She had a history of skin and gastrointestinal hemangiomas and tetralogy of Fallot. Endoscopy revealed multiple new intestinal hemangiomas, which were removed through enterotomies with resolution of the anemia. Iron therapy was prescribed, and her condition was stable at follow-up 5 years later.     

Blue rubber bleb nevus syndrome from the orthopedic viewpoint

The blue rubber bleb nevus syndrome consists of generalized haemangiomatosis associated with iron-deficiency anemia and often with orthopaedic abnormalities. We are reporting one case and reviewing earlier cases from the literature of orthopaedic interest.