金黄如意膏联合地塞米松治疗儿童急性附睾炎的研究

目的 探讨金黄如意膏联合地塞米松治疗儿童急性附睾炎的临床疗效.方法 选取2003年10月至2011年7月间在本院就诊的急性附睾炎患儿27例,按数字表法随机分为抗生素组13例(给予抗生素、金黄如意膏加地塞米松治疗)和无抗生素组14例(给予金黄如意膏加地塞米松治疗),观察其疗效.结果 抗生素组和无抗生素组患儿经治疗后,附睾...     

Surgical treatment of acute pancreatitis today

In case of mild acute pancreatitis the treatment is basically conservative, but in severe cases surgical treatment has an important role. Methods: authors analyze the indications for operation, the timing and the technical questions of it on the basis of the literature published in the previous ten years. Results and conclusions: sterile pancreas necrosis is rarely but septic necrosis is an indication for surgery if the conservative treatment is unsuccessful. Therapy resistant multiple organ failure, abdominal compartment syndrome and other surgical complications such as bleeding, perforation need surgery treatment. In biliary pancreatitis associated with cholestasis urgent endoscopic sphincterotomy and later cholecystectomy is suggested. In case of pancreas necrosis the ideal time of operation is 21 days after the beginning of the disease because the rate of complications and mortality is high in early operations. Careful necrosectomy is important which has to be extended to the retrocolic and retroduodenal areas as well. Open abdominal surgery has more complications so it is suggested only in selected cases. Operation should be amended with postoperative bursa omental lavage.     

Surgical treatment of acute myocardial infarction.

In recent years, advances in surgical techniques and perioperative management of cardiac surgical patients have facilitated more aggressive operative treatment of many serious and even catastrophic complications of acute myocardial infarction (MI). In addition, improved understanding of the natural history of these complications has helped to optimize the indications for and timing of surgical intervention. The role of emergency revascularization for postinfarction angina, evolving acute MI, cardiogenic shock after acute MI, and failed percutaneous transluminal angioplasty has expanded with overall satisfactory to excellent results. Surgical treatment of mechanical with overall satisfactory to excellent results. Surgical treatment of mechanical complications of acute MI such as free-wall rupture, acute ischemic mitral insufficiency, and ventricular septal defect also is undertaken earlier and more aggressively. Although the mortality rates for these conditions remain higher than desired, salvage of many previously doomed patients now is a reality.     

重症急性胰腺炎行手术治疗与非手术治疗的效果

目的 :探讨重症急性胰腺炎行手术治疗与非手术治疗的效果.方法 :选取我院2013年9月-2015年10月接收的重症急性胰腺炎患者90例,采用区组分组法分为对照组与观察组,对照组患者给予手术治疗,观察组患者采用非手术方法治疗,对比两组患者治疗情况及并发症发生率.结果 :观察组患者死亡率17.78%与对照组26.67%相比差异不显著(P>0.05);观察组并发症发生率24.44%低于对照组51.11%(P<0.05);观察组患者住院时间与对照组相比无明显差异(P>0.05).结论 :重症急性胰腺炎患者行非手术治疗的效果较好,并发症发生率明显降低,具有一定临床推广价值.     

急性梗阻性胆管炎合并血小板减少的外科治疗

目的探讨急性梗阻性胆管炎并血小板减少的外科治疗。方法回顾性分析2003~2006年急性梗阻性胆管炎合并血小板减少(80×109/L以下)的10例患者的治疗情况。10例均行胆总管切开取石术,5例急诊手术,5例延期手术。结果急诊手术患者中,1例在ICU治疗10d,血小板上升为130×109/L,1例术中出血、十二指肠损伤,经输血、止血、行空肠营养造瘘术治疗,血小板上升为126×109/L,其余3例手术顺利,血小板上升为(120~140)×109/L。延期手术患者术后血小板除2例年龄较大者上升为96×109/L,余均上升至正常范围,全部患者均成功取石。结论急性梗阻性胆管炎合并血小板减少时,患者的胆管炎分级、手术史、CT诊断合并肝硬化门脉高压脾功能亢进对决定手术时间和方式至关重要。     

超声在慢性附睾炎治疗中的应用价值

目的 观察慢性附睾炎治疗的临床效果和治疗前后超声图像的改变情况,为临床诊断提供参考.方法 2007年1月至2009年2月采用中西医结合治疗的慢性附睾炎患者78例,给予口服司帕沙星片,0.1g/片,3片/次,1次/d,同时采用中药丹红通精方,1剂/d,开水煎,分早晚服.治疗30 d后观察疗效,并采用超声观察治疗前、治疗中(治疗15d时)、治疗后患者附睾大小、内部回声强度、血流阻力指数(RI)、最大与最小血流速度(Vmax及Vmin)、动脉收缩压与舒张压的比值(S/D)、彩色超声多普勒(CDFI)血流变化情况.结果 治愈50例,好转20例,无效8例.有效(治愈+好转)患者治疗中、治疗后附睾大小、Vmax及Vmin、RI和S/D均较治疗前显著改善[附睾大小:尾部厚度:(1.14±0.19)、(0.75±0.13) cm比(1.68±0.25) cm,体部厚度:(0.54±0.17)、(0.46±0.11) cm比(0.63±0.12) cm,头部厚度:(1.12±0.16)、(0.80±0.15) cm比(1.53±0.27) cm;Vmax:(0.22±0.12)、(0.19±0.10)m/s比(0.28±0.13) m/s;Vmin:(0.14±0.05)、(0.07±0.02) m/s比(0.19±0.08) m/s;RI:0.64±0.13、0.52±0.10比0.89±0.17;S/D:3.64±1.40、2.78±1.26比4.35±1.62],差异均有统计学意义(P＜0.05).结论 超声能够较为准确地检测到慢性附睾炎患者治疗前后附睾大小、内部回声强度、RI、Vmax、Vmin及S/D、CDFI血流分级等指标的显著变化,能够给出预后判断,指导临床治疗,在慢性附睾炎的诊治中有重要的应用价值.     

Surgical treatment of acute manifestations of Crohn's disease during pregnancy.

When requiring surgery, acute exacerbations of Crohn's disease in pregnancy have been reported to carry high maternal and fetal mortality. We report six cases. The women presented at 30, 28, 12, 11, 31 and 25 weeks' gestation and all proved to have intraperitoneal sepsis. In three, the acute symptoms were the first indication of Crohn's disease. All the women recovered and five had healthy babies; the other had a miscarriage when a colonic anastomosis dehisced. In pregnant women with Crohn's disease, the indications for surgery are the same as in non-pregnant patients. For acute manifestations we recommend removal of the source of the sepsis and exteriorization of the bowel ends.     

20例左半结肠癌致急性肠梗阻的外科治疗

目的 探讨左半结肠癌致急性肠梗阻行结肠一期切除吻合术的可行性,以促进手术疗效的提高.方法 回顾性分析2004年6月～2010年6月收治的20例左半结肠癌致急性肠梗阻的临床资料,讨论手术时机及其手术方式在左半结肠癌致急性肠梗阻中的应用.结果 20例患者均行结肠一期切除吻合术,出现吻合口瘘1例.结论 合理选择手术时机及手术方式是提高左半结肠癌致急性肠梗阻疗效的重要措施.     

急性附睾炎的超声价值

目的:探讨超声在急性附睾炎的意义.方法:通过对我院的2003年1月～2005年4月门诊及住院的48例急性附睾炎患者进行分析.结果:彩色多普勒能直接显示睾丸附睾的解剖结构及内部情况,并能了解血供情况,对阴囊内的急性疾病的早期诊断具有很重要的价值.