实验兔血管外科手术不同麻醉药物的比较

目的探讨一种简单易行、适用于实验兔血管外科手术的全身麻醉方法。方法选取实验兔96只,随机分为A、B、C、D、E、F六组。A组单纯应用氯胺酮麻醉,B组单纯应用戊巴比妥钠麻醉,C组单纯应用乌来糖麻醉,D组联合应用地西泮和氯胺酮麻醉,E组联合应用地西泮和戊巴比妥钠麻醉,F组联合应用地西泮和乌来糖麻醉。记录六种麻醉方法的麻醉起效时间、麻醉维持时间、麻醉药物用量、动物体温、呼吸频率及麻醉死亡率。结果地西泮和乌来糖复合麻醉起效快、维持时间长、麻醉意外率低、麻醉效果好。结论地西泮和乌来糖复合静脉注射麻醉是一种适用于实验兔血管外科手术的全身麻醉方法。     

血液流变学测定在周围血管疾病中的价值

本文对血栓闭塞性脉管炎、闭塞性动脉硬化症、雷诺氏病、深静脉血栓性静脉炎和下肢静脉曲张患者的全血比粘度、血浆比粘度、红细胞电泳时间、红细胞压积和红细胞沉降率五项血液流变学指标作了测定,并与正常人作了对照。结果发现各患者组的血液流变学改变是不同的。根据本文结果,提示血液流变学测定对于周围血管疾病的辅助诊断、病因及发病机制的探讨以及对周围血管疾病的合理治疗,提高治疗效果等方面均有一定价值     

MRI检查对早期脑梗塞的诊断应用价值

目的：本文通过对20例早期脑梗塞MRI检查，进一步研究磁共振检查(MRI)对本病的诊断价值；方法：20例早期脑梗塞病例均在发病后48小时内行MRI检查；结果：20例早期脑梗塞的MRI检查阳性率为100％；结论：MRI应为早期脑梗塞首选的检查方法。     

磁共振脑血管造影在脑血管疾病诊断中的应用

目的：评价磁共振血管造影对脑血管疾病的诊断价值；方法：对11例脑血管造影病例进行回顾性分析；结果：磁共振血管造影能清楚显示脑大动脉狭窄和阻塞、血管畸形、脑动脉瘤等血管病变；结论：磁共振血管造影具有明显的临床实用价值。     

THE FORMATION OF ''''SUBSTITUTE VALVE'''' AT THE POPLITEAL VEIN IN THE TREATMENT OF PRIMARY VALVULAR INCOMPETENCE OF THE DEEP VEINS IN LOWER EXTREMITY

Forty-five patients (47 limbs) with primary valvular incompetence of deep veins in the lower extremity treated by "substitute valve" operation have been followed for a mean period of 35.54 months with satisfactory results. This procedure is the operation of choice in the treatment of this newly recognized venous disease of the leg. A small percentage of post-thrombotic legs in which the deep vein is completely recanalized constitutes also an indication for this operation. Five patients (5 limbs) of this type operated upon have been followed for over one year with good results. The mechanism of the "substitute valve" in relieving symptoms in the diseased limbs lies in the vigorous massage at the popliteal vein to accelerate venous return rather than acting merely as a barrier to prevent the reflux of blood in the deep venous system. The authors advocate that this operation be recommended for the treatment of venous disease of the lower extremity with typical hemodynamic changes of blood reflux in the deep venous system.     

SURGERY IN ANCIENT CHINA

This report was written by three Chinese surgeons and one medical historian on the basis of extensive study of Chinese ancient medical literature.A summary of historical developments of surgery inancient China, from Zhou Dynasty to Qing Dynastyis documented. In several subjects including anes-thesia, treatment of soft tissue infections and neo-plasms, reduction of fractures and dislocations, andphysical exercises for rehabilitation, the history ofChinese surgery was many years earlier than thoserecorded in the western medicine.     

MoCA在脑小血管病病人认知功能障碍筛查中作用

目的 研究蒙特利尔认知量表(MoCA)在脑小血管病(SVD)病人认知功能障碍评估中的意义.方法 将103例SVD病人分为认知功能正常组和认知功能障碍组,应用MoCA量表及简易精神状态量表(MMSE)进行认知功能评估.结果 认知功能障碍组MoCA总分为(18.08±3.16)分,MMSE总分为(25.53±2.91)分,...     

OPEN HEART SURGERY IN CHINA

Opcn heart surgery in China has a history of about 30 years (Table l).i In January 1957, Liang Qi-sen of Shanghai did the first open val vulotomy for pulmonary stenosis under hypo- thermia. In April 1958, Shi Mei-xin of Shanghai did the first open repair of atrial septail defect under hypothermia. The first open heart opera- tion for VSD under extracorporeal circulation was done by Su Hong-xi of Xian in June 1958, Open repair of tetralogy of Fallot and other con genital cardiac defects soon followed in Beijing, Tianjin, Shanghai and other cities. In the period between 1959-1965, cardiac surgery developed rapidly in a number of medical centers in China. Various type of heart-lung pumps and oxygenators were made in the Chinese factories. Special sur- gical instruments for cardiovascular operations and synthetic material for patching and replace ment in cardiac and vascular procedures were manufactured in the Chinese plants. Experi- mental laboratories were set up for the surgeons before their clinical performances. Anesthesiolo gists and perfusionists were trained. Posto'pera tive intensive care units were organized in the early sixties. Regional and national conferences on cardiac surgery were held annually or bian nually.     

自体静脉移植于动脉后形态学演变的实验研究

本实验用自体颈静脉补片修复腹主动脉缺损,观察自体静脉移植后一年内形态学的演变。实验揭示:1.移植静脉早期的血液接触面经历附壁血栓形成,发展和消褪,伴随血管内皮细胞再生,内皮细胞主要来自邻近动脉,是一个相当缓慢的过程。2部分中膜平滑肌细胞向内皮下层移行,衍化成肌内膜细胞,造成内膜增生:大部分细胞原位发生肌内膜细胞样变,导致中膜纤维性增厚。;实验结果有助于探索提高自体移植静脉的通畅率。     

FOUNDING OF BURN SURGERY IN CHINA

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酒精储骨移植在脊柱外科的应用

102例脊柱外科手术应用酒精储骨移植取得满意效果。酒精储骨方法简单,不要特殊设备,灭菌效果可靠,异物免疫排斥反应小。脊柱外科应用储骨移植可大大缩短手术时间,减少术中出血及并发症的发生,保证足够的植骨量,减少假关节的形成。本文介绍了酒精储骨的方法及临床应用经验。对不同储骨方法的优缺点进行了讨论,并初步探讨了假关节形成的原因及诊断体会。     

COMPLICATIONS IN LAPAROSCOPIC GYNECOLOGIC SURGERY

Objective. To investigate retrospectively the complications and associated factors of gynecological laparescopies.Methods. 1769 laparoscopic surgeries were carried out from January 1994 to October 1999 at our department. The procedures included 1421 surgeries of ovary and tube, 52 myomectomies and 296 cases of laproscopic-assisted vaginal hysterectomy (LAVH). A total of 312 patients had a history of prior laparotomy (17.6%). Results. Complications occured in 34 cases, the overall complication rate was 1.92%. Unintended laparotomies occured in 6 cases(0.34% ). 12 complications were associated with insertion of Veress needle or trocar and creation of pneumoperitoneum, including 5 severe emphysema and 7 vascular injuries, this figure represents 35.3% of all complications of this series. Five intraopemtive complications (14.7 % ) occured during the laparescopic surgery (3 severe bleedings, one bladder injury and one skin bum of leg caused by damaged electrode plate), laparotomy was re-quired in four of these cases. Seventeen complications occured during postoperative stage: 2 intraperitoneal hemor-rhages needing laparotomy, 2 bowel injuries, 4 nerve paresis and 9 febrile morbidities. Cordusions. Operative gynecologic laparoscopy is associated with acceptable morbidity rate, but can not be over-looked. Complication rate seems to be higher in advanced procedures such as LAVH.     

血管内皮生长因子在肾病中的意义

血管内皮生长因子(VEGF)是内皮细胞的增殖存活因子,能保护内皮组织、刺激血管生成。VEGF能在肾脏中表达,并且在肾脏正常生理功能和病理过程中均起重要作用,适当调节内皮生长因子在肾小球的表达可能是今后治疗肾小球疾病的一种方法。     

婴幼儿颌面部血管瘤和血管畸形的诊断与手术疗效评价

通过第一次就诊收集病史和临床检查的２２４例婴幼儿领面部血管性病损，依据其临床生物学行为其中１９２例（９０．２％）被临床诊断分类为血管瘤和血管畸形。所有病有进行手术治疗，７９％病例随访了手术疗效。作者认为血管瘤应尽早手术治疗，因手术操作简单，复发率低，面部美容效果好；而血管畸形则手术较复杂，复发率亦较高。     

我国食管穿孔研究进展

本文探讨了我国城市及基层医院报告食管穿孔的病因、不同治疗方法及疗效。从１９７１～１９９０年文献中收集食管良性疾病１６１１例，其中食管穿孔５１１例，居第五位（７．８％）。组１：大城市医院（ＬＣＨ）３４３例，病因以医源性器械损伤为主（３２．３％）。在以异物为病因的病例中，因误咽假牙而穿孔者占４７．２％。其中胸段食管穿孔多用开胸修复术治疗，占３４．９％。组２：县级医院（ＣＨ）报告１６８例，病因以异物居首位（４３．８％）。胸段食管穿孔主要用闭式引流术治疗，占８２．７％。资料表明，两组在病因和治疗方法上有显著差异（Ｐ＜０．０１）。采用胸腔闭式引流术治疗胸段食管穿孔ＬＣＨ组之死亡率较高（１３．５％），而ＣＨ组较低（９．５％）。本文以为，食管穿孔仍然是一种危险的疾病，关键在于早期诊断和治疗。近年来，大城市医院的青年外科医师多主张开胸作穿孔修复或食管部分切除术，但死亡率达２２．３％～３０．０％。故在基层医院应用胸腔闭式引流术治疗胸段食管穿孔，仍是一种应急、简便、有效的治疗手段。     

急性下肢深静脉血栓形成的外科干预

目的:总结急性下肢深静脉血栓形成(deep venous thrombosis,DVT)的外科干预经验。方法:对急性下肢DVT患者66例进行股静脉切开取栓,合并有左髂静脉狭窄的患者同时行髂静脉球囊扩张内置支架。结果:手术均成功,术后3天患者临床症状基本消退。至出院时,肿胀完全消退56例,肿胀消退2/3以上8例,肿胀消退1/3者2例。结论:以手术为主的综合治疗急性下肢DVT效果良好,疗效确切、安全。