肺大疱破裂引起血气胸的手术治疗

1996年至 2 0 0 1年 ,我科手术治愈肺大疱破裂致自发性血气胸 2 0例 ,现报告如下。临　床　资　料　　男 1 8例 ,女 2例 ,年龄在 1 5岁～ 71岁 ,平均 4 3岁。病变位于左肺 7例 ,占 35 % ,右肺 1 2例 ,占 60 % ,双肺 1例 ,占 5 %。病史最短者 6ｈ ,最长者 1 0ｄ。伴有胸痛 1 7例 ,肩背痛 1 3例。 2 0例均有不同程度的呼吸困难 ,伴休克 2例 ,占 1 0 %。胸部Ｘ线片示肺压缩30 %～ 5 0 % 1 1例 ,占 5 5 % ,压缩 >5 0 % 9例 ,占 4 5 % ;肺大疱单纯位于左上肺 7例 ,占 35 % ;左侧上下肺均有 4例 ,占 2 0 % ;位于右中上肺 3例 ,占 1 5 % ;位于右中…     

自发性血气胸45例外科治疗

自发性血气胸发病率虽不高，但一旦发生，患者病情一般均较凶险，甚至可危及生命，手术治疗是主要的处理手段。本院于1990年4月至2002年5月，收治此类患者共45例．现将外科治疗体会报道如下。     

肺大疱破裂引起自发性气胸的外科治疗

肺大疱破裂引起自发性气胸内科治疗复发率高，外科手术治疗复发率低但创伤相对较大。笔者通过对２５例手术治疗自发性气胸的分析，对手术适应证及病因诊断进行探讨。１临床资料１．１一般资料本组２５例，男１５例，女１０例；年龄１５～５２岁，平均年龄４２岁；右侧１６...     

自发性血气胸38例外科治疗

目发性血气阳在临床上较为少见，由于出血的原因、量、速度及个体差异的不同，表现的临床症状较重缓急不一，部分患者保守治疗即可治愈，相当一部分患者需急诊手术止血，修补肺破口。我科自1976年4月至1997年9月共收治自发性血气胸38例，本文就其外科治疗及手术探查指征作一探讨。l问庆贺现38例中，男32例，女6例。年龄厂～25y，其rt20～38y有26例，占68％。少数病人发病前无明显诱因，大多数病人与活动时用力过控有关，均表现为突然发病，症状出现至就诊时间4h～6d，其中胸痛有35例，胸闷30例，气促28例，紫组6例，收缩压＜12kPa7例，均有…     

自发性血气胸的外科治疗

1999～2006年我院共收治自发性血气胸13例,现就该病的特点及外科治疗探讨如下。     

自发性血气胸的外科治疗

自发性血气胸是指非外伤性原因引起的胸膜腔积血和积气。临床上较少见，我院胸外科从1997年6月～2003年     

自发性血气胸23例外科治疗

自发性血气胸是指非外伤造成的胸腔内积气和积血。1987—2004年6月共收治自发性血气胸23例。现就该病的特点及治疗进行探讨。     

自发性血气胸26例的外科治疗

目的分析自发性血气胸的外科治疗经验。方法回顾性分析26例自发性血气胸患者外科治疗的临床资料。结果26例气胸患者行胸腔闭式引流或者急诊手术治疗治愈。结论自发性血气胸是临床常见急症,需要及时观察和处理,若未及时处理会严重影响心肺功能。     

瓦氏窦瘤破裂的外科治疗

瓦氏窦瘤破理解是一种较少见的心脏病，我院连续手术治疗２０例，手术均在中度低温体外循环下进行，采用冷停跳液和心包腔内小冰袋保护心肌，术中发现窦瘤起自右冠冠１８例，无冠窦２例，窦瘤破入右室１５例，并发畸形包括室间隔缺损，主支动脉瓣关闭不全，重度功能性三尖瓣关闭不全，右室流出道狭窄，卵圆孔未闭，本组无术后早期和晚期死亡，随访１０个月￣１２年，手术效果满意。作者认为本病一旦确诊，宜尽早施行手术治疗。     

肺大泡的诊断与治疗(附14例报告)

本文结合14例肺大泡病人讨论肺大泡的诊断和治疗。临床上长期诊断为慢性自发性气胸或偶而发现的局限性气胸者,经多次抽气气胸不消失或消失后很快又重现者,应想到肺大泡。X光检查和支气管连影诊断价值很大。一般主张在未发生严重并发症(感染、气胸)之前手术,手术应彻底切除大泡和缝扎边缘串珠状小泡,尽可能保存正常肺组织。     

肺动脉瓣狭窄的外科治疗（附46例报告）

１９７８～１９９３年共手术治疗肺动脉瓣狭窄患者４６例，其中３０例行肺动脉瓣交界直视切开，１５例行肺动脉瓣直视切开加右室流出道肥厚肌束切除，１例行肺动脉跨瓣环补片成形术，无死亡。随访５～１８０个月疗效满意。本文着重讨论肺动脉瓣狭窄的诊断、手术适应证及外科治疗。     

直肠癌的外科治疗

本文分析直肠癌根治术45例,其中青壮年患者所占比例高达67％,84％的患者病灶位于腹膜返折以下,很易被直肠指检所触及。因此,早期发现的可能性较大,但本组中仍有51％的患者得不到及时确诊。建议各级医师应随时想到早癌的可能性,对20岁以上患者有便血和排便习惯改变等症状时,必须常规作直肠指检和乙状结肠镜检,以早期发现直肠癌,提高疗效。     

鼻咽纤维血管瘤的外科治疗(附66例分析)

本文报告66例鼻咽纤维血管瘤的临床资料,并结合临床实践对本病的临床分型、治疗方法、术中死亡和并发症的原因及预防等问题进行分析和讨论。     

肺大疱的外科治疗(附11例报告)

本文报告外科手术治疗肺大疱11例,其效果较为满意.作者认为,凡肺大疱被确诊、尤其是反复发生自发性气胸者,可考虑手术治疗.对手术指征、手术方式选择和手术要点等进行了讨论     

SURGICAL TREATMENT OF SCOLIOSIS CAUSED BY NEUROFIBROMATOSIS TYPE 1

Objective To retrospectively analyze the relationship between curve types and clinical results in surgical treatment of scoliosis in patients with neurofibromatosis type 1 (NF-1).Methods Forty-five patients with scoliosis resulting from NF-1 were treated surgically from 1984 to 2002. Mean age at operation was 14.2 years. There were 6 nondystrophic curves and 39 dystrophic curves depended on their radiographic features. According to their apical vertebrae location, the dystrophic curves were divided into three subgroups: thoracic curve (apical vertebra at T8 or above), thoracolumbar curve (apical vertebra below T8 and above L1), and lumber curve (apical vertebra at L1 and below). Posterior spine fusion, combined anterior and posterior spine fusion were administrated based on the type and location of the curves. Mean follow-up was 6.8 years. Clinical and radiological manifestations were investigated and results were assessed.Results Three patients with muscle weakness of low extremities recovered entirely. Two patients with dystrophic lumbar curve maintained their low back pain the same as preoperatively. The mean coronal and sagittal Cobb′s angle in nondystrophic curves was 80.3° and 61.7° before operation, 30.7° and 36.9° after operation, and 32.9° and 42.1° at follow-up,respectively. In dystrophic thoracic curves, preoperative Cobb's angle in coronal and sagittal plane was 96.5° and 79.8°,postoperative 49.3°and 41.7°, follow-up 54.1° and 45.3°, respectively. In thoracolumbar curves, preoperative Cobb's angle in coronal and sagittal plane was 75.0° and 47.5°, postoperative 31.2° and 22.8°, follow-up 37.5° and 27.8°, respectively. In lumbar curves preoperative Cobb's angle in coronal plane was 55.3°, postoperative 19.3°, and follow-up 32.1 °. Six patients with dystrophic curves had his or her curve deteriorated more than 10 degrees at follow-up. Three of them were in the thoracic subgroup and their kyphosis was larger than 95 degrees, and three in lumbar subgroup. Hardware failure occurred in 3cases. Six patients had 7 revision procedures totally.Conclusions Posterior spinal fusion is effective for most dystrophic thoracic curves in patients whose kyphosis is less than 95 degrees. Combined anterior and posterior spinal fusion is stronger recommended for patients whose kyphosis is larger than 95 degrees and those whose apical vertebra is located below T8. Patients should be informed that repeated spine fusion might be necessary even after combined anterior and posterior spine fusion.     

小儿室间隔缺损伴肺动脉高压的外科治疗

本文报道手术治疗小儿室间隔缺损伴肺动脉高压98例的结果。手术时年龄、肺动脉高压程度与死亡率有显著关系,年龄小于1岁,重度肺动脉高压者死亡率最高。术后死亡12例,死亡率12.3％,提出降低手术死亡率的关键是严格掌握手术指征,充分的术前准备,术中的心肌保护和术后的呼吸管理。     

DIAGNOSIS AND SURGICAL TREATMENT OF BRONCHOGENIC CYSTS

Between 1974 and 1993, 22 patients with bronchogenic cysts were operated on in our hospital; there were 14 men and 8 women, ranging in age from 11 to 62 years, The cyst locations were mediastinal in 13 (59.1%) and intrapulmonary in 9 (40.9%). There were symptoms (chest pain and recurrent bronehiolits) in 20 patients (91%). The preoperative complications included infection in the lung and in the cyst and dysphagia due to esophageal eornpression. Chest pain was the main symptom in mediastinal cyst and recurrent infection of lung in intrapulmonary cyst. Plain chest radiograms showed that a rousd shadow, occasional air-fluid levels, and peripheral calcification may be found in cysts. An operation is the best treatment for cysts. All cysts were completely excised. No postoperative complieations, late complica-tions, or recurrence developed in our patients.     

颅内肿瘤继发癫痫的手术治疗

目的：研究颅内肿瘤继发癫痫患者手术治疗的方法及效果。方法：收集自1985—2002年我院经手术治疗的376例颅内肿瘤继发癫痫病人资料并进行分析，总结手术治疗颅内肿瘤继发癫痫的方法及效果。结果：近期癫痫症状消除或服药可完全控制发作者337例，占89．63％；服药可减少发作50％者20例，占5．32％；服药可减少发作10％以上者3例，占0．79％；无改善者2例，占0．53％；手术死亡者14例，占3．72％。术后半年至16年随访到155名患者，其中发作停止不需服抗癫痫药物者108例，占69．68％；服抗癫痫药物可以完全控制发作者12例，占7．74％；服药可以减少发作50％以上者4例，占2．58％；服药可以减少发作10％以上者9例，占5.8％；无改善者1例，占0．65％；死亡者21名，占13．55％。结论：颅内肿瘤继发癫痫的手术治疗宜采用微侵袭的手术方法，只要颅内肿瘤切除彻底，绝大多数病人可以取得显著疗效。手术是治疗颅内肿瘤继发癫痫首选和最有效的方法。