自制简易胸腔闭式引流装置治疗气胸58例报道

我院自1997以年来开始采用自制简易胸腔闭式引流装置治疗气胸58例,取得较好的效果,报告如下:1临床资料与方法1.1一般资料:本组58例,男51例,女9例,年龄16-78岁,平均47岁,其中自发性气胸52例(原发性自发性气胸47例,继发性自发性气胸5例),外伤性气胸5例,医源性气胸2例(均为心脏手术后并发纵隔胸膜损伤所致),本组病例均为单侧气胸,肺压缩经X线证实均>40%。     

自制胸腔装置治疗胸膜腔疾病

自发性气胸是临床常见疾病，对较轻的闭合性气胸通过胸腔穿刺术就可治愈，对张力性气胸、交通性气胸及症状较重的闭合性气胸，复发性气胸需行胸腔闭式引流术。目前胸腔闭式引流术方法较多，有传统的外科切开置粗管，因其切口大，易感染，切口疼痛亦不敢深呼吸，影响肺复张，患者往往难以接受。采用中心静脉导管行胸腔闭胸式引流术，又较贵。自2000年以来我们采用自制简易胸腔闭式引流装置治疗气胸38例，取得较好的效果，报告如下。     

双腔气囊式胸腔引流装置治疗开放性气胸临床研究

双腔气囊式胸腔引流装置治疗开放性气胸临床研究时建华徐大勇侯清奎李祥明王俊棠自１９９４年以来，我们使用自行研制的双腔气囊式胸腔引流装置（专利号ＺＬ９６２２７７６３．０）治疗开放性气胸，收到良好效果，现报告如下。对象选择１９９４年以来住院患者７０例，临床...     

自制双腔引流管持续冲洗引流辅助手术治疗椎间盘炎6例报告

术后椎间盘炎是脊柱手术或介入后的一种严重并发症，治疗困难，恢复缓慢。1998年6月-2006年5月，我们应用自制的双腔引流管持续冲洗引流辅助手术治疗椎间盘炎6例，效果满意。现报告如下。     

脑脊液持续引流治疗蛛网膜下腔出血的围术期护理

目的探讨脑脊液持续引流治疗蛛网膜下腔出血（SAH）的围手术期的护理方法。方法对166例行脑脊液持续引流治疗SAH患者的临床护理情况进行回顾性分析。结果对SAH患者进行脑脊液持续引流治疗的术前护理、术中护理配合及术后病情、并发症的观察与护理,治愈率100%,未出现死亡和严重并发症。结论进行脑脊液持续引流治疗SAH效果好、安全、简便、实用,严密观察病情及采取有效的护理措施能改善患者的预后,减少并发症的发生。     

闭式引流联合持续负压吸引用于胸膜固定术后患者效果观察

自1997年以来，我们对54例恶性胸腔积液（下称胸液）行胸膜固定术患者术后采用闭式引流联合持续负压吸引，效果满意。现报告如下。     

新式胸腔引流装置治疗自发性气胸32例报告

2004年1月～2006年6月，我们采用新式胸腔引流装置治疗自发性气胸32例，效果良好。现报告如下。     

微创胸腔持续引流治疗恶性胸腔积液22例临床观察

目的探讨微创胸腔持续引流对恶性胸腔积液的治疗作用。方法对22例恶性胸腔积液的病人进行微创胸腔持续引流并胸腔内注入顺铂、足叶乙甙等药物，B超检测并作相关分析。结果68．2％的恶性胸水完全缓解，31．8％的恶性胸水部分缓解。结论微创胸腔持续引流治疗恶性胸腔积液可减轻病人痛苦，改善生活质量，且简便易行，值得广泛推广。     

胸腔置管持续引流治疗胸腔积液探讨

目的探讨胸腔置管持续引流治疗胸腔积液的疗效。方法利用中心静脉导管对确诊为中至大量胸腔积液病人进行胸腔置管持续引流治疗胸腔积液,根据胸水病因行针对性药物治疗;对照组采用常规胸穿抽液。结果治疗组98例均操作顺利、一次成功,无一例并发症发生,积液消失为3～8天;对照组82例,胸膜肥厚发生率25．6％,包裹性积液发生率11．25％,积液消失为6～15天。结论胸腔置管持续引流替代常规胸穿抽液治疗胸腔积液是安全、有效、并发症少。     

Endoscopic ultrasonography guided pancreatic pseudocysts drainage by self-made stent

AIM Endoscopic ultrasonography (EUS) guided pancreatic pseudocysts drainage is an ideal therapeuticprocedure. We perform it in just one step by using the self-made drainage stent.ETHODS We made an aperture at the tip of the needle outer sheath, and tied the outer sheath with theself-made stent by suture. EUS-guided pancreatic pseudocysts drainage was performed in five patients. Nopatient had visible endosmotic bulge on the gastrointestinal wall. Mean pseudocyst diameter was 4.5 cm(pancreatic head 1, body 2, tail 4). We determined the optimal site for puncture and advanced the needlyand stent into cyst. Taking out the needle made the stent separated from the sheath.RESULTS No hemorrhage happened among these patients. One patient suffering from fever up to 40℃recovered within two days after operation. All the cysts diminished insige after 7 days and resolvedcompletely after 6.8 weeks in average. Cyst resolution was accompanied by symptomatic improvement in allpatients. During a follow-up of 6 months no cyst recurred.CONCLUSION EUS-guided drainage of pseudocysts is a safe and effective procedure, which performs thejust in one process and diminishes the patients' distness.     

腔内留置细硅胶管引流治疗顽固性心包积液36例

目的探讨一种治疗顽固性心包积液安全有效的治疗方法。方法用国产细硅胶管沿剑突下路穿刺针孔插入留置于心包腔进行定时抽液及注药治疗。结果36例病人中临床治愈21例(58％).好转7例(19％),无效8例(22％)。结论该方法简便实用,疗效可靠,副作用小.并发症低。     

Treatment of persistent cardiac failure by ultrafiltration

Ultrafiltration, a method of extra renal filtering, which accomplishes an iso-osmotic removal of water an sodium from the plasma, was used in twelve patients. It is reserved for terminal persistent heart failures. In one case, it preceded a heart transplant. Simple to carry out, this technique is well tolerated when the pulmonary pressure is elevated, respecting an ultrafiltration output inferior or equal to 500 ml/h. Immediate improvement of the patients is spectacular. A new treatment failure may impose long-term ultrafiltration sessions. Failure of the medical treatment, impossibility of heart transplant, must be an indication for ultrafiltration which improves the comfort, and most likely the life expectancy of patients with persistent heart failure.     

Gastrobronchial fistula repair followed by esophageal leak--rescue by transesophageal drainage of the pleural cavity

A gastrobronchial fistula (GBF) associated with bilateral aspiration pneumonia was diagnosed six years after an esophagectomy with gastric pull-up. After failed surgical repair, an uncontained esophagopleural leak developed. Fistula closure was attempted by implanting a Wilson-Cook endoprosthesis, which quickly became dislodged. Transesophageal drainage was positioned endoscopically through the suture-line defect and led to closure of the leak after 10 days.     

Diaphragmatic lymph vessel drainage of the peritoneal cavity.

We have studied the drainage of peritoneal fluid through the diaphragmatic lymph vessels in sheep. To measure the lymphatic flow rate, we cannulated the lymphatic vessels and timed the flow from the cannula. After we infused Escherichia coli endotoxin into awake sheep, the diaphragmatic lymph flow rate increased substantially. However, we found no increase in lymph flow in anesthetized acutely operated sheep. This indicates that studies in anesthetized animals may yield underestimates of diaphragmatic lymph flow. In sheep, many of the diaphragmatic lymph vessels drain to the caudal mediastinal lymph node. We cannulated an efferent vessel from that node in 5 sheep. Several days later we infused 100 ml/kg of Ringer's solution into the abdominal space of each awake sheep. In response, the lymph flow rate increased from 0.15 +/- 0.16 ml/min (mean +/- SD) to 0.50 +/- 0.17 ml/min. Our results are important because they demonstrate that diaphragmatic lymph flow increases substantially after fluid infusions into the abdominal space.     

Treatment by external drainage of perirenal abscess in AIDS

Fever of undetermined origin in a young white heroin addict with a positive HIV (human immunodeficiency virus), serology was secondary to a staphylococcal perinephric abscess. Ultrasound examination and tomodensitometry allowed the diagnostic. Percutaneous drainage led to complete recovery. Interventional radiology associated with antibiotherapy appears to be an alternative to surgery in the treatment of perinephric abscesses.     

Salmonella pancreatic abscess. Treatment by drainage without cholecystectomy

We report a case of necrotic collection in the head of the pancreas infected by Salmonella typhimurium. Treatment associated necrosectomy and antibiotic therapy without cholecystectomy. The course of pancreatic disease was uneventful. Complete sterilization was obtained with quinolone antibiotic therapy.