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目的 总结创伤性气管、支气管断裂的诊断及治疗经验.方法 回顾性分析1990年3月至2009年10月诊治的27例创伤性气管、支气管断裂患者的临床资料,气管主干完全断裂1例急诊手术.其他24 h至1周手术18例,1~2周手术6例,伤后2、6个月手术各1例.主支气管断裂均经第5肋间或肋床后外侧切口完成手术;气管主干断裂1例在颈部切口.结果 全组患者无手术死亡,无肺部感染,无吻合口瘘发生.3例术后出现阻塞性肺不张,经纤维支气管镜吸痰治愈;1例术后3个月纤维支气管镜检查示吻合口略狭窄.所有患者术后1~3个月复查X线胸片示肺复张良好.结论 提高认识、尽早做出诊断、及时手术治疗是创伤性气管、支气管断裂救治成功的关键. 相似文献
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目的 总结食管癌行食管次全切除胃代食管颈部吻合术的临床经验.方法 回顾性分析132例胸段食管癌手术患者,所有患者均采用食管次全切除胃代食管经食管床颈部吻合术式.结果 全组无围术期死亡患者,无切缘癌阳性.吻合口瘘4例(3.0%),吻合口狭窄5例(3.8%),喉返神经损伤3例(2.3%).103例获随访,所有患者术后生活质量满意,无明显胃食管返流的症状;3、5年生存率分别是78.5%、34.6%.结论 食管次全切除食管纵膈胃颈部吻合术能显著降低食管癌患者围术期病死率和并发症发生率,是治疗食管癌的一种安全有效的手术方式.
Abstract:
Objective To conclude the clinical experience of subtotal esophagectomy and cervical gastroesophagostomy for the treatment of esophageal carcinoma. Methods One hundred and thirty-two patients with esophageal carcinoma of thoracic part who underwent surgical treatment were analyzed retrospectively.All patients were given subtotal esophageal resection and cervical gastroesophagostomy. Results There were no perioperative mortality,no edge-residual cancer,no postoperative gastroesophageal reflux in all patients.Complications included:cervical anastomotic leakage of 4 cases(3.0%);anastomotic stenosis of 5 (3.8%); larygeal nerve injury of 3 (2.3%).One hurdred and three patients who were followed up showed normal and satisfied life quality.The 3-year,5-year survival rate were 78 5%,34.6%, respectively. Conclusions Cervical gastroesophagostomy after subtotal esophagectomy can decrease peioperative mortality and incidence of complications and can be used as a safe and effective surgical procedure for the treatment of esophageal carcinoma. 相似文献
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特重型颅脑损伤指GCS评分3~5分,颅脑原发伤严重,或伴其他部位脏器损伤、休克等,患者伤后即昏迷、去皮质强直、双侧瞳孔散大、呼吸严重紊乱及脑疝晚期,病死率达80%以上.特重型颅脑损伤患者易并发肺部感染,多发于伤后2~10 d,伤情越重发病率越高,发病率最高达78.9%[1-2],因此,肺部感染是除原发性脑损伤过重死亡外致患者死亡的主要并发症之一[3].采取有效手段控制肺部感染,增加脑部供氧,减轻继发性脑损伤,最终改善预后是降低患者病死率的重要手段之一.本研究是在目前常规治疗同时,适时给予静脉注射用人丙种球蛋白(以下简称静丙),观察其在治疗特重型颅脑损伤继发肺部感染中的作用. 相似文献
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