胰腺癌诊断方法的进展与评价：（文献综述）

胰腺癌是预后较差的恶性肿瘤之，早期诊断困难是难是其预后差的主要原因。本文对目前临床广泛使用的超声波、ＣＴ、ＭＲＩ、ＥＲＣＰ、ＰＴＣ、学及癌胚抗等检查手段进行了评价，对胰腺癌基因检测的发展进行了描述，综合多门学科的方法将为胰腺癌的诊断提供新的前景。     

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.     

Wada手术治疗成人漏斗胸

我院1987年1月～1993年10月间Wada手术治疗成人漏斗胸10例(男7例,女3例),平均年龄18岁(14～32岁).术前胸廓指数为0.28±0.09,肺功能平均1秒用力呼气量(?V_1)为71.6%,最大呼气中间流量(MMF)为2.3L/S,最大肺活量(%FVC)为67.8%.胸廓指数越大,肺功能越好.4例胸廓指数>0.30,其肺功能指标明显高于胸廓指数<0.30的6例病人.术后并发症:1例胸骨后感染,与纵隔引流不畅及组织坏死较多有关.1例术后左侧肺不张,经吸痰等治疗后好转.2例病人术后3周内低热.胸骨翻转术应注意减少组织坏死及胸骨后感染,故应尽可能保留胸廓内动脉、清除胸骨上多余的软组织、胸骨翻转后肋软骨应尽量用骨膜包裹、放置有效引流管等以减少并发症.     

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重症急性胰腺炎(severe acute pancreatitis,SAP)是一种外科急重症,病情凶险,病死率高,一直以来都是急性胰腺炎(acute pancreatitis,AP)中治疗的难题和焦点。本文仅就其外科干预时机的选择及多学科协作阐述如下。1外科干预在SAP治疗中的价值随着对SAP的认识越来越深入,对本病的治疗理念也经历了数次转变,最初以内科治疗为主,逐渐转变到外科治疗为主,再到现在的理念,即在非手术治疗基础上进行适时的必要的外科干预治疗。     

胰腺癌的分子生物学治疗进展

胰腺癌因缺乏早期典型的症状,以致大多数胰腺癌确诊时已属中晚期,尽管在治疗方面做了很多努力,但胰腺癌的死亡率仍然很高,新确诊病例数几乎和减少病例数差不多,胰腺癌的5年生存率仍不足5% [1].     

第十四届全国胰腺外科学术研讨会会议纪要

中华医学会外科学分会胰腺外科学组于2012年8月17日至19日在天津召开了第十四届全国胰腺外科学术研讨会.中华医学会副会长、中华医学会外科学分会主任委员、胰腺外科学组组长、中国科学院院士赵玉沛教授致词并宣布大会开幕.在2天的会议期间,来自全国各地的1400余名普通外科医师共聚一堂,全方位的展现了我国胰腺外科领域的最新成就和发展趋势,对胰腺癌的难点热点问题、重症急性胰腺炎的诊治、慢性胰腺炎与器官保留手术、胰腺良性肿瘤以及胰腺内分泌肿瘤的诊治等问题进行了充分而热烈的讨论,同时进一步强化了全国胰腺外科领域的协作,确定了今后全国性科研协作攻关的方向.     

肺多发性硬化性血管瘤二例报告

肺多发性硬化性血管瘤二例报告戈烽，廖泉，王枫，张志庸硬化性血管瘤是一种极少见的肺部良性肿瘤。我院１９９４年诊治了２例多发性硬化性血管瘤，报告如下。例１，女，６８岁。８年前因咳嗽拍胸片，发现右上肺球形阴影，直径约２．０ｃｍ，边缘光滑，密度不均，可见钙化...     

坏死性胰腺炎与感染出血的防治

80%～90%的急性胰腺炎病人仅表现为轻度的水肿性胰腺炎,一般通过非手术治疗可以痊愈;另外15%的病人表现为严重的坏死性胰腺炎.坏死性胰腺炎的自然病程包括两个时期:发病后的14 d内疾病表现为全身炎症反应综合征,炎症介质释放进入循环系统可以引起心肺及肾脏功能衰竭,但由于稳定的诊断程序和重症监护,只有少数病人死于重症急性胰腺炎的全身炎症反应综合征;发病后的2～3周,40%～70%的坏死性胰腺炎会发生胰腺坏死物的感染.由于坏死性胰腺炎合并感染可以诱发多器官功能衰竭,此类病人的死亡率可高达50%,同时坏死组织感染可以浸蚀邻近的血管和组织器官引起出血,加重病情,影响疾病的转归,因此我们应该重视急性坏死性胰腺炎感染出血的防治.     

RCAS1在胰腺癌诊断中的作用

Objective To evaluate the effect of receptor-binding cancer antigen expressed on SiSO cells(RCASI) as serum tumor marker on the diagnosis of pancreatic cancer. Methods Receiver-operating characteristics(ROC) curve methods were used to assay the serum content of RCAS1 ,CA19-9 and CA242 in 46 patients with pancreatic cancer, 18 patients and 20 normal tissues of chronic pancreatitis detected by enzymelinkod immunosorbent assay (ELISA), and the results were analyzed by statistics methods. The expressions of RCAS1 protein were analyzed by immunohistochemical method in 32 patients with pancreatic cancer, 10 patients with chronic pancreatitis and 6 cases of normal pancreatic specimens. Results The serum levels of RCAS1 ,CA19-9 and CA242 in pancreatic cancer were higher than that in chronic pancreatitis respectively (P ＜ 0.01). The area under curve of RCAS1, CA19-9 and CA242 were 0.826, 0.804 and 0.737 ,respectively. Subgroup analysis indicated that the RCAS1 and CA19-9 levels of pancreatic cancer patients without obstructive jaundice were lower than those for patients with obstructive jaundice (P＜0.01). CA19-9 levels of patients with resectable pancreatic cancer were lower than those with unresectable pancreatic cancer(P ＜ 0.01). Immunohistochemistry showed that the expression rates of RCAS1 in pancreatic cancer and chronic pancreatitis were 87.5% and 40.0% ,respectively (P ＜0. 05). Conclusions In diagnosis of pancreatic cancer,the clinical value of RCAS1 is available. And the combination test of RCAS1 and CA19-9 have clinical value to evaluate if the pancreatic cancer can be resected before operation.