某地震灾区日晒伤68例临床分析

5.12汶川地震后,中国人民解放军武警四川总队医院第三医疗队赶赴平武县南坝镇参加地震医疗救援,在5月13日-6月5日共24 d的医疗救援中,诊治皮肤病患者196例,占伤员总数的10.4%(196/1 884),其中日晒伤患者68例,现报告如下.     

ICGR15在肝癌切除术前评估肝脏储备功能的作用

Objective To evaluate the role of ICGR15 in assessment of hepatic functional reserve before hepateetomy for hepatocellular carcinoma.Methods From August 2005 to October 2007, six-ty-six patients with hepatocellular carcinoma were treated in our hospital.The patients were random-ized into Child-Pugh grading group (32 cases) and ICGR15 detection group (34 cases).Preoperative preparation,operative procedures and postoperative management were the same in all the 66 patients.The morbidity and mortality were compared and the relationship between Child-Pugh grading and ICGR15 in assessment of hepatic functional reserve was determined.Results The incidence of hepatic failure after hepatectomy in ICGR15 detection group(23.50%) was significanly lower than that in Child-Pugh grading group(34.4%).ICGR15 (14.38 ±8.2)% in patients with tumor of Child-Pugh grading B was higher than ICGR15 (7.84 ± 4.8)% in those with tumor of Child-Pugh grading A.Conclusion ICGR15 valuecan be more sensitive in evaluating hepatic functional reserve than Child-Pugh grading, but some correlation can be observed between them.ICGR15 is useful in assessing the range of liver resection and prognosis before hepatectomy for hepatocellular carcinoma.     

俯卧位脊柱手术对下肢外周静脉压的影响

了解俯卧位脊柱手术对下肢外周静脉压的影响。方法采用自制的下肢外周静脉测压装置手工测量，分别于术前、俯卧位后及手术过程中测量患下肢外周静脉压力，观察其变化。结果在将手术患摆放为俯卧位后，发生下肢外周静脉压升高的患占92％．其中需要重新调整摆放体位的患占20％。结论采用下肢外周静脉压监测，随时观察俯卧位手术患的静脉压变化情况，较为客观、精确地提供监测指标，协助手术医生正确摆放患的手术体位，及时提醒医生调整体位架的支点，防止因体位改变而压迫患腹部大血管，影响手术的进行及患的康复。     

晚期胰腺癌^125I粒子植入术后并发胃瘫综合征的临床观察与护理

目的 分析晚期胰腺癌^125I粒子植入术后并发胃瘫综合征（postoperative gastroparesis syndrome，PGS）的相关因素，从护理角度探讨预防和促进康复的有效措施。方法回顾性分析了48例不能根治切除的晚期胰腺癌病例，了解PGS发生率和不同姑息性手术术式的关系，包括粒子植入数目、位置等对发生PGS的影响。结果^125I粒子植入术病例PGS发生率高于其他手术组；随着粒子数目增加，PGS的发生奉培高。结论 ^125I粒子植入术治疗晚期胰腺癌可导致术后发生PGS，护理人员应正确认识其发生的相关因素；严密观察病情，识别胃瘫的早期症状，及时治疗；同时，要重视患者的心理护理和发挥家庭支持作用。     

手术器械脉动真空压力蒸汽灭菌效果观察

压力蒸汽灭菌效果可靠，经济快速、环保无毒副作用，是目前医疗器械常用的灭菌方法，其灭菌质量对降低医院感染起着非常重要的作用。为监测灭菌效果，我们对手术室灭菌后30个手术包内撑开和锁住的止血钳共60把进行了无菌采样和普通细菌培养。     

ICGR15在肝癌切除术前评估肝脏储备功能的作用

Objective To evaluate the role of ICGR15 in assessment of hepatic functional reserve before hepateetomy for hepatocellular carcinoma.Methods From August 2005 to October 2007, six-ty-six patients with hepatocellular carcinoma were treated in our hospital.The patients were random-ized into Child-Pugh grading group (32 cases) and ICGR15 detection group (34 cases).Preoperative preparation,operative procedures and postoperative management were the same in all the 66 patients.The morbidity and mortality were compared and the relationship between Child-Pugh grading and ICGR15 in assessment of hepatic functional reserve was determined.Results The incidence of hepatic failure after hepatectomy in ICGR15 detection group(23.50%) was significanly lower than that in Child-Pugh grading group(34.4%).ICGR15 (14.38 ±8.2)% in patients with tumor of Child-Pugh grading B was higher than ICGR15 (7.84 ± 4.8)% in those with tumor of Child-Pugh grading A.Conclusion ICGR15 valuecan be more sensitive in evaluating hepatic functional reserve than Child-Pugh grading, but some correlation can be observed between them.ICGR15 is useful in assessing the range of liver resection and prognosis before hepatectomy for hepatocellular carcinoma.     

地震灾区日晒伤68例

5.12汶川地震后,武警四川总队医院第三医疗队赶赴平武县南坝镇参加地震医疗救援,在5月13日至6月5日的医疗救援中,诊治伤病员1884人(其中皮肤病196例),收治日晒伤患者68名,现报告如下.     

腹腔镜胆囊切除中转开腹手术的应急配合

腹腔镜胆囊切除术(LC)以被作为有症状的良性胆囊疾患的首选术式，其优点超过了传统的开腹胆囊切除术。但是，LC不可能完全取代开腹胆囊切除手术，手术医师根据术中所遇到的具体情况，决定术中的手术方式。而LC中转开腹并不意味着LC治疗失败，而是手术医师采取的更为有效的治疗方法。文献报道LC术中转开腹手术率为3％-12．5％。作为手术室护士应随时作好准备，进行应急配合。     

3例全麻腹腔镜下可调节胃束带手术配合

目的探讨如何做好全麻腹腔镜下可调节胃束带术的手术配合。方法2006年10-11月对3例肥胖患者采用全麻腹腔镜下可调节胃束带手术,针对所开展的新技术,着重对在术前准备,手术的配合,以及术中护理进行如实汇报。结果3例全麻腹腔镜下可调节胃束带手术,术前访视仔细认真,术中护理人员配合娴熟,使手术顺利完成。结论全麻腹腔镜下可调节胃束带手术安全,手术时间短,术中出血少,减肥效果理想。手术室护理人员做好充分的术前准备,术中良好的配合,不仅可以缩短手术时间,还可以减少患者术后并发症的发生。     

ICGR15在肝癌切除术前评估肝脏储备功能的作用

Objective To evaluate the role of ICGR15 in assessment of hepatic functional reserve before hepateetomy for hepatocellular carcinoma.Methods From August 2005 to October 2007, six-ty-six patients with hepatocellular carcinoma were treated in our hospital.The patients were random-ized into Child-Pugh grading group (32 cases) and ICGR15 detection group (34 cases).Preoperative preparation,operative procedures and postoperative management were the same in all the 66 patients.The morbidity and mortality were compared and the relationship between Child-Pugh grading and ICGR15 in assessment of hepatic functional reserve was determined.Results The incidence of hepatic failure after hepatectomy in ICGR15 detection group(23.50%) was significanly lower than that in Child-Pugh grading group(34.4%).ICGR15 (14.38 ±8.2)% in patients with tumor of Child-Pugh grading B was higher than ICGR15 (7.84 ± 4.8)% in those with tumor of Child-Pugh grading A.Conclusion ICGR15 valuecan be more sensitive in evaluating hepatic functional reserve than Child-Pugh grading, but some correlation can be observed between them.ICGR15 is useful in assessing the range of liver resection and prognosis before hepatectomy for hepatocellular carcinoma.