快速康复外科在结直肠癌择期手术中的应用效果

Objective To investigate the clinical application of fast track surgery in patients undergoing elective colorectal carcinoma surgery. Methods Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: fast-track group (35 cases) and conventional care group (35 cases). Results Sixty-two patients finished the study, 32 cases in fast-track group and 30 cases in conventional care group. The median and average time to the first passage of flatus (2±1 vs. 4±2, P<0.01), the first passage of stool (3.8±1.6 vs. 6.4±2.5, P=0.0007), resumption of normal diet [(4±2) vs. (8.2±2.2), P<0.01] and the length of postoperative stay (6±1 days vs. 11.7±3.8 days, P<0.01) were much shorter in the fast-track group than in the conventional care group. The preoperative incidence of thirst (2/32 vs. 23/30, P<0.01), hunger (5/32 vs. 20/30, P<0.01) and postoperative infectious complications (2/32 vs. 8/30, P=0.04) were much lower in the fast-track group than in the conventional care group. Conclusion Fast track surgery in patients undergoing elective colorectal resection was safe and effective.     

彩超诊断心脏肿瘤34例分析

目的：对34例心脏肿瘤病例进行彩超图像分析。方法：回顾性分析34例心脏肿瘤病例,根据病理区分良恶性,并将彩超图像结合临床及心电图对比分析。结果：良性肿瘤10例,病理证实均为心房粘液瘤。恶性肿瘤24例,其中原发性3例,继发性21例。结论：心脏良性肿瘤临床表现类似二、三尖瓣疾病,彩超检查可资鉴别。恶性肿瘤临床表现缺乏特异性,彩超表现具有多样性,有必要进一步探讨提高其诊断准确性。     

快速康复外科在结直肠癌择期手术中的应用效果

目的 探讨快速康复外科在接受择期手术的结直肠切除术中的应用效果.方法 将入选的70例拟接受择期手术的结直肠癌患者随机分为快速康复组和传统治疗组,每组35例,分别接受快速康复治疗及传统治疗.数据资料采用T检验、秩和检验、卡方检验和Fisher's精确概率法.结果 62例患者完成试验,快速康复组32例,传统治疗组30例;快速康复组患者术后的住院时间(6±1 vs.11.7±3.8 d,P<0.01)、首次排气时间(2±1 vs.4±2 d,P<0.01)、首次排便时间(3.8±1.6 vs.6.4±2.5 d,P=0.0007)、首次耐受半流饮食时间[(4±2)vs.(8.2±2.2)d,P<0.01]均比传统治疗组短.快速康复组患者术前口渴发生率(2/32 vs.23/30,P<0.01)、术前饥饿发生率(5/32vs.20/30,P<0.01)及术后感染性并发症发生率(2/32 vs.8/30,P=0.04)较传统治疗组明显降低.结论 快速康复外科在接受择期手术的结直肠癌患者中安全有效,明显加快了术后肠道功能的恢复,降低了术后感染性并发症的发生率,缩短了术后住院时间.     

术前禁食时间对BALB/c裸鼠NK细胞杀伤活性的影响

目的 研究术前禁食时间长短对BALB/c裸鼠NK细胞杀伤活性的影响. 方法 按术前禁食时间分为24小时组、36小时组、48小时组,每组10只BALB/c裸鼠(5只为非禁食对照组),每只裸鼠行取脾术后处死,通过磁珠分选技术将裸鼠脾脏NK细胞分选出来,进而对NK细胞的杀伤活性进行检测.结果 禁食24小时和36小时后裸鼠的NK细胞活性均有不同程度地下降(分别为1.06％和2.2％),但差异无统计学意义(P＞0.05),在禁食48小时后可见裸鼠脾脏的NK细胞杀伤效应进一步下降(5.96％),差异有统计学意义(P=0.014). 结论 术前长时间禁食可降低裸鼠脾脏NK细胞的杀伤效应.     

快速康复外科在结直肠癌择期手术中的应用效果

Objective To investigate the clinical application of fast track surgery in patients undergoing elective colorectal carcinoma surgery. Methods Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: fast-track group (35 cases) and conventional care group (35 cases). Results Sixty-two patients finished the study, 32 cases in fast-track group and 30 cases in conventional care group. The median and average time to the first passage of flatus (2±1 vs. 4±2, P<0.01), the first passage of stool (3.8±1.6 vs. 6.4±2.5, P=0.0007), resumption of normal diet [(4±2) vs. (8.2±2.2), P<0.01] and the length of postoperative stay (6±1 days vs. 11.7±3.8 days, P<0.01) were much shorter in the fast-track group than in the conventional care group. The preoperative incidence of thirst (2/32 vs. 23/30, P<0.01), hunger (5/32 vs. 20/30, P<0.01) and postoperative infectious complications (2/32 vs. 8/30, P=0.04) were much lower in the fast-track group than in the conventional care group. Conclusion Fast track surgery in patients undergoing elective colorectal resection was safe and effective.     

综合性康复训练对肺癌术后化疗病人功能状态与体力状态的改善情况观察

[目的]初步探索以康复学理论为基础,应用综合性康复训练缓解肺癌术后化疗病人功能状态与体力状态的疗效,并观察其改善情况。[方法]通过随机对照的方法将154例肺癌术后化疗病人分为治疗组、对照组,两组均予住院常规治疗及护理,对照组不予其他治疗,治疗组予综合性康复训练,共90d,对比两组间及组内训练前后功能状态与体力状态的改善情况。[结果]治疗组在训练后功能状态与体力状态的改善方面优于治疗前,且治疗组优于对照组,差异具有统计学意义(P0.05)。[结论]综合性康复训练对肺癌术后化疗病人的功能、体力改善方面疗效确切。     

快速康复外科在结直肠癌择期手术中的应用效果

Objective To investigate the clinical application of fast track surgery in patients undergoing elective colorectal carcinoma surgery. Methods Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: fast-track group (35 cases) and conventional care group (35 cases). Results Sixty-two patients finished the study, 32 cases in fast-track group and 30 cases in conventional care group. The median and average time to the first passage of flatus (2±1 vs. 4±2, P<0.01), the first passage of stool (3.8±1.6 vs. 6.4±2.5, P=0.0007), resumption of normal diet [(4±2) vs. (8.2±2.2), P<0.01] and the length of postoperative stay (6±1 days vs. 11.7±3.8 days, P<0.01) were much shorter in the fast-track group than in the conventional care group. The preoperative incidence of thirst (2/32 vs. 23/30, P<0.01), hunger (5/32 vs. 20/30, P<0.01) and postoperative infectious complications (2/32 vs. 8/30, P=0.04) were much lower in the fast-track group than in the conventional care group. Conclusion Fast track surgery in patients undergoing elective colorectal resection was safe and effective.     

阴囊正中带蒂皮瓣修复尿道下裂的临床研究

目的　探索治疗尿道下裂新的手术方法。方法　选择 17例阴茎阴囊型尿道下裂 ,采用阴囊正中带蒂皮辨修复尿道。结果　本组所有病例均治愈 ,病人出院后随访 8个月～ 5年 ,所有病例均未出现尿瘘。结论　采用阴囊正中带蒂皮辩修复尿道下裂是一种简单、取材方便、成活率高的手术方式 ,它可以广泛应用于临床 ,特别是基层医院。     

大鼠广泛肠切除后小肠组织miR-125a和Mcl-1的表达及意义

目的：探讨广泛肠切除后miR-125a和抗凋亡蛋白（Mcl-1）在肠上皮细胞中表达的变化及其在短肠综合征剩余肠管适应性变化过程中的意义。方法选取8周龄的SD雄性大鼠54只,分为实验组（18只,进行70％的大范围小肠切除,距回盲部近端15 cm和Treitz韧带远端10 cm处分别切断小肠,然后行空回肠端端吻合）、肠切除对照组（18只,在距回盲部近端15 cm处切断肠管然后再吻合）和手术对照组（18只,仅行开关腹手术）。术后1周在距吻合口远端1 cm处取材,采用免疫组织化学方法和实时荧光定量 PCR检测各组大鼠小肠组织中 Mcl-1和 miR-125a 表达。结果实验组大鼠肠组织中Mcl-1阳性表达率为18．8％（3／16）,明显低于手术对照组（76．5％,13／17）和肠切除对照组（83．3％,15／18）（均P＜0．01）;miR-125a相对表达量为1.92,明显高于肠切除对照组（1.01）和手术对照组（1.05）（均P＜0．01）。结论 miR-125a和Mcl-1在广泛肠切除诱导的肠道适应过程中发挥重要作用,二者之间通过一定的机制相互调节。     

快速康复外科与自然杀伤细胞活化机制的研究进展

快速康复外科（FTS）通过围手术期多学科综合措施的临床应用,可以降低应激反应,降低术后并发症发生率,增强患者免疫功能,从而促进患者术后快速恢复,缩短住院时间,临床优势明显。自然杀伤（NK）细胞被认为是机体抗病毒感染、抑肿瘤的第一道天然防线,在抗病毒、抗肿瘤、免疫调节等方面发挥重要的生物学作用。应激反应的强弱与NK细胞的活化存在一定关系,本文推测FTS与NK细胞活化有着相互联系,通过内环境细胞因子及其代谢激素水平的变化,从而间接或者直接激活NK细胞。