食管下段颗粒细胞瘤1例临床报道并文献复习

1 临床资料 患者,男,45岁,因"体检发现贲门占位性病变1年余"入院.入院体格检查:生命体征平稳,全身皮肤、黏膜未见皮疹、黄染,浅表淋巴结未扪及,心肺未见明显异常,腹平软,无压痛反跳痛,肝脏和脾肋下未触及,双下肢不肿,病理征未引出.辅检:食管,胃钡餐示:食管下段见不规则充盈缺损,管壁不糙,黏膜线中断.贲门处见隆起性软组织影.余段食管未见明显异常.     

GSH钉固定联合香丹注射液骨折端注射治疗股骨远端AC型骨折

目的探讨GSH钉固定联合香丹注射液骨折端注射治疗股骨远端AC型骨折的应用价值。方法将72例随机分为两组,治疗组采用GSH钉固定＋骨折端处注入香丹注射液治疗,对照组采用GSH钉固定治疗。两组按Mer-chan标准进行膝关节功能评分并运用DEXA（双能X线骨密度仪）对各阶段新生骨痂的BMD含量进行检测。结果两组病例均获随访,膝关节优良率均为94.4%。治疗组在术后第2、6、10、14、18周测定新生骨痂的BMD含量值优于对照组。结论 GSH钉固定联合香丹注射液骨折端注射治疗股骨远端AC型骨折,能允许肢体早期活动,有利于膝关节功能恢复,又能有效促进骨痂生长及骨折愈合,是一种疗效满意、值得推广应用的治疗方法。     

妊娠期肝内胆汁淤积症76例护理体会

妊娠期肝内胆汁淤积症（ICP）是妊娠中晚期特发性并发症,临床表现以皮肤瘙痒或瘙痒与黄疸并存为特征,主要危害胎儿,使围生儿发病率和病死率增高。我院产科2006年1月至2007年7月收治ICP产妇76例,在积极治疗的同时实施积极主动的监护护理,取得较好效果,现将护理体会报道如下：     

A new carotid artery transplantation model of rats

To establish a murine carotid artery transplantation model for the study of the chronic rejection, 80 rats were divided into two groups, an allotransplant （ACI-Lewis） group and an isotransplant （Lewis-Lewis） group （control group）. The donor carotid artery and the recipient carotid artery were anastomosed by using a polyethylene cuff （internal diameter： 0.7 mm, length： 3 mm）.The pathological changes of carotid artery transplant were observed 14, 28 and 56 days after the transplantation. The results showed that the model was successfully established in 95% of the animals. The chronic rejection-associated arteriosclerosis was induced 28 days after the transplantation. The new chronic rejection model of carotid artery by using cuff technique caused fewer traumas and was easy to make. The pathological changes of the transplant mimicked the chronic rejection-associated arteriosclerosis found in human transplant.     

The inhibitory effect of astilbin on the arteriosclerosis of murine thoracic aorta transplant

The inhibitory effect of astilbin on transplant arteriosclerosis in murine model of thoracic aorta transplantation was examined. Model of rat thoracic aorta transplantation was established. Ninety rats were divided into three groups. In isograft group, the thoracic aorta of Brown Norway （BN） rat was anastomosed with the abdominal aorta of another BN rat. In allograft group, the thoracic aorta of BN rat was anastomosed with the abdominal aorta of Lewis rat. In astilbin group, the rats receiving allo-transplantation were given astilbin 5 mg/kg per day for a time of 28 days. The donor thoracic aorta and the recipient abdominal aorta were anastomosed by means of a polyethylene can- nula （inner diameter： 1.5 mm, length： 3 mm length）. The grafts were histologically examined for structural changes. The areas of arterial lumen and endatrium were calculated. Our results showed that, in the allograft group, 28 days after allografting, conspicuous proliferation of smooth muscles and infiltration with a great number of inflammatory cells were found in the tunica intima and tunica media. Astilbin significantly inhibited the proliferation of smooth muscles and ameliorated the infiltration of inflammatory cells thereyby prevent against the development of transplant arteriosclerosis. It is concluded that asltilbin can effectively prevent the development of arteriosclerosis in allotransplant by inhibiting the proliferation of smooth muscles and inhibit the proliferation of smooth muscles in tunica of intima and media and reducing infiltration of the inflammatory cells.     

心脏手术后纵隔感染的早期诊断与治疗

1992年1月～1996年6月，治疗了18例心脏手术后纵隔感染患者，其中1994年1月以前，采用清创、封闭灌洗法治疗11例，治愈9例，以后采用纵隔引流法治疗7例，全部治愈。通过对二种方法的对比研究，提出纵隔引流法简便、有效，对治疗早期纵隔感染有较好疗效，并就临床诊断进行了讨论。     

胸腹主动脉全程置换术中的肋间动脉血运重建

目的:探讨胸腹主动脉置换术中操作方便快捷的肋间动脉血运重建方法,总结分析行胸腹主动脉全程置换术的患者情况。方法:回顾性分析2001-2010年21例胸腹主动脉全程置换术临床资料。其中男15例,女6例,平均年龄(45±8)岁。手术中对主动脉壁进行修剪,利用主动脉后侧壁缝制肋间动脉共同通道,再以直径8 mm人造血管两端分别与肋间动脉共同通道和胸主动脉人造血管行端侧吻合,重建全部肋间动脉血运供应。结果:2例术后死亡。其余19例未发生脊髓缺血并发症。所有的病人随访6-12个月,未发现肢体运动和感觉缺失症状。CT血管造影(CTA)未提示假性动脉瘤形成,肋间动脉共同通道通畅,肋间动脉共同通道未发生异常扩大。结论:利用主动脉后侧壁,缝制肋间动脉共同通道,重建肋间动脉血运,操作方便快捷,有效减少术中脊髓缺血时间,术后能提供脊髓血液供应。     

气管部分切除手术治疗气管狭窄的临床体会

目的:探讨气管切除手术在气管狭窄治疗中的应用及治疗效果。方法:回顾我院2010至2012年之间10例气管狭窄患者,5例为良性气管狭窄,6例为肿瘤相关性气管狭窄,余10例行手术治疗。结果:10例患者完成狭窄段气管切除及重建,气管平均切除长度为(3.55±0.98)cm。1例良性气管狭窄患者术后出现吻合口瘘,行吻合口瘘修复术,术后无复发;1例上段食管癌继发气管狭窄患者术后出现吻合口瘘,于术后12d死亡;余8例患者恢复良好。结论:气管切除是一种治疗气管狭窄安全、有效的措施,尽可能完全肿瘤切除和狭窄段切除重建,减少术后并发症的发生。