十二指肠损伤的诊治体会

目的提高十二指肠损伤的诊疗水平。方法对本组十二指肠损伤12例的病因、伤情、术后并发症及死亡率进行统计和分析。结果单纯十二指肠损伤3例，多发伤9例；并发症7例；治愈10例，死亡2例，均死于十二指肠瘘合并腹腔严重感染。结论早期诊断、术中仔细探查、术后保持引流通畅、营养支持、密切观察病情变化、尽早再次手术是影响十二指肠损伤预后的重要因素。     

Surgical strategy of one stage surgery of anterior release combined with posterior correction in treatment of severe scoliosis

Objective: Severe scoliosis refers to scoliosis with serious and stiff curve. It always combins with trunk imbalance in coronal and sagittal contour. Besides complex pathological changes, cardiopulmonary deficits and other concomitant diseases increase treatmental difficulties. So the treatment of severe scoliosis is always a great challenge to spine surgeon. Methods :Thirty-six patients with severe scoliosis received one stage posterior correction followed by anterior release during July 1997 to January 2003, including 9 males and 27 females. Mean age was 17.2 years. Of them, 33 was idiopathic scoliosis and 3 was neurofibromatosis scoliosis( Cobb angle: 85-116 degree); 20 cases were abnormal in sagital plane. Three-dimensional devised instrumentation were applied such as CD, CD-Horizon, TSRH or Isola in posterior procedure followed by anterior release during the same anesthesia. 31 cases of this group received thorac icplasty. Results: The correction in the frontal plane achieved an average of 48.5%. In the sagittal plane, the pathological shape of the spine was reduced and distinctly ameliorated. 80. 6% of the patients maintained or achieved balance of sagittal plane. There were no complications of severe neurological deficit, hook displacement, rod broken, and deep infection at follow-up. One case occurred traumatic pleurisy after operation and another appeared pseudarthrosis 2 years later. One case demonstrated imbalance 11 months after operation. One patient was presented loss of correction more than 10 degree at one year follow-up and 5.2 degree in average. Conclusion:The study indicates that the one stage posterior correction combined with anterior release in treatment of severe scoliosis can achieve satisfactory correction. Appropriate choice of cases, preoperational detailed assessment and application of SEP and wake-up test during operation can possibly reduce severe complication. The long-term outcomes still need further observation.     

STYLOID PROCESS SYNDROME LENGTFI AND PALPATION OF THE STYLOLD PROCESS

In 1980, 267 patients with related symp- toms were examined by tomography in our hos- pital. Among them the styloid process (SP) of 128 cases were 30 mm or more in length. Pha- ryngeal palpation was performed in 98. The SPs of 61 patients were palpable and tender. Diagno- sis was based on the related symptoms, tomogra- phy, positive pharyngeal palpation and SP tender- ness. Tomography showed that the longest SP was 75 mm, while the longest one with symptoms was 65 mm. The medial angulations of the SPs were from 100 t0 27° and the anterior angulations from 300 t0 50°.     

维药清热解毒颗粒挥发油提取及其β-环糊精包合工艺的研究

目的：建立清热解毒颗粒的挥发油提取工艺。方法：采用水蒸气蒸馏法提取挥发油；β-环糊精包令挥发油。结果：所制得制剂质量稳定、操作方便。     

第九讲 小儿结核病的治疗

结核病是慢性、全身性疾病,只有在全身疗法的基础上,充分调动小儿身体的抗病能力,用特效的抗结核药物治疗才能更好地发挥其抗菌作用,取得更好的治疗效果。有的抗结核药物只是起到抑菌作用,要彻底消灭体内的结核菌,就得靠患儿本身的免疫力发挥作用,慢慢地清除结核菌。所以在结核病的治疗上,全身疗法不能忽视。全身疗法中首先要注意合理的营养和休息,给以高蛋白质、高维生素的饮食。患儿的     

急性心肌梗塞误诊为呼吸系疾病11例分析

在基层,由于对一部分非典型急性心肌梗塞(AMI)认识不足和/或警惕性不高,往往延误诊断,给治疗及预后带来严重影响。本文分析了本院近10年来收治的误诊为呼吸系疾病的非典型AMI11例资料,供参考。     

自然肿瘤抑制物体外净化自体骨髓移植治疗AMOL1例报告

骨髓移植（BMT）已成为治愈白血病的基本方法。报告1例急性单核细胞性白血病（AMOL）用低分子量自然肿瘤抑制物（LNTS）体外净化骨髓作自体BMT成功。患者女，39岁。因头昏发热一周于1993年1月13日经骨髓检查诊断为AMOL。骨髓原幼单69．5％。经DAE方案（柔红霉素40mg／d×3，阿糖胞着0．1／d×6，足叶乙式0．1／d×6）2个疗程后完全缓解。再2个疗程强化治疗。又HAE方案（三尖杉脂碱3mg／d×6代替柔红霉素）1疗程后作自体BMT。入院时心肺听诊（一）。肝脾淋巴结不肿大。胸膝位见6、12点陈旧性肛裂。Hb112g／L，WBC4．2×109／L…     

加减养阴清热汤配合西药治疗单疱角膜炎

加减养阴清热汤配合西药治疗单疱角膜炎河北省献县人民医院眼科（０６２２５０）白国际，崔艳琨，崔景歧地图状单疱病毒性角膜炎（简称地图状角膜炎），是近年来较为常见的一种顽固性角膜炎，病情严重，治疗棘手，迄今为止尚无特效疗法。笔者近年来选用加减养阴清热汤配合...     

肝炎-再生障碍性贫血综合征——关于“发热、咽痛、鼻出血”的病案讨论

(思考病案见本期 4 1页 )1　全血细胞减少的常见病1 .1　再生障碍性贫血　 再生障碍性贫血并非少见病 ,可分为先天性及后天性。先天性者常有家族倾向或伴有其他先天异常 ,如Ｅｓｔｒｅｎ和Ｄａｍｅｓｈｃｋ贫血、Ｆａｎｃｏｎｉ贫血、Ｓｃｈｗａｃｈｍａｎ综合征等。从本病例情况看 ,可排除先天性再生障碍性贫血。后天性、获得性再生障碍性贫血又可分为原发性和继发性。原发性者病因及发病机制尚不清楚 ,可能系造血干细胞缺乏或缺陷 ,造血微环境缺陷 ,免疫紊乱 (包括细胞免疫和体液免疫失调、血液抑制因子和细胞调节因子异常 )。根据发病急…