颌骨牙源性囊肿袋形术/减压术引流装置的设计与临床应用

颌骨牙源性囊肿是一组来源于与牙发生相关组织的病变,上皮衬里的囊腔包含液体或半流体。由于囊腔内的压力、骨吸收因子释放及上皮增生引起囊肿不断增大,导致颌骨膨隆、牙松动移位,面部畸形及咬合功能障碍。牙源性囊肿的袋形术/减压术是一种简单易行而有效的保守性治疗方法。成功的治疗需要术后采用不同引流装置保持囊肿引流。较大的囊肿常在术后配戴囊肿塞或阻塞器,而较小的病变则通过减压管保守引流。大多数病例是在袋形术/减压术后囊肿缩小时二期行囊肿刮除术,可减少邻近结构的损伤或手术并发症,仅少数病例中袋形术作为惟一的治疗方式。文章简要介绍了袋形术/减压术的相关治疗机制以及多种引流装置的设计与临床应用。     

鼻内窥镜下揭盖法鼻前庭囊肿造袋术21例分析

目的 探讨鼻内窥镜下揭盖法鼻前庭囊肿造袋术手术方法的临床应用.方法 使用鼻内窥镜对21例鼻前庭囊肿病例行揭盖法鼻前庭囊肿造袋术.结果 21例病例2周内创面基本愈合,无并发症发生,随访半年无复发.结论 在鼻内窥镜下行揭盖法鼻前庭囊肿造袋术手术简单,术后病人反应轻,创伤小,值得临床推广应用.     

鼻内镜微创手术治疗蝶筛窦囊肿25例疗效分析

目的 对鼻内镜微创手术治疗蝶、筛窦囊肿疗效进行评估。方法 回顾总结25例鼻内镜下袋状化手术治疗蝶、筛窦囊肿及1-3年随访的资料。结果 25例囊肿在内镜下均暴露良好，术野清晰，术后囊腔得到充分引流，23例获得满意疗效，无严重并发症发生。结论 鼻内镜下袋状化手术是一种治疗蝶、筛窦囊肿安全、有效的方法。     

不同肠道重建方式对低位直肠癌保肛术后肛门功能的影响

目的研究直接吻合术、结肠成形袋术和J型贮袋术对低位直肠癌保肛术后肛门功能的影响。方法选择2007年1月。2011年5月在郑州大学附属郑州中心医院治疗的低位直肠癌患者109例,随机分为直吻组36例行直接吻合术,结袋组37例行结肠成形袋术,J袋组36例行J型贮袋术,观察三组患者术后肛门功能情况。结果三组均无死亡;直吻组、结袋组、J袋组手术重建成功率[94．44％（34／36）、97．30％（36／37）、94．44％（34／36）1、术后并发症发生率[8．82％（3／34）、5．55％（2／36）、5．88％（2／34）1差异均无统计学意义（均P〉0．05）。术后3、6、12个月结袋组和J袋组24h排便次数、不能区分排便和排气均显著少于直吻组,差异有统计学意义（P〈0．05或JP〈0．01）;术后3、6、12个月三组大便不能完全排空感差异无统计学意义（P〉0．05）;术后3个月三组肛门功能主观感受评价得分差异无统计学意义（P〉0．05）;术后6、12个月结袋组[（7．83±1．75）、（8．34±1．85）分]和J袋组[（7．69±1．63）、（8．41±1．74）分]肛门主观感受评价得分显著高于直吻组[（6．36±1．78）、（6．89±1．67）分],差异有统计学意义（P〈0．05或P〈0．01）。术后3、6、12个月结袋组和J袋组静息压和最大耐受容量高于直吻组,术后12个月结袋组和J袋组最大收缩压和顺应性均高于直吻组,差异均有统计学意义（P〈0．05）;结袋组和J袋组静息压、最大收缩压、最大耐受容量、顺应性等指标差异无统计学意义（P〉0．05）。结论直接吻合术对低位直肠癌全直肠结肠系膜切除术后患者肛门功能影响最为显著．结肠成形袋和J型贮袋术改善患者术后肛门功能作用相似,结肠成形袋方法更简单。     

Pancreatogastrostomy in experimental acute necrotizing pancreatitis

Experimental acute necrotizing pancreatitis was induced retrogradely in dogs with sunflower oil injected intraductally. Then, a zipper was sutured into the abdominal wound. From the first postoperative day, three different treatments were started: first group: only conservative therapy was used; second group: removal of necrotized tissue and single peritoneal lavage were aplied; and third group: the necrotic part of the pancreas was marsupialized into the stomach. Through the systematic opening of the zipper, the abdominal cavity could easily be explored and the temporal course of disease could be observed in all animals. During this regular procedure, the amylase concentration and the amount of peritoneal exudate were determined. The blood amylase and glucose levels were also measured. On the first postoperative day, the amylase level and the amount of peritoneal exudate were high in all groups. The dogs of the pancreatogastrostomized group showed a dramatic decrease of the exudate and the most advantageous temporal course of the blood amylase level. The survival rate similarly was advantageous in the pancreatogastrostomized group.     

Laparoscopic marsupialization of a giant posttraumatic splenic cyst.

BACKGROUND AND OBJECTIVE: Nonparasitic cysts are rare clinical lesions of the spleen. Causes include congenital malformations and trauma. Historically, management has entailed partial or total splenectomy using an open approach. Recently, laparoscopic approaches have been developed. In this report, we describe laparoscopic marsupialization of a giant splenic cyst (diameter > 15 cm). METHODS: A 25-year-old African-American man presented with a 9-month history of early satiety, constipation, and left upper quadrant pain. Additionally, he reported blunt trauma to the abdomen 2 years earlier. Physical examination revealed a large, fixed, nontender left upper quadrant mass. Computed tomography scan confirmed a simple cyst within the spleen, measuring 20 x 25 cm. Echinococcus and Entamoeba histolytica serologies were negative. Laparoscopic exploration was performed. Four liters of brown fluid were aspirated and intraoperative cytology confirmed a nonparasitic cyst. The cyst wall was excised and the cavity was packed with omentum. RESULTS: The patient's recovery was uneventful, and he was discharged to home tolerating a regular diet on postoperative day 3. At 6-month follow-up, the patient was asymptomatic and showed no evidence of recurrence. CONCLUSION: Nonparasitic splenic cysts are rare lesions. Laparoscopic marsupialization is safe and effective for giant nonparasitic splenic cysts and should be considered the treatment of choice.     

Scanning electron microscopic study of the nasolabial cyst: its clinical and embryological implications

OBJECTIVE: Nasolabial cyst is an uncommon midfacial cyst. It is considered to be a developmental anomaly arising from the rest of nasal respiratory epithelium. Although the cyst is a well-recognized entity, there remains some confusion of its origin, cell types, and ultrastructures. Based on the routine light microscopic study, some authors reported the epithelial cells of the inner lining of the nasolabial cyst were ciliated; some others reported they were nonciliated. To clarify this, a scanning electron microscopic study is needed. STUDY DESIGN: This was a prospective clinical series. METHODS: A transnasal marsupialization method was used to treat 10 patients with nasolabial cyst. With patients under local anesthesia, the roof of the cyst wall and a disk of nearby nasal mucosa were excised together with a sickle knife and scissors. Surgical specimens were dissected and processed for scanning electron microscopy and histochemistry. Patients were followed up for 8 to 65 months. RESULTS: Marsupialization of cysts was successfully performed on all patients. Electron microscopically, the inner surface of the nasolabial cysts in all the cases was lined with nonciliated columnar epithelium consisting chiefly of goblet cells and basal cells. It is suggested that goblet cells contributed to clear, thin, and yellow mucus present in the cyst lumen. Instead of cilia, these epithelial cell surfaces were equipped with numerous short, globular, or irregular microvilli. Apical cytoplasm of adjacent cells did not tightly adhere to each other. Instead, microsulci of 1 to 3 microm in width formed between cells. Cytoplasmic processes from the lateral border spanned the microsulcus and contacted with those from neighboring cells. CONCLUSION: The novel study has proved that the lining epithelium on the inner surface of the nasolabial cyst is columnar epithelium that chiefly consisted of two types of cells: goblet cells and basal cells. Not present were ciliated cells that were essential in the other portion of the respiratory tract. Numerous microvilli, instead of cilia, covered the inner lining of the nasolabial cyst, probably as a result of lacking the stimulation of air in ventilation as that on the other portion of the respiratory tract. The cilia of the epithelium were ill developed.     

经鼻内镜囊肿造袋术治疗鼻窦黏液囊肿的临床研究

目的 探讨经鼻内镜囊肿造袋术治疗鼻窦黏液囊肿的临床疗效，并研究鼻窦黏液囊肿组织的超微结构及与病理特性之间的关系，为鼻寞黏液囊肿造袋术提供理论依据。方法 30例鼻窦黏液囊肿病人均行经鼻内镜囊肿造袋术，手术后标本作电镜超微结构检查。结果 术后随访6～12月无1例复发。30例均为黏液囊肿，除1例为立方状上皮外，其余内衬上皮为假复层纤毛柱状上皮。上皮纤毛发达，线粒体丰富，内质网、高尔基氏体发达，黏液性腺细胞和杯状细胞浆中有大量黏液分泌颗粒，基底膜下有大量淋巴细胞、中性粒细胞及少量嗜酸性粒细胞浸润。结论 经鼻内镜囊肿造袋术是治疗鼻窦黏液囊肿的有效术式，具有微创、面部无瘢痕等优点。鼻窦黏液囊肿内衬上皮与鼻腔大部分黏膜一样均为假复层纤毛柱状上皮，纤毛发达，术后纤毛功能可以恢复，其超微结构与病理特性密切相关。     

袋形术治疗萌出囊肿26例报告

目的:通过袋形术治疗萌出囊肿,探索囊肿内牙齿移动及囊肿损伤对牙齿发育的影响.方法:回顾性分析1996-05-2009-12间26例混合牙列期萌出囊肿行袋形术治疗的病例.测量袋形术后囊内牙齿在一定时期内的移动速度和方向,及囊肿对牙齿发育的影响.结果:术后随访1年,发现所有患者囊肿的囊腔消失,牙齿移动速度随着牙齿的萌出而减...