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51.
目的:探讨直肠癌Miles术后内疝性肠梗阻的原因、预防和诊治.方法:对1998年1月至2006年10月间收治的直肠癌Miles术后并发内疝性肠梗阻5例进行回顾性分析.结果:Miles术后并发内疝性肠梗阻的发生率为6%(5/82),表现术后不同程度的腹胀,阵发性腹痛,呕吐,胃管引流液每天超过500 mL者,结肠造瘘口无排气排便;腹部轻压痛,肠鸣音活跃或亢进.腹部立、卧位X线片检查,均发现肠腔扩张、多个液平或孤立性肠袢扩张.5例均行剖腹探查而证实,疝内容物为回肠,其中行单纯粘连松解复位2例,部分回肠切除、端端吻合术3例.再次手术后均痊愈出院.结论:Miles术后内疝性肠梗阻常缺乏典型的临床表现,早期诊断和及时剖腹探查是处理的关键,其重点在于预防. 相似文献
52.
Jun-ichi Shikata MD Kazuhiko Ohtaki Kenjiro Amino Yoshitsugu Takeda 《Surgery today》1990,20(6):660-664
Two nationwide questionnaire surveys of intestinal obstruction in Japan were undertaken, covering two two-year periods, from
January, 1975 to December, 1976 and from January, 1985 to December, 1986, respectively. The findings of a comparative review
of these two surveys indicated that although the overall mortality of intestinal obstruction had not changed between 1975/76
and 1985/86, being 6.8 per cent and 6.5 per cent, respectively, simple adhesive obstruction had decreased from 3.2 per cent
in 1975/76 to 2.0 per cent in 1985/86. The main cause of adhesion was laparotomy and in cases of both simple adhesive obstruction
and strangulated adhesive obstruction, the rate of adhesion secondary to laparotomy of the upper gastrointestinal tract and
colon and rectum had increased between 1975/76 and 1985/86. Obstructions caused by neoplasms had increased from 8.2 per cent
in 1975/76 to 10.0 per cent in 1985/86, while those caused by adhesions had incresed further still, from 42.5 per cent in
1975/76 to 60.8 per cent in 1985/86. Among the latter group, nonoperatively treated cases had increased, which may be accounted
for by the fact that facilities which adopt non-operative treatment using intestinal decompression as the first choice for
simple adhesive obstruction cases have increased. In both surveys, the mortality of cases receiving nonoperative treatment
was lower than that of operative cases. 相似文献
53.
We report a case of acute upper airway obstruction after tracheal extubation 24 hours after surgery. The respiratory complications of surgery for posterior fossa lesions are discussed. 相似文献
54.
F. Teixeira Brandt C. D. Costa Albuquerque J. W. Barros Leal 《International urogynecology journal》1997,8(6):332-335
We report on the vaginal mucosal folds (VMF) at the urethral external meatus. Resection of the VMF reduces the dispersed micturition
and other urinary symptoms.
EDITORIAL COMMENT: The investigators describe the presence of a vaginal mucosal fold (VMF) just dorsal to the urethral meatus
and its relationship to voiding abnormalities. VMF were found on physical examination in 8.9% of the clinic population, all
of whom complained of dispersed micturition, and 79% also experienced other voiding abnormalities. The complaint of dispersed
micturition was successfully treated with excision of the VMF, and the other associated symptoms were improved. This structure
should be routinely looked for on physical examination, especially in patients with voiding symptoms. Only further investigation
of this newly described entity at other centers around the world will determine the incidence of the anatomic finding and
the prevalence of associated voiding disturbances across different populations. 相似文献
55.
Chun Yuan Jay S. Tsuruda Kirk N. Beach Cecil E. Hayes Marina S. Ferguson Charles E. Alpers Thomas K. Foo D. Eugene Strandness 《Journal of magnetic resonance imaging : JMRI》1994,4(1):43-49
Atherosclerotic cardiovascular disease is the most common cause of death in the United States. Investigation of atherosclerotic plaque morphology and composition is important because the findings may be useful in predicting prognosis or response to therapy. This study presents high-resolution magnetic resonance (MR) imaging techniques developed on a 1.5-T whole-body imager with a custom-built surface coil, for characterizing the composition and morphology of plaque removed at carotid endarterectomy. The initial comparison of MR imaging and histologic results showed good correlation. In conjunction with MR angiography, these techniques could be used in in vivo imaging to define the size, location, and contents of atherosclerotic plaque at the carotid bifurcation. 相似文献
56.
Edwina J. Popek R. Weslie Tyson Gary J. Miller Sherrie A. Caldwell 《Fetal and pediatric pathology》1991,11(1):1-29
Prune belly syndrome (PBS) has been recognized since 1950 as the triad of absent abdominal wall musculature, undescended testes, and urinary tract anomalies. The etiology, however, remains uncertain. Theories of mesenchymal maldevelopment, obstruction, and genetic origin have been proposed. To evaluate the role of lower urinary tract obstruction as it relates to prostatic development and PBS, we studied the lower urinary tract of 15 cases of PBS, 8 cases of posterior urethral values (PUV), and 34 age-matched controls. It is generally accepted that prostatic growth and development are dependent on mesenchymal-epithelial interactions. We evaluated the mesenchymal and epithelial differentiation and relationships, and found distinctly different and consistent abnormalities between PBS and PUV as compared with one another and controls. The findings suggest that in PBS, prostatic growth and development are hindered because of destruction or absence of the appropriate primitive mesenchyme. Our studies could not definitely exclude very early obstruction as a cause of the findings because of lack of appropriate fetal material. 相似文献
57.
Morito Nakayama MD Naoyuki Kataoka MD Yutaka Usui MD Naohiko Inase MD Shigemitsu Takayama MD Hirotaro Miura MD 《The Journal of emergency medicine》1992,10(6):729-734
When nasotracheal intubation with a fiberoptic bronchoscope is performed, the tube may be blocked in the nasal cavity or larynx, resulting in several complications including epistaxis and hoarseness. We review the causes and complications of tube blockage and discuss optimal techniques for minimizing it. 相似文献
58.
59.
目的 探讨内皮素 1(ET 1)及受体A、B(ETAR、ETBR)在良性前列腺增生 (BPH)组织中的表达及意义。 方法 应用免疫组化和RT PCR方法检测前列腺组织ET 1及ETAR、ETBRmRNA的表达 ,并与患者临床参数行相关分析。 结果 ET 1、ETARmRNA和ETBRmRNA在BPH组织中的表达 (吸光度A值分别为 0 .94± 0 .0 8、0 .6 4± 0 .0 8、0 .97± 0 .0 8)与正常前列腺组织(0 .5 7± 0 .0 6、0 .37± 0 .0 5、0 .5 1± 0 .0 4 )相比 ,差别均有显著性意义 ,P均 <0 .0 5 ,其中ET 1、ETARmRNA与IPSS、前列腺体积、前列腺尿道长度、前列腺尿道压、最大尿道压呈正相关 ,与最大尿流率、平均尿流率呈负相关。 结论 ET 1和ETAR在BPH中的表达量与膀胱出口梗阻严重程度密切相关。 相似文献
60.
目的:探讨老年性肝外胆管梗阻的治疗。方法:85例老年胆管梗阻中良性疾病引起的梗阻为59例,主要是由于胆管结石嵌顿MIRRIZI‘S综合征;恶性肿瘤引起的梗阻为26例,主要为壶腹部周围癌,肝门区肿瘤等。手术分别采取胆囊切除术、胆总管切开取石+T管引流术、胰十二指肠切除术、腹部探查+内外引流术以及ERCP下行置管内支撑术后引流和ENBD等。结果:良性疾病引起的梗阻中仅1例术后死于ARDS,恶性肿瘤 引起的梗阻者中有11例术后死于肝肾综合征、ARDS和DIC等。结论;手术仍是老年肝外胆管梗阻的首选方法。老年患者合并其它脏器病变,病情较重者如先行胆管引流,能有效降低病死率及延长生命。 相似文献