小儿脾创伤诊断治疗新进展

近三十年来对脾脏损伤无论是基础角度 ,还是临床应用均有很大进展。目前已有大量证据表明脾脏是具有多种重要功能的免疫器官 ,在很多情况下不可缺少 ,特别是免疫功能尚未健全的儿童更是如此。从形态 ,尤其功能上保留脾脏或脾组织是客观要求 ,此为脾脏外科现代观的基本核心。1　保留脾脏的临床意义脾脏具有抗感染免疫功能。脾脏富含ＴＢ淋巴细胞及巨噬细胞、杀伤Ｔ细胞及中性粒细胞互相配合 ,共同清除抗原异物 ,发挥细胞免疫效应。此外 ,Ｂ细胞在抗原刺激下 ,转化为浆细胞 ,可产生特异性免疫球蛋白 ,特别是Ｔｕｆｔｓｉｎ(ｒ 球蛋白的亲白细…     

艾易舒注射液联合介入治疗中晚期肝癌36例疗效分析

目的观察艾易舒注射液联合介入治疗中晚期肝癌的疗效及不良反应。方法将72例中晚期肝癌随机分成治疗组36例和对照组36例,治疗组:艾易舒注射液0.5mg/d、静滴、d1-14,于第3天行介入治疗,术中动脉注射艾易舒注射液0.5mg。对照组单纯行介入治疗。2～3周期为一疗程,观察疗效和不良反应。结果治疗组总有效率48.5%(CR PR),中位生存期12个月,18个月生存率34.3%,24个月生存率为14.3%,生存质量提高率60%。对照组总有效率33.5%(CR PR),中位生存期8.9个月,18个月生存率12.1%,24个月生存率为0,生活质量提高率27.2%。结论艾易舒注射液联合介入治疗中晚期肝癌,可提高生活质量,延长中位生存期,提高长期生存率,值得进一步探讨。     

改良引流法用于肛肠术后的临床观察

目的 :评价改良引流法用于肛肠术后的临床价值。方法 :用半随机方法将 10 0例患者分为观察组和对照组 ,各 5 0例 ,对肛肠术后患者切口分别采用传统引流法和改良引流法 ,比较术后出现的并发症及并发症出现的平均时间。结果 :观察组术后并发症和并发症出现的时间少于对照组 (P <0 0 5 )。结论 :改良引流法能减轻患者痛苦 ,疗效好 ,并发症少。     

真性红细胞增多症并广泛性脾梗死1例

真性红细胞增多症是一种骨髓干细胞异常增生性疾病,临床易误诊,我科收治1例,现报告如下:1临床资料患者男性,39岁,长期从事房屋装修,接触有机溶剂及有害气体,因发现左上腹胀痛伴肋下肿块逐渐增大及消瘦20余天,于2004年10月19日入院。查体:血压正常,皮肤黏膜红紫,面颊、唇、舌、鼻尖绛红色,脾大,下极平脐,质硬,无触痛。RBC 7.35×1012/L,HCT 69.1%,Hb 232g/L,PLT 257×109/L,WBC 14.4×109/L,PPT 18 s,ALP298.3 U/L,-γGT 177.4 U/L,AST 53.8 U/L,LDH 404.2U/L。食道钡餐无异常。彩色B超提示:门静脉增宽,脾脏巨大,内见多个大…     

外剥、内扎硬化注射术治疗混和痔800例

目的观察和评价外剥、内扎硬化注射术治疗混合痔的近期疗效.方法作者采用外剥、内扎硬化注射术治疗混和痔800例.结果近期治愈788例,治愈率98.5%,好转12例,好转率1.5%.治愈天数10～21天.结论外剥、内扎硬化注射术治疗混合痔简单实用,手术时间短,术后痛苦小,伤面愈合快,并发症少,无后遗症,复发率低,是治疗混合痔的较好方法.     

表达谱基因芯片筛选体外循环前后心肌细胞因子的变化

Objestive Systemic inflarmmation may be triggered by injury, hypothermia, ischemia-reperfusion and the contact of the blood with foreign body during cardiopulmonary bypass (CPB). To determine the application values of gene chip technique in the clinical practice and the study of cardiovascular stagery, as well as to provide clues to the study of inflammatory responess during CPB, microarry for gene expression profiles was used to identify the differences in the gene expression of myocardium between pre-and post- CPB. Methods Six adult patients who underwent CPB from March to May in 2003 were involved. Samples of right atrium were col- lected before and at immediate end of CPB. BD AtlasTM cDNA Expression Arrays was used to identify the differences in the gene ex- pression of cytokines. The results were compared with that of semi-quantative RT-PCR. Resellts The mean age of 6 patients (5 males and 1 female) was (32.67± 11.72) years. The baseline heart function was gradeⅡin 3 cases and grade Ⅲ in 3 other cases. The baseline left ventricular ejection fraction(LVEF)was (58.17±7.91)%. The mere duration was (91.67±43.88) minutes for CPB and was (58.67±43.46) minutes for aorta blocking. The minimum nasopharynx/rectal temperture was (29.37±1.90)℃/ (32.15±1.52)℃. Gene expression profiles of cytokines in the myocardium pre- and post-CPB were analysed successfully. The ex- pression of IL-6, IFN-γ,Wnt5a, TNFRSF1B, a member of tumor necrosis factor receptor superfamily, PIGF and MFNG in the myo- cardium were unpregulated after CPB. Conclusion Microarray technique is applicable in the study of cytokines changes dying CPB. cDNA microarray identified pleliminarily the differences in the gene expression between pre- and post-CPB. These genes may be in- valved in inflammation and other psthophysiological responses incuced by CPB. The myocardiym is probably one of the major sources of cytokines during CPB. Further study may be helpful in understanding the llngthe development of inflammation during CPB, and eventually, reducing the post-operative complications.     

剖宫产术后并发下肢静脉栓塞的护理及预防

通过对20例剖宫产术后并发下肢静脉栓塞病人的观察,分析了发生静脉栓塞的原因,提出了相应的护理、观察、预防等一系列措施.     

老年人股骨颈骨折术后并发症的预防护理

压疮、肺部感染、泌尿系统感染、深静脉栓塞是骨科术后常见并发症,尤其高龄患者,体质弱,各种脏器机能减退,上述并发症发病率高.做好术后护理直接影响手术的成功率,正确及时地护理能有效地预防或减少上述并发症发生.2003年1月至2006年9月,对我院骨科收治的80例老年人股骨颈骨折术后进行精心护理,效果满意,现将护理体会报道如下.     

四肢骨折小夹板固定术后的护理

四肢骨折是临床常见的一种损伤。应用小夹板固定治疗四肢骨折是临床常用的一种治疗方法，其方法简单、取材方便、固定可靠、效果理想。在配合医生实施小夹板固定的术后护理，有效的保证了治疗效果。     

高龄前列腺病人电切术的康复护理

近几年来，我科对高龄病人实施TURP术治疗前列腺增生取得了较好的临床效果。它具有出血少、痛苦小、恢复快等优点。现将自2003～2005年89例高龄前列腺增生患者行TURP术临床护理总结报告如下：