药物冰块用于减轻甲状腺切除术后吞咽疼痛的效果观察

目的观察药物冰块含漱对减轻甲状腺切除术后患者吞咽疼痛的效果。方法将212例甲状腺切除术后患者按手术顺序分成A组70例、B组75例、C组67例,A组不含漱,B组采用高渗葡萄糖冰块含漱,C组采用高渗葡萄糖加利多卡因混合冰块含漱,观察3组患者在术后麻醉清醒时和麻醉清醒后6h、24h、48h的吞咽疼痛评分。结果 B组、C组患者麻醉清醒后6h疼痛评分与麻醉清醒时比较,P<0.05;麻醉清醒后24h,3组间疼痛评分比较,P<0.05。结论甲状腺术后吞咽疼痛用药物冰块含漱具有良好的镇痛效果。     

胃平滑肌肉瘤2例

胃平滑肌肉瘤２例（３６３０００）福建省漳州市芗城区医院王建彪苏锦坤病例１，女，５６岁。７年前自感上腹部不适，无其他症状未加重视。半月前无明显诱因感上腹部疼痛，门诊体检扪及上腹肿物，Ｂ超检查提示胃肿瘤。胃镜及病理活检诊断为胃窦炎。在持硬麻醉下行剖腹探查...     

微创化甲状腺手术研究进展

微创是21世纪外科发展的趋势,近10余年来微创手术在甲状腺外科有了很大进展。微创化甲状腺手术具有术后疼痛轻、住院时间短、术后恢复快和美容效果好等优点。笔者现对微创化甲状腺手术的手术方式、适应证与禁忌证、手术效果和最新进展作一综述。     

改良Miccoli模式内镜手术的工作腔室:WSM-Ⅰ型建腔器所成腔室的空间形态特征研究

Objective To comprehend spatial characteristics of the cavity created by a working space market.Methods 40 patients were successively operated according to the surgJical mode of minimally invasive video-assisted thyroidectomy from Jan.2010 to Aug.2010.Instead of hand-retraction.a mechanical arm-working space marker type I(WSM-I(R),MIEO Medinstr Co.Ltd,China),was applied to establish a working space.After the pathway making,a cavity above the gland was created and adjusted properly by the space maker,and then,endoscopic view was built and manipulation in the cavity was progressed throughout the later process.Geometric measurement of the cavity were performed at a"basic space position"just after the initial cavitation,and parameters such as length,width and height of the cavity were measured with a specifically scale-marked puncture needle(MC1820,Bard4(R)Max·Cor(R)Instrument)through mini-holes lay in the lifting hook(φ4mm,middle point and distant point).Results 13 cases received a lobectomy and isthmectomy.The other 27 cases received a partial thyroidectomy.Dimensional parameters were calculated as below.①The basic length of cavity button was(4.35±0.39)cm.The basic width of cavity button(distance at central point)was(4.66±0.53)cm.The basic central height of cavity was( 1.36±0.34)cm.The maximal central height archived by readjusting was(1.66±0.32)cm and a height increase of0.3 cm can be achieved(22.1％).②The basic peripheral height was(0.98±0.29)cm.The maximal peripheral height archived by readjusting directionally was(1.33±0.14)cm and a height increase of 0.35 cm can be achieved(35.7％).③Statistic analysis yielded a negative correlation between the cavity volume and the size of the nodule.Conclusions The working space created by WSM-I appears to be an laigh and irregular trapezoid stock with oblique roof formed by lifting hook.Although vertical height,especially the peripheral height,is a major restrictive dimension,the cavity can still be usable and enough for factual observation and manipulation,due to"compensating effect"of endoscope,finite space requirement of harmonica and"directional volume shifting"of WSM.     

改良Miccoli模式内镜手术的工作腔室：WSM-I型建腔器所成腔室的空间形态特征研究

目的观测WSM—I型建腔器所成腔室的空间形态特征。方法2010年1月至8月在我院接受改良Miccoli模式内镜甲状腺手术40例。入路制备完成后,统一采用建腔器建腔。手术包括一侧腺叶及峡部切除13例,腺叶部分切除27例。于建腔操作中运用空间测量针测量建腔器所成腔室的长、宽、高度等参数。结果①腔室底面的基本长度为（4．35±0．39）cm;中心基本宽度为（4．66±0．53）cm;中心基本高度为（1．36±0．34）cm;中心最大高度为（1．66±0．32）cm;周边基本高度为（0．98±0．29）cm;周边最大高度为（1．33±0．14）cm。②腔室体积与肿块大小呈负相关。③在手提吊钩感觉明显阻力时,借助垂直向微调,还可将腔室中心高度提升0．3cm（22．1％）。④在周边基本高度基础上,借钩端三维定向调节,叮将该方位上的腔室周边高度增加0．35cm（35．7％）。结论建腔器所成腔室为一以钩端为脊顶的不规则形低矮类梯台状空间。此空间不仅非常稳定,且可灵活变形。后者可能是机械牵张法建腔的一个关键技术进步：总空间不变,通过三维调节,使有限空间得到最充分利用。     

原发性甲状腺恶性淋巴瘤3例报告

原发性甲状腺恶性淋巴瘤３例报告许磊，陈钦恭，王建彪福建省肿瘤医院病理科（福州３５００１４）恶性淋巴瘤是较常见，然而原发于甲状腺的恶性淋巴瘤罕见。我院遇见３例，现报告如下：病例介绍例１，女，４４岁（住院号９０４１）。因颈前无痛性肿物一个月，进行性增大，...     

星形胶质细胞对神经元作用的研究进展

星形胶质细胞能够释放多种胶质细胞源性递质,调节突触信号的传递;释放的 雌激素、凝血栓蛋白、IL-1β和IL-6能够诱导突触的形成和神经干细胞的神经发生.此外 ,星形胶质细胞还能为神经元提供重要的营养和保护作用.星形胶质细胞可能是治疗某些神经系统疾病的新靶点.     

原发性小肠恶性肿瘤8例临床分析

原发性小肠恶性肿瘤发病率低,临床不多见,早期不易发现,诊断较困难,一经确诊多属晚期。本文主要探讨其临床特点与诊断,旨在提高诊断率。现将我院1997年~2004年收治原发性小肠恶性肿瘤8例进行回顾性分析,报告如下。临床资料1·一般资料:男性6例,女性2例,年龄3~72岁,平均年龄42·     

BRAFT1799A基因和TERT启动子突变在甲状腺乳头状癌诊治中的价值

BRAFT1799A和TERT启动子突变是甲状腺乳头状癌最常见的分子标志物，其在甲状腺乳头状癌的辅助诊断、评估预后和指导治疗等方面的价值越来越突出。本文对这两者突变在甲状腺乳头状癌临床诊治中的价值作一综述。