胆道外引流术后螺旋CT三维成像术的临床应用

结合胆管造影术及螺旋CT（SCT）三维成像技术就胆道手术后经引流管行胆道三维成像术进行研究,探讨该技术的应用价值.……     

胸骨前径路与改良Miccoli腔镜甲状腺手术临床研究

目的比较胸骨前径路腔镜甲状腺手术及改良Miccoli腔镜甲状腺手术的疗效。方法60例甲状腺肿瘤患者分别行了改良Miccoli(改良Miccoli组,n=30)和胸骨前径路(胸骨前径路组,n=30)腔镜甲状腺手术,比较2组的手术时间、术后引流量、美容满意度、住院时间、住院费用及并发症。结果手术时间和术后引流量胸骨前径路组明显多于改良Miccoli组〔(99.9±23.4)min比(74.0±29.6)min;(68.6±8.7)ml比(40.9±6.1)ml〕,差异均有统计学意义(P0.05)。美容满意度评分胸骨前径路组明显高于改良Miccoli组〔(4.7±0.2)分比(3.7±0.1)分〕,差异亦有统计学意义(P0.05)。住院时间和住院费用胸骨前径路组均要多于改良Miccoli组〔(6.5±1.7)d比(5.5±0.9)d;(9328.3±1107.1)元比(8568.2±1032.3)元〕,但差异均无统计学意义(P0.05)。2组各有1例(3.3%)短暂声音嘶哑,均于术后1个月左右恢复;其余患者均未发生酸中毒、皮下气肿、纵隔气肿、气体栓塞等并发症。结论改良Miccoli腔镜甲状腺手术是微创兼美容手术,胸骨前径路腔镜甲状腺手术美容满意度较高,能减少患者心理创伤,对于部分对美容有特殊要求者可选择性使用经胸骨前径路腔镜甲状腺手术。     

溃疡病外科治疗的趋向

消化性溃疡 (ＰＵ)是常见病 ,在 2 0世纪 5 0年代前后的发病高峰时曾称人口的 1 1 0曾患本病。据当时统计约 1 1 0的ＰＵ病人因内科治疗不愈或并发有大出血、穿孔及梗阻等原因而需手术治疗。1　ＰＵ流病学的变化　　近 2 0余年的统计资料表明ＰＵ的发病率有明显降低 ,约仅为 5 0年前的 1 2 ,原因未明 ,可能由于社会进步 ,人民生活改善与健康教育的普及等因素有关。近年来对本病的病理生理研究、诊断及治疗等均有很大进步 ,例如纤维内镜的普及 ;相继发现了Ｈ2 受体阻滞剂及更强有力的质子泵Ｈ+ Ｋ+ ＡＴＰ酶抑制剂 ;幽门螺杆菌感染与ＰＵ…     

1018例甲状腺癌临床病理分析

目的 探讨吉林大学第一医院甲状腺外科收治患者中甲状腺癌的发病状况及病理学特征.方法 回顾性分析吉林大学第一医院2000年1月-2010年7月收治的1018例甲状腺癌患者的临床病理资料.结果 2008年、2009年收治的甲状腺癌患者比之前8年总数高73%以上,2009年1月至2010年7月一年半收治的甲状腺癌患者比之前9年的总数高48%以上;男女发病比例约为1∶4.0;1018例甲状腺癌患者中病理类型明确者976例,其中乳头状癌897例(91.91%),滤泡状癌43例(4.41%),髓样癌22例(2.25%),未分化癌6例(0.61%);1018例甲状腺癌患者中淋巴结转移情况明确者804例,男、女淋巴结转移率分别为39.24%、28.64%,二者差异有统计学意义(χ2=6.71,P＜0.05),45岁以下(不包括45岁)及45岁以上患者淋巴结转移率分别为37.65%、23.26%,二者差异有统计学意义(χ2=19.54,P＜0.05).结论 过去的10年半我院收治的甲状腺癌患者逐年增多,以乳头状癌患者升高最明显,女性患者数明显多于男性,男女发病年龄高峰均为30～59岁.淋巴结转移率男性大于女性,45岁以下患者多于45岁以上患者.

Abstract：

Objective To explore the incidence and pathologic feature of patients with thyroid carcinoma treated at the First Hospital of Jilin University. Methods From January 2000 to July 2010,clinicopathologic data of 1018 patients with thyroid carcinoma treated in the First Hospital of Jilin University were retrospectively analyzed. Results The cases of thyroid carcinoma between 2008 and 2010 were more than 73% higher than that in the preceding 8 years. Cancer cases from January 2009 to July 2010 were more1018 cases reviewed, 976 cases were clearly classified pathologically. Papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and anaplastic thyroid carcinoma were present in 897 (91.91%), 43(4. 41% ), 22(2. 25% ) and 6(0. 61% ) cases respectively. Of the 1018 cases reviewed,804 cases were recorded with or without lymphnode metastasis. The rate of lymphnode metastasis of male and female patient were 39. 24% and 28. 64% respectively and the difference was significant( χ2 = 6. 71 ,P ＜0. 05). The rate of lymphnode metastasis of age ＜45 years and age ≥45 years were 37.65% and 23. 26%respectively and the difference was significant ( χ2 = 19. 54, P ＜ 0. 05 ). Conclusions In the past ten and a half years, the number of the thyroid carcinoma patients treated in the First Hospital of Jilin University increased year by year. The increase of papillary thyroid carcinoma was the most obvious. Thyroid carcinoma was more common among females. The peak incidence age of males and females was 30 -59. The rate of lymphnode metastasis of males was larger than that of females. The rate of lymphnode metastasis of age ＜45years was larger than that of age≥45 years.     

1018例甲状腺癌临床病理分析

Objective To explore the incidence and pathologic feature of patients with thyroid carcinoma treated at the First Hospital of Jilin University. Methods From January 2000 to July 2010,clinicopathologic data of 1018 patients with thyroid carcinoma treated in the First Hospital of Jilin University were retrospectively analyzed. Results The cases of thyroid carcinoma between 2008 and 2010 were more than 73% higher than that in the preceding 8 years. Cancer cases from January 2009 to July 2010 were more1018 cases reviewed, 976 cases were clearly classified pathologically. Papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and anaplastic thyroid carcinoma were present in 897 (91.91%), 43(4. 41% ), 22(2. 25% ) and 6(0. 61% ) cases respectively. Of the 1018 cases reviewed,804 cases were recorded with or without lymphnode metastasis. The rate of lymphnode metastasis of male and female patient were 39. 24% and 28. 64% respectively and the difference was significant( χ2 = 6. 71 ,P ＜0. 05). The rate of lymphnode metastasis of age ＜45 years and age ≥45 years were 37.65% and 23. 26%respectively and the difference was significant ( χ2 = 19. 54, P ＜ 0. 05 ). Conclusions In the past ten and a half years, the number of the thyroid carcinoma patients treated in the First Hospital of Jilin University increased year by year. The increase of papillary thyroid carcinoma was the most obvious. Thyroid carcinoma was more common among females. The peak incidence age of males and females was 30 -59. The rate of lymphnode metastasis of males was larger than that of females. The rate of lymphnode metastasis of age ＜45years was larger than that of age≥45 years.     

双阑尾炎一例报告

双阑尾畸形是十分罕见的外科疾病，双阑尾炎更为少见。最近本科收治1例双阑尾炎患者，现将有关资料报道如下。     

胆道引流术后胆道造影的几种方法

1895年著名物理学家Roentgen在一次实验中,偶然发现X射线,并拍摄了其夫人手的第一张照片,为临床放射诊断学奠定了基础。Mirrizzi在1930年介绍的手术时的胆管造影术,此后在肝胆外科得以广泛开展。在我国,童尔昌、谭毓铨等于上世纪50年代率先在我国开展胆管造影术,距今已有60余年的历史[1]。对于因各种原因而行胆道引流术的病人,对于术后引流效果、病变发展情况的评估非常重要。随着科学技术的不断发展,胆道造影、成像技术,日新月异。现将有关方法作一简单介绍。1口服法胆管造影有传统口服胆管造影法、口服胆石染色造影法等,由于费时、繁琐…     

人参二醇皂苷对大鼠急性重症胰腺炎多脏器损伤时NF-κB的影响

目的探讨NF-кB在急性重症胰腺炎（SAP）多脏器损伤发生发展中的机制及人参二醇皂苷（PDS）对SAP多脏器损伤的治疗作用。方法 Wistar大鼠24只,随机分为假手术组（SO）、SAP组、PDS组三组,每组8只。除SO组外,其余两组胰管内注射5%牛黄胆酸钠制备SAP大鼠模型。各组造模6 h后处死,经下腔静脉采血,进行血常规、肝肾功能、炎症介质的检测;取各组大鼠肝、肾、小肠组织做免疫组化染色,观察NF-кB的表达情况。结果①SAP组血常规、肝肾功能指标明显高于SO组（P〈0.05）,SAP组血清TNF-α、IL-6水平明显高于其他两组（P〈0.01）,PDS组BUN、HCT、RBC明显低于SAP组（P〈0.05）②免疫组化染色显示SAP组NF-кB在肝、肾、小肠组织中均高表达,向核内迁移,而PDS组表达明显减少。结论 NF-кB促进炎症介质TNF-α、IL-6的表达,介导了SAP多脏器损伤的发生发展;PDS有减轻SAP多脏器损伤的作用,具有良好的应用前景。     

中医药治疗前列腺疾病用药规律的数据挖掘研究

目的：探讨中医药治疗前列腺疾病的用药规律。方法：将周祯祥主编《前列腺疾病效方287首》中1985—2000年中医药内服治疗前列腺疾病的中医处方录入计算机,使用Microsoft Office Excel2003软件,建立数据库,运用统计学方法进行数据统计并分析其用药规律。结果：整理了中医药内服治疗前列腺疾病的中药复方共238首,涉及中药220种,总用药次数为2427次;所用中药种类依次以活血化瘀药、清热药、补虚药、利水渗湿药、理气药为主,占总用药的81．829％;药味以甘、苦、辛为主,累计频率达85．341％;药性以寒、平、温为主,累计频率达95．325％;归经以肝、肾、脾、胃、心、肺为主,累计频率达82．578％。结论：中医药治疗前列腺疾病以活血化瘀药、清热药、补虚药、利水渗湿药、理气药等中药运用较多;使用核心单味药依次为牛膝、甘草、王不留行、车前子、穿山甲、黄芪、黄柏、桃仁、茯苓、丹参、赤芍等。     

绝经期后老年副乳癌1例

副乳癌是临床上极少见的一种恶性肿瘤,本院近期收治一绝经期后的老年副乳癌患者,现报道如下. 1临床资料 患者,女性,72岁,于2年前偶然发现右腋下较固定鸽卵大小肿块,局部无红肿热痛.