针刺配合肠炎散保留灌肠治疗肛窦炎临床研究

目的观察肛窦炎应用针刺配合肠炎散保留灌肠治疗的效果。方法选取2017年10月-2018年10月就诊的72例肛窦炎患者,采用随机数字表法分为观察组(n=36)与对照组(n=36)。对照组给予肠炎散保留灌肠治疗,观察组为针刺配合肠炎散保留灌肠治疗,比较2组症状、疗效及安全性。结果观察组症状(放射痛、指诊症状及镜检症状)少于对照组,总有效率高于对照组,差异有统计学意义(P<0.05);2组安全性相比,差异无统计学意义(P>0.05)。结论针对肛窦炎患者,予以针刺配合肠炎散保留灌肠治疗效果确切,可减少临床症状,加快疾病转归,且治疗安全性较好。     

大陷胸汤灌肠治疗流出急性肾衰的观察与护理

目的 探讨中药大陷胸汤高位保留灌肠对流行性出血热（EHF）急性肾衰的治疗作用。方法 将60例EHF急性肾衰患者随机分为对照组与治疗组各30例，对照组予以常规治疗，治疗组在常规治疗的基础上加用大陷胸汤高位保留灌肠，观察两组患者治疗前后的疗效。结果 治疗组治愈23例，好转6例，无效1例，总有效率96．7％；对照组治愈17例，好转7例，无效6例，总有效率80．0％；两组疗效比较，有显著差异性p〈0．05（x^2=4．630）。结论 大陷胸汤高位保留灌肠治疗EHF急性肾衰疗效显著，且简便、安全、经济、病人乐于接受等优点。     

保留冠状动脉的猪心螺旋形心室肌带的解剖

Objective Based on the Helical Ventricular Myocardial Band (HVMB) theory proposed by Torrent-Guasp,the ventricular myocardial hand extends from the root of the pulmonary artery to the root of the aorta with two helical coils.This new theory is considered as a revolutionary concept for further understanding the global, three-dimensional and functional architecture of the ven- tricular myocardium. No repot had described techniques for disecting HVMB while keepin～ the integrity of the coronmy artery sys- tern. We explored techniques for dissecting HVMB in swine.Methads 33 fresh swine hearts were randomly divided intoll groups, 3 bearts in each. 160% barium sulfate (type I)suspmmion was injected into the coronary artery system. The coronary arteries were li- gated. The strial tissue was removed following puuing the hearts in boiling water then cooling for several hours. The superficial coro- nary vessels and fat tissue around the atrio-ventricular taxi inter-ventricular sulcus we～'e preserved. Some branches of the left anterior descending artery, distal segment, of posterior descending branch, and middle and distal segment of obtuse marginal branches were mu- tilated appropriately. HVMB dissection was completed with fingers in accordnce with Torrent Guasp' s technique. Results A contin- ued bundle of muscle, originated at the root of pulmonary artery and ended at the root of aorta, was unwrapped along the major dire- tion of the cardiac muscle fiber in all of the 33 hearts with spating of the coronary artery. The swine hearts' ventricular myocandium was cumosed of two loops, with basal loop firm the root of the pulmonart artery to the anterior papillary muscle and apical from the beginning of the anterior papillary muscle to the root tithe aorta. Each loop consisted of two segments: the right segment-coincid- ing with the right ventricular free wall and the left segment-coinciding with the basal d the left ventricular free wall. Posterior papillary muscle, which belongs to the descendant segment, denmrcated the border between the descendent and the ascendant of the HVMB's apical loop. Conclusion Although controversies about the theory of the HVMB remain, we have dissected the HVMB in the swine hearts' ventricular myocardium successfully with sparing of the coronary artery systems. This dissection procedure provides technical information for the studies of associated diseases based on the theory of HVMB.     

胃癌大肠转移的X线钡灌肠表现

目的:分析胃癌大肠转移的X线钡灌肠表现。方法:104例胃癌入院术前检查发现结肠转移或胃癌术后转移入院治疗的病例。分析钡灌肠初次发现大肠转移征象的年龄、发现胃癌原发病变距初次发现大肠转移的间隔时间、转移病变的发生部位和病变造成的X线钡灌肠图像上的肠管变形和粘膜面的改变。结果:104例胃癌结肠转移,男67例,女37例。胃癌术前检查中发现结肠转移者32例,术后发现的大肠转移中,多数转移发生在手术后3年内(占91.3%)。胃癌原发灶的肉眼形态BorrmannⅢ型(28例)和BorrmannⅣ型(65例)者占89.4%,组织学中以低分化腺癌和印戒细胞癌为主要成分者占91.3%。X线钡灌肠检查显示大肠转移的好发部位为横结肠(80),其次为直肠(50)。转移灶可累及多节段肠管,其中横结肠中1/3段(47),横结肠左1/3(44),横结肠右1/3(39)和直肠腹膜返折之上(39)。X线显示肠管单侧变形者227处,双侧变形者96处。黏膜面表现为梳齿状黏膜纹聚集改变253处,颗粒结节状改变23处,外压性改变20处,弥漫性改变62处。结论:胃癌大肠转移的好发部位为横结肠和直肠,结肠黏膜面的梳齿状黏膜纹聚集为胃癌大肠转移的主要X线钡剂灌肠表现。     

侧方扩展型大肠肿瘤的X线特征

目的:探讨扩展型大肠肿瘤的X线与病理学特征。方法:分析了经组织病理学证实的46例54处病变的X线钡灌肠造影表现和内镜图像,将病变分为非结节扁平隆起、结节集簇性隆起和混合性结节集簇隆起3种类型,与病理组织学进行对照研究。结果:扩展型大肠肿瘤好发于直肠、盲肠和升结肠近段,组织病理学多为腺瘤或黏膜内癌,混合结节集簇隆起型病变癌变率高、浸润较深,且有进展期癌。结论:扩展型大肠肿瘤表面的形态改变,可以作为推测有无癌变与癌变浸润深度的指标。     

钡灌肠和CT及MRI对结直肠癌诊断的比较影像学研究

目的比较钡灌肠(BE)、计算机X线断层扫描(CT)和磁共振成像(MRI)对结直肠癌检查的临床价值。方法对64例经临床拟诊结直肠癌患者的影像学资料进行对比分析。结果64例患者中39例行BE检查,31例行螺旋CT检查,42例行MRI检查。其中经手术病理证实的结直肠癌54例。BE、CT和MRI对结直肠癌检查的敏感度分别为96.9%、96.2%和97.1%;准确度分别为92.3%、83.9%和90.5%。CT和MRI对结直肠癌T分期诊断的准确度分别为73.1%和82.9%。结论BE是结直肠癌的基本影像学检查方法,CT和MRI是BE必要的补充检查手段,BE加MRI是诊断结直肠癌的优选组合检查方法。     

中药高臀位灌肠治疗慢性肾功能衰竭疗效观察

目的 观察中药高臀位灌肠治疗慢性肾功能衰竭(chronic renal failure,CRF)的临床疗效.方法 将100例CRF患者随机分为两组,治疗组70例采用中药高臀化灌肠治疗,对照组30例口服活性炭治疗.结果 治疗组总有效率为88.6%,对照组总有效率为50.0%.结论 中药高臀位灌肠治疗CRF有效.     

鱼油抗大鼠实验性心律失常作用

鱼油口服给药1.4 ml/kg·d,连续15d能显著升高氯化钡致大鼠心律失常的阈剂量(P<0.05),降低心律失常的严重程度(P<0.05),60 min内窦性心率恢复率为85.7％(P<0.01),死亡率为0。心肌细胞膜脂肪酸分析显示,鱼油影响大鼠心肌细胞膜脂肪酸组成,升高DHA含量(P<0.05),降低AA含量及AA/DHA比值(P<0.01)。多元逐步回归分析表明,鱼油的抗心律失常作用与其升高心肌细胞膜DHA含量有关,相关系数为r=-0.5872(P<0.01)。     

中药灌肠治疗慢性肾功能不全的近期疗效观察

目的探讨以生大黄为主的中药保留灌肠治疗慢性肾功能不全的确切疗效。方法对324例临床确诊为慢性肾功能不全的患者，在内科保守治疗的基础上加用以生大黄为主的中药保留灌肠，每晚1次，4周为1疗程，通过观察治疗前后肾功能的变化评价疗效。结果疗程结束后，氨质血症及尿毒症早期患者的BUN、Ser较治疗前明显降低（P＜0.05），胃肠道症状明显改善。对终末期尿毒症患者的临床症状及肾功能指标改善不明显。结论以生大黄为主的中药保留灌肠对氨质血症及尿毒症早期疗效肯定，对终末期尿毒症病人疗效不佳。     

Long-term results of the antegrade continent enema procedure for constipation in adults

OBJECTIVE: The aim of this study was to evaluate the long-term results of the Antegrade Continent Enema (ACE) procedure for treating severe constipation in adults. METHODS: Over 10 years 37 ACE conduits were created in 32 patients (median age 35 years, 26 women) with constipation caused by slow transit, obstructed defaecation or both. Conduits were created from the appendix (n = 20, 54%), ileum (n = 10, 27%), neoappendix caecostomy (n = 5, 14%) or colon (n = 2, 5%). Clinical records were retrospectively reviewed to determine outcome. RESULTS: After a median follow up of 36 (range 13-140) months, 28 (88%) required at least one further procedure on a primary conduit, including reversal in 19 (59%). Five patients had a second conduit fashioned, two successfully. Conduit type and constipation cause did not significantly influence the rates of ACE reversal or major revision. Ileal conduits were associated with fewer minor revision procedures for stenosis (1 in 7 patients) than appendix conduits (21 in 20 patients). There was one (3%) serious complication. Satisfactory ACE function was ultimately achieved in 47% of patients, at last follow up. After ACE reversal, 9 (28%) patients underwent formation of an end stoma and 3 patients had a colectomy. CONCLUSIONS: Revision procedures are common, but approximately half of patients can expect satisfactory long-term ACE function. ACE conduit reversal does not preclude subsequent alternative surgical strategies to treat this difficult condition.