妇科腹腔镜手术中转开腹的原因及预防

目的探讨妇科腹腔镜手术中转开腹的原因及其预防措施。方法回顾性分析1143例妇科腹腔镜手术中36例中转开腹患者的临床资料。结果中转开腹率为3．15％。中转开腹的主要原因：盆腹腔粘连23例（63．89％）、术中操作困难或并发症8例（22．22％）、恶性肿瘤3例（8．33％）。有下腹部手术史和开展腹腔镜手术初期中转开腹率较高。结论妇科腹腔镜手术中转开腹的最主要原因为盆腹腔粘连。加强术前对患者病情的评估、提高手术操作技巧可以降低腹腔镜手术中转开腹率。

The role of serum dihydropyrimidine dehydrogenase activity in patients with gastric cancer resistance to fluorouracil: a prospective study

Objective To investigate the mechanism of the fluorouracil(FU)drug resistance and to prove deeply the role of serum dihydropyrimidine dehydrogenase(DPD)activity in patients with gastric cancer resistance to FU with the level of cell culture. Methods The peripheral blood was collected from 45 patients with advanced gastric cancer before chemotherapy to detect the activity of DPD by high performance liquid chromatography(HPLC).The patients were divided into two groups(high activity group and low activity group)according to the results. The FU drug inhibitory rate of gastric cancer cell cultured in vitro were tested with MTT to compare the effects of the two groups. Result The FU drug inhibitory rate of gastric cancer cell cultured in vitro was obviously lower in high activity group than that in low activity group,(47.6±±4.0)%,(53.7±8.0)%respectively. Conclusion The activity of serum DPD may be simple and convenient indicators in predicting the resistance to FU.