胆肠吻合术后难治性呕吐的诊治体会

目的:分析胆肠吻合术护出现难治性呕吐的原因并总结其处理的经验.方法:回顾性分析2001～2009年我院收治的16例胆肠吻合术后并发呕吐患者的临床资料.结果:所有患者呕吐症状都得到有效缓解.结论:胆肠吻合术后患者出现呕吐,应及早给与重视并处理引起呕吐的原因.     

肠造瘘术治疗单纯性肠穿孔较肠吻合术具有较好的疗效

为探讨单纯性肠穿孔患者实施肠造瘘术和肠吻合术治疗效果及预后差异,本研究选取单纯性肠穿孔患者75例作为研究对象,根据患者手术方式分为造瘘组(肠造瘘术治疗, 43例)和吻合组(肠吻合术治疗,32例),比较两组患者围手术期指标、近期疗效、术后并发症发生率及生活质量。研究发现两组患者发病到手术时间、手术时间、术中出血量比较无统计学意义(p>0.05);造瘘组患者胃肠功能恢复时间、术后禁食时间、卧床时间、住院时间均短于吻合组患者(p<0.05);造瘘组患者术后肠梗阻、二次手术、死亡发生率均低于吻合组患者(p<0.05);然而,造瘘组患者术后生活质量评分低于吻合组患者(p<0.05)。因此,本研究的初步结论为,肠造瘘术治疗单纯肠穿孔,相对肠吻合术治疗可缩短患者术后恢复时间、降低并发症发生率,但可对患者术后生活质量造成一定影响。     

降落伞式缝合在肠道吻合术中的应用

目的：通过胆肠吻合缝合技术的改进,减少并发症的发生。方法：对52例肠道吻合手术采用降落伞式缝合。结果：降落伞式胆肠吻合时间平均20min,明显缩短了手术时间,全部病例均未出现胆肠吻合漏,无死亡病例。结论：降落伞式胆肠吻合术具有操作简便、省时、并发症少等特点。     

降落伞式缝合在肠道吻合术中的应用

目的:通过胆肠吻合缝合技术的改进,减少并发症的发生。方法:对52例肠道吻合手术采用降落伞式缝合。结果:降落伞式胆肠吻合时间平均20 min,明显缩短了手术时间,全部病例均未出现胆肠吻合漏,无死亡病例。结论:降落伞式胆肠吻合术具有操作简便、省时、并发症少等特点。     

肺复合性血管内皮瘤1例报道及文献复习

目的:探讨复合性血管瘤(composite hemangioendothelioma,CHE)的临床病理和生物学特点。方法:结合相关文献对1例肺复合性血管内皮瘤伴皮肤和脑转移的临床资料、组织病理特征及免疫组化结果进行分析。结果:镜检见肿瘤组织由良性、中间型及恶性血管多种成分混合组成:肺组织与头皮的真皮及皮下组织的病变相似,为浸润性生长,病变包括上皮样血管内皮瘤(约占50%)、网状型血管内皮瘤(约占15%)、梭形细胞血管瘤(约占20%)、"血管肉瘤样"区域(约占5%)和良性血管病变(约占10%)。颅内病变可见上皮样血管内皮瘤、梭形细胞肿瘤及动静脉畸形区域。免疫组化标记示FⅧRAg( )、cD34( )。结论:肺复合性血管内皮瘤属交界性/低度恶性肿瘤,确诊依赖于病理形态学,有复发倾向,少见转移。     

改良式第Ⅲ肝段肝内胆肠吻合术在无法切除的肝门部胆管癌中的应用

目的:提高无法切除的肝门部胆管癌病人的生活质量,改进第Ⅲ肝段肝内胆肠吻合术.方法:回顾分析15例改良式第Ⅲ肝段肝内胆肠吻合术,讨论其在治疗晚期肝门部胆管癌病人应用.结果:所有的病人手术均顺利进行,无严重并发症发生.结论:改良式第Ⅲ肝段肝内胆肠吻合术在治疗晚期肝门部胆管癌中,减黄效果好,胆漏少,为一个合理安全的术式.     

1例结肠穿孔行肠造口术后并发肠脱垂的护理体会

肠造口术是外科最常施行的手术之一。全球每年由于结肠癌、直肠癌、外伤、炎症及先天性畸形而行肠造口术者达数十万人之多。其中最常见的是回肠末端或结肠造口,俗称人工肛门。肠造口术虽然挽救了很多生命,但肠造口术后并发症发生率很高．国外文献报道,术后并发症发生率达21％～71％。国内报道为16．3％～53．8％。肠造口术后并发症的发生主要与施术者的技术和术后的护理质量有关。     

肠小体在猪肠道冠状病毒感染中的研究进展

猪肠道冠状病毒是引起仔猪腹泻的重要致病因素,主要感染小肠绒毛上皮细胞,给养猪业造成了巨大的经济损失。由于缺乏能模拟胃肠道高度复杂生理特性的体外研究模型,猪肠道冠状病毒感染与宿主肠上皮之间相互作用的研究也受到了极大的限制。随着干细胞技术的快速发展,一种能模拟肠道复杂的细胞类型及空间结构的体外模型——肠小体引起了人们的广泛关注。与传统的细胞系相比,肠小体不仅能模拟肠的结构和功能,同时还保留宿主的遗传特性,有望成为研究宿主-肠道病原相互作用的一种理想模型。本文就猪肠道冠状病毒以及肠小体在肠道病原研究中的应用进行综述,以期为猪肠道冠状病毒的基础研究提供新的思路与见解。     

一例严重的肠菌群失调症的临床治疗分析

随着医疗技术的发展和抗菌药物的广泛应用,临床上细菌感染的病原菌种类与耐药特性已发生很大变化,代之而来的是耐药菌株的出现,微生态平衡的破坏,条件致病菌的转化,因而导致一系列的菌群失调症。本病例即为严重的肠菌群失调症患者。１材料与方法杨某,女,３２岁,...     

结肠癌术后吻合瘘分析(附38例)

吻合口瘘是结肠癌术后最严重的并发症之一,占所有结肠吻合术后死亡病例的1／3．一般报告发生率约5％～10％。导致产生吻合口瘘的原因较多,且常常并非单一因素造成。可归纳为全身和局部因素两大类。预防和减少术后吻合口瘘,无疑是提高结肠癌外科手术治疗成功率的关键问题。该院从1995～2003年作结肠癌Ⅰ期或Ⅱ期手术切除加肠吻合术共38例,就术后预防吻合瘘进行回顾性总结。     

Cleavage of pig embryos after labeling with fluorescent dyes

In studies on embryonic development, treated and control ova could be co-mixed before transfer to recipients if nontoxic labels for ova were available. These experiments were conducted to determine whether pig ova would continue to cleave after being stained with the fluorochromes tetramethylrhodamine isothiocyanate (TRITC) and fluorescein isothiocyanate (FITC). In the first experiment, pig ova stained with TRITC and unstained control ova were transferred into opposite oviducts of recipient gilts. In the second experiment, ova stained with TRITC and ova stained with FITC were transferred into opposite oviducts of recipient gilts. Embryos were recovered 96 h after transfer (Day 6; Day 0 = onset of estrus), the presence of fluorescence was determined, and the number of nuclei per embryo was assessed. Stained ova retained sufficient fluorochrome to permit detection until the zonae pellucidae were shed. Development of embryos stained with TRITC was equal to that of unstained control embryos. However, development of embryos stained with FITC appeared slightly retarded in comparison to that of TRITC-stained embryos. These findings demonstrate the efficacy of the fluorescent staining technique for pig ova during the first six days of pregnancy.     

Embryonic survival in the pig after insemination with antigen-enriched semen

Ninety-two first-litter Dutch Landrace sows were inseminated at their first oestrus after weaning with diluted semen containing 2.3 x 10(9) motile sperm cells. Immediately before insemination of 46 randomly chosen sows, 2 x 10(8) fresh bovine leucocytes were added to the semen. All sows were slaughtered on Day 8, 9, or 10 after insemination. In the control group and leucocyte-treated group respectively, 41 and 39 sows were pregnant at slaughter. The average number of corpora lutea (+/- SEM) in pregnant animals was 15.72 +/- 0.60 and 15.22 +/- 0.61, respectively. The average number of embryos was 10.66 +/- 0.79 and 10.36 +/- 0.80, respectively. The addition of bovine leucocytes to semen had neither influence on the pregnancy rate, nor on the number of embryos during early pregnancy.     

Persistence of nasal colonization with livestock-associated methicillin-resistant Staphylococcus aureus in pig farmers after holidays from pig exposure

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is frequently transmitted from pigs to farmers. This study analyzed whether an absence from direct contact with pigs during holidays had an impact on nasal MRSA colonization rates of pig farmers. Overall, 59% of the farmers did not clear MRSA colonization during their leave.