腹腔镜和传统开腹胆囊手术术后肠粘连发生率比较

目的 比较腹腔镜和传统开腹胆囊手术术后肠粘连的发生率,同时对比两组患者术后生存质量情况.方法 调查两组手术患者术后是否有肠粘连现象,采用消化病术后生存质量指数(CLQI指数)测定手术后患者的生存质量值.结果 腹腔镜胆囊手术术后肠粘连发生率是8.75%,而开腹胆囊手术肠粘连发生率是64.28%,两组差异具有显著性意义;腹腔镜胆囊手术后患者生存质量指数高于开腹胆囊手术患者,两组差异具有显著性意义.结论 腹腔镜胆囊手术较开腹胆囊手术肠粘连发生几率低,且手术后患者生存质量较后者高.     

开腹胆囊切除术与腹腔镜胆囊切除手术两种术式肠粘连发生率比较分析

目的:分析、研究、比较开腹胆囊切除术与腹腔镜胆囊切除手术两种术式的肠粘连发生率。方法:选取200例胆结石患者作为此次的研究对象,按入院时间分为观察组与对照组,各100例。观察组患者行腹腔镜胆囊切除手术;对照组患者行开腹胆囊切除术。对两组患者进行一年的随访记录,对比两组患者的肠粘连发生率以及术后的治疗满意率。结果:观察组患者的肠粘连发生率为1.00%,治疗满意率为99.00%;对照组患者的肠粘连发生率为7.00%,治疗满意率为92.00%,两组比较,差异有统计学意义(P<0.05)。结论:腹腔镜胆囊切除手术能够显著降低术后的肠粘连发生率,且出血少、恢复快,提高了患者的治疗满意度,减少了医患纠纷,值得临床推广。     

腹腔镜胆囊切除术与开腹手术治疗胆结石的临床疗效观察

目的:比较腹腔镜胆囊切除术与开腹胆囊切除术治疗胆结石的临床效果。方法:选取本院接受胆囊切除的50例胆结石患者,随机分为观察组(腹腔镜胆囊切除术)和对照组(开腹胆囊切除术)各25例,对比两组手术效果。结果:观察组术中出血量[(41.58±10.78)mL]、手术时间[(51.59±5.12)min]、肛门排气时间[(11.21±4.32)h]和住院时间[(5.71±2.61)d]均低于对照组术中出血量[(68.54±16.47)mL]、手术时间[(76.18±10.48)min]、肛门排气时间[(24.62±8.37)h]和住院时间[(9.63±1.82)d](P0.05)。观察组并发症发生率12.00%显著低于对照组32.00%(P0.05)。结论:腹腔镜胆囊切除治疗胆结石具有创伤小、术后恢复快、并发症少优点,值得临床推广。     

开腹胆囊术与腹腔镜胆囊手术后肠粘连的临床分析

目的 比较研究开腹胆囊术与腹腔镜胆囊手术后肠粘连的发生率.方法 选取胆囊类疾病患者98例均分为两组,开腹组49例进行传统开腹胆囊术,腹腔镜组49例行腹腔镜胆囊手术,比较两组围术期手术时长等观察指标及术后肠粘连发生率.结果 腹腔镜组的手术时长(36.8±4.3)min、术中出血量(25.8±4.6)mL、术后排气时间(2.6±0.6)h和下床时间(24.5±3.1)h均明显低于开腹组的(65.3±4.9)min、(59.8±5.1)mL、(7.1±0.8)h、(48.6±3.8)h,差异均有统计学意义(P<0.05);术后肠粘连发生率4.1%显著低于开腹组的20.4%,差异有统计学意义(P<0.05).结论 与传统开腹胆囊术相比,腹腔镜胆囊手术对患者的医源性创伤更小,手术时长和术中出血量大大减少,术后肠粘连发生率显著降低,临床应用价值更高.     

腹腔镜与小切口胆囊切除术治疗胆囊结石合并胆囊炎疗效预后及生活质量比较研究

目的:比较腹腔镜(laparoscopic cholecystectomy,LC)与小切口胆囊切除术(Minilaparotomy cholecystectomy,MC)治疗胆囊结石合并胆囊炎的疗效和预后.方法:选择江苏大学附属医院65例胆囊结石合并胆囊炎患者分为MC组31例和LC组34例,分别给予MC和LC手术治疗,比较患者手术、术后恢复状况、并发症发生率、复发率及术后生存质量.结果:MC组与LC组均顺利完成胆囊切除手术.相比于MC组,LC组切口长度显著缩短,术中出血量和手术时间显著减少;LC组禁食、抗菌治疗、下床及住院时间均显著缩短,医疗费用显著提高;LC组并发症发生率显著降低,2.9％ vs25.8％;LC组患者生存质量指数评分显著提高,(118.7±12.1)vs (108.1±13.6)分,差异均具有统计学意义(P＜0.05).结论:LC手术治疗胆囊结石合并胆囊炎尽管手术费用相对较高,但创伤小、术后恢复快、并发症发生率低,并显著提高患者生存质量.     

不同胆囊手术术后肠粘连临床观察

目的：研究腹腔镜和开腹实施胆囊手术患者术后出现肠粘连的情况。方法选择我院2008年8月—2013年8月间诊治的82例胆囊手术患者,根据患者的经济及身体情况分为2组,对照组的41例患者实施传统开腹手术,观察组的41例患者实施微创手术,比较2组患者术后出现肠粘连的概率。结果通过对2组患者进行比较,观察组患者中有1例出现肠粘连,发生率为2.44%;对照组患者中有6例出现肠粘连,发生率为14.63%,2组比较差异有统计学意义（P<0.05）。结论运用腹腔镜实施胆囊切除手术具有术后恢复快、效果明显、安全性高、微创、痛苦小等多项优点,适合在临床上大力推广使用。     

为患者行开腹胆囊切除手术与腹腔镜胆囊切除手术诱发术后肠粘连几率的分析

目的：对比分析为患者行开腹胆囊切除手术（OC）与腹腔镜胆囊切除手术（LC）诱发术后肠粘连的几率。方法：将2010年1月至2013年12月我院收治的76例胆囊结石伴慢性胆囊炎患者随机分为开腹手术组和腹腔镜手术组,在为其实施相应的手术治疗后对比其发生肠粘连的几率。结果：对两组患者进行术后随访的结果显示,在开腹手术组患者中有6例患者发生肠粘连,其发生肠粘连的几率为15.8%。在腹腔镜手术组患者中有2例患者发生肠粘连,其发生肠粘连的几率为5.26%。两组患者发生肠粘连的几率相比较显著差异（P<0.05）,有统计学意义。讨论：与进行开腹手术相比,为患者施行腹腔镜手术导致术后肠粘连的几率较低,此类手术更值得在临床上推广应用。     

腹腔镜胆囊切除术与开腹手术治疗胆结石的临床效果

目的比较腹腔镜胆囊切除术和开腹手术对胆结石的临床效果。方法选取2016年1月~2017年7月于我院治疗胆结石的74例患者作为研究对象,根据治疗方法将患者分成采用常规开腹手术治疗的对照组(37例)与采用腹腔镜胆囊切除术治疗的观察组(37例),对两组患者的手术治疗时间、手术出血量、住院天数、术后排气时间以及术后并发症等相关情况进行观察并比较。结果采用腹腔镜胆囊切除术治疗的观察组手术治疗时间为(55.9±4.1)min,术中出血量为(44.2±9.3)m L,住院天数为(5.4±1.2)d,术后排气时间为(10.9±2.6)h。对照组手术治疗时间为(74.1±3.9)min,术中出血量为(61.8±8.6)m L,住院天数为(8.1±2.4)d,术后排气时间为(24.7±3.6)h。观察组上述指标均显著优于对照组(P均0.05),此外观察组术后并发症发生率为13.51%,显著低于对照组的27.73%(P0.05)。结论腹腔镜胆囊切除术与常规开腹手术相比,能够在保证胆结石患者治疗效果的基础上,缩短治疗时间,减少对患者的创伤,加速恢复时间,减少术后并发症,安全有效,值得推广。     

开腹胆囊手术与腹腔镜胆囊手术术后肠粘连发生率对比

目的 对比分析开腹胆囊手术与腹腔镜胆囊手术术后肠粘连发生率.方法 选取140例胆囊炎患者,将其依据随机方式分为观察组和对照组,各70例,对照组性开腹胆囊切除术予以治疗,观察组则于腹腔镜下行胆囊切除术予以治疗.就两组患者术后肠粘连发生状况予以比较.结果 观察组术后发生肠粘连3例,发生率4.29%;对照组15例,发生率21.43%,观察组患者术后肠粘连发生率低于对照组,差异有统计学意义(P<0.05).结论 针对胆囊炎患者,对其于腹腔镜行胆囊手术予以治疗,相比于采取开腹胆囊手术治疗举措,可显著减少术后肠粘连发生率,在临床中具有良好应用价值.     

老年患者良性胆囊疾病腹腔镜胆囊切除与开腹胆囊切除的比较分析

目的比较分析腹腔镜胆囊切除手术与开腹胆囊切除手术治疗老年良性胆囊类疾病治疗效果,探讨在治疗老年患者时,哪一种手术方式更为可靠、安全。方法回顾性分析本院的98例老年良性胆囊疾病患者,58例患者进行了腹腔镜的胆囊切除手术,记为A组,40例患者进行了开腹胆囊切除手术,记为B组。比较两组的术前信息、术中的各项指标以及术后的恢复情况。结果腹腔镜胆囊切除手术组在手术时间、术中的出血量、术后的排气时间、止痛剂的使用情况、术后患者的卧床时间、术后的并发症等方面要明显的好于开腹切除手术组（P〈0.05）。前者的治疗效果要明显好于后者。结论腹腔镜切除胆囊术后所造成的手术创伤小,痛苦少,对胃肠道的干扰少,患者恢复快,住院时间短。根据老年患者身体器官的老化以及生理功能的衰退情况,比较适合采用腹腔镜的切除手术来进行治疗     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.