手助腹腔镜改良Sugiura术在特发性门静脉高压症的临床应用

目的探讨手助腹腔镜改良Sugiura术在特发性门静脉高压症中的临床应用价值。方法 2007年5月～2011年9月对福州总医院及中国人民解放军第302医院肝胆外科6例伴食管胃底静脉重度曲张、脾明显肿大及脾功能亢进的特发性门静脉高压症(idiopathic portal hypertension,IPH)患者行手助腹腔镜行改良Sugiura术治疗。结果 6例手助腹腔镜改良Sugiura手术均获得成功,平均手术时间为193.2 min,平均出血量236.8ml,未发生严重并发症,术后平均住院日为9.7天。术后随访时间2～54个月,平均随访15.8个月,均无再出血及肝性脑病发生。结论手助腹腔镜改良Sugiura术治疗伴食管胃底静脉重度曲张、脾明显肿大及脾功能亢进的IPH安全有效,具有一定的临床应用价值。     

改良Sugiura手术加自体脾移植治疗门静脉高压症的临床效果观察

目的 评价改良Sugiura 手术加自体脾移植治疗门静脉高压症的疗效.方法 回顾性分析50例门静脉高压症患者施行改良Sugiura 手术加自体脾移植治疗情况.结果 手术无死亡病例,术后近期止血效果确切.随访时间1/2～4年,肝性脑病发生率为2%,再出血率为2%.术后所有患者食管下段静脉曲张消失或明显好转,术后血清Tuftsin和IgM水平与术前比较无显著性下降,磁共振及同位素显像证实移植脾块成活.结论 改良Sugiura手术加部分自体脾移植手术操作较简单,再出血率低,并发症少,且保留脾脏的免疫功能,是一种值得推广的治疗门静脉高压症手术方法.     

改良Sugiura手术治疗门静脉高压症

目的 探讨改良Sugiura术式治疗门静脉高压症的效果. 方法 回顾性分析60例门静脉高压症患者行改良Sugiura手术加内镜套扎术的临床资料.结果 手术死亡率为零.术后发生腹腔感染1例,胃瘘1例.术后早期6例并发消化道中小量出血.60例均获随访,随访2～7年,平均随访5年,随访期间无肝性脑病发生,再出血1例,占1.7%,生存率100%(60/60).结论 改良Sugiura手术能有效防治断流术后再出血.手术时机和手术方式的个体化选择、规范的手术操作、注重围手术处理、尽量避免急症手术等要高度重视.     

改良Sugiura手术加自体脾移植治疗门静脉高压症的临床效果观察

目的评价改良Sugiura手术加自体脾移植治疗门静脉高压症的疗效。方法回顾性分析50例门静脉高压症患者施行改良Sugiura手术加自体脾移植治疗情况。结果手术无死亡病例,术后近期止血效果确切,随访时间1/2～4年,肝性脑病发生率为2%,再出血率为2%。术后所有患者食管下段静脉曲张消失或明显好转,术后血清Tuftsin和IgM水平与术前比较无显著性下降,磁共振及同位素显像证实移植脾块成活。结论改良Sugiura手术加部分自体脾移植手术操作较简单,再出血率低,并发症少,且保留脾脏的免疫功能,是一种值得推广的治疗门静脉高压症手术方法。     

改良Sugiura手术加自体脾移植治疗门静脉高压症的护理

目的 总结46例行改良Sugiura手术加自体脾移植治疗门静脉高压症患者的临床护理经验. 方法 对46例肝硬化门静脉高压症患者实施改良Sugiura手术加腹膜后部分自体脾移植症,护理中注重心理护理与术前准备,术后做好出血、感染、引流管的观察与护理,化验观察血细胞、肝功、免疫学指标的变化,影像学观察静脉消失情况及移植脾成活情况,加强术后、出院的康复指导. 结果 手术无死亡病例,止血效果确切,术后随访肝性脑病发生1例,发生3例.术后所有患者食管下段静脉曲张消失或明显好转,术后血清Tuftsin和IgM水平与术前比较无显著性下降,磁共振及同位素显像证实移植脾块成活.结论 改良Sugiura手术加部分自体脾移植术是一种治疗门静脉高压症新方法 .对该手术患者术前注重心理护理、术前准备,术后密切观察病情和正确护理与处理是提高手术成功率的重要手段.     

改良Sugiura术治疗门静脉高压症38例疗效评价

目的评价改良Sugiura手术治疗门静脉高压症的疗效。方法回顾性分析我院38例门静脉高压症患者行改良Sugiura手术的临床资料。结果死亡率为0％,近期止血效果确切,无肝性脑病发生,随访时间0．5—8年,再出血率为2．6％（1／38）;术后所有患者食管下段静脉曲张消失或明显好转。结论改良Sugiura手术治疗门静脉高压症的疗效满意,创伤小,操作较简单,再出血率低,是一种值得推广的治疗门静脉高压症手术方法。     

改良Sugiura手术加自体脾移植治疗门静脉高压症的护理

目的总结46例行改良sugiura手术加自体脾移植治疗门静脉高压症患者的临床护理经验。方法对46例肝硬化门静脉高压症患者实施改良Sugiura手术加腹膜后部分自体脾移植症,护理中注重心理护理与术前准备,术后做好出血、感染、引流管的观察与护理,化验观察血细胞、肝功、免疫学指标的变化,影像学观察静脉消失情况及移植脾成活情况,加强术后、出院的康复指导。结果手术无死亡病例,止血效果确切,术后随访肝性脑病发生1例,发生3例。术后所有患者食管下段静脉曲张消失或明显好转,术后血清Tuftsin和IgM水平与术前比较无显著性下降,磁共振及同位素显像证实移植脾块成活。结论改良Sugiura手术加部分自体脾移植术是一种治疗门静脉高压症新方法。对该手术患者术前注重心理护理、术前准备,术后密切观察病情和正确护理与处理是提高手术成功率的重要手段。     

改良Sugiura手术治疗门静脉高压症94例临床分析

目的：探讨改良Sugiura术治疗门静脉高压症的疗效。方法：回顾性分析94例门静脉高压症行改良Sugiura术患者临床资料。结果：术后近期止血效果确切,手术死亡率为1．06％（1／94）,再出血率为2．13％（2／94）,未发生肝性脑病,术后所有患者食管下段静脉曲张消失或者明显好转。无吻合1：7瘘和狭窄发生。结论：改良Sugiura术治疗门静脉高压症操作简便,并发症少,疗效较好,值得临床推广应用。     

改良Sugiura手术治疗门静脉高压症的疗效分析

目的:分析改良Sugiura手术治疗门静脉高压症的疗效。方法:回顾性分析127例门静脉高压症患者施行改良Sugiura手术治疗的情况。结果:无手术死亡,左膈下积液15例,肺部感染发热6例,切口感染9例,切口裂开3例,腹腔大出血2例,吻合口瘘1例。106例得到随访,随访6个月～8年,无肝性脑病发生。结论:改良Sugiura手术治疗肝硬化性门静脉高压症的操作简便、安全,疗效满意。     

两种断流术式治疗门静脉高压症疗效比较

贲门周围血管离断术是临床应用广泛的门奇断流术之一,但这一术式仍有较高的术后再出血率.为了降低门静脉高压症的术后再出血率,我院采用改良Sugiura手术治疗门静脉高压症54例,并进行了比较,现将结果报道如下.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

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…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.     

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.     

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.