我院自2006年1月至2011年1月共收治38例胰腺假性囊肿,现就其治疗方法优、缺点探讨如下. 临床资料 1.一般资料:本组38例,男30例,女8例,年龄38～65岁.均经术前B超或CT证实为胰腺假性囊肿.均有胰腺炎发作史,多发囊肿20例,单发囊肿18例,囊肿体积范围3cm×3cm×4cm～8cm×9cm×12cm,合并慢性支气管炎及肺气肿3例,高血压7例,糖尿病5例,心功能不全3例,5例伴有既往腹部手术史,其中3例因重症胰腺炎脓肿探查引流1～2次,1例伴有胆结石手术史,1例阑尾切除史.
Objective To study the effects of tota parenteral nutrition with Somatostatin on the patients with early postoperative inflammatory small intestinal obstruction.Methods Patients treated with Somatostatin were compared with those treated without related medicine(as control).Inflammatory mediators expression(IL-6 and TNF-α) of patients who have been treated for 2,4,6,10 days by ELISA were detected,followed by the recording of intestinal ventilation and feeding time,cure time.Results Compared with control group,Somatostatin group significantly reduced inflammatory mediators expression level(IL-6 and TNF-α)(P0.01),the intestinal tract secretion flow and the cure time and bowel ventilation time(P0.01).Conclusion Somatostatin of parenteral nutrition can obviously increase the effects of early inflammatory bowel obstruction,shorten the curative process and reduce the inflammatory factor expression,so it is worth putting to wide application.
【Objective】 To observe the clinical significance and effects of debridement combined with negative pressure drainage on wound healing in obese patients with Class III abdominal incision.【Methods】 A prospective,randomized and controlled clinical study was performed with 618 obese patients with Class III abdominal incision.Patients were randomly divided into the group of debridement combined with negative pressure drainage(Group A,n =309) and the group of conventional suture(Group B,n =309).Group A underwent the debridement combined with negative pressure drainage,while group B took the conventional suture.The occurrence of abdominal incision infection and the wound healing grades were observed,analyzed and compared.【Results】 Significant differences(P 0.05) were found in group A and group B in the proportion of Class A healing [95.7%(300/309) vs 81.5%(252/309)],and also found in the proportion of Class B healing [2.5%(8/309) vs 9.3%(29/309)] and in the rate of abdominal incision infection [1.61%(5/309) vs 9.06%(28/309)].【Conclusion】 The rate of abdominal incision infection declines rapidly in obese patients with Class Ⅲ abdominal incision when the debridement combined with negative pressure drainage is administered.The rate of Class A healing was also markedly increased.These indicate that the debridement combined with negative pressure drainage is helpful in early rehabilitation and promotion of life quality.
患者,男,34岁,胸腹结合部外伤疼痛1h入院(既往有膈疝病史).查体:BP 90/60mm Hg,HR 98次/分,右肺呼吸音低,腹平,腹肌紧张,上腹压痛,有反跳痛,肠鸣音弱,中下腹叩诊呈浊音,左下腹诊断性穿刺呈血性液.实验室检查:ALT、AST、BS正常,WBC 15.2×109/L,HGB 104g/L,胸腹CT示肋骨骨折,右膈疝,致右肺受压,右侧胸腔积液,右肺体积明显缩小,肝胃先天转位并肝挫伤.
患者,女性,60岁,因发现左乳肿块半个月余于2011年1月10日入院.患者既往无手术史,家族中无乳腺癌病史.体格检查:双乳对称,皮肤无红肿,无桔皮样外观,乳头无内陷,无溢液;左乳外上象限可扪及6cm×5cm×3cm大小的肿块,质地硬、边界不清、可推动、轻压痛,皮肤表面无静脉怒张,双腋下及浅表淋巴结未扪及明显肿大.
