<正>1引言胃、十二指肠溃疡是基层医生在临床工作中经常遇到的常见病和多发病。近年来的研究发现,胃溃疡和十二指肠溃疡的发病虽然都与胃酸分泌异常有密切的关系,但是这两种疾病的发生部位、临床特点、溃疡本身及其并发症

Objective: To investigate the treatment of colon injury and evaluate the safety and efficacy of primary repair of colon injuries. Methods: From Feb 1999 to Dec 2004, 21 patients with colon injury were analyzed retrospectively, and a literature review was made of 13 publications containing 489 colon injuries in retrospective studies. Results: All cases underwent an emergency operation. Primary repair was performed in 410 cases(80.4%). The leak rate and other complications after primary repair is 6.1% and the diverted patients is 16.0%. Conclusion: The primary repair is the major way to treat the colon injury at the present time. The colon injuries are safely managed by primary repair, but colostomy may still be advised in selected cases.

目的:探讨残胃癌的早期诊断和手术治疗效果.方法:对28例残胃癌病人的临床资料进行回顾性分析,比较不同手术方式的生存率.结果:28例主要临床表现为上腹部胀痛,主要诊断方法是消化道钡餐和胃镜检查.其中21例行手术治疗,手术根治性切除的12例病人生存5年以上者7例,非限治手术的16例均在1年内死亡.结论:对胃部分切除术后病人定期随诊并胃镜检查有利于早期发现残胃癌.手术是其主要治疗手段,残胃癌根治性手术后的5年生存率近似于胃原发癌.早期诊断对提高残胃癌术后的生存率有重要意义.

Objective To evaluate the effect of tube-type anastomat on the reconstruction of upper digestive tract.Method After total or subtotal gastrectomy,the proximal jejunum was excided between two scheduled stomas,the tube-type anastomat was placed,then side-to-side intestinal,oesophagus-jejunum or gastric renmant-jejunum anastomosis was performed,and the intestinal tract in contracted incision was sutured.Results No complications such as stoma fistula,stenosis,bleeding and emptying obstruction occurred after the operation.Pain in esophago and gastric remnant and vomiting were not found during 3～6 months follow-up.Conclusions The method is simple and easy to control,especially in oesophagus-jejunmu anastomosis,which not only maintains the continuity of jejunmu,but also prevents the regurgiation of duodenal and produce the effect of Roux-en-Y.

肛镜明知有癌肿两次活检未见癌--1例直肠癌长期误诊的教训 患者,男性,39岁.因腹痛、腹胀、解黏液血便6个月,拟诊为直肠癌入院.患者于6个月前,无明显诱因而出现大便次数增多,有脓血黏液、里急后重感.当地诊所诊断:细菌性痢疾.给服诺氟沙星和小檗碱等药.腹泻无好转.于发病后3个月,到某诊所求治.诊断"内痔出血",用消痔灵局部注射2次,但脓血黏液便无减轻,且出现脐周阵发性疼痛、腹胀等.解大便后可缓解.1个月后赴某县医院求医.