[目的]探讨肝切除术后患者早期运用吴茱萸热熨腹部对门静脉血流动力学的影响.[方法]将90例行肝切除术患者随机分为治疗组、阳性对照组和基础治疗组,每组各30例.基础治疗组术后仅给予西医常规基础治疗,治疗组术后在基础治疗的同时给予吴茱萸+粗盐热熨腹部治疗,阳性对照组术后在基础治疗的同时给予粗盐热熨腹部治疗,疗程为7d.观察3组患者在肝切除术前及术后1、3、5、7 d的门静脉内径、血流速度、血流量及血清谷草转氨酶(AST)、谷丙转氨酶(ALT)水平的变化情况.[结果]与术前比较,术后1 d,3组患者的门静脉内径均明显缩小,血流速度均明显下降,血流量均明显减少,血清ALT和AST水平均明显升高,差异均有统计学意义(P<0.01),但组间比较,差异均无统计学意义(P>0.05);术后3、5、7 d,3组患者的门静脉内径、血流速度和血流量均较术后1 d增加(P<0.01),血清ALT和AST水平均较术后1 d降低(P<0.01),且随着治疗天数的增加,门静脉内径、血流速度和血流量呈增大趋势,血清ALT和AST水平呈下降趋势,至术后7 d,3组患者的门静脉内径、血流速度、血流量及血清ALT和AST水平均已恢复至术前水平,差异均无统计学意义(P>0.05).组间比较,术后3 d,治疗组的门静脉内径、血流速度和血流量均大于阳性对照组和基础治疗组(P<0.01);术后5 d,治疗组和阳性对照组的门静脉血流速度和血流量均大于基础治疗组(P<0.01);术后7 d,3组患者的门静脉内径、血流速度和血流量比较,差异均无统计学意义(P>0.05).而3组间各观察时点的血清ALT和AST水平比较,差异均无统计学意义(P>0.05).[结论]肝切除术后早期运用吴茱萸热熨腹部的中医外治法治疗,可增加门静脉的血流量,加快门静脉的血流速度,从而促进肝脏功能恢复,对肝切除术后患者的快速康复具有积极的作用.

Objective:To study on the effects of gastrointestinal function and portal vein hemodynamics applicated with abdominal hot compressing with evodiae fructus and crude salt after hepatectomy.Methods:A total of 60 patients who underwent hepatectomy were randomly divided into 2 groups by random number table method, with 30 in each group. The control group was treated with conventional basic western medicine, while the treatment group was treated with medicinal evodiae fructus and crude salt hot compress on abdomen on the basis of the control group. The portal vein diameter (PVD), portal venous flow velocity (PVV), recovery time of main clinical indexes, clinical symptom scores and liver function indexes were dynamically monitored at different observation time points.Results:The scores of abdominal distension, nausea and vomiting in the treatment group were significantly lower than those in the control group 3 days after treatment ( t values were -3.489 and -2.740, respectively, all Ps<0.05). The recovery time of bowel sounds, first exhaust time and first defecation time in the treatment group were significantly earlier than those in the control group ( t values were -3.622, -4.297 and -4.151, respectively, all Ps<0.01). With the extension of treatment time, ALT in 2 groups showed a gradual downward trend ( P<0.05 or P<0.01), DBIL in control group was significantly higher at 3 days after treatment than before ( t=-2.157, P=0.039), and TBIL was significantly lower at 7 days after treatment than before ( t=2.175, P=0.038). The PVD ( t values were 3.528, 2.160) and PVV ( t values were 11.096, 4.264) of the treatment group were significantly higher than those of the control group 3 and 5 days after treatment ( P<0.01 or P<0.05). Conclusion:Early application of abdominal hot compressing with evodiae fructus and crude salt hot compress on abdomen after hepatectomy can improve the portal vein blood circulation and promote the rehabilitation of gastrointestinal function in patients with hepatectomy.

Background The application of laparoscopic liver resection (LLR) has expanded rapidly in recent decades. Although multiple authors have reported LLR shows improved safety and efficacy in treating hepatocellular carcinoma (HCC) compared with open liver resection (OLR), laparoscopic (LMLR) and open (OMLR) major liver resections for HCC treatment remain inadequately evaluated. This work aimed to test the hypothesis that LMLR is safer and more effective than OMLR for HCC. Methods Comparative cohort and registry studies on LMLR and OMLR, searched in PubMed, the Science Citation Index, EMBASE, and the Cochrane Library, and published before March 31, 2018, were collected systematically and meta-analyzed. Fixed- and random-effects models were employed for generating pooled estimates. Heterogeneity was assessed by the Q-statistic. Results Nine studies (1173 patients) were included. Although the pooled data showed operation time was markedly increased for LMLR in comparison with OMLR (weighted mean difference [WMD] 74.1, 95% CI 35.1 to 113.1, P = 0.0002), blood loss was reduced (WMD = − 107.4, 95% CI − 179.0 to − 35.7, P = 0.003), postoperative morbidity was lower (odds ratio [OR] 0.47, 95% CI 0.35 to 0.63, P < 0.0001), and hospital stay was shorter (WMD = − 3.27, 95% CI − 4.72 to − 1.81, P < 0.0001) in the LMLR group. Although 1-year disease-free survival (DFS) was increased in patients administered LMLR (OR = 1.55, 95% CI 1.04 to 2.31, P = 0.03), other 1-, 3-, and 5-year survival outcomes (overall survival [OS] and/or DFS) were comparable in both groups. Conclusions Compared with OMLR, LMLR has short-term clinical advantages, including reduced blood loss, lower postsurgical morbidity, and shorter hospital stay in HCC, despite its longer operative time. Long-term oncological outcomes were comparable in both groups.

The application of laparoscopic liver resection (LLR) has expanded rapidly in recent decades. Although multiple authors have reported LLR shows improved safety and efficacy in treating hepatocellular carcinoma (HCC) compared with open liver resection (OLR), laparoscopic (LMLR) and open (OMLR) major liver resections for HCC treatment remain inadequately evaluated. This work aimed to test the hypothesis that LMLR is safer and more effective than OMLR for HCC.Comparative cohort and registry studies on LMLR and OMLR, searched in PubMed, the Science Citation Index, EMBASE, and the Cochrane Library, and published before March 31, 2018, were collected systematically and meta-analyzed. Fixed- and random-effects models were employed for generating pooled estimates. Heterogeneity was assessed by the Q-statistic.Nine studies (1173 patients) were included. Although the pooled data showed operation time was markedly increased for LMLR in comparison with OMLR (weighted mean difference [WMD] 74.1, 95% CI 35.1 to 113.1, P = 0.0002), blood loss was reduced (WMD = - 107.4, 95% CI - 179.0 to - 35.7, P = 0.003), postoperative morbidity was lower (odds ratio [OR] 0.47, 95% CI 0.35 to 0.63, P < 0.0001), and hospital stay was shorter (WMD = - 3.27, 95% CI - 4.72 to - 1.81, P < 0.0001) in the LMLR group. Although 1-year disease-free survival (DFS) was increased in patients administered LMLR (OR = 1.55, 95% CI 1.04 to 2.31, P = 0.03), other 1-, 3-, and 5-year survival outcomes (overall survival [OS] and/or DFS) were comparable in both groups.Compared with OMLR, LMLR has short-term clinical advantages, including reduced blood loss, lower postsurgical morbidity, and shorter hospital stay in HCC, despite its longer operative time. Long-term oncological outcomes were comparable in both groups.

目的:探究围手术期综合护理干预对肝癌介入术后患者生活质量的影响.方法:选取本院于2014年至2017年收治的100例肝癌手术患者作为研究对象,采用随机分配的方式,分为参照组和观察组,每组50例.参照组患者采用常规护理,观察组患者在参照组的基础上进行围手术期综合性护理干预.观察两组患者的护理效果.结果:观察组的并发症发生率、QOL-C30评分均优于参照组,P＜0.05,具有统计学意义.结论:予以肝癌介入术后患者围手术期综合性护理干预,能有效提高患者的生活质量.

外科术后常需大量静脉输液,容易发生静脉输液渗漏,从而影响治疗,因此需要尽快解决局部的渗漏问题。从实验结果可以看出,双柏散组的疗效优于马铃薯组,在预防并发症方面疗效明显,保持湿敷时间长,不需要频繁更换敷贴,在必要时可以加热敷贴,同时进行热疗等优点,具有广泛的临床使用价值。

目的探讨阑尾周围脓肿中西医结合治疗的护理方法。方法分析50例阑尾周围脓肿患者中西医结合治疗的临床及护理资料。结果 50例患者中1例中转手术治疗,其余患者经中西医结合治疗及护理效果良好,平均腹痛缓解时间10.5h,平均包块缩小时间5.5d,平均住院时间为6.4d。结论阑尾周围脓肿中西医结合治疗护理效果较好,但应严格掌握中转手术指征。

在创业者最需要资金的时候,天使投资者从天而降。这样的投资方式,给与创业者最初的支持。然而,天使投资者投资方式的特殊,却无法得到法律的保护。他们被称为＂天使＂,却没有翅膀;他们热衷于投资,却不唯利是图;他们无处不在,却又难觅踪迹;他们是,天使投资者。在美国,这个群体的活跃人数已经接近30万之多,他

Objective: To observe the effect of medicated ironing combined with electroacupuncture on gastrointestinal function recovery after undergoing abdomen operation.Method: 120 cases were divied into 2 groups randonmly,the observation group and the control group,60 cases in each group.Both groups were received conventional care.The observation group were treated with medicated ironing on the acupoint Shenque with Evodia rutaecarpa and electroacupunture on the acupoint Zusanli.Result: The recovery of intestinal peristalsis,anal exhaust of the observation group was superior to that of the control group(P < 0.01).The defecating time of the observation group was shorter than that of the control group(P < 0.01).Conclusion: Medicated ironing combined with electroacupuncture could improve gastrointestinal function recovery after undergoing abdomen operation.