OBJECTIVE To investigate the risk factors of infections in gastric cancer patients after subtotal distal gastrectomy so as to provide the theoretical basis for prevention of the infections.METHODS A total of 190 cases of gastric cancer patients,who underwent the subtotal distal gastrectomy from Jan 2007 to Oct 2011,were retrospectively analyzed in the hospital.The univariate analysis of risk factors of the infections was performed.RESULTS Of totally 190 cases of gastric cancer patients investigated,32 cases were infected with the infection rate of 16.8%.The main postoperative infection site was surgical wound,accounting for 40.6%,followed by abdominal cavity(25.0%),respiratory tract(21.9%),and intestinal tract(12.5%).The χ2 analysis showed that more than 60 years of age,operation duration more than 100 min,poor tumor stage,intraoperative blood transfusion,and white blood cell count less than 2×109/L were the high risk factors for the infections in the gastric cancer patients after subtotal distal gastrectomy(P0.05),however,there was no significant correlation between the infections and the gender and surgical approach.CONCLUSION The surgical incision infection is dominant in the gastric cancer patients after subtotal distal gastrectomy,followed by abdominal cavity infection and respiratory tract infection.The age,operation duration,tumor stage,intraoperative blood transfusion,and white blood cell count are the high risk factors of infections in gastric cancer patients after subtotal distal gastrectomy.

目的了解胶囊内镜对小肠疾病的诊断价值。方法对123例经胃镜、结肠镜检查未发现病因的消化道出血,慢性腹痛、腹泻,不明原因的消瘦或胰腺肠癌相关抗原(CA199)偏高等3组患者应用OMOM胶囊内镜检查,诊断分析结果。结果 123例均完成检查,其中3例(2.4%)出现胶囊滞留,其他胶囊均排出体外。共检出小肠病变81例(65.9%),其中不明原因消化道出血组阳性率为78.9%,慢性腹痛腹泻组阳性率6 1.6%,不明原因消瘦或CA 199偏高组阳性率为6/12。结论胶囊内镜对可疑小肠疾病特别是不明原因消化道出血、慢性腹痛腹泻患者有较高的诊断阳性率,检查过程相对安全、舒适、无创,但使用过程要严格掌握其适应证及禁忌证。

目的探讨药物治疗对老年慢性闭角型青光眼(CACG)患者的疗效及其维持有效视功能的可行性。方法选取吉林大学第一医院2007年6月～2008年6月收治的33例(65只眼)CACG患者,均采用抗青光眼药物局部点眼,制定个体化的治疗方案,观察其用药前后眼压(IOP)值、视网膜神经纤维层(RNFL)厚度与视乳头杯盘(C/D)比值及视野的差异,并行统计学分析。随访期限为3年。结果 Paired-Sample t Test显示:用药前后,CACG患者眼压的差异具有统计学意义,而反映疾病进展程度的RNFL厚度、C/D比值及视野均不具有显著性差异(P<0.05)。结论对于老年慢性闭角型青光眼患者,局部给药可以明显降低眼压,且没有其他副作用;通过制定个体化治疗方案及规范化的随访,老年闭角型青光眼患者可以维持长久可用视力。

目的:分析总结医源性肝功能异常的常见原因。方法:对2007年6月-2010年5月,我院诊断为医源性肝功能异常的61例患者的临床资料进行回顾性分析。结果:医源性肝功能异常病因多样,主要为药物36例(占59.02%)、外科手术20例(占32.79%)和造血干细胞移植5例(占8.12%)。结论:尽量避免使用具有肝脏毒性的药物和治疗方式,能有效防止医源性肝功能异常的发生。

OBJECTIVE To analyze the clinical features and related factors of hospital infection in old patients with hepatic cirrhosis.METHODS The clinical data of 741 hospitalized patients with hepatic cirrhosis were analyzed retrospectively.These patients were enrolled from Jan 2008 to Jan 2010.RESULTS 48 aged patients and 42 non-aged patients with hepatic cirrhosis had hospital infections with the infection rates of 18.39% and 8.75%.The difference was significant(P0.05).Most infections were abdominal infections,then were respiratory infections and gastrointestinal infections.Most pathogenic bacteria were Gram-negative bacilli.Age,hopitalization time,concomitant disease,upper gastrointestinal bleeding,antibiotics and invasive operations were correlated with hospital infection.CONCLUSION The incidence of hospital infection in old patients with hepatic cirrhosis is high.Comprehensive measures should be adopted to reduce the rate of hospital infection and increase the quality of life in old patients with hepatic cirrhosis.

目的:探讨老年人肠梗阻的病因。方法:对120例老年人肠梗阻的临床资料进行回顾性分析。结果:肿瘤引起的肠梗阻50例(41.7%)、粘连性肠梗阻38例(31.7%)、嵌顿疝8例(6.7%)、粪石阻塞7例(5.8%)、缺血性肠病5例(4.2%)、假性肠梗阻5例(4.2%)、肠扭转2例(1.7%)、胆石症1例(0.8%)、肠套叠1例(0.8%)、柿石1例(0.8%)、系统性红斑狼疮1例(0.8%)、膈疝1例(0.8%)。结论:恶性肿瘤和肠粘连占肠梗阻总数的73.4%,成为肠梗阻的主要病因。

目的通过检测视网膜神经纤维层厚度(RNFL)及视盘结构参数,结合视野改变,探讨光学相关断层成像术(OCT)在青光眼早期诊断中的价值。方法采用OCT对正常人10眼、疑似青光眼患者34眼,慢性闭角型青光眼(CACG)早中期患者36眼进行视盘扫描及以视乳头中心为圆心、直径为3.4 mm的环形扫描,观察各组人群的OCT图像特征。分别比较各组受检者的各象限RNFL厚度、视乳头水平、垂直杯盘比及杯/盘面积比,平均RNFL厚度与视野指数进行直线回归和相关分析。结果OCT检测正常人、疑似青光眼和CACG早中期三组间各象限RNFL厚度、各视盘参数均有显著性差异(P<0.05)。平均RNFL厚度与视野平均缺损值(MD)呈强的且正的直线关系。结论OCT能够早期反映RNFL厚度及视盘的改变,与视野检查有较好的相关性,可以作为青光眼早期诊断的方法。

原发性青光眼是严重的不可逆转的致盲性眼病之一,早期诊断和干预是防止青光眼患者视功能严重丧失的关键措施.近年来,原发性青光眼在基础和临床研究中取得了重要进展,同时先进的仪器设备辅助检查进一步提高了青光眼的早期确诊率,同时有利于随访观察并可指导治疗.本文对与原发性青光眼的早期诊断相关的几点新概念及相关辅助检查进行综述.

内镜下乳头括约肌切开取石术(EST)是治疗胆道结石及十二指肠乳头狭窄有效的非剖腹性治疗方法,具有操作简便灵活,疗效肯定,创伤小、并发症少,时间较短,患者痛苦小、恢复快和住院时间短,机体的应激反应轻,对机体的免疫功能抑制小等优点,有确切的临床实用价值,尤其更适宜老年患者[1～3].

目的分析白癜风合并消化道肿瘤患者的临床特点及意义,探讨消化道肿瘤与白癜风之间的相关性。方法对9例确诊为消化道肿瘤的白癜风患者,对其临床表现及实验室指标进行分析。结果消化道肿瘤与白癜风之间存在某些相关性。结论白癜风可能是内脏肿瘤的先兆,对白癜风患者进行监测肿瘤指标及B超、CT等检查,对早期发现肿瘤有一定临床意义。

目前,内镜下乳头括约肌切开取石术(EST)已广泛应用于临床,其具有创伤小,手术时间较短,患者痛苦小,恢复快和住院时间短,机体的应激反应轻,对机体的免疫功能抑制小的特点 [1,2].

目的观察替普瑞酮治疗慢性萎缩性胃炎的临床疗效.方法 64例慢性萎缩性胃炎患者随机分为两组.治疗组服用替普瑞酮胶囊50 mg,每日3次,连服6月;对照组服用叶酸片10 mg,每日3次,连服6月.6月后复查胃镜.结果治疗组临床症状改善有效率88.2%,对照组43.3%,两组比较差异有显著性(P＜0.05).均无严重肝肾功能损害发生.结论替普瑞酮是治疗慢性萎缩性胃炎的安全、有效药物.

内镜下乳头括约肌切开术(EST)已广泛应用于临床,尤其是对胆管结石的治疗,在很大程度上取代了外科剖腹手术治疗.我院自2002年以来采用EST对113例老年胆管结石病人行胆管取石,取得较好效果.