目的：探讨慢性便秘与混合痔治疗的相关性。方法选择收住的混合痔患者120例，其中观察组为混合痔合并慢性便秘患者60例，对照组为混合痔患者60例，均采用外剥内扎法，比较两组患者术后住院时间、愈合时间、首次排便时间以及并发症等，以及观察混合痔合并便秘患者治疗前后的排便状态。结果观察组在早期恢复期首次排便时间，愈合时间、住院时间相对于对照组延长，出血、排便疼痛、肛缘水肿、肛门坠胀等评分在术后3、5 d 与对照组有统计差异，混合痔合并慢性便秘患者治疗后与治疗前对比便秘症状评分有统计学差异。结论慢性便秘与混合痔治疗具有一定的相关性：（1）慢性便秘对混合痔治疗预后有明显影响，主要表现为术后并发症发生率较高，愈合时间延长。（2）对于合并慢性便秘的混合痔患者及时治疗，可在一定程度上缓解便秘症状。

目的 探讨应用脱细胞异体真皮基质(acellular dermal Matrix,ADM)填塞治疗高位肛瘘的临床疗效.方法 回顾性分析2013年9月～ 2015年3月就诊于新疆医科大学第一附属医院的52例高位肛瘘患者的临床资料,分为ADM治疗组和传统挂线对照组进行术后相关指标的分析.结果 两组患者在性别(x2=0.087,P=0.768)、年龄(t=0.231,P=0.389)、民族(x2=0.391,P=0.532)、病程(t=0.316,P=0.690)、随访时间(t=0.512,P=0.209)上差异均无统计学意义,ADM组术后相关指标如肛门失禁(x2=5.532,P=0.019)、肛门畸形(x2=4.457,P=0.035)、术后疼痛时间(t=19.652,P=0.033)、术后愈合时间(t=14.186,P=0.003)及生活质量评分(t=13.188,P=0.041)差异均有统计学意义(P＜0.05),明显优越于挂线组,但复发率(x2=4.127,P=0.042)较挂线组偏高.结论 运用ADM治疗高位肛瘘具有微创、缩短愈合时间和保护肛门功能及外形等优势.

AIM:To compare biofeedback-guided pelvic floor exercise therapy (BFT) with the use of oral polyethylene glycol (PEG) for the treatment of obstructive defecation.METHODS:A total of 88 subjects were assigned to treatment with either BFT (n = 44) or oral PEG (n = 44). Constipation symptoms (including difficult evacuation, hard stool, digitation necessity, incomplete emptying sensation, laxative dependence, perianal pain at defecation, and constipation satisfaction), Wexner Scores, and quality of life scores were assessed after 1, 3, and 6 mo.RESULTS:At the 6 mo follow-up, the symptoms of the BFT group patients showed significantly greater improvements compared with the PEG group regarding difficult evacuation, hard stools, digitation necessity, laxative dependence, perianal pain at defecation, constipation satisfaction, Wexner Constipation Score, and quality of life score (P < 0.05). The quality of life score of the BFT group at the final follow-up time (6 mo) was 80 ± 2.2. After a complete course of training, improvements in the clinical symptoms of the BFT group were markedly improved (P < 0.05), and the Wexner Constipation Scores were greatly decreased compared with the oral PEG group (P < 0.05).CONCLUSION:We concluded that manometric biofeedback-guided pelvic floor exercise training is superior to oral polyethylene glycol therapy for obstructive defecation.

OBJECTIVE To investigate the effective surgical methods for parapharyngeal space tumors located in the medial part of the carotid artery.METHODS Clinical data and surgical processes of 12 cases with parapharyngeal space tumors located in the medial part of the carotid artery were summarized retrospectively.All tumors were removed through transcervical approach.For the tumor was situated upon the carotid bifuracation,the external carotid artery was cut in order to provide excellent exposure of the tumors.If the tumor was too big and can not be removed in bloc,the tumor can be removed piece by piece under the capsular membrane of the tumor.Also,endoscopic techniques would help a lot for the tumors involving the skull base.RESULTS All of the tumors of the 12 cases were removed completely without any complications,and the pathological report showed schwannoma in 8 cases,paraganglioma,lipoma,parotid mixed tumor and adenoid cystic carcinoma in one case respectively.CONCLUSION Based on the extent,location and the pathological type of the tumor in parapharyngeal space,proper method can be adopted to make the tumors exposed clearly and remove the tumors completely.

OBJECTIVETo discuss imaging characteristics of CT, MRI of tumors involving skull base in the parapharyngeal space,maximatily limit and improve the diagnosis rate of tumors involving skull base in the parapharyngeal space.METHODThirty-one patients with tumors involving skull base in the parapharyngeal space treated in our department were collected and reviewed. All the patients have pathological diagnosis and were examined by CT and/or MRI. To explore shape of tumor, its relation with surrounding structures, CT shows density size and the MRI signal directly through retrospective analysis of imaging characteristics of CT, MRI.RESULTIn all the 31 cases, 19 tumors were schwannoma, 8 tumors were mixed tumor of salivary gland, 2 tumors were carotid body tumor. 2 tumors were nasopharyngeal carcinoma involving skull base. Schwannomas and salivary gland mixed tumor can be expressed as round or oval with periphery smooth, and had intact capsule. The tumors had necrosis, sac variable area. Pleomorphic adenoma are all derived from deep parotid. Schwannoma had clear boundary with deep parotid. The effect of cavum nasopharyngeal and cavum oropharyngeal is relevant to tumor sizes and locations. Imaging characteristics of CT, MRI for carotid body tumor show soft tissue mass with attenuation similar to that of muscle. CT enhancement scan show intense enhancement. MRI show imaging of flowing empty vein. Imaging characteristics of MRI for nasopharyngeal carcinoma involving skull base in the parapharyngeal space show oval mass with low density signal, T1WI enhancement scan show necrosis, sac variable area.CONCLUSIONCT and MRI could provide the position, size, boundary of the tumor and its relationship with cervical blood vessels well, which were important to operation schemes. CT and MRI before operation are valuable to the treatment of PPS tumors.

目的:探讨鼻腔及鼻窦非霍奇金淋巴瘤(NHL)的CT特点,提高诊断准确性.方法:回顾性分析24例经病理证实的鼻腔及鼻窦NHL的CT表现.结果:24例中16例位于单侧,8例累及双侧.原发于鼻前庭2例、鼻腔6例、鼻窦9例、鼻腔鼻窦7例.病灶肿块表现15例,浸润表现9例.24例中22例病灶密度相对均匀,2病灶密度相对不均,增强后部分强化.原发于鼻腔的淋巴瘤1例见骨质破坏,原发于鼻窦和鼻腔鼻窦的有6例见骨质破坏；常累及邻近结构.结论:鼻腔鼻窦NHL的CT表现缺乏特征性征象,但有一些相对特异性征象有助于鼻腔鼻窦NHL的诊断.根据CT的相对特征性表现,结合临床,有助于及时诊断该类疾病.

目的:探讨原发性甲状腺淋巴瘤(primary thyroid lymphomas,PTLs)的CT影像学特征,最大限度提高甲状腺淋巴瘤的诊断率.方法:自2007年～2012年5月,手术探查并经病理证实的PTLs患者共9例,回顾性分析其CT表现,并与病理结果作对照诊断.结果:9例患者术后病理诊断均为B细胞性非霍奇金淋巴瘤.病灶呈单发结节型2例,多结节型2例,弥漫肿大型5例.CT平扫示单结节型、弥漫肿大型病灶皆呈均匀密度或稍低密度;增强扫描病灶大部分强化不明显,病灶密度仍呈均匀改变,病灶边缘可见残存的强化的甲状腺组织.CT平扫示多结节型病灶密度均匀,有多个低密度区;增强后病灶不均匀强化.结论:原发性甲状腺淋巴瘤的CT表现有一定特征性,正确认识甲状腺淋巴瘤的CT特征有助于早期临床诊断,最大限度地减少误诊,对临床早期治疗提供重要依据.