Objective:To analyze the effect of radiofrequency ablation combined with foam sclerosing agent closure and punctate stripping in the treatment of great saphenous varicose veins.Methods:A total of 104 patients with great saphenous varicose veins admitted to Xinxiang Second People’s Hospital from May 2019 to May 2022 were selected as the study subjects, and they were divided into control group and study group according to random sampling method, with 52 cases in each group. The control group was treated by high ligation of great saphenous vein and varicose vein stripping, and the study group was treated by radiofrequency ablation combined with foam sclerosing agent closure and punctate stripping. The venous clinical severity score (VCSS) and chronic venous insuff iciency questionnaire (CIVIQ) score before and after treatment were compared between the two group. And the perioperative related indexes, postoperative pain score and postoperative complications were compared between the two groups.Results:There was no significant difference in VCSS and CIVIQ score between the two groups before treatment ( P>0.05); after treatment, the VCSS of the study group was lower than that of the control group, and the CIVIQ score was higher than that of the control group ( P<0.05). The number of incisions in the study group was less than that in the control group, the hospital stay was shorter than that in the control group, and the intraoperative volume was less than that in the control group ( P<0.05). The pain degree score of the study group was lower than that of the control group at 2, 6, 12 and 24 hours after surgery (all P<0.05). The incidence of postoperative complications in the study group (1.92%, 1/52) was lower than that in the control group (13.46%, 7/52), P<0.05. Conclusions:Radiofrequency ablation combined with foam sclerosing agent closure and punctate stripping is effective and safe in the treatment of great saphenous varicose veins.

Objective:To investigate the clinical effect of laparoscopic sleeve gastrectomy (LSG) for obesity related menstrual disorder.Methods:The baseline data and the body mass indexes (BMI), total weight loss rates (%TWL), and serum testosterone levels 3, 6, and 12 months after the operation of the 103 patients with obesity related menstrual disorder who received LSG from January 2017 to June 2019 at Second People's Hospital of Xinxiang were retrospectively analyzed.Results:The patients were (30±5) years old. Their BMI was (39.91±5.56) kg/m 2. Their preoperative serum testosterone level was (1.43±0.84) μg/L. Their glycosylated hemoglobin (HbA1c) was (7.25±1.29)%. The BMI's 3, 6, and 12 months after the operation were (30.76±5.71) kg/m 2, (28.93±5.07) kg/m 2, and (27.63±5.43) kg/m 2; the % TWL's 3, 6, and 12 months after the operation were (11.51±2.79)%, (20.30±3.11)%, and (27.92±3.17)%; the serum testosterone levels 3, 6, and 12 months after the operation were (1.12±0.65) μg/L, (0.98±0.43) μg/L, and (0.57±0.13) μg/L; which were significantly different from those before the operation (all P＜0.05). Twelve months after the operation, 72 cases' (69.9%) menstruation returned to normal, 6 cases' menstruation (5.83%) alleviated, and 10 cases (9.71%) were successfully conceived. Conclusion:LSG can improve the menstruation and ovulation in patients with obesity related menstrual disorder.

目的观察祛疤硅凝胶膜治疗烧伤后瘢痕的效果。方法对168例Ⅱ度、Ⅲ度烧伤愈后患者分于患处外敷祛疤硅凝胶膜和应用祛疤硅酮凝胶,均连续3个月,观察治疗效果。结果患处外敷祛疤硅凝胶膜患者瘢痕的痛、痒、潮红及增生有显著改善,应用祛疤硅酮凝胶患者瘢痕的紧束感及增生硬化明显缓解。结论祛疤硅凝胶膜对深度烧伤创面瘢痕,有明显疗效。

目的探讨无明显早期意识障碍的创伤性蛛网膜下腔出血临床特点,减少临床漏诊、漏治。方法分析24例无明显早期意识障碍的创伤性蛛网膜下腔出血患者的临床资料。结果 24例患者中恢复良好19例,中度伤残2例,昏迷状态1例,2例死亡。结论无明显早期意识障的颅脑外伤患者要严密观察,避免漏诊,及早诊治,降低患者致残率及病死率。

目的观察Roux-en-Y胃转流术治疗2型糖尿病的方法及疗效。方法分析新乡市第二人民医院外二科开展Roux-en-Y胃转流术治疗糖尿病的9例资料,通过患者手术前后口服葡萄糖耐量试验(OGTT)、糖化血红蛋白(HbAlc)的改变进行对比分析。结果 9例患者术后1个月血糖均有明显下降,葡萄糖耐量明显增强(P<0.01),9例术后随访6个月,血糖在正常范围,无需药物控制;所有患者空腹糖化血红蛋白(HbA1c)与手术前相比明显降低(P<0.01);1例手术后并发胃排空障碍,经保守治疗后痊愈。结论 Roux-en-Y胃转流术治疗2型糖尿病,手术安全有效,值得临床推广。

目的探讨急性胃扩张的诊断和治疗方法。方法回顾性总结1990年1月～2012年2月收治的7例急性胃扩张病例的临床特征、诊断及治疗。结果 7例中经手术治疗4例,其中胃切开减压后缝合2例,胃部分切除术1例,胃切开减压后胃造口术1例,手术组死亡1例;保守治疗3例,死亡1例。结论急性胃扩张是临床上一种少见急腹症,病程进展迅速,死亡率高。早期诊断,采取积极有效措施,可减少病死率。

目的探讨青年乳腺癌的误诊原因及应对办法。方法选择2006-01—2009-12新乡地区乳腺癌患者206例,就其临床表现及辅助检查特点进行误诊原因分析。结果青年乳腺癌患者误诊率高于对照组,辅助检查确诊率低。结论加强乳腺癌知识宣传,医生提高重视,联合仪器检查,提高青年乳腺癌确诊率。

目的探讨腹腔间质瘤的诊疗方法和病理特点。方法回顾性总结17例腹腔间质瘤的临床特征、诊断及治疗。结果 17例随访6~94个月。胃间质瘤8例中全胃切除3例,1例患者于术后7个月局部复发,因恶病质并全身衰竭死亡,2例术后随访24~60个月,未见复发;胃大部切除5例,1例于术后9个月局部复发,再次行残胃切除术,术后2 a死于肿瘤多器官转移,4例术后随访60个月,未见复发。肠道间质瘤5例均行肠切除吻合术,1例36个月再发肝脏间质瘤,1例94个月再发侧腹膜后间质瘤均再次手术切除,其余3例随访至今,未见肿瘤复发或转移。腹膜后间质瘤4例,1例因高龄且肿瘤巨大,术中失血多导致死亡,其余3例手术切除术后随访至今,未见肿瘤复发或转移。所有病例术后均未行放化疗。结论腹腔间质瘤的诊断以消化道内镜和CT等影像学检查为主,主要治疗手段是手术切除术。

目的探讨胰十二指肠切除术的护理措施。方法回顾分析60例患者的临床资料。结果本组手术均获成功,术后7～12d拆线,患者术后消化功能恢复良好,并发症少,治疗效果良好,均顺利康复出院。结论加强手术后病情的观察和精心护理是非常重要的,护士应熟练掌握术后护理的要点,减少并发症的发生率,提高手术的成功率,促进患者康复。

人性化管理是基于科学的人性化基础上的以人为本的管理。护理管理者要正视护士的合理需求,用亲情温暖和感召护士,尽可能的发挥每个护士工作的积极性、主动性及创造性,使护士在受尊重的前提下自觉自愿地为病人实施人性化护理。实施人性化护理管理,可最大限度地了解和满足护士的合理要求,使其身心愉悦地投入到工作中。

对15例2型糖尿病患者行胃转流术,结果本组研究对象住院12-44d,术后3-5d肛门排气后给予糖尿病流质饮食,术后6-10d给予糖尿病半流质饮食,术后10d左右给予糖尿病普食。术后继续使用小剂量胰岛素,出院后停用且空腹血糖为4.5-9mmol/L。6例空腹血糖为11-13mmol/L,出院后继续口服降糖药。在此提出:对行胃转流术治疗2型糖尿病的患者充分做好围手术期的护理,对于患者术后恢复有着举足轻重的作用。

痔核的外剥内扎手术是一种常见的肛肠手术,术后创面出血也是常见并发症[1]. 但因痔手术而激发上消化道大出血并失血性休克险些造成严重后果的情况则实属罕见.现报道1例:

自Mouret于1987年行第一例腹腔镜胆囊切除术以来,腔镜外科经历了一两年的争论和彷徨,及此后一段轰轰烈烈的发展过程,现在已进入成熟的临床应用.目前就腹腔镜而言,暂且将手术指征放置一边,凡是开腹能作的手术,用腹腔镜都有可能完成.1988年德国外科医师协会已将内镜技术列入外科医师进修课程.美国在全国各大城市和医疗中心建立腹腔镜培训中心,并将之列为医学继续教育计划.近些年我国除在大城市,重点院校医院开展腔镜手术外,许多地区、县区医院也已开展腔镜手术.而我国尚未建立一套完整的腔镜外科医师培训制度和腔镜外科医师审查标准.所以,外科医师必须在作腔镜手术前参加严格的腔镜外科技能培训.

目的:对比小儿外科中不同手术横切口的优缺点。方法:分别使用普通横切口和改良横切口进行手术,观察开关腹时间及出血量有无差异。结果:两组病例手术平均进腹时间、出血量之间对比差异有显著意义;关腹时间之间比较差异无显著意义。结论:小儿外科改良横切口行腹部手术,操作简单,缩短手术时间,损伤小,术后切口美观,并发症少,愈合良好,宜在临床推广应用。

我们于2000-06～2005-02共收治闭合性胰腺损伤患者27例,均采用手术治疗,治疗效果满意,报道如下.

目的探讨门静脉高压症所致的上消化道出血的外科治疗及效果。方法回顾性分析了79例门静脉高压征致上消化道出血的临床资料。结果79例均采用贲门周围血管离断术,止血成功73例,6例术后再次发生大出血并肝肾功能衰竭死亡。结论贲门周围血管离断术是治疗门静脉高压征致上消化道大出血的有效方法,疗效满意。