Objective To investigate the early diagnosis and treatment of acute mesenteric arterial occlusion.Methods The patients with acute mesenteric artery occlusion treated at our hospital from 2008 to 2015 were retrospectively analyzed.Results Among the 18 patients,14 had acute superior mesenteric artery embolism and 4 arterial thrombosis;5 took superior mesenteric artery thrombectomy,6 arterial embolectomy and bowel resection,4 stent implantation through intervention,and 3 gave up the operation and automatically discharged.The case fatality rate was 50.0％.Conclusions The early diagnosis and early release of superior mesenteric artery embolism is the key to increase the cure rate.

目的 探讨髋部骨折早期使用抗凝药物对下肢深静脉血栓发生率的影响,并初步探讨其原因,为临床提供指导方案.方法 2013年3月至2015年6月80例髋部骨折患者,均行手术治疗,其中40例在入院时即开始口服利伐沙班(观察组),术前24 h停药,术后8h开始继续使用;40例在术后8h开始口服利伐沙班(对照组),疗程均为5周.观察两组用药期间不良反应,采用静脉彩超检测血栓发生情况.结果 观察组血浆活化凝血时间(ACT)、D-二聚体水平及血小板聚集率低于对照组(P＜0.05).入院时两组下肢深静脉血栓发生率比较差异未见统计学意义(P＞0.05),而术前和术后5周观察组均低于对照组,差异有统计学意义(P＜0.05).在不良反应方面,两组均未发生致命性大出血,观察组和对照组各出现切口渗血1例,观察组1例出现皮下瘀斑,停药后缓解.切口引流量观察组为(445.5±102.7) ml,对照组为(425.4±121.6)ml,两组比较差异未见统计学意义(P＞0.05).结论 外伤早期口服利伐沙班有利于降低下肢深静脉血栓的发生率,并不提高出血的发生率,其机制与降低血浆ACT和D-二聚体水平有关.

目的:观察胫骨开放性骨折伴骨缺损行一期骨搬移治疗的临床效果.方法:回顾性分析2013年12月至2015年6月本院收治的110例胫骨开放性骨折伴骨缺损患者的临床资料,按治疗所用方法分为两组,对照组48例行常规分期术治疗,观察组62例行一期骨搬移治疗,对比两组患者治疗效果.结果:观察组骨折愈合时间、住院时间与住院费用均比对照组少,且手术次数、植骨病例数与感染病例数均比对照组少,差异具有统计学意义(P＜ 0.05).结论:胫骨开放性骨折伴骨缺损患者行一期骨搬移治疗效果显著,可优化手术相关指标,加速患者骨折愈合.

目的：探讨血糖、血脂水平与胆囊结石发病的关系。方法：对我院初诊为慢性胆囊炎，B超确诊合并胆囊结石的90例患者为观察组，另选取80例健康体检者设为对照组，检查各组餐后2h血糖和血脂水平，并分析胆囊结石患者性别与血脂水平的关系。结果：观察组餐后2h血糖水平高于对照组，差异具有统计学意义（ P＜0．05），血脂指标中甘油三酯、总胆固醇及低密度脂蛋白水平均高于对照组，高密度脂蛋白低于对照组，差异具有显著性（P＜0．05）；胆囊结石女性患者血脂异常增高率明显高于男性患者，差异具有统计学意义（P＜0．05）。结论：血糖和血脂水平异常是慢性胆囊炎合并胆囊结石发病的原因之一，其中女性的异常情况尤为明显，检测血糖、血脂水平有助于预防疾病的发生发展。

Objective:To observe the effect of Lidan Decoction treatment for postoperative gallbladder stones recurrence. Method:93 cases of patients with gallbladder stones were selected and randomly divided into observational group (n=47) and control group (n=46),patients on control group were given routine treatment,and the observational group were given Chinese medicine Lidan Decoction oral.Extraction time of T tube postoperatively,gallbladder contraction function,and rate of stone recurrence and recrudesce were compared between the two groups.Results:Extraction time of T tube postoperatively of observational group was significantly shorter than that of control group (P<0.05),and gallbladder contraction function was significantly better than that of control group (P<0.05);The rate of stone recurrence and recrudesce of observational group was significantly lower than that of control group (P<0.05).Conclusion:The application of Lidan Decoction can effectively prevent postoperative gallbladder stones recurrence and improve the contraction function of gallbladder.

目的 探讨肿瘤坏死因子(TNF)-α和脂多糖水平与重症闭合性损伤患者凝血功能障碍的相关性.方法 随机选取2012年1月至2014年1月诊治的重症闭合性损伤患者65例,出血量＞2000 ml,创伤指数＞17,检测所有患者血清TNF-α和脂多糖水平及凝血功能指标[包括凝血酶原时间(PT)和部分活化凝血酶原时间(APTT)以及血小板(PLT)],采用线性相关分析上述指标的相关性;并根据患者凝血功能指标异常程度分两组[当PT＞ (18.00±5.23)s和APTT＞ (45.00 ±9.20)s时,定义为凝血功能明显异常]:凝血功能明显异常组(46例)和凝血功能轻度异常组(19例).比较两组TNF-α和脂多糖水平的差异.结果 凝血功能明显异常组患者血清TNF-α和脂多糖水平分别为(41.28 ±8.64) ng/ml和(374.23±121.23) U/L,均明显高于凝血功能轻度异常组[(28.64±5.61)ng/ml,(302.65±107.69)U/L,P均＜0.01];进一步线性回归分析发现,脂多糖与APTT、PT呈正相关(r=0.745,0.871,P均＜0.01),与PLT呈负相关(r=-0.815,P＜0.01);TNF-α与APTT、PT呈正相关(r=0.894,0.928,P均＜0.01),与PLT呈负相关(r=-0.785,P＜0.01).此外,痊愈患者APTT、PT水平明显低于死亡患者(P均＜0.0l),PLT水平明显高于死亡患者(P＜0.01).结论 TNF-α和脂多糖与重症闭合性损伤患者凝血功能障碍密切相关,两者可能通过促进血小板及其他凝血因子的大量消耗,参与其凝血功能障碍的发生发展,早期检测TNF-α和脂多糖水平并给予相应治疗将有助于改善患者凝血功能.