目的 总结术中胆道造影的应用体会。方法 回顾性分析甘肃省中医院2000年5月至2007年12月期间进行术中胆道造影151例患者的临床资料。结果 所有患者术中胆道造影均顺利完成。经胆囊管造影成功者75例，其中有65例将软管直接置入胆囊管中造影，有10例经钢针穿刺胆囊管造影； 有4例直接穿刺胆总管造影； 经T管造影者72例，均直接从T管内注入造影剂。本组151例手术患者均1次完成手术，没有残余结石或术后胆管损伤的发生。结论 术中胆道造影可避免残余结石及胆管损伤的发生。
ObjectiveTo evaluate feasibility and clinical effect of individual therapy for venous ulceration of lower extremity. MethodsFrom February 2012 to February 2014, 360 cases (totally 421 lower limbs) treated by the individual therapy were analyzed retrospectively. There were 126 male and 234 female patients, with a mean age of 53 years (ranging from 45 to 78 years). The venous ulceration occurred in left limb for 176 cases, right limb for 123 cases, and both limbs for 61 cases. The individualized treatment plans were performed for all the patients according to the color Doppler before the operation. The perforating vein was ligated during the operation, and elastic stockings were wore after operation. The operation time, postoperative VAS pain score, perioperative complications, ulcer healing and recurrence were recorded. ResultsThe operations were completed in all the patients, the average operation time was 35 min. The average VAS pain score was 2.6 at 8 h after operation, the pain was disappeared nearly at 24 h after operation. The time of returning to normal activity was 3 d. The incision bleeding occurred in 5 cases, the ulcer infection occurred in 32 lower limbs. The patients were followed-up for 12 months to 24 months, all the ulcers were healed, there were 9 cases of recurrence. ConclusionIndividual therapy for venous ulceration of lower extremity is safe, effective, fewer complications, fast ulcer healing, and less postoperative pain.
ObjectiveTo study a new method for establishing the rat model of incomplete adhesive intestinal obstruction. MethodsThe serosal stripping method was adopted, the general health condition changes of rats were observed on day 3, 5, and 7 after modeling, meanwhile the weight was measured, the superior mesenteric artery flow velocity and small intestine wall thickness were observed via the color Doppler ultrasound and orthostatic X ray. The level of D-lactate acid in the blood plasma, and the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in the intestine tissue were tested. The pathological changes of the intestine tissue were observed. ResultsCompared with the normal group (no treatment was done), the general health conditions of rats were worse, the weight significantly decreased (Plt;0.01), the superior mesenteric artery blood flow velocity significantly increased and small intestinal wall was thickened (Plt;0.05, Plt;0.01), airfluid level or a great deal of seroperitoneum and pneumatosis flat appeared via orthostatic abdominal X-ray, the level of D-lactic acid in the blood plasma and the content of MDA in the intestine tissue significantly increased on day 5 after modeling (Plt;0.05, Plt;0.01), the activity of SOD in the intestine tissue significantly decreased on day 7 after modeling in the model group (Plt;0.05). The pathological changes consistented with adhesive intestinal obstruction via pathological observation. On the 7th day, the rat model of incomplete adhesive intestinal obstruction was successfully built . ConclusionThe rat model of incomplete adhesive intestinal obstruction is completed by serosal stripping method.
ObjectiveThis study is designed to explore the indications, clinical pathway, and benefits of ultrasound-guided local anesthesia in radiofrequency endovenous obliteration (RFO) for great saphenous vein varices (GSV).MethodsA total of 350 patients diagnosed with GSV were divide into observation group (n=175) and control group (n=175). Patients in the observation group underwent local anesthesia RFO, and patients in the control group underwent intravertebral anesthesia. Comparion in the visual analogue scale pain scores (VAS) when anesthesia and after surgery, operative indexes, recovery time, satisfaction, and complications were performed.ResultsCompared with the control group, the VAS score with anesthesia time were lower (P<0.05), while in the surgery were higher (P<0.05), as well as the operative time, the first time for underground activity, normal activity time, incidences of complication of anesthesia and urinary were shorter (P<0.05), and the satisfaction rate was higher (P<0.05). There was no difference in the pain score of 12 h and 24 h after surgery, blood loss, volume of anesthetic swelling fluid, postoperative hospitalization, incidences of urinary tract infection, incisional infection, and deep vein thrombosis (P>0.05).ConclusionsThe RFO is feasible and safe after local anaesthesia. It can decrease the complication of anesthesia, that will promote the patient soon to be restored to health.