Perioperative management of 58 hypertensive patients suffering from surgical disease is reported. We emphasize that before operation the blood pressure should be adequately controlled, and heart function promoted. It is safer that the diastolic pressure is controlled under 14 kPa before operation. During operation we strictly observe the change of the blood pressure and manage it in time. Analgesic and antihypertensive agents are used after operation.
Abstract: Due to complicated procedures and severe trauma, esophagectomy still remains an operation with high mortality and morbidity. With the advancement of anesthetic and surgical technique, as well as perioperative management, the mortality and morbidity after esophagectomy decreased significantly in recent years. The optimal perioperative management, normalized and individualized treatment was of importance in preventing postoperative complications and decreasing mortality after esophagectomy. This review summarizes the current state of perioperative management for esophagectomy.
Objective To investigate the peroperative treatment of cranio-orbital tumors and the method of the reconstruction of the skull base. Methods Between April 2008 and April 2011, 35 patients with cranio-orbital tumor were treated. There were 21 males and 14 females, aged 17-73 years (mean, 46.3 years). The first symptoms were orbital pain in 13 cases, hypopsia in 12 cases, exophthalmos or abnormal eye position in 5 cases, headache and dizziness in 2 cases, di plopia in 2cases, and pulsating eyeball in 1 case. Some of the patients needed resecting the zygomatic arch, supercil iary arch, and orbit roof. The autogenous bone, titanium net, frontal bone periosteum, biogel, and artificial meninges were used to reconstruct the skull base. Results Tumors were resected by one-stage operation, and the anterior skull bases were reconstructed. Postoperative MRI indicated that total removal of tumors was achieved in 30 cases, subtotal in 3 cases, and partial in 2 cases at 3 days. There was no operative death. Cerebrospinal rhinorrhea and infection occurred at 1 week in 1 and 2 cases respectively, and were cured after lumbar drainage and antibiotics. The patients were followed up 6 to 36 months (mean, 18 months). In patients having hypopsia, the visual function was improved in 9 cases at 1 month; in patients having orbital pain, pain rel ief was achieved at 2 weeks after operation; in patients having exophthalmos or abnormal eye position and pulsating eyeball, sympotoms disappeared after operation. In 27 patients with benign tumor, 24 were cured, without recurrence during follow-up; in 8 patients with mal ignant tumor, 6 had recurrence within 18 months and underwent second operation or radiotherapy, 2 relapsed cases died of cerebral hernia and respiratory circulating failure at 24 months after operation. No complication of enophthalmos, pulsating exophthalmos, or collapse of zygomatic region occurred. Conclusion Using the autogenous bone, titanium net, frontal bone periosteum, biogel, and artificial meninges to reconstruct the skull base has rel iable foundation, simple operation, and easy anatomical reconstruction, so it is an effective method after the removal of cranio-orbital tumors; better effectiveness would beobtained when combining with the peroperative nursing.
目的:探讨脊柱结核一期内固定手术的围手术期处理方法。方法:一期手术治疗脊柱结核患者68例。围手术期处理主要包括正规化疗、围手术期营养支持、选择正确的手术时机、术后支具保护下逐步功能锻炼、定期随访、监测药物副作用等。结果:68例患者切口均一期愈合,无窦道形成。平均2.2 年随访,结核治愈、后凸畸形纠正,10 例患者出现化疗相关的并发症对症或调整药物后症状控制。结论:正确的围手术期处理是脊柱结核手术成功的重要保证。.
摘要:目的:探讨老年人梗阻性大肠癌的围手术期处理。方法:回顾性分析2003年至2008年间71例60岁以上老年人梗阻性大肠癌的围手术期处理情况。 结果:术前发现并存病者43例,术中出现并发症19例,术后发生并发症37例得,除5例死亡外,均得到有效控制,死亡原因与并存疾病有关。结论:加强围手术期处理,积极治疗并存疾病,老年人梗阻性大肠癌的治疗同样能取得满意的效果。Abstract: Objective:To study the perioperative measures for the aged patients with Obstructive Colorectal Cancer. Methods: Seventyone cases above 60 years with Obstructive Colorectal Cancer were analysed retrospectively on their individual accompanied diseases and perioperative treatments, from 2003 to 2008.Results: Fortythree cases of them had suffered from other diseases. Midoperative complications occurred in 19 cases. Postoperative complications occurred in 37 cases. Except 5 cases of death, complications occurring in others cases were well controlled. The death causes mainly were correlated with accompanied chronic diseases. Conclusion: Strengthen care, active management of other chronic diseases are important significantly for senile patients with colorectal carcinoma to get satisfied outcome.
目的 探讨围手术期处理措施在胆管损伤（BDI）治疗中的作用。方法 分析我院1990年7月至2008年7月期间46例BDI患者的临床资料。结果 46例BDI患者术中发现32例，术后发现13例，1例外伤所致。2例BDI患者行二期胆管修复术后，死于漏胆引起的弥漫性腹膜炎及全身衰竭，1例十二指肠降部憩室手术胆胰管损伤死于并发症，2例胆肠吻合因反复胆管炎死于全身衰竭。结论 除手术措施外，围手术期处理措施对BDI预后有重要影响。应及时发现并处理BDI，术中胆管造影对诊断和治疗有指导意义，术后发现BDI并严重腹腔感染者，围手术期应选择恰当的非手术处理措施有效控制病情后决定手术时机。