目的 总结分析普通B超监测引导PTCD方法改进后的优点及经验。方法 用普通B型超声诊断仪，腹部扇扫探头和国产配套的专用PTCD套针及引流管，改进监测引导PTCD的方法，总结分析其方法的优越性。结果 95例梗阻性黄疸患者PTCD成功率为100%，引流效果良好，并发症发生率为零。结论 用改进普通B超监测引导的方法进行PTCD，能克服在X线下进行PTCD的盲目性，对碘过敏者无禁忌，避免了长时间X线对人体的伤害。同时具有定位准确、费时少、成功率高、并发症少、价格便宜、适宜在基层医院推广应用等优点。
Objective To summarize clinical application status of auxiliary heterotopic liver transplantation. Methods Reviewed relevant literatures and made a summary. Indications, contraindications, surgical treatment, therapeutic efficacy, and existing problems of auxiliary heterotopic liver transplantation were summed up. Results Main indication of auxiliary heterotopic liver transplantation is fulminant liver failure, and with no absolute contraindications. Partial liver transplantation is more popular. The therapeutic efficacy of auxiliary heterotopic liver transplantation is confirmed, but there are still some problems needed to be solved. Conclusion Auxiliary heterotopic liver transplantation is an effective method and replacement therapy for acute and chronic liver failure.
【摘要】目的 总结分析原位背驮式肝移植手术后并发症与供肝修整的关系。方法 回顾性分析我院12例行原位背驮式同种异体肝移植患者的资料。结果 本组12例肝移植围手术期无死亡； 手术成功率为100%。12例中行动脉血管变异整形2例，门静脉搭桥吻合1例； 各韧带修剪后缝合7例，未缝合5例。手术后发生腹腔内出血3例，其中2例与供肝修整有关，即修肝时各韧带未仔细缝合及结扎而导致细小血管出血，另1例系凝血功能障碍所致； 在供肝修整中注意了血管的变异整形及胆管的血供，术后无动脉及门静脉血管并发症和胆道并发症发生。结论 修肝质量的好坏，直接关系到术中植肝时手术操作的难度、术后供肝的存活质量、并发症的发生和患者的康复。
目的 分析重症急性胰腺炎（SAP）并发症发生的原因，拟定最佳治疗方案，减少对预后的影响。方法 对1992～2001年收治的35例SAP进行回顾性分析，观察其胰腺病理改变、治疗方式、并发症及其预后间的关系。结果 ①胰周积液者无死亡； ②胰腺组织坏死伴感染时易发生胃肠瘘，创面开放和闭合引流与胃肠瘘的发生无明显关系（Pgt;0.05）； ③4例胰周积液者有胰腺假性囊肿形成； ④胰周积液无感染者平均住院时间为19 d，胰腺及胰周组织坏死者住院时间gt;49 d。结论 急性呼吸窘迫综合征、腹腔脓肿、肠瘘及胰瘘是SAP的主要并发症，可影响其预后。
Objective To study the clinical anatomical basis of the liver hanging maneuver through research of applied anatomy. Methods Retrohepatic portions of the inferior vena cava of 21 cadaver were observed intracavitarily, and the numbers of short hepatic vein (SHV) opening were counted based on different possible pathway of the liver hanging maneuver and different width of retrohepatic tunnel (10 mm, 6 mm). Results The number of SHV was 0 to 3 (median=1) using standard pathway of the liver hanging maneuver in 6 mm retrohepatic tunnel, and the number of SHV was 0 to 2 (median=0) using EM pathway that was on the right border of retrohepatic portion of the inferior vena cava and 1 cm away from the inferior border of liver. There was a significant difference between the EM pathway and standard pathway, P=0.003.Conclusion The results show that setting up a retrohepatic tunnel through the liver hanging maneuver is feasible and safe.