【摘要】目的探讨肝移植术后再次腹部手术的围手术期处理。方法对7例肝移植术后再次腹部手术患者的资料进行回顾性分析。结果5例择期手术患者围手术期平稳，痊愈出院。2例急诊手术患者中1例术后因并发上消化道应激穿孔、出血和切口感染自动出院。结论肝移植术后再次腹部择期手术的风险较急诊手术者低，与非肝移植行类似手术者相仿。
【摘要】 目的 探讨腹部闭合性损伤的外科急救方法。方法 2003年1月—2009年1月收治200例腹部闭合性损伤患者,根据病史、体征、辅助检查等做出诊断后,在确保重要器官血流供应的基础上进行外科手术治疗。结果 治愈187例,治愈率93.5％；死亡13例,9例患者死于多脏器受损引起的出血性休克,2例脾破裂患者因失血过多术中死亡,2例患者因合并颅脑损伤形成脑疝死亡。结论 对于腹部闭合性损伤患者,应快速准确地根据病史、体征、辅助检查等做出诊断,进行积极外科急救治疗。有效控制出血,保证重要器官血液供应,是外科急救能否成功的关键。
ObjectiveTo investigate the clinical features and strategy of diagnosis and treatment of the abdominal trauma in elder people. MethodsClinical data of 68 elderly patients with abdominal trauma were analyzed retrospectively.ResultsDiagnosis in 35 of 68 cases were confirmed within 12 hours after trauma (51.5%). Fiftyeight cases in this group were treated surgically and 10 cases with nonsurgical treament.There were 7 death, the overall mortality was 10.3%. The cause of death was septic shock and multiple organ systemic failure. ConclusionThe elder patient with abdominal trauma has its speciality in clinical and pathophysiological characteristics and is less tolerant to trauma, which easily leads to misdiagnosis or maldiagnosis. The principle of treatment is to choose positive surgery, to streng then the perioperative management, to protect the function of each important organ, and to prevent the occurrence of multiple organ dysfunction syndrome.
目的:分析汶川8.0级大地震致腹部外伤的患者的心理问题并探索其护理对策。方法:以汶川8.0级大地震致腹部外伤的19名患者为暴露组,普通患者20名和医务人员19名作为对照组。由3名医护人员运用汉密顿抑郁量表进行调查和分析。结果:地震伤员在睡眠质量、精神焦虑、抑郁情绪等3个方面与普通患者及医务人员比较有明显异常。结论:地震致腹部外伤患者的心理影响明显大于普通患者及医务人员,应进行及时有效的心理干预护理,以控制和减缓其心理问题。
目的:探讨四川汶川地震腹部损伤伤员CT表现及其诊断价值。方法:对我院因汶川地震受伤,需做腹部CT的伤员27例的治疗,进行CT分析。结果:在本组腹部损伤伤员中, 肝脏病变7例,胆囊病变2例,胰腺病变11例,脾脏病变8例,肾脏病变11例,腹腔积液6例,腹腔积气9例,胃肠道病变8例,子宫病变1例。部分伤员为两个或两个以上器官受累。结论: CT检查结合临床治疗能快速、准确、有效的对地震腹部损伤伤员进行判断,对临床诊治具有重要作用。
目的探讨腹腔镜在腹部外伤诊断与治疗中的应用价值。方法 对36例腹部外伤患者行腹腔镜探查术，首先明确诊断，根据不同的损伤脏器和类型，进行腹腔镜下处理，处理困难或无效时及时中转开腹。结果本组病例术中均明确诊断。10例开放性腹部外伤中，胃破裂伤2例，肝裂伤2例，脾破裂1例，小肠破裂伤2例，大网膜损伤1例，肠系膜血管破裂1例，单纯腹壁裂伤1例。26例闭合性腹部外伤中，胃破裂2例，肝破裂7例，脾破裂12例，小肠破裂2例，肠系膜血管破裂1例，单纯腹膜后血肿2例。于腹腔镜下行缝合、修补、电凝、明胶海绵止血等治疗20例（55.6%），10例（27.8%）未做特殊处理，6例（16.6%）中转开腹。本组病例术中出血量为55~1 800 ml（平均520 ml），手术时间为60~186 min（平均128 min）。 所有病例均放置腹腔引流2~5 d（平均3 d），住院时间3~16 d（平均9 d）。全组均无气腹相关并发症和死亡病例。结论腹腔镜诊治腹部外伤具有创伤小、诊断率高、恢复快等优点，大部分病例还可在腹腔镜下达到诊治一体化的目的。
ObjectiveTo investigate the necessity of subcutaneous suture for gynecologic abdominal incision, and to prove the clinical value of suture without subcutaneous ligature. MethodsWe retrospectively studied the clinical data of 210 cases of gynecologic abdominal incision treated between May 2010 and May 2013. A total of 111 cases had the suture without subcutaneous ligature and 99 received the traditional suture. ResultsOne patient (0.90%) had fat liquefaction in the group of suture without subcutaneous ligature, while 7 (7.07%) of fat liquefaction were found in the traditional suture group, and the difference was statistically significant (χ2=3.883, P=0.049). No hospital infection occurred. The healing period averaged (15.1±4.7) days, and the patients were followed up for 2 months without any complication of abdominal incision in all the patients. ConclusionSuture without subcutaneous ligature is simple and easy to practice, with precise effect, which deserves clinical application.
【摘要】 目的 探讨多层螺旋CT血管造影（MSCTA）对腹部巨大肿块定位定性的诊断价值。 方法 收集2005年6月-2009年12月98例腹部巨大肿块，作MSCTA检查，观察供血动脉来源和肿块与血管关系。 结果 98例肿块发现有主要供血动脉76例，其中恶性肿块69例，血管受侵改变51例。 结论 由于MSCTA快捷、无创、经济、方便、空间分辨率高等优点，对腹部巨大肿块定位定性有较高诊断价值。【Abstract】 Objective To investigate the diagnostic value of multislice CT angiography (MSCTA) to abdominal huge mass from June 2005 to December 2009. The relation among blood vessel and supply origin and tumor was analyzed. Methods MSCTA was performed in 98 cases with abdomenial huge mass. Results The feeding artery of mass was discovered in 76 cases, in which malignant tumors were confirmed in 69 cases, the vessels were encroached on in 51 cases. Conclusion MSCTA may be of high value to diagnose abdominal huge mass because of noninvasiveness, convenience, and high resolution.