目的 探讨电化学疗法(EChT)对肝海绵状血管瘤(CHL)的治疗价值。方法 应用EChT在剖腹下治疗8例CHL，17个瘤灶。1例合并结节性肝硬变，5例为多发性CHL，14个瘤灶。结果 治疗过程中肝出血量均不超过20 ml。术后无胆漏、腹腔内出血、黄疸、气体栓塞等并发症产生。治疗后随访5～7年，无1例出现瘤灶复发。结论 EChT是治疗CHL的安全而有效的新方法，适合伴有背景肝病的CHL和多发性CHL的治疗，且易于在基层医院推广。
Objectives To investigate the diagnosis and laparoscopic surgical treatment methods of calculus of cystic duct. MethodsThe clinical data of 147 patients with calculus of cystic duct underwent laparoscopic cholecystectomy (LC) in the Second Affiliated Hospital of Wenzhou Medical College from June 2008 to June 2013 were analyzed retrospectively. ResultsAmong the 147 patients with calculus of cystic duct, 19 cases were given preoperative diagnosis by B-ultrasound and CT scanning, 128 cases were found by exploration in operation; 146 cases underwent LC successfully and 1 case was converted to laparotomy.The 147 cases were followed-up for 3 months to 2 years with an average of 7 months and all cases were out of bile duct injury, hemorrhage, bile leakage, residual calculi or other complications. ConclusionsPreoperative diagnosis of calculus of cystic duct is difficult, meanwhile, routine intraoperative probe is very necessary for the diagnosis of calculus of cystic duct.Proficiency in surgical technique with laparoscopic treatment of calculus of cystic duct is the key to the success of LC.
目的总结胰岛细胞增生症的诊治经验，探讨手术范围及手术方式。方法对我科收治的1例胰岛细胞增生症患者的资料并结合文献资料进行分析。结果本例患者首次行胰体尾切除术，术后2个月复发，再次行保留脾脏的胰远端次全切除术。两次术中均快速冰冻切片及术后病检证实为胰岛细胞增生症，随访1年无复发。结论术前诊断为胰源性低血糖但影像学无异常时，应高度怀疑为胰岛细胞增生症。术中快速冰冻切片病检，门静脉连续血糖及免疫反应性胰岛素(IRI)监测可指导诊断和手术切除范围，而胰远端95%次全切除安全可行，疗效肯定。