目的:探討內鏡下氬離子凝固術(APC)聯合抑酸治療對Barrett食管的臨床療效。方法:選擇經內鏡及病理確診的Barrett食管患者40例,隨機分為兩組,治療組21例,對照組19例,治療組經內鏡下APC治療后聯合埃索美拉唑20mg 2次/日連續3月,對照組單用埃索美拉唑20mg 2次/日連續3月,分別于3月、6月、12月對兩組進行臨床癥狀積分和內鏡及病理隨訪。結果:兩組治療后3、6、12月臨床癥狀積分緩解無明顯差異性(Plt;0.05),但從內鏡、病理隨訪的有效率來看,治療組與對照組相比有顯著差異性(Plt;0.05)。結論:BE內鏡下APC聯合抑酸治療能有效逆轉Barrett上皮,是一種安全、有效的治療方法。
Objective To investigate the gastrin level in patients with type 2 diabetes mellitus (T2DM) with gastroesophageal reflux disease (GERD), and analyze the possible mechanism of gastrin in the pathogenesis of T2DM combined with GERD. Methods Thirty-eight patients with T2DM combined with GERD treated between January 2013 and January 2015 were designated as group A; 40 patients with T2DM only were regarded as group B; 36 patients with GERD only were regarded as group C; and another 40 healthy volunteers who underwent physical examination at the same period were regarded as group D. The fasting serum levels of gastrin were measured and compared among the above four groups. Results The fasting serum level of gastrin was significantly higher in group A [(116.53±22.02) pg/mL] than group B [(101.89±20.76) pg/mL], group C [(90.04±21.16) pg/mL], and group D [(92.48±19.69) pg/mL] (P<0.01). The fasting serum level of gastrin in group B was significantly higher than group C and D (P<0.05). There was no significant difference between group C and D in terms of fasting serum level of gastrin (P>0.05). Conclusions There is a high level of gastrin in patients with GERD combined with T2DM. Abnormal secretion of gastrin may be closely related with the occurrence and development of T2DM and GERD.
【摘要】 目的 探討膠囊內鏡對小腸疾病的診斷價值及順應性和安全性。 方法 分析2009年4月-2010年3月對35例疑有小腸疾病者行膠囊內鏡檢查的臨床資料。 結果 35例中發現小腸病變26例 （74.3%），包括血管畸形9例，間質瘤1例，息肉2例，小潰瘍 1例，非特異性炎癥 11例，寄生蟲2例，其中 4例患者同時存在兩種病變。所獲取的圖像質量良好。膠囊胃內運行平均時間為 62 min（5～460 min），小腸運行時間為 347 min（103～538 min），平均到達盲腸時間為384 min （120～540 min），平均記錄時間為547 min（299～605 min），平均獲取照片數為54 766張，膠囊排出體外時間平均為33 h（10～120 h）。受檢者順應性良好，無任何并發癥發生。 結論 膠囊內鏡是一種對小腸疾病具有較高的檢出能力；其安全性高、順應性好 。【Abstract】 Objective To investigate the diagnostic value of capsule endoscope for small intestine diseases, and to evaluate the compliance and security of capsule endoscopy. Methods The clinical data of 35 patients who underwent capsule endoscopy due to small bowel diseases between April 2009 and March 2010 were retrospectively analyzed. Results In the 35 patients, 26 (74.3%) had intestine diseases including vascular malformation in nine, interstitialoma in one, polyp in two, aphtha in one, non-specific inflammation in 11 and parasite in two; 4 patients had two lesions simultaneously. The quality of the obtained images was good. The average running time of the capsules in the stomach ranged from five to 460 minutes with an average time of 62 minutes. The running time of the capsules in the small intestine ranged from 103 to 538 minutes with an average of 347 minutes. The running time of the capsules arriving at the cecum ranged from 103 to 538 minutes with an average of 347 minutes. The time of the capsules egested out ranged from 10 to 120 hours with an average of 33 hours. The recording time ranged from 299 to 605 minuets with an average of 547 minutes. The mean acquired images were 54 766 pieces, The patients had good compliance, and none had any complications. Conclusion The capsule endoscopy had high security and good compliance. It has high detectivity in diagnosing small intestine diseases.
ObjectiveTo summarize the injury characteristics and therapeutic strategy of patients injured in " 8·8” Jiuzhaigou earthquake.MethodsThe clinical data of 48 patients injured in " 8·8” Jiuzhaigou earthquake who were admitted to Mianyang Central Hospital were analyzed retrospectively. There were 25 males and 23 females with an average age of 36 years (range, 5-87 years). The average interval from injury to admission was 30 hours (range, 3-53 hours). The patients from Sichuan province accounted for 45.8% (22 cases), from other province for 52.1% (25 cases), and from abroad for 2.1% (1 case). Patients were primarily hurted by collapsing houses and flying stones. Thirty-seven patients (77.1%) had single injury, mainly involving 36 patients (75.0%) in limbs, and the other 11 patients (22.9%) had multiple injuries. Ten patients (20.8%) had open fractures, including 1 case rated as typeⅠ, 2 as typeⅡ, 3 as type Ⅲa, 2 as type Ⅲb, and 2 as type Ⅲc according to Gustilo classification criteria. The abbreviated injury scale (AIS) score was 2-3 in 37 patients of single injury, and the injury severity score (ISS) was 8-22 (mean, 13.2) in 11 patients of multiple injuries. Sixteen patients (33.3%) were diagnosed as mental disorders by Hamilton rating scale for anxiety (HAMA), including 8 cases had their anxiety scores≥29, 4 cases of 21-28, 3 cases of 14-20, and 1 case of 7-13. Of the 16 patients, 2 showed suicidal tendency.ResultsExcept 2 referrals, 30 patients received operation［28 patients (93.3%) for orthopaedic surgeries］and 16 patients received conservative treatment. The procedures included internal fixation, soft tissue debridement, external fixation, bipolar femoral head replacement, embolization of carotid cavernous sinus arteriovenous fistula, and amputation. Among the 46 patients treated in this hospital, 21 discharged from hospital at 2-12 days (mean, 6.7 days) after admission, the others received further rehabilitation in this hospital or local hospital. No undesirable consequence occurred in 16 patients with mental disorders. Five cases of infection occurred out of hospital were cured after debridement. No dead and nosocomial infection case reported.ConclusionIntensive treatment, specialist management, multidisciplinary team, and early intervention of nosocomial infection and deep venous thrombosis are the key to improve the general level of successful earthquake medical rescue.