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    find Author "李俊" 38 results
    • 乙狀結腸腸脂垂致嵌頓性閉孔疝1例報告

      患者,女,71歲。因反復左大腿前內側脹痛1年,加重半月入院。疼痛放射至左膝部伴酸脹、麻木,持續時間不等,休息能自行緩解。左髖、膝關節疼痛,活動稍受限。近半月持續疼痛不能緩解,無腹脹、腹痛、惡心、嘔吐、便秘。查體: 全腹平軟,無壓痛、反跳痛,腸鳴音正常。左腹股溝區未捫及明顯腫塊。直腸指檢于左閉孔管內口處捫及一索狀包塊、壓痛。伸髖關節及旋轉運動時加重,即HR征(+)。考慮為左閉孔疝。在持續硬膜外麻醉下,取下腹正中切口,行剖腹探查,術中見左閉孔處有一直徑約1.2 cm盆腹膜缺損,鄰近乙狀結腸壁上有三枚腸脂垂簇集,約1 cm×1.5 cm×1 cm大,其中兩枚呈暗紅色,略腫脹,腸脂垂中部有嵌頓跡象,一枚外觀正常。探查乙狀結腸、左附件、膀胱及小腸未見異常。考慮為此2枚腸脂垂嵌入左閉孔疝囊中所致。術中因麻醉后閉孔疝環松弛,故見腸脂垂自行還納腹腔,未再嵌入。遂將此3枚腸脂垂切除送病檢。然后探查閉孔疝囊,約1 cm×2 cm大,將疝囊切除,用絲線間斷縫合修補閉孔環。檢查無出血后關腹。

      Release date:2016-08-28 04:49 Export PDF Favorites Scan
    • 結腸腺癌合并原發性肝癌骨轉移1例

      Release date:2016-09-08 09:56 Export PDF Favorites Scan
    • The valuation of quantitative lung data of vibration response imaging in diagnosis of obstructive lung diseases

      Objective Vibration response imaging(VRI) is a new lung sound imaging technology.It provides quantitative lung data(QLD) of vibration in respiratory system.The study is to explore the value of QLD in diagnosis of obstructive lung diseases.Methods The QLD of 61 chronic obstructive pulmonary disease(COPD) patients,58 asthma patients and 64 healthy volunteers were reviewed.The QLD were transferred to abnormity and variation by a formulation and were analyzed.Results The mean QLD of healthy volunteers were 8.4,14.5,22.0,11.1,18.5,25.5 with mean abnormity as 10.0 and mean variation as 2.0.The mean QLD of the COPD patients were 11.6,16.7,21.9,12.6,17.2,20.1 with mean abnormity as 47.1 and mean variation as 10.9.The mean QLD of the asthma patients were 12.8,17.2,19.9,13.3,17.5,19.3 with mean abnormity as 58.1 and mean variation as 12.2.The abnormity and variation of the patients were different from those of volunteers(Plt;0.05).When abnormity≥20.0 or variation≥5.0 was define as threshold value,the specificity was 87.5%.The diagnosis sensitivity for COPD is 82.0% and sensitivity for asthma is 82.8%.Conclusion COPD and asthma patients can be detected by quantitative lung data from vibration response imaging.

      Release date:2016-09-14 11:56 Export PDF Favorites Scan
    • 星狀神經阻滯致臂叢神經長時程阻滯一例

      Release date:2016-09-08 09:25 Export PDF Favorites Scan
    • 膽囊殘株炎23例診治體會

      Release date:2016-08-28 04:47 Export PDF Favorites Scan
    • CT Guided Transpedicular Biopsy in Diagnosing Vertebral Body Lesions

      【摘要】 目的 探討CT引導下經椎弓根穿刺活檢對椎體病變的診斷價值及可行性。 方法 回顧性分析2009年5月—2010年4月42例椎體病變患者經椎弓根穿刺活檢的穿刺活檢方法、病理結果、最終診斷及穿刺并發癥。 結果 患者總穿刺準確率為95.2%(40/42)。其中惡性病變的穿刺準確率為94.3%(33/35),良性病變穿刺準確率為100%(7/7);所有患者均未發生嚴重穿刺并發癥。 結論 CT引導下經椎弓根穿刺活檢診斷椎體病變有安全可靠、準確性高等特點。【Abstract】 Objective To explore the value and the feasibility of CT guided transpedicular biopsy in diagnosing vertebral body lesions.  Methods From May 2009 to April 2010, 42 patients with vertebral body lesions underwent CT guided transpedicular biopsy. The clinical data including the puncture method, pahtological resutls, final diagnosis, and the pucture complications were retrospectively analyzed.  Results The total accuracy rate of the puncture was 95.2%(40/42). The accuracy rate of the puncture was 94.3% (33/35) for malignant lesions and 100.0% (7/7) for benign lesions. No complication occurred.  Conclusion CT guided transpedicular biopsy is very helpful in diagnosing vertebral body lesions with high accuracy and fewer complications.

      Release date:2016-09-08 09:26 Export PDF Favorites Scan
    • 外傷性氣管、支氣管斷裂18例

      Release date:2016-08-30 05:59 Export PDF Favorites Scan
    • B SCAN ULTRASONIC EXAMINATION IN INFECTIOUS ENDOPHTHALMITIS IN CHILDREN

      PURPOSE:To evaluate the B sean ultrasonic examination in diagnosis and prognosis of infectious endophthalmitis in children. METHODS:The hospital records of 44 children with infectious endophthalmitis were retrospectively analysed. The correlation between the initial B scan eehographic findings and the initial vision and the vision at discharge were analysed by t-test. RESULTS :The average visual, acuity was hand moving on admission,and 0.04 at discharge. Both the final vision and the initial vision were associated with the severity of vitreous opacity. The ultrasonic findings including retinal detachment and choroidal detachment were associated with poor vision outcomes. CONCLUSION :The ocular B scan ultrasonic examination was effective to predict the final vision in infectious endophthalmitis in children. (Chin J Ocul Fundus Dis,1997,13: 134-135)

      Release date:2016-09-02 06:12 Export PDF Favorites Scan
    • Efficacy of jejunostomy combined with Ivor-Lewis or McKeown operation in the treatment of middle and lower esophageal cancer: A retrospective cohort study

      ObjectiveTo investigate the effect of jejunostomy combined with Ivor-Lewis or McKeown operation on the treatment of middle and lower esophageal cancer.MethodsThe clinical data of 127 patients with middle and lower esophageal cancer admitted to our hospital from June 2018 to October 2019 were retrospectively analyzed, including 89 males and 38 females, aged 62.82±8.65 years. The patients were divided into an Ivor-Lewis group (IL group, 72 patients) and a McKeown group (MK group, 55 patients) according to surgical methods. Patients in the IL group received jejunostomy combined with Ivor-Lewis operation, and patients in the MK group received jejunostomy combined with McKeown operation. The operation time, postoperative bedside electrical impedance tomography (EIT) parameters, postoperative inflammatory factor levels, postoperative complications and rehabilitation of the two groups were compared.ResultsThe operation time (262.65±49.78 min vs. 303.04±60.13 min), postoperative eating time (10.54±2.22 d vs. 11.47±2.49 d) and postoperative hospital stay (14.78±2.47 d vs.15.72±2.36 d) in the IL group were significantly shorter than those in the MK group (P<0.05). The blood loss (156.13±52.43 mL vs. 158.87±48.47 mL) and the number of lymph node dissection (29.47±8.88 vs. 30.17±9.80) in the IL group were less than those in the MK group, but the differences were not statistically significant (P>0.05). The repeated measurement analysis of variance showed that the time point could significantly affect tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-8 levels (Ftime point=520.543, 272.379, 147.688, all P<0.05), but the surgical methods and the interactive effect of time point and surgical methods did not affect the levels of TNF-α, IL-6 and IL-8 (P>0.05). Postoperative bedside EIT image parameters were statistically different on the postoperative 1 d, 3 d, 5 d and 7 d between the two groups (P<0.05). Compared with the MK group, the incidences of recurrent laryngeal nerve injury, arrhythmia, pulmonary infection and atelectasis, anastomotic leakage, gastric wall necrosis and stump fistula, secondary thoracotomy and abdominal hemostasis, and intestinal obstruction were lower, but the differences were not statistically different (P>0.05). The recurrence rate of patients in the IL group within 6 months was lower than that in the MK group, but the difference was not statistically significant (8.33% vs. 9.09%, P>0.05).ConclusionJejunostomy combined with Ivor-Lewis or McKeown surgery have equivalent effects on patients with middle and lower esophageal cancer.

      Release date:2021-10-28 04:13 Export PDF Favorites Scan
    • Clinical Outcome of n-HA/PA66 Composite Artificial Vertebral Body in Anterior Reconstruction of Cervical Intervertebral Disc Herniation

      【摘要】 目的 探討納米羥基磷灰石/聚酰胺66(nano-hydroxyapatite polyamide66,n-HA/PA66)頸椎融合器在頸椎間盤突出癥前路手術重建中的臨床療效。 方法 2008年12月-2010年6月,對14例頸椎間盤突出癥患者行前路椎間盤切除、椎管減壓,以n-HA/PA66椎間融合器支撐植骨、鋼板螺釘內固定治療。隨訪時間3~12個月,平均6.3個月;隨訪時以日本矯形外科學會(Japan Orthopaedic Assoctiation, JOA)評分改善率評價患者神經功能恢復情況,復查X線片評估椎間融合器植骨融合情況,包括椎間高度及椎間融合器下沉情況。 結果 14例患者均成功完成頸椎前路減壓手術以及椎間融合器的安放固定。所有患者術前癥狀均得到不同程度的改善,術后3、6、12個月的JOA改善率分別為87.0%、94.0%、97.0%。影像學檢查顯示所有患者植骨融合,椎間高度及椎間融合器的位置維持良好,無下沉、移位。 結論 n-HA/PA66頸椎間融合器具有早期支撐穩定功能,可有效維持頸椎椎間高度;術后植骨融合率高且便于X線片觀察,是頸椎間盤突出癥患者前路手術植骨的理想支撐材料,但長期效果需進一步隨訪觀察。【Abstract】 Objective To evaluate the clinical effect of artificial cervical vertebra fusion apparatus of n-HA/PA66 in anterior reconstruction of cervical intervertebral disc herniation. Methods From December 2008 to June 2010, 14 patients with cervical intervertebral disc herniation underwent anterior cervical discectomy,spinal canal decompression,spinal canal decompression and reconstruction by n-HA/PA66 composite artificial vertebral body combined with plate instrumentation. The patients were followed up for 3 to 12 months with an average of 6.3 months. Neurological function was evaluated by improvement rate of JOA score and situations of the supporting body was observed by X-ray in 3,6,and 12 months after the surgery.The intervertebral height,the 1ocations, and the fusion rate of the supporting body were assessed in order to evaluate the stability of the cervical spine and alignment improvements. Results All the patients had undergone the operation successfully.The preoperative symptoms improved to varying degrees.JOA improvement rate were 87.0%, 94.0%, and 97.0% 3,6,and 12 months after the operation,respectively.Imaging studies showed that in all cases graft fusion were achieved,and cervical alignments,intervertebral height,cervical spine stability and the locations of the artificial vertebral body were well maintained.No displacement and subsidence of the artificial vertebral body occurred. Conclusion n-HA/PA66 artificial vertebral body can provide early cervical spine support and stability and cervical intervertebral height.It has a high rate of graft fusion and is convenient to observe by X-ray.Therefore,n-HA/PA66 can be taken as an ideal graft for anterior degenerative cervical spine operation,but further follow-up study is still needed to evaluate the long-term effects.

      Release date:2016-09-08 09:52 Export PDF Favorites Scan
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  • 松坂南