【摘要】目的探索內鏡直視下應用帶膜記憶合金支架對晚期食管、賁門惡性狹窄的介入治療方法。方法2005年1月2009年11月對49例失去手術機會或拒絕手術的晚期食管癌或賁門癌致食管或賁門狹窄患者,行電子胃鏡引導下放置鎳鈦合金支架;對狹窄程度重、胃鏡不能通過者,先行Savary探條擴張再放置支架。結果49例均成功置入支架,解除狹窄有效率達100%。結論內鏡直視下帶膜支架置入操作方法簡便、安全,可改善患者的生存質量,延長生存時間。
Objective To compare the clinical efficacy and safety of suturesuspension single hole laparoscopic cholecystectomy and traditional laparoscopic cholecystectomy (LC) in the treatment of gallbladder disease. Methods A total of 86 cases who got treatment in our hospital from February 2014 to July 2015 were collected prospectively, and then 86 cases were divided into 2 groups: 43 cases of control group underwent LC and 43 cases of experimental group underwent suturesuspension single hole laparoscopic cholecystectomy. Clinical efficacy and safety of the two groups were compared. Results ① Complication. No one suffered from bile duct injury, bile leakage, bile duct stricture, and umbilical hernia; but there were 2 cases suffered from complications in control group, including 1 case of abdominal pain and 1 case of bloating, and the morbidity was 4.65% (2/43). The morbidity of experimental group was 0, there was no significant difference between the 2 groups in the morbidity (P>0.05). During the follow-up period, 1 case suffered from long-term compilation in experimental group, and 2 cases in normal group, there was no significant difference in the long-term complication between the 2 groups (P>0.05). ② Operation and hospitalization. The blood loss and operation time in the experimental group were lower than those of the control group (P<0.05), but there was no significant difference in the hospital stay and hospitalization cost between the 2 groups (P>0.05). ③ Postoperative electrolytes, liver and kidney function. The levels of Na+ and K+ in the experimental group were higher than those of the control group (P<0.05), and the levels of alanine aminotransferase and aspartate aminotransferase were lower than those of control group (P<0.01), but there was no significant difference in the blood urea nitrogen and serum creatinine between the 2 groups (P>0.05). ④ The recovery of gastrointestinal function after surgery. The anal exhaust time and bowel sounds recovery time in experimental group were shorter than those of the control group (P<0.01). Conclusion Suturesus-pension single hole laparoscopic cholecystectomy in the treatment of gallbladder disease is safe, effective, and minimally invasive, and it has little disturbance on gastrointestinal function and liver function, which is worthy of clinical application.
【摘要】 目的 觀察莫沙必利聯合復方消化酶膠囊治療功 能性消化不良的臨床療效和安全性。方法 2008年1月—2009年7月對62例功能 性消化不良患者隨機分為兩組,每組31例,兩組均口服莫沙必利片,三餐飯前30 min服用5 mg;試驗組加服復方消化酶膠囊,進餐后30 min服用1粒。4周后觀察療 效。結果 試驗組治療總有效率明顯優于對照組,分別為87.1%和61.3%(Plt;0 05)。對上腹痛、餐后飽脹、早飽、上腹燒灼感癥狀改善情況進行比較,試驗 組治療前后的癥狀總積分及癥狀改善有效率與對照組比較差異有統計學意義( Plt;005),而且起效時間明顯縮短。兩組患者均未發現嚴重不良反應。結論 莫沙必利聯合復方消化酶膠囊治療功能性消化不良安全有效，其療效明顯優于 單用促動力藥莫沙必利。
Objective To explore the clinical effect of ventricular septal defect repair and lung allograft (simply as "heart repair and lung transplant") in the treatment of ventricular septal defect complicated with severe pulmonary hypertension. Methods A 21-year-old female patient with ventricular septal defect and severe pulmonary hypertension was treated with cardiopulmonary bypass (CPB) under general anesthesia, and then right lung transplantation was performed, and then left lung transplantation was performed after changing body position. Results The operation was conducted successively. The intraoperative CPB support time was 90 minutes, and the blood loss was 2000 mL. Extracorporeal membrane oxygenation was removed on the second day after operation, the ventilator was evacuated on the third day, and the patient recovered and discharged on the 38th day. Postoperative echocardiography showed significant improvement in pulmonary artery pressure. Conclusion For patients with simple congenital heart disease complicated with severe pulmonary hypertension, "heart repair and lung transplant" can improve their quality of life.