目的 研究完全腹膜外腹腔鏡腹股溝疝修補術對睪丸血流灌注及體積的影響。 方法 2009年7月－2011年5月，對62例行完全腹膜外腹腔鏡單側腹股溝疝修補術男性患者進行自身前后對照研究，比較術前、術后患側睪丸的睪丸動脈（TA）、睪丸包膜動脈（CA）、睪丸內動脈（ITA）血流參數[收縮期峰值血流速度（PSV）、舒張未期血流速度（EDV）及血管阻力指數（RI）]、睪丸體積（TV）及血清睪酮的變化情況。 結果 患者獲隨訪7～24個月，平均15.6個月，無復發患者。術前及術后3、6個月時患側TV分別為（9.91 ± 3.72）、（10.23 ± 4.18）和（10.16 ± 3.94）cm3，同期血漿睪酮水平分別為（544.25 ± 123.72）、（532.89 ± 145.66）和（565.65 ± 138.13）μg/L，手術前后比較患側TV（F=1.350，P=0.263）、血漿睪酮水平（F=1.673，P=0.192）無統計學意義，血漿睪酮水平均在正常范圍內。術后3、6個月患側TA、CA和ITA的EDV明顯高于術前，RI較術前明顯降低，差異均有統計學意義（P＜0.05）；PSV與術前比較差異無統計學意義（P＞0.05）。術后3個月患側睪丸各動脈PSV、EDV、RI與術后6個月比較差異無統計學意義（P＞0.05）。 結論 完全腹膜外腹腔鏡腹股溝疝修補術后患側睪丸血流灌注情況可能會有所改善，不影響TV及血清睪酮水平。
【摘要】 目的 探討腹部手術史對急性闌尾炎腹腔鏡闌尾切除術（LA）的影響。 方法 2005年1月-2010年9月，將既往有腹部手術史并行LA的111例患者納入觀察組，同期隨機抽取無腹部手術史行LA的220例患者納入對照組。入選患者排除多次手術史、免疫功能低下、肝腎功能不全及血液病。比較兩組中轉開腹率、手術時間、術中出血量、術后并發癥及住院時間的差異。 結果 兩組均未出現術中并發癥及死亡，兩組患者的中轉開腹率、手術時間、術中出血量、術后并發癥及住院時間比較，差異均無統計學意義（Pgt;0.05）。 結論 即往腹部手術史對急性闌尾炎LA沒有明顯影響。【Abstract】 Objective To investigate the effect of previous abdominal surgery on appendectomy under laparoscope for acute appendicitis. Methods From January 2005 to September 2010, 111 patients with a history of abdominal surgery who had undergone laparoscopic appendectomy due to acute appendicitis were in the observe group and 220 patients selected randomly from the patients without a history of previous abdominal surgery who had undergone laparoscopic appendectomy were in the control group. The patients with a history of multiple operations, immunodeficiency, liver and kidney dysfunction, and hematopathy were excluded. The data were collected retrospectively and the differences of conversion rate, operative time, intraoperative blood loss, postoperative complications, and hospital staying were compared between the two groups. Results There were no death or intraoperative complications in both of the two groups. The differences in the conversion rate, operative time, intraoperative blood loss, postoperative complication rates, and hospital staying between the two groups were not significant (Pgt;0.05). Conclusion Previous abdominal surgery has no significant effect on laparoscopic appendectomy for acute appendicitis.
【摘要】 目的 探討遠端胃癌根治術后早期經口進食的可行性、安全性及術后早期康復情況。 方法 將2009年5月-2011年1月收治的62例遠端胃癌根治術患者隨機分為早期經口進食（early oral feeding，EOF，30例）組及傳統進食（traditional feeding，TF，32例）組。比較兩種營養支持方法對患者術后并發癥、胃腸功能恢復及血清蛋白的影響。 結果 EOF組術后早期經口進食耐受率達90%（27/30），兩組術后并發癥發生率相比差異無統計學意義（χ2=0.046，P=0.830）。EOF組術后首次肛門排氣及排便時間均早于TF組（P=0.000）。術后8 d時EOF組血清前清蛋白和轉鐵蛋白明顯高于TF組（P=0.028，0.013）。 結論 遠端胃癌根治術后早期經口進食是安全、可行的，能促進患者的早期恢復。【Abstract】 Objective To discuss the feasibility and safety of early oral feeding after curative surgery for distant gastric cancer, and investigate whether it has an effect on early recovery of the disease. Methods From May 2009 to January 2011, 62 distal gastric cancer patients with open radical resection were divided into the early oral feeding group (EOF group, n=30) and traditional feeding group (TF group, n=32) randomly. We compared the complication rate, gastrointestinal function recovery, serum protein change before and after operation between the two groups. Results Early oral feeding can be tolerated by as much as 90% (27/30) of the patients in EOF group. There was no significant difference in the postoperative complication rate between the two groups (χ2=0.046, P=0.830). The EOF group had a faster onset of flatus and defecation than the TF group (P=0.000). The serum pre-albumin and transferrin were significantly higher in the EOF group than those in the TF group 8 days after operation (P=0.028,0.013). Conclusion Early oral feeding after curative surgery for distal gastric cancer is safe and feasible, and can promote early rehabilitation of the patients.