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吻合术

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Methods: From May 1985 to December 2002, 2240esophageal and stomach cardia cancer patients treated by intrathoracic esophagogastric "layer-to-layer"anastomosis with esophageal mucosa extended varied in plane were retrospectively analyzed.

回顾性总结1985年5月~2002年12月共进行胸腔内食管黏膜延长不同平面与胃、食管分层吻合术2240例,统计手术后和出院后随访资料发生吻合口瘘和吻合口狭窄的情况。

Fifteen patients underwent operation, including gastrostomy (6 cases), gastrotomy (4 cases), partial gastric fundus resection (2 cases), others operations (2 case), and laparotomy exploration (1 case); among them four patient died.

手术治疗15例,包括胃切开减压、胃造口术(6例),胃切开减压后再缝合创口(3例),胃切开减压、胃造口、空肠造口术(1例),胃底部分切除术(2例),十二指肠空肠吻合术(1例),空肠造口术(1例),开腹探查术未切开胃壁(1例),死亡4例(26.7%)。

Results Irritative symptoms (78%) and gross hematuria (36%) were the most common symptoms encountered in these patients.

结果尿路刺激症状和血尿为最常见症状,分别为78%和36%。24小时尿抗酸杆菌和尿结核PCR的阳性率分别为25%和40%,IVU,逆行尿路造影及CT的诊断符合率分别为38%,63%和44%。33例患者接受了肾及部分输尿管切除术,肾上盏结核病灶清除术1例,对侧输尿管膀胱吻合术1例及肾穿刺造瘘术1例。1例患者并发血行播散型结核死亡。

Results Irritative symptoms (78%) and gross hematuria (36%) were the most common symptoms encountered in these patients.Acid-fast stains on urinary sediment were positive in 25% of cases and TB-PCR was positive in 40%.The diagnostic accuracy of IVU,retrograde urography and CT in these patients were 38%,63% and 44% respectively.33 patients underwent a nephrectomy and partial ureterectomy,one of them had a contralateral ureter reimplantation.One patients died of miliary tuberculosis. Conclusions Acid-fast stain remains a major pathogen-detecting tool and the value of TB-PCR needs to be confirmed.

结果 尿路刺激症状和血尿为最常见症状,分别为78%和36%。24小时尿抗酸杆菌和尿结核 PCR 的阳性率分别为25%和40%, IVU ,逆行尿路造影及 CT 的诊断符合率分别为38%,63%和44%。33例患者接受了肾及部分输尿管切除术,肾上盏结核病灶清除术1例,对侧输尿管膀胱吻合术1例及肾穿刺造瘘术1例。1例患者并发血行播散型结核死亡。

Radical excision 153 cases,of which 128 cases in pancreatoduodenectomy,20 cases in the expansion of pancreatoduodenectomy,and 5 in total pancreatectomy; 102 cases with palliative operation,of which 33 cases in RouxY biliaryenteric anastomosis,69 cases in the Rouxen bridge T tube drainage.

根治性切除术153例中,胰十二指肠切除术128例,扩大胰十二指肠切除术20例,全胰切除术5例;姑息性手术102例中,胆肠RouxY吻合术33例,胆肠T管架桥内引流术69例。

They were male in 8 eases and female in 14. Pancreatic cystoadenoma was in 14 cases (63.30%) and pancreatic cystoadenocarcinoma in 8(36.3%). It was 1.7:1 between two groups. Tumor at the head of pancreas was 6 cases (27.21%). at body-tail 12 (54.5%). at tail 4 (18.1%). Local resection was performed in one case, pancreatic body-tailectomy pancreatoc1uodenectoni in 3, central pancreatectomy in 2 cases.

男8例,女14例。14例(63.3%)为胰腺囊腺瘤(浆液性6例、黏液性8例),8例(36.3%)为胰腺囊腺癌,两者之比为1.7:l肿瘤位于胰腺头部6例(27.2%),胰腺体尾部12例(54.5%),胰腺尾部4例(181%)行胰腺肿瘤局部切除术l例,肤腺体尾部切除术14例,胰头十二指肠切除术3例,胰腺中段切除术2例,囊肿-空肠Roux-Y吻合术1例,T管架桥胆-肠内引流术1例。

The dacryocystorhinostomy was operated by the same experienced doctor.During the operation putting methylcellulose into the lacrimal sac before cut.

摘要] 目的通过对慢性泪囊炎患者施行泪囊鼻腔吻合术,手术中在制作泪囊鼻黏膜瓣前应用甲基纤维素,评价其在提高泪囊鼻腔吻合术成功率的作用。

Methord 45 patients of the esophageal carcinomawho were, at random, elected had been undergone the ligation of thoracic duct( Low level: under the 8th thoracic vertebrae) during resection of esophageal carcinoma and esophagogastrostomy, while the other 92 patients of the esophageal carcinomahad only been operated the resection of esophageal carcinoma and esophagogastrostomy.

随机选取45例食管癌患者,在食管癌切除加胃-食管残端吻合时,一期行预防性低位胸导管结扎术(第8胸椎水平以下);另92例作对照组,仅做食管癌切除加胃-食管残端吻合术

The patients may occur exhaust distention more possibly in BillrothⅡanastomotic operation,that is partial resection of stomach with gastrojejunal anastomosis,than Billroth Ⅰanastomotic operation.

两种不同消化道重建术手后,行毕Ⅱ式吻合术即行胃空肠吻合的患者更容易出现腹胀,应采取有效的护理干预措施,以减少腹胀的发生。

The patients may occur exhaust distention more possibly in BillrothⅡanastomotic operation,that is partial resection of stomach with gastrojejunal anastomosis,than Billroth Ⅰanastomotic operation.

两种不同消化道重建术手后,行毕Ⅱ式吻合术即行胃空肠吻合的患者容易出现腹胀,应采取有效的护理干预措施,以减少腹胀的发生。

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