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        west china medical publishers
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        find Author "董培德" 5 results
        • Eight Cases Review of Obturator Hernia

          目的 探討閉孔疝的診斷和治療方法。方法 回顧性分析了我院2001年10月至2009年8月期間收治并經手術證實的8例閉孔疝患者的臨床資料。結果 8例均為女性,其中7例是老年、體弱的多產婦,1例是已婚年輕女性。平均年齡74.6歲(46~85歲),平均體重為39.1 kg(34~43 kg),平均生育5胎(1~10胎)。8例患者中5例術前經CT檢查確診而行手術治療,3例由外院轉入者在行急診剖腹探查術中確診。7例行壞死小腸切除吻合術,1例行嵌頓小腸復位術。 術后4例出現并發癥:1例肺炎、1例切口感染、1例低蛋白水腫、1例為酸中毒和低血鉀(死亡)。7例痊愈出院,1例死亡。結論 閉孔疝缺乏特異性表現,對年老體弱的經產婦出現腹痛、嘔吐和股部疼痛應想到閉孔疝的可能;CT檢查能提高閉孔疝的診斷率。準確的診斷和及時的手術干預是改善閉孔疝患者預后的關鍵。

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        • Clinical Study on Improvement of Pancreatoduodenectomy of Pancreatic Duct Jejunal Anastomosis to Prevent Pancreatic Fistula

          Objective To explore the clinical value of the improved style of pancreatodeodenectomy. Methods Retrospective analysis the data of 111 cases of pancreatodeodenectomy. Forty-one cases of 111 cases were performed the modified Whipple pancreatic jejunal anastomosis, which reconstruction residual pancreatic duct jejunum into the intestinal mucosa sets of accurate end to side anastomosis type (modified group). Another 70 cases were performed the conventional Whipple pancreatic jejunal anastomosis, which classic lines set into the pancreas jejunum anastomosis (conventional group). The incidence rate of pancreatic fistula after operation were compared in two groups. Results The postoperative recovery in modified group was smooth, and there was no case of pancreatic fistula. Thirteen cases (18.57%) had pancreatic fistula in conventional group. The difference of incidence rate of pancreatic fistula between two groups was statistically significant (P<0.05). The difference in other complications such as gastrointestinal bleeding, delayed gastric emptying, biliary fistula, abdominal infection, lung infection, and wound infection were no statistically significant (P>0.05), and the difference of survival rate was also no statistically significant (P>0.05) in two groups. Conclusions Pancreatic duct jejunum end to side into the mucous membrane of the mucosal anastomosis sets of pancreatodeodenectomy can significantly prevent pancreatic fistula, it is worth to promote the use in clinical work.

          Release date:2016-09-08 10:37 Export PDF Favorites Scan
        • Analysis of Perioperative Complications in Patients with Pancreaticoduodenectomy

          Objective To explore the situation and prevention of pancreaticoduodenectomy perioperative complications. Methods The clinical data of 111 cases of pancreaticoduodenectomy were retrospectively analyzed, and the possible factor of complications was analyzed. Results There were postoperative complications in 48 patients (43.2%), which one kind complication occurred in 25 cases, two kinds in 15 cases, and three kinds or more in 8 cases. Four cases (3.6%) died after operation. Conclusions Pancreaticoduodenectomy is a higher risk surgery in abdominal operation. Strengthen perioperative prevention and treatment are important measures to reduce morbidity and mortality after pancreaticoduodenectomy.

          Release date:2016-09-08 10:35 Export PDF Favorites Scan
        • Clinical Efficacy of Early Enteral Nutrition on Patients with Gastric Cancer after Radical Operation

          ObjectiveTo explore the clinical efficacy and security of early enteral nutrition (EN) on patients with gastric cancer after radical operation. MethodsSeventy cases who treated in Affiliated Hospital of Inner Mongolia Medical University from Dec. 2008 to Apr. 2013 were randomly divided into EN group (n=35) and parenteral nutrition (PN) group (n=35), analysis and comparison of nutrition indicators and recovery indicators between 2 groups were performed. ResultsThere were no significant differences on levels of count of white blood cell (WBC), serum albumin (ALB), prealbumin (PA), and transferring (TRF) before operation between the 2 groups (P > 0.05). On 3 and 7 days after operation, the levels of ALB, PA, and TRF were all higher in EN group (P < 0.05) besides level of count of WBC. In addition, hospital stay and hospitalization cost were both lower in EN group (P < 0.05), but there was no significant difference on postoperative exhaust time and complication incidence (P > 0.05). ConclusionsEN is a safe, effective, and economical method of nutritional supplements, and it is a preferred method of nutritional support for patients with advanced gastric cancer after operation at prophase, which is worthy to apply widely in clinical.

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        • Clinical Experience on Treatment of Short Bowel Syndrome with Intestinal Fistula byLiving-Related Intestinal Transplantation (Report of 1 Case )

          目的 總結活體部分小腸移植在治療短腸綜合征合并腸瘺中的臨床經驗。方法 1例短腸綜合征合并腸瘺患者接受其子的150 cm 回腸,供腸動、靜脈分別與受體的腹主動脈和下腔靜脈行端側吻合,受體殘余空腸與供體回腸近端行端端吻合,受體結腸與供腸遠端行端側吻合,供腸遠端造瘺作為觀察窗,術后給予免疫抑制等治療。 結果 患者小腸移植術后恢復順利,腸道功能恢復,血管吻合口通暢,正常生活110 d后因心臟意外死亡。結論 短腸綜合征合并腸瘺患者實施活體部分小腸移植是可行的,植入腸管的血管植入技術對小腸移植成功非常重要。

          Release date:2016-09-08 11:47 Export PDF Favorites Scan
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