【摘要】目的探讨乳腺囊性肿块的临床特点及诊治经验。方法对我院1988年4月至2003年5月期间收治的220例乳腺囊性肿块患者的临床资料进行回顾性分析。结果经均手术切除及病理学检查，本组病例中乳腺囊性上皮增生症162例，积乳性乳腺囊肿26例，单纯性乳腺囊肿23例，乳腺叶状囊肉瘤5例，大导管内乳头状瘤4例。结论乳腺囊性肿块具有一定的共性和个性特点，术前B超检查和诊断性穿刺对乳腺囊性肿块的诊断和鉴别诊断有一定价值，但确诊有赖于病理学检查，手术可以明确诊断和治愈疾病。
目的 全面介绍先天性囊性腺瘤样畸形(CCAM)其可能的病因，临床、病理特点及诊断手段，循证探讨针对CCAM的治疗方法及预后。 方法 对我院2011年11月收治的1例罕见的CCAM患者的临床资料进行分析，并对相关文献进行复习。 结果 患者数次误诊后最终诊断为CCAM，予手术治疗后痊愈，随访1年无复发。 结论 CCAM是一种少见的、非遗传性的、错构瘤样的肺发育异常，为一种良性的肺部畸形，其特点是局部肺终末呼吸性细支气管过度生长。CCAM多通过产前影像学检查、活组织检查或术后病检诊断。手术为治愈该病的最根本、最重要措施。
Objective To investigate the surgical technique of reduced sized liver transplantation. Methods A reduced size liver transplantation was successfully performed on a 11-year old girl with incurable caroli′s disease. Results The recovery of liver graft function was good after the operation in this patients without complications. Conclusion Reduced size liver transplantation is a safe and effective technique for pediatric liver transplantation to provide liver graft. Authors introduced their experiences of surgical technique in this patient.
Objective To summarize the current progress in diagnosis and treatment of polycystic liver disease, and provide ideas for further research direction and clinical practice of polycystic liver disease. Method The domestic and foreign literature about polycystic liver disease was reviewed, screened, and summarized. Results The diagnosis, evaluation, and classification of polycystic liver disease were mainly performed clinically by abdominal ultrasound and CT. Surgical treatment was the main treatment, including aspiration sclerotherapy, fenestration, segmental hepatectomy, and liver transplantation. Conclusions The classification and evaluation scheme of polycystic liver disease needs to be improved, and its medical treatment still needs further research. Estrogen receptor and gonadotropin-releasing hormone receptor are promising therapeutic targets.
【摘要】 目的 探讨CT对婴幼儿腹部巨大囊性病变的诊断价值及其鉴别诊断。 方法 搜集2003年-2009年间经手术病理证实的2岁以内患儿腹部巨大囊性病变62例，分析其病变部位、大小、形态、分隔、密度和强化、囊壁及与周围脏器关系等要素。 结果 62例中，先天性胆总管囊肿4例，重度肾积水36例，巨输尿管2例，囊性肾母细胞瘤4例，大网膜囊肿4例，肠系膜囊肿3例，卵巢囊肿6例，囊性畸胎瘤3例。 各种囊性病变有其一定的发病部位和特征性的CT表现。 结论 CT是婴幼儿腹部囊性病变定位、定性诊断的重要影像学方法。【Abstract】 Objective To explore the value of CT diagnosis and differential diagnosis of the giant cystic lesions in abdomen of the infants. Methods A total of 62 infants younger than 2 years old with the giant cystic lesions in abdomen confirmed by surgery and histopathology from 2003 to 2009 were collected. The location of the lesion, range, configuration, thickness of cystic wall and septa, density, contrast enhancement, and adjacent organs were observed and analyzed. Results In 62 infants, there were congenital cyst of common bile duct in 4, giant hydronephrosis in 36, primary megaureter in 2, cystic Wilms tumor in 4, greater omentum cyst in 4, mesenteric cyst in 3, ovarian cystic in 6, and cystic teratoma in 3. Each disease had its own lesions location and features of CT images. Conclusion CT is very effective on the localized and qualitative diagnosis of the giant cystic lesions in abdomen of infants.
ObjectiveTo review the current clinical application of Beger procedure and Frey procedure for benign disease or low-grade malignant potential lesion of pancreas. MethodsRelevant literatures about current advance of clinical application of Beger procedure and Frey procedure published recently of domestic and abroad were collected and reviewed. ResultsWith the concept of organ-preserving operations was adopted in recent years, Beger procedure and Frey procedure were applied generally. Beger procedure and Frey procedure were associated with tolerable perioperative risk, postoperative complications, and good outcomes in the aspects of preservation of function and curability in these lesions compared to conventional pancreatectomy, with preservation of the physiological food passage, thus patients gained weight faster, had less pain, and demonstrated better exocrine and endocrine pancreatic function postoperatively and an improvement in the quality of life. Both procedures had reached an international position as a standard operation for the treatment of benign disease or low-grade malignant potential lesion of pancreas. But after long-term following-up early advantages were no longer present. ConclusionsBeger procedure and Frey procedure are safe and effective in providing good outcomes in the aspects of preservation of function and curability in benign disease or low-grade malignant potential lesion of pancreas. Organ-preserving pancreatectomy could become a new organ-preserving standard operation.
目的 提高对囊性纤维化的认识。 方法 2011年11月收治1例自幼有临床表现的囊性纤维化患者，回顾其诊断及治疗经过，复习相关文献总结其临床特征、诊疗进展及预后评价。 结果 囊性纤维化起病年龄较早，患者自幼年起即反复出现肺、消化道、肝脏等多系统病变，最终导致多器官功能衰竭。 结论 应提高对囊性纤维化的识别度，对于发病年龄过早、反复发作的严重支气管扩张，伴随生长发育延迟、肝硬化等临床征象应注意对囊性纤维化的筛查。
ObjectiveTo summarize the experience of diagnosis and treatment of pancreatic cystic neoplasms (PCN).MethodThe general information, imaging findings, preoperative blood biochemical indexes, tumor markers, operation related data, postoperative complications, and pathological results of patients with PCN confirmed by pathological examination in Affiliated Hospital of Xuzhou Medical University from January 1, 2014 to December 31, 2019 were retrospectively analyzed.ResultsAmong the 158 patients who underwent surgical resection, the male to female ratio was 1∶1.6, and the median age was 56.2 years (range 26 to 82 years). Serous cystadenoma (SCN) was the most common, accounting for 34.2% (n=54), followed by mucinous cystadenoma (MCN) and intraductal papillary mucinous neoplasm (IPMN), accounting for 26.6% (n=42) and 20.2% (n=32). The proportion of solid pseudopapillary tumor (SPT) was the smallest, which was 19.0% (n=30). The PCN malignant rate was 19.0% (n=30), with the highest malignant rate being IPMN (43.8%, n=14), and the lowest being SCN (3.7%, n=2). Patients with PCN malignant group had significantly higher serum CA19-9, CEA, CA125, and neutrophil/lymphocyte ratio (NLR) than those in the benign group（all P<0.05）. The preoperative diagnosis of PCN was ambiguous, and the rate of misdiagnosis was high. The correct diagnosis rate of accurate preoperative specific classification was only 31.6% (n=50), and the lowest SCN (14.8%, n=8). High CA19-9, high NLR value, tumor location in the head/neck of pancreas and enhanced solid component were independent predictors of malignant PCN (P<0.05).ConclusionImproving the preoperative diagnosis ability of PCN and accurately determining the PCN classification before operation are helpful for the standardized treatment of PCN.