目的 探讨十二指肠球部远端溃疡的诊断和选择合适的手术治疗。方法 对我院25例十二指肠球部远端溃疡的临床资料进行了分析。结果 术前行上消化道X线钡餐检查8例，提示十二指肠球部溃疡4例，幽门梗阻2例； 纤维胃镜检查9例，发现十二指肠球部远端溃疡7例。术前确诊7例，误诊18例。20例曾行非手术治疗，但效果差，并出现溃疡并发症，如出血、穿孔、梗阻性黄疸、胆囊内瘘、幽门梗阻、急性胰腺炎等。本次手术治愈25例，1例术后9天并发输入、输出襻粘连性肠梗阻，经再次手术而愈。结论 纤维胃镜检查是诊断本病的主要方法，手术是该病的重要治疗措施。
【摘要】 目的 探讨多尿性梗阻性肾衰的诊断和治疗。 方法 回顾性分析2004年5月-2007年5月收治的15例多尿性梗阻性肾衰患者的临床资料。 结果 经治疗后15例患者肾功能均恢复正常。 结论 多尿性梗阻性肾衰的治疗关键在于诊断，诊断明确后可以用各种方法解除功能性孤立肾的梗阻，挽救肾脏功能。【Abstract】 Objective To investigate clinical experience of the diagnosis and therapy for the hyperdiuresis post-renal acute renal failure. Methods Clinical data of 15 patients with hyperdiuresis post-renal acute renal failure admitted from May 2004 to May 2007 were retrospectively analyzed. Results All of the patients were treated successfully without death and complications. Conclusion The core for the treatment of hyperdiuresis post-renal acute renal failure is the diagnosis. Several therapies can be used to relieve obstruction and save renal function after precise diagnosis.
ObjectiveTo evaluate the value of carcinoembryonic antigen (CEA), ferritin, D-dimer, fibrinogen degradation product (FDP), white blood cell (WBC) and C-reactive protein (CRP) in diagnosis and prognosis of severe community-acquired pneumonia (SCAP).MethodsThis was a prospective observational study. One hundred and seventy-seven candidates were divided into 3 groups: SCAP group including 61 SCAP patients, CAP group including 56 patients with normal community-acquired pneumonia group and HP group including 60 healthy people. Initial level of above biomarkers was compared and analyzed in the three groups. Then the efficiency of diagnosing and predicting the outcome of SCAP by single and combined index were evaluated by receiver operating characteristic (ROC) curve. Meanwhile the patients in SCAP group were divided into two groups according to the CEA level named CEA increasing group and normal group, between which the differences in prognosis and biomarker level were compared.ResultsThe initial level of all biomarkers increased in two pneumonia groups and exceeded the HP group (P< 0.01) while between SCAP and CAP groups, all indexes in SCAP group were higher than the CAP group (P< 0.001). The areas under the ROC of CEA, ferritin, D-dimer, CRP, WBC and united respectively were 0.800, 0.834, 0.769, 0.898, 0.756 and 0.956. The sensitivity of united index was 91.8% while specificity was 90.5%. Among SCAP group, only CEA level made sense to predict the prognosis (P< 0.01). There were significant differences in intubation rate, mortality, length of RICU stay and FDP, D-dimer between CEA increasing group and normal group (P< 0.05).ConclusionsHigh level CEA, ferritin, D-dimer, CRP and WBC have significant value in diagnosis of SCAP. And the combined index has higher diagnostic value than single one. SCAP with increased CEA level indicates more serious condition and poor prognosis.
目的 探讨胰腺结石的临床特点及诊治方法。方法 回顾性分析我院1993年5月至2011年5月期间收治的25例胰腺结石患者的临床资料。结果 本组25例中经手术及EST确诊为胰腺真性结石（胰管结石）5例，胰腺假性结石（胰实质内钙化）20例。X线、B超、CT、ERCP及MRCP诊断符合率分别为40.0%（10/25）、88.0% (22/25)、84.2%(16/19)、88.9% (8/9)和100%（2/2)。手术治疗18例，无手术死亡病例，术后患者腹痛症状均明显减轻或消失，术后3d1例发生胆漏，经充分引流治愈；非手术治疗7例，1例行EST后发生出血，经保守治疗治愈。所有患者均获随访，随访时间9个月～10年，平均5.2年，其中2例合并胰腺癌患者分别于术后9个月和11个月因肿瘤复发和转移死亡，18例手术治疗患者3年内胰管结石复发2例（11.1%），7例非手术治疗患者3年内胰管结石复发2例（28.6%），4例复发患者均经非手术治疗好转。结论 胰腺结石大多继发于慢性胰腺炎，B超为首选诊断方法；手术仍是最有效的治疗手段，手术和内镜十二指肠乳头内切开取石为主的各种治疗方法的联合应用，能提高胰腺结石的疗效。
目的 总结术后早期炎性肠梗阻的临床特点及诊治经验。方法 回顾性分析我院2004年1月至2010年12月期间收治的22例腹部手术后早期炎性肠梗阻患者的临床资料。结果 全组均行保守治疗，均治愈出院。肠梗阻解除时间平均6.5d。2例出院后再次出现慢性肠梗阻，经保守治疗好转。结论 术后早期炎性肠梗阻在腹腔严重感染性疾病术后多见，治疗以保守治疗为主，同时应动态观察腹部症状、体征变化，严防误诊、误治。
Objective To evaluate the variability of four parameters of multi-focal electroretinogram (mERG) a-wave amplitude, b-wave amplitude, awave latent period, b-wave latent period. Methods Sixty normal eyes of 46 volunteers were divided into 3 groups of different ages. RETIscan 3-12 system was used to carry out mERG examination. The stimulus matrix of 61 hexagonal elements spanning the central 24deg;of the visual field. These hexons were scaled with eccentricity and divide d into 5 rings. First-order kernel was selected. Results The variability of four parameters of mERG was great. The variability of b-wave latent period was the smallest, its coefficient of variatian was 4.52%～15.62%；that of a-wave latent period held the second place:10.29%~48.67%；that of b-wave amplitude was greater:25.92%~76.11%；that of a-wave amplitude was the greatest:43.82%~88.23%. The results of three groups showed that b-wave amplitude of ring 1 had the smallest variability. Conclusions The variability of latent period is smaller than that of amplitude; the variability of b-wave was smaller than that of a-wave. The longer the centrifugal distance, the lower the amplitude density of a-wave and b-wave. Physiological and anatomical factors might be important for the variability of parameters of multi-focal electroretinogram. (Chin J Ocul Fundus Dis, 2001,17:277-279)
目的探讨腹腔镜在胆瘘或肠瘘诊治中的应用价值。 方法回顾性分析2008年11月至2013年4月期间广西壮族自治区桂东人民医院和广西壮族自治区民族医院收治的应用腹腔镜诊治的12例胆瘘或肠瘘患者的临床资料。 结果12例患者中胆瘘7例，肠瘘5例，均在手术后发生，均经腹腔镜探查后确诊。12例患者均在腹腔镜下行再次置管引流、缝闭迷走胆管或肠瘘管等处理。手术时间60～170 min、（90±19）min，住院时间3～7 d、（4±1）d，术中出血量20～150 mL、（70±12）mL，术后均顺利康复出院。术后12例患者均获访，随访时间为1个月～5年，平均随访时间为36个月，未发现胆瘘或肠瘘复发者。 结论腹腔镜探查有助于胆瘘或肠瘘的诊断，并可达到微创手术治疗的目的。