目的 探討改道置管肛外引流術治療直腸黏膜下膿腫的臨床療效。 方法 2007年5月－2012年5月，將76例直腸黏膜下膿腫患者分為改道置管肛外引流術（治療組）和傳統切開引流術（對照組）治療，每組各38例，兩組患者在年齡、性別比、病程等方面具有可比性。觀察兩組患者治愈時間、治愈率、隨訪3個月的復發情況以及肛門直腸壓力測定，評價兩組患者臨床療效及肛門功能保護情況。 結果 治療組患者治愈時間為（21.3 ± 6.37）d，對照組為（29.5 ± 4.52）d，治療組時間明顯縮短（t=5.79，P＜0.01）；治療組治愈率97.3%，對照組為73.6%，差異有統計學差異（χ2=6.81，P＜0. 01）；兩組患者隨訪3個月的肛門功能比較，RRP治療組為3.48 ± 0.61，對照組3.22 ± 0.79，差異無統計學意義（t=?1.61，P＞0.05）；ARP治療組為19.05 ± 3.76，對照組為17.55 ± 3.31，差異無統計學意義（t=?1.85，P＞0.05）；ALCT治療組為36.74 ± 4.70，對照組為37.13 ± 3.90，差異無統計學意義（t=?0.39，P＞0.05）；AMCP治療組為24.03 ± 5.80，對照組為21.8 ± 4.91，差異無統計學意義（t=?1.61，P＞0.05）。 結論 改道置管肛外引流術治療直腸黏膜下膿腫可縮短療程，提高治愈率。
外科引流是指將存在于體腔內、器官或組織內的積存液體，包括血液、膿液、炎癥滲液、消化道滲漏液等引出體外或改道流至體內別處，目的是有效預防或治療這些液體對組織的壓迫或消化作用，減少炎癥的發生或對機體的損害，從而避免組織壞死等嚴重后果，故正確使用外科引流可以預防這些并發癥的發生和擴散; 相反，不必要的或不正確的引流反而會增加感染的機會和其他并發癥的發生，因而在對外科疾病和引流原理深刻認識的基礎上，選擇適宜的引流時機，運用正確的引流方法，才能充分發揮引流的作用。所以說，引流是外科工作中最常用、最重要的基本技能之一，正確掌握和運用這項技術是每位臨床外科醫生必須具備的能力。.................
目的:應用微創液化引流術治療高血壓殼核出血的療效。方法:對120例高血壓殼核出血患者,在CT引導下,依據血腫大小、形態及患者病情,選擇適宜的穿刺點、方向,行CT平面導向下微創液化引流術,清除血腫。結果:120例患者出院94例,死亡26例,病死率為21.6%。對存活65例患者隨訪6個月至2年,以日常生活能力(ADL)評估患者神經功能,ADL128例(43％),ADL220例(30.7%)、ADL310例(15.3％)、ADL45例(7.6％)、ADL52例(3.0%)。結論:應用微創液化引流治療殼核出血,能最大限度地清除血腫,避免或減輕并發癥,具有較大優越性。
Objective To explore the effectiveness and safety of self-made washable endotracheal tube for subglottic secretion drainage. Methods Ordinary endotracheal tube and sputum aspirating tubes were used to make washable endotracheal tube for subglottic secretion drainage in our hospital. The self-made tubes were compared with washable endotracheal tube available on the market. The suction resistance, the cases of obstruction in the tubes, the average daily drainage, and the cases of infection of incisional wound were compared between the two kinds of tubes, and their safety was evaluated. Results After three days of application, the suction resistance of endotracheal tube available on the market increased, with six cases of the blockage of the lumen ( 85% ) , while that of self-made endotracheal tube did not change, with no cases of blockage ( 0% ) . There was significant difference between these two kinds of tubes ( P lt;0. 01) . The average daily drainage in the former was ( 16. 55 ±8. 66) mL/d; while that in the latter was ( 40. 12 ±25. 48) mL/d. There was no significant statistical difference between the two kinds of tubes ( P gt;0. 05) . The incidence ofinfection of incisional wound in the ordinary endotracheal tube was 50% ( 5 cases) ; that in the tubes available on the market was 28% ( 2 cases) ; that in the self-made tubes was 15% ( 2 cases) . There was significant difference among the three groups. When tube cuffs were inflated, the distance between the back edge of suction tubes and tube cuffs was was 2-4 mm. Conclusion Self-made washable endotracheal tubes are effective for subglottic secretion drainage with good safety and low price.
目的 探討胰十二指腸切除術中引流管的放置與術后管理的方法。方法回顧性分析88例胰十二指腸切除術后管理經驗。結果 術后腹腔并發癥的發生率為10.2%(9/88)，胃排空障礙發生率為3.4(3/88)%，其中保留幽門胰十二指腸切除術后胃排空障礙發生率為5.5%(3/55)。結論 胰十二指腸切除術后腹腔引流是預防術后并發癥的重要方法，術中合理放置引流管，術后加強腹腔引流的管理，能減少術后并發癥的發生。
Proper management of chest drainage after pulmonary lobectomy is a topic that every thoracic surgeon must face up to. Reasonable chest drainage plays a critical role in postoperative normal physiological recovery. However， there are still controversies and discrepancies in many aspects of chest drainage management after pulmonary lobectomy. In this review，we focus on five aspects of chest drainage management after pulmonary lobectomy，including the choice of chest drainage system，single or double chest tubes，suction or not，treatment of persistent air leak，and removal of chest tube.
Ｔｏ ｆｉｎｄ ｏｕｔ ｔｈｅ ａｐｐｒｏｐｒｉａｔｅ ｎｅｇａｔｉｖｅ ｐｒｅｓｓｕｒｅ ｆｏｒ ａｂｄｏｍｉｎａｌ ｄｒａｉｎａｇｅ ａｎｄ ａｐｐｌｙ ｉｔ ｔｏ ｔｈｅ ｐｏｓｔｏｐｅｒａｔｉｖｅ ａｂｄｏｍｉｎａｌ ｄｒａｉｎａｇｅ ｏｆ ｐａｔｉｅｎｔ ｗｉｔｈ ａｃｕｔｅ ｐａｎｃｒｅａｔｉｔｉｓ ａｒｅ ｒｅｐｏｒｔｅｄ．Ａｂｄｏｍｉｎａｌ ｔｕｂｅ ｗａｓ ｉｎｓｅｒｔｅｄ ｔｏ ｒａｂｂｉｔ ｆｏｒ ｎｅｇａｔｉｖｅ ｐｒｅｓｓｕｒｅ ｄｒａｉｎａｇｅ ｍｏｎｉｔｏｒｉｎｇ ａｎｄ ａｎｏｔｈｅｒ ｔｕｂｅ ｗａｓ ｃｕｓｅｒｔｅｄ ｉｎｔｏ ｔｈｅ ａｂｄｏｍｅｎ ｆｏｒ ｃｏｎｔｉｎｕｏｕｓ ｎｏｒｍａｌ ｓａｌｉｎｅ ｉｎｓｔｉｌｌａｔｉｏｎ．Ｔｈｅ ｒｅｃｏｌｌｅｃｔｉｏｎｓ ｏｆ ｄｒａｉｎａｇｅ ｆｌｕｉｄ ｕｎｄｅｒ ｄｉｆｆｅｒｅｎｔ ｎｅｇａｔｉｖｅ ｐｒｅｓｓｕｒｅ ｗｅｒｅ ｍｅａｓｕｒｅｄ．Ｔｈｅ ｒｅｓｕｌｔｓ ｓｈｏｗｅｄ ｔｈａｔ ｔｈｅ ｆｌｕｉｄ ｄｅｐｌｅｔｉｏｎ ｒａｔｅ（７０％）ｏｆ ｔｈｅ ｌｏｗ ｎｅｇａｔｉｖｅ ｐｒｅｓｓｕｒｅ ｇｒｏｕｐ（１．５ ｋＰａ）ｗａｓ ｈｉｇｅｈｅｒ ｔｈａｎ ｔｈａｔ ｏｔｈｅｒ ｉｎ ３ ｇｒｏｕｐｓ（ｎｅｇａｔｉｖｅ ｐｒｅｓｓｕｒｅ ０ ｋＰａ，５ ｋＰａ ａｎｄ １５ ｋＰａ）（Ｐ＜０．０１）．Ｗｉｔｈ ｔｈｉｓ ｃｏｎｔｉｎｕｏｕｓ ｌｏｗ ｎｅｇａｔｉｖｅ ｐｒｅｓｓｕｒｅ ｄｒａｉｎａｇｅ ｉｎ ２０ ｐａｔｉｅｎｔｓ ａｆｔｅｒ ｓｅｖｅｒｅ ｐａｎｃｒｅａｔｉｔｉｓ ｏｐｅｒａｔｉｏｎ，ｗｅ ｆｏｕｎｄ ｔｈａｔ ｔｈｉｓ ｍｅｔｈｏｄ ｈａｖｅ ｍｏｒｅ ａｄｖａｎｔａｇｅｓ ｏｆ ｒｅｄｕｃｉｎｇ ｃｏｍｐｌｉｃａｔｉｏｎ，ｐｒｏｍｏｔｉｎｇ ｒｅｃｏｖｅｒｙ ａｎｄ ｒｅｄｕｃｉｎｇ ｄｅａｔｈ ｒａｔｅ．