目的 探討股疝的發病特點、診斷注意事項、誤診分析及治療方法。方法 回顧性分析我院1993年1月至2008年1月期間38例股疝患者的臨床資料。結果 38例患者年齡均在40歲以上，全部行手術治療，1例術后3 d因心肌梗死死亡，1例因腸壞死、多器官功能衰竭死亡，余36例均痊愈出院，術后平均隨訪72個月無復發。結論 股疝容易嵌頓，中老年患者多見,臨床上易被誤診，應盡早確診，及時手術。
【Abstract】Objective To explore the relation between the expression of telomerase and DNA ploidy with biliarypancreatic system cancer, so as to find a better way to diagnose and distinguish jaundice between malignance and benign disease.Methods Endoscopic retrograde cholangiopancreatography (ERCP) were performed before operation in patients with obstructive jaundice. The bile and pancreatice juice were collected before ERCP. Biopsy specimens from part of patients were obtained during ERCP. All cancer specimens were possessed once again during operation and were assessed by the activity of telomerase and DNA ploidy. Results ① Telomerase positive rate 〔87.50%(56/64)〕 of tissue specimens in malignant obstructive jaundice were higher than that in benign obstructive jaundice 〔3.33%(2/60)〕，P=0.000. ② Telomerase positive rate〔71.88%(46/64)〕of Bile and pancreatice juice in malignant obstructive jaundice were higher than that in benign obstructive jaundice 〔3.33%(2/60)〕， P=0.000, tissue specimens obtained by endoscopy with malignant obstructive jaundice had detectable telomerase activity, positive rate was 83.33%（20/24）. ③ The rate of DNA heteroploid with malignant obstructive jaundice was 62.50%（40/64）, that of diploid can be seen in all patients with benign obstructive jaundice, the difference was statistically significant (P=0.000). ④ The rate of telomerase positive and DNA heteroploid in high differentiation tumor were significantly lower than in middlelow differentiation tumor （P=0.028，P=0.001）.Conclusion Applying the duodenoscope we collected the bile and pancreatic fluid before operation and obtain biopsy specimens whose telomerase activity and DNA ploid were detected. This is simple, safe, quick method which can identify the malignant and benign obstructive jaundice.
目的 探討腹腔鏡粘連松解術治療粘連性腸梗阻的應用價值。方法 對我院2005年7月至2011年9月期間采用腹腔鏡進行腸粘連松解術的27例患者的臨床資料進行回顧性分析。結果 27例患者中除2例因術中探查發現小腸壞死而中轉開腹行腸切除外，其余25例均手術成功，手術時間（65±15） min （40～115min）。27例均獲隨訪，隨訪時間（14±6）個月（8個月～2年），1例患者于術后1個月時有陣發性腹痛，經保守治療緩解，其余病例均無腹脹、腹痛等癥狀發生。結論 腹腔鏡粘連松解術治療粘連性腸梗阻具有創傷小、恢復快的優點，是較理想的治療術后腸粘連的手段。
目的探討脾靜脈高壓的臨床特征及診斷依據。方法 回顧性分析6例脾靜脈高壓病例的臨床癥狀、體征、影像學檢查及術中發現等資料。結果 臨床癥狀主要表現為嘔血和便血； CT掃描3例脾靜脈狹窄，3例脾靜脈顯示不清； 術中測定門靜脈壓力，切脾前左側為2.94±0.2 kPa(35.0±2.1 cmH2O)，高于右側的1.96±0.2 kPa(20.0±2.3 cmH2O)，切脾后左側為2.06±0.1 kPa(21.0±1.3 cmH2O)，右側為1.76±0.1 kPa(18.0±1.4 cmH2O)，二者無明顯差異。術中探查脾靜脈，5例脾靜脈栓塞，1例狹窄。結論 術前CT增強掃描，術中測定左右半門靜脈壓力以及術中發現脾靜脈栓塞或狹窄，可以診斷脾靜脈高壓。