【摘要】 目的 探討自制雙孔導線針在腹腔鏡小兒腹股溝疝手術中的應用價值。 方法 回顧性分析2006年4月-2010年6月行腹腔鏡小兒腹股溝疝手術655例患兒的臨床資料。單孔針手術組452例，雙孔針手術組203例，將兩組患兒術中、術后資料進行對比分析。 結果 單孔針組手術時間(17. 7±3. 5) min；術中出血(5. 4±1. 3) mL，住院時間(2. 5±1. 0) d發生腹壁下小血腫15例，術后復發3例；雙孔針組手術時間(8. 2±2. 3) min，術中出血(1. 4±0. 3) mL，住院時間(2. 1±0. 8) d，發生腹壁下小血腫2例，術后復發1例。雙孔針組的手術時間、術中出血、并發癥發生率等均明顯優于雙孔針組(Plt;0. 05)，兩組住院天數、復發率差異均無統計學意義(Pgt;0. 05)。 結論 自制雙孔導線縫扎針在腹腔鏡小兒腹股溝疝手術中應用能夠縮短手術時間，操作安全快捷，創傷更小等優點，值得推廣應用。【Abstract】 Objective To explore the clinical value of self-made diplopore suture needle in laparoscopic herniorrhaphy in children. Methods The clinical data of 655 patients who underwent laparoscopic herniorrhaphy between April 2006 and June 2010 were retrospectively analyzed. The patients were divided into the single-hole needle group (452 patients) and the diplopore needle group (203 patients), and the operative and post-operative data of the two groups were analyzed and compared. Results The operation time in the single-hole needle group was (17.7±3.5) minutes and the bleeding volume during the operation was (5.4±1.3) mL; while 15 patients suffered from small hematoma under the abdominal wall and three recurred. The operation time in the diplopore needle group was (8.2±2.3) minutes with (1.4±0.3) mL blood loss; while two patients suffered from small hematoma under the abdominal wall and one recurred. The patients in the single-hole needle group stayed in the hospital for (2.5±1.0) days, while the patients in diplopore needle group stayed for (1.4±0.3) days. The operation time, bleeding volume, rate of complications in diplopore needle group were significantly less than those in the single-hole needle group (Plt;0.05). The hospital staying days, and the recurrence rate in the two groups didn’t differ much (Pgt;0.05). Conclusion The advantages of self-made diplopore needle in laparoscopic herniorrhaphy in children include short operation time, less trauma, and simple operation; it is worth generalizing and applying.
目的:探索早期乳腺癌的臨床特點和診斷方法。方法:回顧性分析46例早期乳腺癌的臨床資料。結果:46例患者中表現為乳腺痛及腫塊者30例,以乳房腫塊就診者16例。鉬靶照片14例,診斷為乳腺癌5例(35.7%)。42例作彩色超聲檢查,發現不規則低回聲結節37例(89.0％),部分腫塊內可見點狀強回聲,周圍有蟹足狀,血流增加。細針穿刺細胞學檢查40例,23例發現癌細胞,直接住院,術中冰凍切片決定手術方式;23例門診先行切除活檢后住院治療。結論:高危婦女表現為乳腺增生,用藥不好轉、癥狀加重者,應懷疑乳腺癌,首選彩色超聲檢查,診斷價值優于鉬靶照片。有腫塊者結合穿刺細胞學檢查,可提高早期乳腺癌的診斷率。
目的:分析原發性肝癌手術切除的方法及效果。方法:對手術切除的原發性肝癌112例從腫瘤部位、大小、人肝血流阻斷、切除方式、失血量、手術時間等方面進行分析。結果:手術切除率26.23%,手術死亡率0.89%,5年生存率18.75%,10年生存率僅2例。結論:原發性肝癌患者就診時多數已為中晚期或大肝癌,手術切除后療效較差。提高生存率關鍵是:小肝癌的切除、切除方式、術后TACE、復發再切除及術后生物治療等。
目的:探討青年人大腸癌臨床表現、病理特點。方法:回顧性分析四川省成都市第五人民醫院普外科1997年7月至2007年12月收治的23例35歲以下青年大腸癌患者臨床資料。結果:23例青年大腸癌患者平均年齡24.5歲,男女比例為2.8∶1;病變部位以直腸多見,組織學分型以低分化腺癌與印戒細胞癌最多;Dukes分期:A期1例,B期3例,C期13例,D期6例。結論:青年大腸癌表現為病理分化程度低、Dukes分期晚,更具進展性。提高認識及早期行腸鏡檢查有助于早期診斷。