目的:探討纖維支氣管鏡(簡稱纖支鏡)肺泡灌洗術在治療肺部感染性疾病的療效。方法:共從內科系統中入選社區獲得性肺炎和醫院獲得性肺炎患者122例,將其分為二組,治療組:傳統治療加纖支鏡肺泡灌洗術治療肺部感染,共52例;對照組:傳統方法治療肺部感染,共70例。結果:兩組病例在發熱時間,咳嗽,咳痰及肺部羅音消失時間,住院日,抗生素使用時間,治愈率和死亡率方面對比均有顯著性差異(Plt;0.05)。結論:纖支鏡肺泡灌洗術在治療肺部感染性疾病的療效確切,且術中危險性小,值得推廣。
【摘要】 目的 探討早期微創腹腔置管灌洗在重癥急性胰腺炎（severe acute pancreatitis，SAP）治療中，對減輕炎性反應的作用。 方法 選擇2007年1月-2009年6月收治的SAP患者56例，隨機分為早期微創腹腔置管灌洗組（灌洗組，n=28）和常規治療組（對照組，n=28）；兩組同時給予生長抑素，抑酸，抗感染，保持水、電解質及酸堿平衡等綜合治療，灌洗組在常規治療基礎上早期予以微創腹腔置管灌洗。檢測兩組治療前及治療后2、5、7 d C反應蛋白（C-reactrve protein，CRP）、血清腫瘤壞死因子α（tumor necrosis factor α，TNF-α）、 白細胞介素6（interleukin，IL-6）、IL-8水平。 結果 兩組治療前CRP、TNF-α、IL-6、IL-8水平差異無統計學意義（Pgt;0.05），治療后2、5、7 d比較差異有統計學意義（Plt;0.05）。 結論 早期微創腹腔置管灌洗操作簡便易行、創傷小、療效佳，對減輕SAP所致的全身炎性反應具有較好效果，是治療SAP有效方法之一。【Abstract】 Objective To explore the effect of the early minimally invasive peritoneal lavage in severe acute pancreatitis (SAP) from Januany 2007 to June 2009. Methods A total of 56 cases of SAP were randomly divided into early minimally invasive peritoneal lavage group (lavage group, n=28) and conventional treatment group (control group, n=28). The patients were given comprehensive treatment, including somatostatin, acid suppression, anti-infection, and maintaining water, electrolyte, and acid alkali balance.In lavage group, the patients were treated with early minimally invasive peritoneal lavage in addition.The levels of C reactive protein(CRP), serum tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and interleukin 8(IL-8)were detected before and 2, 5, 7 days after tretment. Results There was no significant difference in CRP, TNF-α, IL-6, or IL-8 before treament between the two groups (Pgt;0.05). There were significant differences in CRP, TNF-α, IL-6, and IL-8 after treatment between the two groups (Plt;0.05). Conclusion Early minimally invasive peritoneal lavage is a simple, minially invasive, and effective techinique in treating SAP.
Objective To develope a modified surgical lavage tube to improve the efficacy of the treatment of orthopaedic postoperative infection. Methods A retrospective analysis was performed on 126 patients who received the pulsed lavage therapy with side-hole double valve lavage tube between March 2005 and March 2010. There were 98 males and28 females, aged 19-63 years (mean, 35 years). The infected sites included femur in 61 cases, tibiofibula in 46 cases, humerus in 12 cases, and patella in 7 cases. The lavage tube obstruction and defluvium, secondary infection of drainage opening, and wound heal ing were observed during treatment. Results No lavage tube defluvium occured during the lavage in all cases. Lavage tube obstruction occurred in 68 cases, edema at the peri pheral tissue was caused by obstruction in 9 cases; secondary infection at the lavage and drainage opening in 10 cases, which were cured after corresponding treatment. All cases achieved wound healing by first intention within 2 weeks. Lavage tube and drainage opening were closed within 1 month. All patients were followed up 1-5 years (mean, 18 months) with no recurrence. Conclusion Pulsed lavage therapy with side-hole double valve lavage tube can obviously improve the efficacy of the treatment of orthopaedic postoperative infection, so it is an effective modification to convention lavage.
目的 改善左半結腸癌性梗阻一期切除吻合術中結腸灌洗的方法。方法 利用市售塑料自來水三通管及大口徑(直徑3 cm)螺紋管制成結腸灌洗器，于梗阻近端結腸置入形成術中封密式結腸灌洗。結果 24例患者采用自制結腸灌洗器行術中結腸灌洗，無腹腔污染，術后無一例發生吻合口漏，均一期愈合，順利出院。結論 掌握好一期手術適應證，自制結腸灌洗器可運用于左半結腸癌性梗阻一期切除吻合，術中腸腔灌洗徹底，方便，無污染，無溢漏，且制作簡單，成本低。