In order to preserve more normal tissue in situ in case of severe traumatic rupture of spleen, simultaneous ligation of splenic artery and vein was performed successfully on animals and then was applied for clinic use. The preserved splenic tissue all survivied and functioned well. Patients with severe traumatic rupture of spleen grade Ⅳ-Ⅴ were all cured by ligation of both the splenic artery and vein at the same time.
目的 探討創傷性十二指腸破裂的死亡原因及破裂口修補后易再破裂的原因。方法 對廣西省北海市人民醫院近8年來所作的12例十二指腸破裂手術進行回顧性分析。結果 全組病例中，治愈9例，死亡3例。死因： ①合并傷過重； ②單純修補術后破裂口滲漏，繼發腹腔感染； ③多處破裂被遺留，造成高位腸瘺。結論 對創傷性十二指腸破裂患者，①應首先處理重要合并傷； ②對十二指腸破裂應詳細檢查，防止遺留多發性破裂傷； ③十二指腸曠置減壓術能有效降低十二指腸內壓，減少胰液和膽汁分泌，提高破裂口的愈合率。
目的 探討外傷性脾破裂非手術治療的可行性、適應證及其治療效果。 方法 回顧性分析我院1990年1月至2005年1月收治的外傷性脾破裂非手術治療46例臨床資料。結果 非手術治愈43例，3例因提前下床活動致大出血而中轉手術，其中1例并發膈下膿腫，仍經保守治療痊愈。無死亡病例。結論 在嚴格掌握適應證前提下非手術治療外傷性脾破裂安全可行，年齡及腹腔外合并傷不是影響非手術治療的主要因素。
Objective To study the relationship of hepatitis B virus （HBV） to spontaneous rupture of hepatocellular carcinoma （HCC-SR） and its mechanism. Method The related literatures about theory of HCC-SR were consulted and reviewed. Results The injury of small arteries was usually followed in patients with HCC-SR， which was related to vascular autoimmune injury caused by the HBV infection. The small arteries in which immune complex deposited were readily injured， as a result HCC-SR happened while vascular load increased. Conclusion The HBV infection resulted in vascular autoimmune injury maybe a important factor in the pathogenesis of HCC-SR.
Objective?To investigate clinical characteristics， diagnosis， and treatment for patients with spontaneous esophageal rupture， and improve clinical diagnostic and treatment level.?Methods?We retrospectively analyzed the clinical data of 34 patients with spontaneous esophageal rupture who were treated in Subei People’s Hospital from January 1996 to June 2010. There were 28 male patients and 6 female patients with their age ranging from 32 to 80 years old (mean 57.6 years old). Main clinical manifestations included severe chest and abdominal pain after vomiting， fever， dyspnea and shock. The duration between disease onset and establishing diagnosis ranged from 4 hours to 7 days. Thirteen patients received conservative treatment including chest drainage， retrograde gastrointestinal decompression and enteral nutrition through jejunostomy. Twenty one patients received surgical treatment including layered anastomosis of the ruptured esophagus， retrograde gastrointestinal decompression and enteral nutrition through jejunostomy.?Results?All the patients were cured without in-hospital death. The mean hospital stay of the 13 patients who received conservative treatment was 46 days， while that of the 21 patients who received surgical treatment was 17 days. All the ruptured esophagus were one-stage healed. All the 34 patients were followed up from l to 8 years， including 11 patients in the conservative treatment group and 19 patients in the surgical treatment group， but 4 patients was lost during follow-up. All the patients had a normal diet without symptoms of esophageal stricture， reflux esophagitis or chronic thoracic empyema.?Conclusion Spontaneous esophageal rupture is a thoracic emergency with a high misdiagnosis rate and mortality．Early diagnosis， early surgical repair of ruptured esophagus and satisfactory chest drainage play a vital role in the treatment for patients with spontaneous rupture of esophagus.
目的 總結應用脾動脈結扎加脾部分切除術治療外傷性脾破裂的臨床經驗。方法 對本院近8年間收治的64例接受脾動脈結扎加脾部分切除治療的脾外傷患者的臨床資料進行回顧性分析，重點分析脾部分切除術的手術方法、臨床療效和適應證。結果 術中雙重結扎脾動脈，然后根據脾臟損傷的情況決定保留脾臟的部位，保證殘脾不少于原脾體積的30%。全組無手術死亡病例，術后出現早期并發癥者16例（25.0%），其中發熱8例，脾窩積液1例，腸梗阻2例，左側胸腔積液3例，切口感染2例，均經對癥處理后治愈。結論 對部分外傷性脾破裂患者的治療選擇脾動脈結扎加脾部分切除術是安全可行的。
Objective To investigate the feasibility of elective laparoscopic hepatectomy in the treatment of ruptured hepatocellular carcinoma. Methods We tried to perform an elective laparoscopic hepatectomy for a middle-aged man who had a ruptured hepatocellular carcinoma without active hemorrhage. The data of this patient was summarized. Results The patient received the elective laparoscopic hepatectomy, and the liver lesions were completely removed. The operation was successful. Operative time was 300 min and intraoperative bleeding was 500 mL. Postoperative recovery of this patient was good and no complication occurred. The abdominal drainage tube was removed on 4 days after operation, and he discharged on 8 days after operation. The pathology confirmed that the hepatocellular carcinoma was moderately differentiated and ruptured. Conclusion Elective laparoscopic hepatectomy is safe and feasible in the treatment of ruptured hepatocellular carcinoma for specific patient, but this operation needs to be performed by experienced surgeons with laparoscopic skills.