Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
目的 探讨胃切除术后近期上消化道大出血的原因及再手术治疗。 方法 对我院1986~2002年间收治的14例胃切除术后近期(24~72 h内)上消化道大出血行再手术治疗的病例资料进行回顾性分析。 结果 本组14例,术后吻合口出血4例,残胃粘膜损伤出血2例,残胃肠套叠出血2例,十二指肠残端出血1例,遗漏十二指肠球后溃疡及贲门粘膜撕裂出血各1例,原因不明出血3例,均经再次手术治疗后痊愈。 结论 胃切除术后近期上消化道大出血原因多为操作不当及病灶遗漏所致,出血灶直视下缝扎为有效止血方法。
目的:应用微创液化引流术治疗高血压壳核出血的疗效。方法:对120例高血压壳核出血患者,在CT引导下,依据血肿大小、形态及患者病情,选择适宜的穿刺点、方向,行CT平面导向下微创液化引流术,清除血肿。结果:120例患者出院94例,死亡26例,病死率为21.6%。对存活65例患者随访6个月至2年,以日常生活能力(ADL)评估患者神经功能,ADL128例(43%),ADL220例(30.7%)、ADL310例(15.3%)、ADL45例(7.6%)、ADL52例(3.0%)。结论:应用微创液化引流治疗壳核出血,能最大限度地清除血肿,避免或减轻并发症,具有较大优越性。
目的 探讨原发性肝癌自发性破裂腹腔内出血的临床特点和手术治疗方法。方法 回顾性分析我院1998~2007年收治的53例经手术证实的原发性肝癌自发性破裂腹腔内出血患者的临床资料,结合文献复习进行讨论。结果 53例患者均以突发性腹痛为首发症状,有前期症状者33例,无症状者20例; 有外伤史者(左上腹或季肋区)6例; 有腹膜炎体征46例,腹腔穿刺抽出不凝血41例,合并休克29例。术前误诊16例。行急诊手术48例,施行肝切除33例。术后肝功能不全34例,其中3例死于肝功能衰竭。术后生存3 d~78个月,平均34.6个月。结论 原发性肝癌自发性破裂腹腔内出血多以腹痛为首发,常以血性腹膜炎表现为特点,术前误诊率较高; 手术方式根据病变位置、大小,肿瘤是否局限、转移和肝硬变程度决定。术后近期死亡原因主要是肝功能衰竭,远期死亡原因主要是复发转移。