【摘要】目的探讨外科手术治疗原发性肝癌致阻塞性黄疸的方法及疗效。方法自1991年1月至2001年12月期间我院对17例原发性肝癌致阻塞性黄疸的患者进行外科手术治疗，其中行肝叶切除及胆总管切开取癌栓者14例,行同种异体原位肝移植术3例。结果患者平均生存时间为8个月,最长24个月。结论外科治疗原发性肝癌致阻塞性黄疸明显改善了患者生活质量,延长了生存时间。
Objective To investigate the operative effects of gluteal muscle contracture. Methods A total of 128 cases of gluteal muscle contracture treated with operative methods from February 2001 to May 2009 were reviewed. Results All the patients received operation. Most patients were satisfied with the treatment via function exercise in the early stage. No severe complication was found. The patients were followed up for 6 to 84 months, at the average of 36 months. According to Huang Yaotians criteria, 67.9% (87/128) of the patients were excellent; 27.3% (35/128) were good; 3.9% (5/128) were fair; and 0.8% (1/128) were poor in effectiveness. Conclusion Operation and function exercise after operation have advantages of minitrauma and good function recovery, and it is a satisfactory method to treat the gluteal muscle contracture.
目的：探讨松果体区肿瘤的治疗策略。方法:我院自2003年12月至2007年12月收治的58例松果体区肿瘤，按肿瘤标志物甲胎蛋白（AFP）和人β促绒膜性腺激素（hCG-β）将其分为标志物增高组和正常组，回顾分析两组临床资料和治疗体会。结果:肿瘤标志物正常组36例，其中27例行手术切除肿瘤，9例行伽马刀治疗（其中5例行伽马刀加脑室腹腔分流治疗）。术后4例因病理报告示生殖细胞瘤行伽马刀补充治疗，3例因梗阻性脑积水行脑室腹腔分流。增高组22例，均选用伽马刀治疗（其中17例合并梗阻性脑积水者行伽马刀加脑室腹腔分流）。治疗后3例因症状缓解不佳行手术切除肿瘤术。手术病例中24例采用经胼胝体入路，4例经枕部小脑幕入路，2例经幕下小脑上入路。手术全切24例，次全切5例，部分切除1例，术后住院期内死亡者1例。病理诊断:生殖细胞瘤14例，畸胎瘤5例，中枢神经细胞瘤4例，室管膜瘤2例，表皮样囊肿2例，脑膜瘤1例，胶质瘤1例，皮样囊肿1例。放射外科治疗病例中28例术后3个月临床症状明显改善，4例随访期内肿瘤无明显变化，3例肿瘤增大。2例放疗后出现鞍区转移。结论:松果体区肿瘤组织类型多样，应尽可能先明确肿瘤性质后选择合理治疗策略。
We evaluated the surgical results in 32 patients with liver metastasis from colorectal carcinoma. Twenty four patients had 1-3 metastatic hepatic nodules and 20 patients had synchronous hepatic metastasis. Liver resection was carried out simultaneously with radical resection of the primary tumour in 15 patients, 5 patients experienced resection 2 to 4 weeks later. Liver and primary tumour were resected as a whole in 5 patients with infiltrating metastasis from colonic carcinoma.Other operative types included atypical resections, left lateral lobectom and right posterior lobectomy, and right hemihepatactomy, right trilobectomy.Hepatic metastasis were all documented by pathology. The 3year and 5year survival rate were 37.5% and 25.0%, with no operative death. The authors believed that the number of metastasis is the most important factor influencing the surgical result, and liver resection is an effective form of treatment for patients with resectable liver metastasis from colorectal carcinoma, but the type of surgery shall be choosed reasonably.
ObjectiveTo study the application value of mixed formulations consisting of paraffin oil, dimethyl silicone oil, and senna preparations in treatment for incomplete adhesive intestinal obstruction after laparotomy. MethodsOne hundred and twentyeight patients diagnosed incomplete adhesive intestinal obstruction admitted to this hospital from March 2005 to May 2008 were randomly divided into trial group and control group. For the control group, the tradition therapy including fasting, gastrointestinal decompression, fluid replacement therapy, and enema with soap and water were used for treatment. For the trial group, the mixed formulations consisting of paraffin oil, dimethyl silicone oil, and senna preparations were injected into stomach by the nasogastric tube on the basis of traditional treatment used for the control group. Some indicators including the successful rate of nonoperative treatment, the time that obstructive symptoms resolved and returned to normal exhaust and defecation and normal diet, and recurrence rate were compared between two groups. ResultsThe successful rate of nonoperative treatmentin in the trial group were significantly higher than that in the control group 〔92.1% (70/76) versus 69.2% (36/52), Plt;0.01〕. The average time that recovered to normal exhaust and defecation in the trial group and the control group was 32.5 d and 47.8 d, respectively. The average time that recovered to normal diet in the trial group and the control group was 3.2 d and 5.3 d, respectively. The time that recovered to normal exhaust and defecation, and diet in the trial group were significantly shorter than those in the control group (Plt;0.01). The recurrence rate had no significant difference between two groups (Pgt;0.05). ConclusionThe mixed formulations consisting of paraffin oil, dimethyl silicone oil, and senna preparations improve recovery of intestinal function and reduce surgical intervention rate.
Objective To explore the value of surgical treatment in rectal small cell neuroendocrine carcinoma (RSCC). Method The clinical data of patients with pathologically diagnosed as RSCC from 2000 to 2019 were extracted from the Surveillance, Epidemiology and End Results (SEER) database, to explore the effect of surgical treatment on cancer-specific survival (CSS) and overall survival (OS). Results A total of 348 cases were included with the median follow-up of 8 months (IQR: 3–16 months). Of the 101 patients in the operation group, 84 died (83.2%), including 56 tumor-related deaths (55.4%). Of the 247 patients in the non-operation group, 215 died (87.0%), including 131 tumor-related deaths (53.0%). The estimated 1-year OS of the operation group and the non-operation group were 49.6% and 34.4%, respectively, and the estimated 1-year CSS of those were 62.2% and 49.2%, respectively. There were significant differences between the two groups (both P<0.05). Results of multivariate prognostic analysis by Cox proportional hazard model showed that differentiation, SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for OS, and SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for CSS (all P<0.05). The OS [RR=0.61, 95%CI was (0.45, 0.81), P<0.001] and CSS [RR=0.67, 95%CI was (0.47, 0.95), P=0.025] in RSCC patients were significantly improved by surgical treatment. Conclusion Surgical treatment can improve the OS and CSS in RSCC patients.
【摘要】 目的 对比玻璃体手术和巩膜环扎术对治疗非复杂性孔源性视网膜剥离（rhegmotogenous retinal detachment，RRD）的疗效。 方法 检索Pubmed、Embase、Cochrane对照试验中心注册数据库，对相关的随机对照临床试验（randomized controlled trialc，RCT）按Cochrane协作网推荐的方法进行Meta分析。 结果 有晶状体组包括3篇RCT共523例，人工晶状体/无状晶体组包括4篇RCT共690例。有晶状体组玻璃体手术（pars plana vitrectomy，PPV）术后白内障的发生率更高[OR=4.18，95%CI（2.75，6.35），Plt;0.000 01]。人工晶状体/无晶状体组PPV术后最终解剖复位率更高[OR=1.97，95%CI（1.04，3.73），P=0.04]。 结论 巩膜环扎术通过降低术后白内障的发生率在治疗非复杂性有晶状体眼RRD中占有优势；PPV可提高最终解剖复位率，更适合人工晶状体/无晶状体眼RRD。【Abstract】 Objective To compare the efficacy of pars plana vitrectomy (PPV) and scleral buckling (SB) in treating uncomplicated rhegmatogenous retinal detachment (RRD). Methods Randomized controlled trials (RCTs) were searched from Pubmed, Embase and the Cochrane Central Register. Meta-analysis was conducted using the methods recommended by the Cochrane Collaboration. Results Three RCTs with 523 phakic eyes and four RCTs with 690 pseudophakic/aphakic eyes were included. In the phakic group, the rate of postopertative cataract was higher with PPV [OR=4.18, 95% CI (2.75,6.35), Plt;0.000 01]. In the pseudophakic/aphakic group, final anatomic success outcome was in favor of PPV [OR=1.97, 95% CI (1.04,3.73), P=0.04]. Conclusions SB results better in terms of postoperative cataract in phakic RRDs. PPV is more likely to achieve a favorable final reattachment in pseudophakic/aphakic RRDs.