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两种不同手术方法治疗马蹄形肛瘘的临床效果研究
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作者 张磊 霍新凯 +3 位作者 袁吉林 李梦龙 于伟悦 史忠瑞 《中国临床实用医学》 2019年第2期34-37,共4页
目的探讨两种不同手术方法治疗马蹄形肛瘘的临床效果。方法选取2016年1月至2018年6月德州市人民医院肛肠外科收治的98例马蹄形肛瘘患者,按照不同手术类型分为马蹄形A组与马蹄形B组,每组49例。马蹄形A组男26例,女23例,年龄(45.23±2.... 目的探讨两种不同手术方法治疗马蹄形肛瘘的临床效果。方法选取2016年1月至2018年6月德州市人民医院肛肠外科收治的98例马蹄形肛瘘患者,按照不同手术类型分为马蹄形A组与马蹄形B组,每组49例。马蹄形A组男26例,女23例,年龄(45.23±2.67)岁,年龄范围为24~68岁。马蹄形B组男27例,女22例,年龄(46.19±2.34)岁,年龄范围为22~66岁。马蹄形A组对肛门后正中内口进行切开处理,在外口部位或者是两侧的肛管末端作一呈现出放射状的切口,将纤维组织切除之后,保证其贯通肛缘的两侧切口,随后使用刮匙。马蹄形B组则是在探针探出之后使用挂线,并使用刮匙。比较两组不同手术方法治疗马蹄形肛瘘的临床治疗效果、创面愈合时间、术后疼痛评分、肛门括约肌评分及治疗满意率。结果马蹄形A组患者的有效率为89.8%(44/49),马蹄形B组患者的有效率为73.5%(36/49)。马蹄形A组有效率高于马蹄形B组,差异有统计学意义(P<0.05)。马蹄形A组患者的创面愈合时间[(6.54±0.89)d]较马蹄形B组[(7.89±0.92)d]短,术后疼痛评分[(2.87±0.43)分]与肛门括约肌评分[(5.67±0.67)分]较马蹄形B组[(3.91±0.51)分、(7.89±0.71)分]低,差异有统计学意义(P<0.05)。马蹄形A组患者的治疗满意率为89.8%(44/49),马蹄形B组患者的治疗满意率为71.4%(35/49),马蹄形A组患者的治疗满意率高于马蹄形B组,差异有统计学意义(P<0.05)。结论放射状切开挂线对口引流术治疗马蹄形肛瘘能够获得更好的临床治疗效果,缩短创面愈合时间,预后更好,治疗满意度较高。 展开更多
关键词 肛瘘 肛管直肠瘘 马蹄形肛瘘
Prevalence of anal fistula in the United Kingdom 预览
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作者 Suvi RK Hokkanen Naomi Boxall +2 位作者 Javaria Mona Khalid Dimitri Bennett Haridarshan Patel 《世界临床病例杂志》 2019年第14期1795-1804,共10页
BACKGROUND Anal fistula is a pathological connection between the anal canal and perianal skin, which most commonly develops from an infected anal crypt. While the majority of anal fistulas are idiopathic, they are als... BACKGROUND Anal fistula is a pathological connection between the anal canal and perianal skin, which most commonly develops from an infected anal crypt. While the majority of anal fistulas are idiopathic, they are also associated with Crohn’s disease (CD) and other inflammatory conditions. The prevalence of anal fistula is estimated to be 1-2 per 10000 patients, but population-based studies on anal fistula epidemiology are limited and outdated. AIM To assess the prevalence of anal fistula and relevant comorbidities, with and without CD in the United Kingdom and Europe. METHODS A retrospective population-representative observational cohort study was performed in The Health Improvement Network (THIN), a United Kingdom primary care database. Mid-year point prevalence of anal fistula was calculated on the first of July for each year between 2014 and 2017. Estimates were calculated for anal fistula overall and by CD status and standardized to the United Kingdom and European population. Prevalence of relevant comorbidities including lymphogranuloma venereum, hidradenitis suppurativa, anal presentation of sexually transmitted diseases, diabetes mellitus, and radiation in the pelvic area was reported. RESULTS The United Kingdom-standardized overall point prevalence of anal fistula was 1.80 (95%CI: 1.65-1.94) per 10000 patients in 2017, while the Europe standardized estimate was 1.83 (95%CI: 1.68-1.98) per 10000 patients. Both these standardized point prevalence estimates ranged from 1.89 to 2.36 between 2014-2016. The United Kingdom-standardized point prevalence of anal fistula without CD was 1.35 (95%CI: 1.23-1.48) per 10000 patients, while the Europe-standardized estimate was 1.39 (95%CI: 1.26-1.52) per 10000 patients. In contrast, the standardized point prevalence estimate of anal fistula with CD was lower for both United Kingdom and Europe (0.44;95%CI United Kingdom: 0.37-0.52, 95%CI Europe: 0.37-0.51) per 10000 patients in 2017. In 2017, 19% of anal fistula patients without CD and 13% of anal fistula patients with 展开更多
关键词 Anal FISTULA United KINGDOM Europe Crohn's disease COMORBIDITIES PREVALENCE
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瘘管纱布填塞引流器的设计和应用 预览
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作者 冯清波 冯春梅 +3 位作者 顾加祥 袁超群 刘宏君 张文忠 《中国中西医结合急救杂志》 CAS CSCD 北大核心 2019年第4期481-482,共2页
纱布填塞引流是治疗各类腹壁瘘管及窦性压疮的常用手段.由于压疮或瘘管外口较小、窦道深,常规纱布填塞法有许多的弊端.在没有熟练操作基础和合适工具时需要靠镊子牵拉外口,扩张窦道,进行纱布填塞引流,给患者带来极大的痛苦,还可能使伤... 纱布填塞引流是治疗各类腹壁瘘管及窦性压疮的常用手段.由于压疮或瘘管外口较小、窦道深,常规纱布填塞法有许多的弊端.在没有熟练操作基础和合适工具时需要靠镊子牵拉外口,扩张窦道,进行纱布填塞引流,给患者带来极大的痛苦,还可能使伤口扩大导致愈合延迟.目前缺少对纱布填塞的辅助工具.因此,特设计了一种用于各类瘘管及窦性压疮填塞引流治疗的纱布填塞器,该装置具有引流效果良好、操作简单、成本低廉、安全有效的优点,不仅提高了患者舒适度,减少了换药次数,并且减轻了医务工作者负担,值得在临床工作中推广使用. 展开更多
关键词 压疮 瘘管 开放引流术 纱布填塞
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人参白茅根汤在促进肛瘘术后创面愈合中的应用价值研究 预览
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作者 罗会华 王罡艳 王倩 《结直肠肛门外科》 2019年第2期207-211,共5页
目的研究人参白茅根汤对肛瘘术后创面生长因子及炎症指标的影响。方法纳入2013年4月至2017年4月武汉市第八医院收治的70例接受切开挂线术治疗的肛瘘患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组各35例。对照组术后... 目的研究人参白茅根汤对肛瘘术后创面生长因子及炎症指标的影响。方法纳入2013年4月至2017年4月武汉市第八医院收治的70例接受切开挂线术治疗的肛瘘患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组各35例。对照组术后接受高锰酸钾坐浴干预,观察组术后口服人参白茅根汤并进行人参白茅根汤坐浴干预。观察记录两组患者总体疗效、创面愈合时间,比较两组入院时及术后2w创面生长因子和炎症指标水平变化情况及两者的关系。结果观察组患者总体疗效和显效率均优于对照组(均P<0.05);观察组创面平均愈合时间为(23.54±3.61)d,对照组为(28.29±4.57)d,两组比较差异有统计学意义(P<0.05)。两组术后2w时EGF、VEGF、FGF-1水平均高于入院时(均P<0.05),且观察组均高于对照组(均P<0.05)。两组术后2w时IL-6、TNF-α及IFN-γ水平低于入院时(P<0.05),且观察组均低于对照组(均P<0.05)。两组术后2w时IL-6、TNF-α、IFN-γ水平均与EGF、VEGF及FGF-1水平具有负相关性(均P<0.05)。结论人参白茅根汤用于肛瘘切开挂线术后能缩短术后创面愈合时间,这可能与人参白茅根汤促进创面生长因子分泌、减轻炎症反应有关。 展开更多
关键词 肛瘘 人参白茅根汤 生长因子 炎症反应 创面
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以耳轮棘为解剖标志的精细耳前瘘管切除术疗效及复发相关因素分析
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作者 周萍 陈金辉 +1 位作者 黄婷 陶泽璋 《中国耳鼻咽喉头颈外科》 CSCD 2019年第4期194-197,共4页
目的探讨以耳轮棘为解剖标志的精细耳前瘘管切除术治疗先天性耳前瘘管的疗效及复发相关因素。方法回顾性分析2015年3月~2018年3月于武汉大学人民医院接受治疗的69例(75耳)先天性耳前瘘管患者的临床资料。结果所有患者的切口均一期愈合,... 目的探讨以耳轮棘为解剖标志的精细耳前瘘管切除术治疗先天性耳前瘘管的疗效及复发相关因素。方法回顾性分析2015年3月~2018年3月于武汉大学人民医院接受治疗的69例(75耳)先天性耳前瘘管患者的临床资料。结果所有患者的切口均一期愈合,术后随访6~42个月,复发3耳,治愈率96%,复发率4%。有前期瘘管切除史的患者及行本次瘘管切除术的患者术后复发时间为2个月~8年不等。不同的性别、年龄、侧别、术前是否处于感染期、感染病程长短、局麻和全麻的复发率差异均无统计学意义。结论以耳轮棘为解剖标志的精细耳前瘘管切除术有良好的疗效,较低的复发率。术后需长期随访。 展开更多
关键词 耳疾病 复发 耳轮棘 精细手术
磁化传递成像评估克罗恩病肠瘘发生风险的应用价值 预览
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作者 林锦江 卢宝兰 +6 位作者 王红莉 方壮念 黄斯韵 孙灿辉 冯仕庭 李子平 李雪华 《中山大学学报(医学版)》 CAS CSCD 北大核心 2019年第1期130-135,共6页
【目的】探讨磁化传递成像(MTI)预测克罗恩病(CD)患者肠瘘发生风险的应用价值。【方法】分析12例CD手术患者的术前MTI资料,在磁化传递率(MTR)图像上测量并计算病变肠壁的标准化MTR(标准化MTR=肠壁MTR/肌肉MTR)。采用MTI图像和手术切除... 【目的】探讨磁化传递成像(MTI)预测克罗恩病(CD)患者肠瘘发生风险的应用价值。【方法】分析12例CD手术患者的术前MTI资料,在磁化传递率(MTR)图像上测量并计算病变肠壁的标准化MTR(标准化MTR=肠壁MTR/肌肉MTR)。采用MTI图像和手术切除肠道区域对区域定位的方法,切取对应位置的肠壁组织行Masson染色以评估纤维化程度。采用Wilcoxon秩和检验比较有肠瘘和无肠瘘肠壁的标准化MTR,绘制ROC曲线分析标准化MTR预测CD肠瘘发生的效能。【结果】12例患者手术切除15个病变肠段,共获取35个肠壁标本,其中发生肠瘘的肠段有5段共12个标本,无发生肠瘘的肠段有10段共23个标本。有肠瘘的肠壁标准化MTR高于无肠瘘者(P=0.045)。ROC曲线分析显示标准化MTR预测病变肠壁发生肠瘘风险的曲线下面积为0.674(95%置信区间:0.537-0.811);以标准化MTR=0.768为诊断阈值时,诊断可能发生肠瘘的敏感度和特异度分别为93.3%、51.1%。有肠瘘的肠壁的纤维化评分高于无肠瘘者(P=0.012)。肠壁标准化MTR与纤维化评分呈正相关(r=0.708,P<0.001)。【结论】MTI可能有助于预测CD肠瘘的发生风险,可提前为临床制定有效治疗策略提供有价值的信息。 展开更多
关键词 磁化传递成像 克罗恩病 肠瘘
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Effect of Blumgart anastomosis in reducing the incidence rate of pancreatic fistula after pancreatoduodenectomy 预览
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作者 Ya-Tong Li Han-Yu Zhang +6 位作者 Cheng Xing Cheng Ding Wen-Ming Wu Quan Liao Tai-Ping Zhang Yu-Pei Zhao Meng-Hua Dai 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第20期2514-2523,共10页
BACKGROUND Pancreatic fistula is one of the most serious complications after pancreatoduodenectomy for treating any lesions at the pancreatic head. For years, surgeons have tried various methods to reduce its incidenc... BACKGROUND Pancreatic fistula is one of the most serious complications after pancreatoduodenectomy for treating any lesions at the pancreatic head. For years, surgeons have tried various methods to reduce its incidence. AIM To investigate and emphasize the clinical outcomes of Blumgart anastomosis compared with traditional anastomosis in reducing postoperative pancreatic fistula. METHODS In this observational study, a retrospective analysis of 291 patients who underwent pancreatoduodenectomy, including Blumgart anastomosis (201 patients) and traditional embedded pancreaticojejunostomy (90 patients), was performed in our hospital. The preoperative and perioperative courses and longterm follow-up status were analyzed to compare the advantages and disadvantages of the two methods. Moreover, 291 patients were then separated by the severity of postoperative pancreatic fistula, and two methods of pancreaticojejunostomy were compared to detect the features of different anastomosis. Six experienced surgeons were involved and all of them were proficient in both surgical techniques.RESULTS The characteristics of the patients in the two groups showed no significant differences, nor the preoperative information and pathological diagnoses. The operative time was significantly shorter in the Blumgart group (343.5 ± 23.0 vs 450.0 ± 40.1 min, P = 0.028), as well as the duration of pancreaticojejunostomy drainage tube placement and postoperative hospital stay (12.7 ± 0.9 d vs 17.4 ± 1.8 d, P = 0.031;and 21.9 ± 1.3 d vs 28.9 ± 1.3 d, P = 0.020, respectively). The overall complications after surgery were much less in the Blumgart group than in the embedded group (11.9% vs 26.7%, P = 0.002). Patients who underwent Blumgart anastomosis would suffer less from severe pancreatic fistula (71.9% vs 50.0%, P = 0.006), and this pancreaticojejunostomy procedure did not have worse influences on long-term complications and life quality. Thus, Blumgart anastomosis is a feasible pancreaticojejunostomy procedure in pancreatoduodenectomy sur 展开更多
关键词 Blumgart ANASTOMOSIS PANCREATICOJEJUNOSTOMY POSTOPERATIVE pancreatic FISTULA PANCREATODUODENECTOMY INCIDENCE
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两种MRI脂序列诊断肛瘘内口的准确性比较 预览
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作者 王峰 刘杰 刘绍富 《结直肠肛门外科》 2019年第1期96-99,共4页
目的比较磁共振成像(MRI)质子密度加权像(PDWI)与增强T1加权像(T1WI)抑脂序列诊断肛瘘内口的准确性,以提高肛瘘诊治效果。方法选取2015年1月至2017年12月东莞仁康医院收治的40例经手术病理证实为肛瘘的患者,术前均接受MRI检查,以术中病... 目的比较磁共振成像(MRI)质子密度加权像(PDWI)与增强T1加权像(T1WI)抑脂序列诊断肛瘘内口的准确性,以提高肛瘘诊治效果。方法选取2015年1月至2017年12月东莞仁康医院收治的40例经手术病理证实为肛瘘的患者,术前均接受MRI检查,以术中病理结果为准,对比MRI PDWI抑脂序列与增强T1WI抑脂序列诊断肛瘘内口的准确性。结果40例患者手术病理共确诊内口58个;增强T1WI抑脂序列提示内口57个,真阳性55个;PDWI抑脂序列提示内口55个,真阳性53个。两种序列对内口的诊断敏感度、阳性预测值对比,差异均无统计学意义(均P > 0.05)。两种序列诊断对术中病理确诊内口的诊断具有中等一致性(Kappa = 0.465,P < 0.001)。增强T1WI抑脂序列的显示效果分级高于PDWI抑脂序列(P < 0.05)。结论PDWI抑脂序列和增强T1WI抑脂序列均能够在术前有效定位肛瘘内口,且后者对内口的显示效果相对较好。 展开更多
关键词 肛瘘 内口 磁共振成像 质子密度加权像抑脂序列 增强T1加权像抑脂序列
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层级护理干预在肾结石患者取石术后造瘘管护理中的应用价值体会 预览
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作者 胡宇 《中国卫生产业》 2019年第18期27-29,共3页
目的探讨层级护理干预在肾结石患者中的影响。方法将200例进行取石术的肾结石患者进行分组,观察组接受层级护理干预,对照组给予常规护理,对比术后相关指标及护理不良事件发生情况。结果观察组尿液转清时间、置管时间及住院时间均短于对... 目的探讨层级护理干预在肾结石患者中的影响。方法将200例进行取石术的肾结石患者进行分组,观察组接受层级护理干预,对照组给予常规护理,对比术后相关指标及护理不良事件发生情况。结果观察组尿液转清时间、置管时间及住院时间均短于对照组,该组的非计划拔管率、瘘管不畅或堵塞率及瘘管移位率均低于对照组(P<0.05)。结论肾结石患者在取石后应用层级护理干预能加快患者的术后康复,缩短住院时间。 展开更多
关键词 肾结石 层级护理 造瘘管 取石术
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Traditional Chinese medicine nursing protocols for anal fistulae 预览
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作者 Editorial Board of Nursing of Integrated Traditional Chinese and Western Medicine 《中西医结合护理(中英文)》 2019年第4期226-230,共5页
Anal fistula is a common disease in anorectal department that typically describes a miscommunication between the anorectum and the perianal skin. At present, surgical treatment is effective for anal fistulae, but the ... Anal fistula is a common disease in anorectal department that typically describes a miscommunication between the anorectum and the perianal skin. At present, surgical treatment is effective for anal fistulae, but the formation of fistula is different due to individual difference, consequently leading to a limited efficacy of surgical treatment. TCM has recently shown its unique advantages in accelerating the wound healing after anal fistula surgery, but the standards for syndrome differentiation of anal fistulae are still in deficiency. Thereby, this article mainly explored the key points of common syndromes, TCM nursing methods and health guidance of anal fistulae, in order to further develop the advantages of TCM and standardize related nursing management . 展开更多
关键词 ANAL FISTULA ANORECTUM injury PERIANAL ABSCESSES NURSING of traditional Chinese medicine syndrome differentiation
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Pancreatitis, panniculitis, and polyarthritis syndrome caused by pancreatic pseudocyst: A case report 预览
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作者 Sungho Jo Sanghyun Song 《世界临床病例杂志》 2019年第18期2808-2814,共7页
BACKGROUND Panniculitis, polyarthritis, and pancreatitis (PPP) syndrome is a triad comprising an extremely rare extra-pancreatic complication of pancreatic disease. Herein, we describe a patient with PPP syndrome caus... BACKGROUND Panniculitis, polyarthritis, and pancreatitis (PPP) syndrome is a triad comprising an extremely rare extra-pancreatic complication of pancreatic disease. Herein, we describe a patient with PPP syndrome caused by fistula formation between the inferior vena cava (IVC) and pancreatic pseudocyst. CASE SUMMARY A 64-year-old man visited the hospital with bilateral leg pain that began one week prior. He had no specific diseases, except hypertension. His vital signs were normal. Blood test revealed the following findings: White blood cell count, 28690/μL;amylase level, 9055 U/L;lipase level, 2089 U/L;and C-reactive protein level, 12.94 mg/dL. Computed tomography of the pancreas revealed recent acute pancreatitis. Nonsteroidal anti-inflammatory drugs were administered with no improvement. After steroid administration, pain slightly improved. Skin lesions were diagnosed as panniculitis. Bone scan and knee magnetic resonance imaging revealed osteoarthritis and bone marrow infarctions. Surgical treatment was considered;total pancreatectomy with splenectomy was performed. A pseudocyst was present posterior to the head of the pancreas, forming a fistula with the suprarenal IVC. After surgery, amylase and lipase levels decreased. However, the patient died of an uncontrolled infection on the 13th postoperative day. CONCLUSION PPP syndrome should be suspected when accompanied by skin and joint lesions. Delays in diagnosis could have catastrophic consequences. 展开更多
关键词 PANNICULITIS POLYARTHRITIS PANCREATITIS FISTULA Case report
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Giant Aneurysm of a Coronary-Pulmonary Artery Fistula:A Rare Cause of a Diastolic Murmur 预览
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作者 Andreas Seitz Sophie Schafer +2 位作者 Maik Backes Heiko Mahrholdt Peter Ong 《心血管创新与应用》 2019年第B07期143-145,共3页
A coronary-pulmonary artery fistula with giant aneurysmal dilatation is an extremely rare clinical constellation.The natural course of this disease and the incidence of complications are unknown.Hence,optimal treatmen... A coronary-pulmonary artery fistula with giant aneurysmal dilatation is an extremely rare clinical constellation.The natural course of this disease and the incidence of complications are unknown.Hence,optimal treatment,particularly in asymptomatic patients,is still a matter of debate.Here we report a case of a 71-year-old asymptomatic woman with a diastolic murmur.Comprehensive cardiovascular assessments including cardiac computed tomography and invasive coronary angiography revealed a coronary-pulmonary artery fi stula with giant aneurysmal dilatation.The patient was managed conservatively and has now been followed up for 5 years without any events. 展开更多
关键词 CORONARY ANOMALY CORONARY FISTULA giant ANEURYSM PULMONARY artery DIASTOLIC murmur
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比较食管-胃吻合口三种不同加固方法的吻合口瘘发生率
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作者 蒋修全 陈朝奇 +3 位作者 郑伟 左天理 杨铁 唐海军 《实用肿瘤杂志》 CAS 2019年第1期75-78,共4页
目的探讨三种不同的食管-胃吻合口加固处理方法对食管癌术后吻合口瘘发生率的影响。方法选择经左胸食管-胃端侧弓上机械吻合手术患者438例,根据食管-胃吻合口不同的加固处理方法分为3组,A组(n=190)在食管胃端侧机械吻合术后采用悬吊减... 目的探讨三种不同的食管-胃吻合口加固处理方法对食管癌术后吻合口瘘发生率的影响。方法选择经左胸食管-胃端侧弓上机械吻合手术患者438例,根据食管-胃吻合口不同的加固处理方法分为3组,A组(n=190)在食管胃端侧机械吻合术后采用悬吊减张处理吻合口;B组(n=114)在食管胃端侧机械吻合术后采用间断全层加强缝合处理吻合口;C组(n=134)采用间断全层加强缝合+大网膜再次包埋的方法处理吻合口。分析不同的加固处理方法对食管-胃吻合口瘘发生率的影响。结果 A组、B组和C组吻合口瘘发生率,组间两两比较,差异均无统计学意义(均P> 0. 05)。结论食管癌弓上机械吻合术后采用3种不同吻合口加固处理方法,吻合口瘘发生率无差别。 展开更多
关键词 食管肿瘤/外科学 手术后并发症 吻合术 外科/方法 吻合术 外科/仪器和设备
Application of a 3D-printed “fistula stent” in plugging enteroatmospheric fistula with open abdomen: A case report 预览
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作者 Zi-Yan Xu Hua-Jian Ren +2 位作者 Jin-Jian Huang Zong-An Li Jian-An Ren 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第14期1775-1782,共8页
BACKGROUND Open abdomen (OA) has been generally accepted for its magnificent superiority and effectiveness in patients with severe trauma, severe intra-abdominal infection, and abdominal compartment syndrome. In the m... BACKGROUND Open abdomen (OA) has been generally accepted for its magnificent superiority and effectiveness in patients with severe trauma, severe intra-abdominal infection, and abdominal compartment syndrome. In the meantime, OA calls for a mass of nursing and the subsequent enteroatomospheric fistula (EAF), which is one of the most common complications of OA therapy, remains a thorny challenge. CASE SUMMARY Our team applied thermoplastic polyurethane as a befitting material for producing a 3D-printed “fistula stent” in the management of an EAF patient, who was initially admitted to local hospital because of abdominal pain and distension and diagnosed with bowel obstruction. After a series of operations and OA therapy, the patient developed an EAF. CONCLUSION Application of this novel “fistula stent” resulted in a drastic reduction in the amount of lost enteric effluent and greatly accelerated rehabilitation processes. 展开更多
关键词 3D PRINTING Enteroatmospheric FISTULA Open ABDOMEN ISOLATION technique Case report
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参黄合剂对大鼠瘘管创面血管内皮细胞信号通路的影响 预览
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作者 王传思 谢贻祥 +2 位作者 姚磊 黄鸿武 王永森 《安徽中医药大学学报》 2019年第1期66-70,共5页
目的观察参黄合剂对大鼠瘘管创面组织中血管内皮细胞信号通路FLK-1/KDR、PIP2、PIP3蛋白及其mRNA的影响。方法将180只雄性SD大鼠按随机数字表法分为空白对照组、空白模型组、模型对照组、生理盐水组、高锰酸钾组、参黄合剂组,每组30只... 目的观察参黄合剂对大鼠瘘管创面组织中血管内皮细胞信号通路FLK-1/KDR、PIP2、PIP3蛋白及其mRNA的影响。方法将180只雄性SD大鼠按随机数字表法分为空白对照组、空白模型组、模型对照组、生理盐水组、高锰酸钾组、参黄合剂组,每组30只。采用弹簧纱条埋置于大鼠颈背部并加混合菌液的方法复制体表瘘管模型。术后l、7、14d,分别采用Western blot法、RT-PCR法检测各组大鼠创面组织中FLK-1/KDR、PIP2、PIP3蛋白及其mRNA表达水平。结果除空白对照组外,其余5组大鼠创面FLK-1/KDR、PIP2、PIP3蛋白及其mRNA表达水平均随术后时间的延长而明显升高;术后14d,其余5组上述指标(除高锰酸钾组PIP2 mRNA外)表达水平显著高于术后1d(P<0.05)。术后1、7、14d,高锰酸钾组和参黄合剂组FLK-1/KDR、PIP2、PIP3蛋白及其mRNA表达水平均高于空白对照组、模型对照组和生理盐水组;术后7、14d,参黄合剂组FLK-1/KDR、PIP2、PIP3蛋白及其mRNA表达水平均显著高于空白对照组、模型对照组和生理盐水组(P<0.05),部分指标表达水平显著高于高锰酸钾组(P<0.05)。结论参黄合剂对大鼠瘘管创面组织中血管内皮细胞信号通路相关因子的表达具有促进作用,从而促进血管新生,加速创面愈合。 展开更多
关键词 参黄合剂 瘘管 血管内皮细胞 信号通路
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Colon cancer arising from colonic diverticulum: A case report 预览
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作者 Hajime Kayano Yusuhiko Ueda +5 位作者 Takashi Machida Shinichiro Hiraiwa Hidenori Zakoji Takuma Tajiri Masaya Mukai Eiji Nomura 《世界临床病例杂志》 2019年第13期1643-1651,共9页
BACKGROUND Colonic diverticulosis is a common disease, and the coexistence of colonic diverticulosis and colorectal cancer is often seen clinically. It is very rare that colon cancer arises from the mucosa of a coloni... BACKGROUND Colonic diverticulosis is a common disease, and the coexistence of colonic diverticulosis and colorectal cancer is often seen clinically. It is very rare that colon cancer arises from the mucosa of a colonic diverticulum. When colon cancer arises in a diverticulum and then tends to develop outside the wall, without developing within the lumen, the differential diagnosis from complicating lesions due to colonic diverticulitis is difficult. CASE SUMMARY A 76-year-old man was admitted to a nearby clinic with a chief complaint of discomfort and urinary frequency. Since a vesicosigmoidal fistula was seen on abdominal computed tomography, he was referred to our hospital. Laparoscopic sigmoidectomy was performed because the various diagnostic findings were diagnosed as a vesicosigmoidal fistula with diverticulitis of the sigmoid colon. However, on histopathological examination, it was diagnosed as a vesicosigmoidal fistula due to colon cancer arising in the diverticulum. Laparoscopic partial resection of the bladder was performed because local recurrence was observed in the bladder wall one and a half years after surgery. It is currently one year after reoperation, but there has been no recurrence or metastasis. CONCLUSION Colon cancer arising in a diverticulum of the colon should be considered when diverticulitis with complications is observed. 展开更多
关键词 COLON cancer DIVERTICULUM Colovesical FISTULA Laparoscopic surgery DIVERTICULITIS Case report
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Gastropericardial fistula: a case report
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作者 Sahar Oladzade Mehdi Zolfagharkhani +2 位作者 Alireza Sanei Motlagh Arefeh Babazadeh Soheil Ebrahimpour 《急性病杂志(英文版)》 2019年第4期173-175,共3页
Rationale: Gastropericardial fistula is a rare condition in which the patient presented with chest pain, dyspnea, tachycardia, pneumo/hydropericardium, or pericarditis. Alcohol intake or previous history of gastroesop... Rationale: Gastropericardial fistula is a rare condition in which the patient presented with chest pain, dyspnea, tachycardia, pneumo/hydropericardium, or pericarditis. Alcohol intake or previous history of gastroesophageal surgery made the patient susceptible to fistula formation. Patient concerns: An 80-year-old male complained of sudden onset of dyspnea and respiratory distress. Nausea, hematemesis, and constipation were noted on clinical examination. Diagnosis: Herniation of the gastric fundus and massive pneumopericardium due to formation of fistula in the lesser curvature. Interventions: Urgent surgery was performed. Outcomes: The patient was discharged without any complication. Lessons: Although the lethal form of this condition is rare, gastroepicardial fistula should be included in the differential diagnosis workup of cases with stomach cardia and fundus ulceration. 展开更多
关键词 Gastropericardial FISTULA DIAPHRAGMATIC HERNIA PERICARDITIS PNEUMOPERICARDIUM
先天性外中耳畸形合并第一鳃裂瘘五例临床病例分析
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作者 窦敬敏 王丹妮 +4 位作者 赵守琴 李轶 马晓波 陈沛维 杨劲松 《中华耳鼻咽喉头颈外科杂志》 CAS CSCD 北大核心 2019年第5期349-354,共6页
目的探索先天性外中耳畸形合并第一鳃裂瘘的临床病例特点。方法回顾性分析首都医科大学附属北京同仁医院2015年10月至2018年3月收治的5例先天性外中耳畸形合并第一鳃裂瘘患者的临床资料,其中男3例,女2例,年龄5~28岁。分析5例患者的临床... 目的探索先天性外中耳畸形合并第一鳃裂瘘的临床病例特点。方法回顾性分析首都医科大学附属北京同仁医院2015年10月至2018年3月收治的5例先天性外中耳畸形合并第一鳃裂瘘患者的临床资料,其中男3例,女2例,年龄5~28岁。分析5例患者的临床特点、影像学表现、治疗方法及效果。结果 5例患者均为先天性外中耳畸形外耳道狭窄合并第一鳃裂瘘,其中3例伴外耳道胆脂瘤,CT示外耳道狭窄,外耳道内软组织影充填,有时其内可见气体影或骨性分隔,外耳道骨质伴不规则破坏。5例患者均行第一鳃裂瘘切除术,合并胆脂瘤的同时切除胆脂瘤,并行外耳道成形术,术后随访10~39个月,未见感染及复发。结论先天性外耳道狭窄伴或不伴胆脂瘤均可与第一鳃裂瘘同时存在,影像学可见外耳道狭窄,外耳道内软组织影,完整切除第一腮裂瘘管及胆脂瘤并外耳道成形术,效果良好。 展开更多
关键词 耳畸形 先天畸形 耳道 胚胎发育 胆脂瘤 鲍区
Congenital bronchobiliary fistula: A case report and review of the literature 预览
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作者 Tian-Yu Li Zhi-Bo Zhang 《世界临床病例杂志》 2019年第7期881-890,共10页
BACKGROUND Congenital bronchobiliary fistula is a rare developmental abnormality with an abnormal fistula between the respiratory system and biliary tract. The aim of this report is to analyze and summarize the clinic... BACKGROUND Congenital bronchobiliary fistula is a rare developmental abnormality with an abnormal fistula between the respiratory system and biliary tract. The aim of this report is to analyze and summarize the clinical features and experience of diagnosing and treating congenital bronchobiliary fistula (CBBF) occurring in the neonatal period. CASE SUMMARY The onset of symptoms was 3 d after birth in our patient with progressive cyanosis and respiratory distress, and a large amount of green fluid was noticed in her respiratory secretion. We performed computed tomography (CT), fiberoptic bronchoscopy, and cholangiography to make a diagnosis, as well as fistulography with a bronchoscope for the first time. These examinations provided us with valuable images to make a correct diagnosis. The fistula was dissected and removed with excellent results. Surgical removal of the fistula was successful, and the baby recovered well and was discharged. She has been followed for 4 mo without any signs of discomfort. CONCLUSION The main symptom of CBBF is bile-like sputum. CT, bronchoscopy, fistulography, and intraoperative cholangiography can provide important evidence for diagnosis. Surgical resection of the fistula is the first choice of treatment. 展开更多
关键词 CONGENITAL bronchobiliary FISTULA NEONATE COMPUTED TOMOGRAPHY BRONCHOSCOPY Fistulography Case report
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Complications of proximal hypospadias repair with transverse preputial island flap urethroplasty: a 15-year experience with long-term follow-up
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作者 Chao-Xu Wang Wei-Ping Zhang Hong-Cheng Song 《亚洲男性学杂志:英文版》 SCIE CAS CSCD 2019年第3期300-303,共4页
There is still debate regarding the optimal surgical approach for proximal hypospadias. This retrospective study aims to evaluate the long-term outcomes using transverse preputial island flap urethroplasty. A total of... There is still debate regarding the optimal surgical approach for proximal hypospadias. This retrospective study aims to evaluate the long-term outcomes using transverse preputial island flap urethroplasty. A total of 320 patients were included, with a mean follow-up of 40.2 months (range: 1–156 months). Complications were encountered in 125 patients (39.1%), including fistulas in 53 (16.6%), urethral strictures in 31 (9.7%), and diverticula in 41 (12.8%). The mean timing of presentation with a complication was 15.8 months (median: 1.7, range: 1–145), of which 79.2% were early complications and 20.8% were late complications. In all, 20.8% of the patients with complications presented after ≥1 year, and 12.8% presented after ≥5 years. Univariate analysis revealed that age at the time of surgery, flap length, and location of the urethral meatus were not correlated with complications. A stricture was present in 31.7%(13/41) of those with diverticula (P < 0.001), while late urethral diverticula were accompanied by urethral strictures in 11.1%(1/9) of cases (P = 0.213). These results indicate that transverse preputial island flap urethroplasty still has a high incidence of complications, even when performed by highly experienced physicians. Most complications of hypospadias are diagnosed within 1 year postoperatively, while fistulas and urinary strictures generally occur within 2 months and diverticula tend to be present by 1 year. 展开更多
关键词 DIVERTICULUM fistula follow-up HYPOSPADIAS late COMPLICATIONS URETHRAL STRICTURE
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