目的 探讨闭合性十二指肠损伤的诊断与术式选择及其效果。 方法对1980～1999年间收治的33例闭合性十二指肠损伤患者临床资料进行回顾性总结分析。结果 合并伤27例，其中胰腺损伤占24.2%(8/33)，术前诊断率为18.2%(6/33)，术中漏诊率为15.2%(5/33)。术式选择：单纯十二指肠损伤以修补为主，十二指肠裂口较大或缺损者，可采用空肠浆膜覆盖术及十二指肠空肠Y型吻合术等其它术式，合并有胰腺损伤者宜行Graham简化术。同时应行充分的十二指肠减压和腹腔引流。术后并发症发生率为39.4%(13/33)，治愈率为84.8%(28/33)，死亡率为15.2%(5/33)。 结论 十二指肠损伤应重视早期诊断，在剖腹探查中应识别其损伤特征，并掌握切开探查方法，防止漏诊；术式选择宁简勿繁，不同患者适时、适当地采用最佳的诊断和治疗方法是十二指肠损伤手术成功的关键。
目的 探讨外伤性脾破裂手术适应证和方法。方法 对77例外伤性脾破裂进行保脾手术治疗，按姜洪池脾损伤四级分类法： Ⅰ级8例，Ⅱ级41例，Ⅲ级18例，Ⅳ级10例。附加脾动脉结扎术6例。结果 死亡4例； 2例并粘连性肠梗阻。获随访45例，随访时间3个月至3年，仅4例儿童有反复上呼吸道感染，无1例发生脾切除后凶险感染(OPSI)。结论 根据脾损伤的部位和程度，可采用两种以上的联合保脾术式，对控制伤脾出血及保留脾脏功能有重要价值。
目的探讨疝环充填式无张力疝修补术在腹外疝修补术中的价值。方法回顾性总结1999年5月至2002年10月我院应用疝环充填式无张力疝修补术治疗腹外疝患者58例，共62例次。其中合并高血压、心肺功能不全、前列腺肥大、糖尿病者占39.7%（23/58）。 结果切口均为一期愈合。术后3～7 d出院。随访１～29个月，平均18个月，随访率为89.7%（52/58）,无一例复发。结论疝环充填式无张力疝修补术具有创伤小、符合解剖生理、痛苦少、恢复快及复发率低等优点。
Objective To analyze the effect of meglumine diatrizoate on diagnosing and treating adhesiveness small intestinal obstruction. Methods The clinic data of 484 cases of adhesiveness small intestinal obstruction were analyzed retrospectively. Those patients were treated with radiography with 76% of meglumine diatrizoate by orally or injected. Results After taking meglumine diatrizoate, 362 patients were cured, and the other 122 cases were diagnosed clearly and treated with surgery. Conclusions Meglumine diatrizoate can be used to diagnose adhesiveness small intestinal obstruction and confirm where the obstruction is. It can be the routine treatment for adhesiveness small intestinal obstruction and can be used repeatedly. It also can provide evidence to surgical treatment and guide to make the surgical project.
目的 观察泛影葡胺在粘连性肠梗阻中的诊断及治疗效果和手术时机的选择。方法 对137例粘连性肠梗阻患者经胃管注入76%泛影葡胺60~100 ml行胃肠道造影，通过腹部X线摄片动态观察造影剂在胃肠道中的位置及通过情况，以确定梗阻部位以及梗阻是否完全，从而确定手术时机。结果 137例中103例造影剂在6~24 h后到达结肠而给予保守治疗，平均症状缓解时间为14.8 h，1~6 d (平均3.3 d)后症状消失。另34例见造影剂不能到达结肠且症状体征加重而行手术治疗,痊愈。结论 泛影葡胺胃肠道造影在对粘连性肠梗阻明确梗阻部位及手术时机的选择方面有很好的指导作用，可作为临床医师诊断与治疗粘连性肠梗阻的一种手段。
Objective To observe the effect of gefitinib on expression of epidermal growth factor receptor (EGFR) in bile duct epithelial cells, and the feasibility of inhibiting hyperplasia of bile duct epithelial cells with gefitinib. Methods Sixty-one patients with hepatolithiasis having to be in hospital for surgery from the First People’s Hospital of Shuangliu county were selected, with 25-65 years old, average 46.92 years. The patients were randomly divided into therapy group and control group. There were 30 cases in therapy group, in which fine duct was placed on lesion bile duct during operation, and through whom gefitinib solution was perfused after operation. There were 31 cases in control group with only T tube drainage after operation. The bile duct sample was obtained respectively during the operation and 6 weeks and 12 weeks after operation. The histology and expression change of EGFR were observed by HE staining, immunohistochemistry and RT-PCR method respectively. Results There were no significant differences in pathohistology changes of bile duct and the EGFR protein and mRNA expression between therapy group and control group during operation. The hyperplasia of epithelium mucosae and submucosal gland in the therapy group were obviously decreased as compared with those in control group, the EGFR mRNA and protein expression in therapy group were weaker than those of control group （Plt;0.05） 6 weeks and 12 weeks after gefitinib treatment. Conclusion EGFR is overexpressed in the chronic proliferative cholangitis, and continuously local application of gefitinib after operation can specifically interrupt the activation and expression of EFGR and then effectively inhibit the hyperplasia of bile duct epithelial cells.