目的:探讨急性胰腺炎(AP)并发胰腺假性囊肿(PPC)的早期诊断、早期治疗方法及疗效观察。方法:急性胰腺炎患者给予常规治疗,每周复查B型超声,必要时复查上腹部CT,一旦检查诊断为胰腺假性囊肿形成,即给予TDP(CQ型特定电磁波治疗器)烤腹部相应囊肿部位皮肤,烤后再以适量黄冰解毒消肿软膏外敷腹部相应囊肿部位皮肤,每周复查B超1次,直致囊肿消失。结果: 63例胰腺假性囊肿56例胰腺假性囊肿经保守治疗后完全消失,有效率8889%(56/63),平均68周时间,最短时间2周,最长时间12周。7例囊肿未消失,其中2例囊肿有缩小,5例无效。结论: 胰腺假性囊肿形成早期诊断,早期联合物理治疗和中药外敷疗效显著,不失为一种安全、有效、经济的治疗方法。
目的探讨袋形缝合术联合中药外敷治疗骶尾部藏毛窦的临床疗效。 方法应用袋形缝合术联合中药外敷治疗骶尾部藏毛窦13例。 结果13例患者全部治愈，随访1年，未见明显复发及并发症。 结论袋形缝合术联合中药外敷治疗骶尾部藏毛窦手术操作简单，治疗彻底，缩小了手术创面，愈合时间相对缩短，复发少，患者痛苦少，长期效果优良，治疗骶尾部藏毛窦安全、有效，值得临床推广应用。
Objective To observe the different clinical response patterns of uveal melanoma (UM) patients after external scleral plaque radiotherapy (PRT), and to investigate the risk factors of secondary enucleation after treatment failure. MethodsA single-centre retrospective study. Demographic baseline characteristics and clinical data were collected from 465 UM patients treated with 125I external scleral PRT at Beijing Tongren Hospital from March 2011 to September 2017. Among them, 217 were male and 248 were female, tumor all occurred monocularly. The mean age of subjects was 46.7±12.1 years. Reasons for secondary enucleation included local tumor treatment failure, glaucoma, scleral necrosis and patient request. Tumor grading was based on the grading standards established by the American Joint Committee on Cancer (AJCC). The pattern of tumor response after PRT was classified as degenerated type, growth type, stable type or other types according to literature criteria. The median follow-up time after PRT was 59 months to observe tumor changes. Complete follow-up records of 3 or more color doppler ultrasound imaging (CDI) was available in 245 cases. A t-test was performed to compare the patient's age, intraocular pressure, best corrected visual acuity, tumor thickness and maximum basal diameter before treatment; a chi-square test was performed to compare the patient's gender, AJCC T classification of the tumor, whether the ciliary body was involved, presence of subretinal fluid, optic disc invasion and vitreous hemorrhage, tumor shape and location. Kaplan-Meier survival analysis was used to estimate the cumulative probability of secondary enucleation after extra-scleral PRT. Univariate and multivariate Cox proportional hazards regression analyses were used to evaluate the relationship between tumor characteristics and secondary enucleation after extra-scleral PRT. ResultsAmong 465 patients, eecondary enucleation was performed on 78 (16.8%, 78/465) patients during the follow-up period. The 1, 3 and 5 year secondary enucleation rates were 5.4%, 9.3% and 17.1%, respectively. Eye preservation was successful in 387 cases (83.2%, 387/465). Patients treated by secondary enucleation had a larger maximum basal diameter of tumor, a higher proportion of irregular and diffuse morphology, a cumulative macular involved and a higher AJCC T classification, the difference was statistically significant (P＜0.05). There were 115, 76, 27, and 27 cases of degenerated type, stable type, growth type, and other type, respectively. The tumor thickness of the growth type and other types was significantly smaller than that of the degenerated type and the stable type, and the difference was statistically significant (P＜0.05). Univariate Cox analysis showed that the maximum basal diameter of the tumor (HR=1.19), tumor thickness (HR=1.08), AJCC T classification (HR=1.90), growth type response pattern (relative to degenerated type response pattern) (HR=4.20) was associated with failure of eye preservation (P＜0.05). In the multivariate Cox analysis, the largest tumor basal diameter (HR=1.24) and the growth type response pattern (relative to the degenerated type response pattern) (HR=4.59) were still associated with failure of eye preservation (P＜0.05). ConclusionsThe tumor thickness of UM patients with growing and other response patterns after PRT is smaller before treatment; the maximum basal diameter of the tumor and the growing response pattern are independent risk factors for secondary enucleation.
ObjectiveTo determine the effectiveness of Yidantong recipe retained enema combined with external application of Jinhuang powder on non-severe acute pancreatitis (NSAP). MethodsA total of 134 patients with NSAP, admitted to the Third People’s Hospital of Chengdu from September 2019 to August 2022 were included in this retrospective cohort study. All patients received routine Western medicine treatment, and they were divided into a observation group (n=66) and a control group (n=68) based on whether they underwent treatment of Yidantong recipe retained enema combined with external application of Jinhuang powder. The variables including incidence of adverse clinical outcome events, severity scores after treatment, the recovery time of flatus and bowel movement, duration of fasting food and water, scores of traditional Chinese medicine (TCM) syndromes and numerical value of blood indices before and after treatment, and the treatment effect of the two groups were statistically analyzed. ResultsCompared with that of the control group, the incidence of multiple organ dysfunction syndrome (MODS) and severe acute pancreatitis (SAP) of the observation group was lower (P<0.05), and the reduction before and after treatment of APACHEⅡ score, BISAP score and Ranson score in the observation group was more than those in the control group (P<0.05). Compared with that of the control group, the recovery time of flatus and bowel movement and duration of fasting food and water of the observation group was shorter (P<0.05). The reduction before and after treatment of the scores of TCM syndromes (abdominal pain, abdominal distention, nausea and vomiting, dry mouth and bitter taste) and numerical value of blood amylase (AMY), alanine aminotransferase (ALT), alanine aminotransferase (AST) and C-reactive protein (CRP) in the observation group were more than those in the control group (P<0.05). Compared with that of the control group (83.33%), the total effective rate of the scores of TCM syndromes (95.59%) of the observation group was higher (P<0.05).ConclusionYidantong recipe retained enema combined with external application of Jinhuang powder in the treatment of NSAP is effective by combining with routine Western medicine.