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find Author "张学华" 3 results
  • 食管癌术后乳糜胸的治疗

    目的 探讨食管癌术后乳糜胸的治疗方法和效果。 方法 回顾分析湖北医药学院附属襄阳一医院684例食管癌术后并发乳糜胸18例患者的临床资料,其中男12例,女6例;年龄57.5 (38~66)岁。食管上段癌2例,食管中段癌15例,食管下段癌1例。所有患者均行左胸径路食管癌根治术,术中均未见明确的胸导管损伤,未行预防性胸导管结扎。 结果 18例均先行保守治疗,10例痊愈;再手术治疗8例,手术时间60~90 min,术后无感染等并发症发生,住院时间8~10 d;7例治愈,1例死于术后吻合口瘘。17例治愈患者3个月后复查无乳糜胸再发。 结论 食管癌术后乳糜胸患者有必要早期行10 d严格、正规的保守治疗,经保守治疗后乳糜液量仍>800 ml/d者应及时再手术治疗,手术方式以右胸径路、膈上低位胸导管结扎术为宜。

    Release date:2016-08-30 05:28 Export PDF Favorites Scan
  • Epidemiology Study of Allergic Diseases in Liangshan District

    【摘要】 目的 调查凉山地区青少年四种常见变应性疾病——湿疹、荨麻疹、变应性鼻炎(allergic rhinitis,AR)、支气管哮喘(bronchial asthma,BA)的发病情况,及农村与城区患病差异。 方法 采用分层整群抽样方式确定调查点。受调查者填写调查问卷,接受皮肤科、耳鼻喉科、内科专科医师检查。 结果 湿疹调查8 113人,发现患者810例,患病率10.0%,标准化患病率9.3%;男性患病率8.1%,女性患病率11.2%(Plt;0.01);城区与农村患病率均为10.0%。荨麻疹调查8 113人,发现患者513例,患病率6.3%,标准化患病率6.5%;男性患病率4.6%,女性患病率7.5%(Plt;0.01);农村患病率6.9%,城区患病率4.9% (Plt;0.01)。AR调查7 977人,发现患者741人,患病率9.3%,标准化患病率9.1%;男性患病率9.4%,女性患病率9.2%(Pgt;0.05);农村患病率9.0%,城区10.1%(Pgt;0.05)。BA调查7 741人,发现患者296例,患病率3.8%,标准化患病率4.0%;男性患病率3.2%, 女性患病率4.2%(Plt;0.05);农村患病率4.1%,城区患病率2.9%(Plt;0.05)。 结论 通过调查获得了凉山地区青少年四种变应疾病患病数据。发现女性湿疹、荨麻疹、BA患病率均高于男性,AR患病率相近。农村湿疹、荨麻疹、支气管哮喘患病率均高于城区,AR患病率相近。【Abstract】 Objective To obtain the prevalence rate of four common allergic diseases, including eczema, urticaria, allergic rhinitis, and bronchial asthma, in adolescent of Lianshan district; and to explore the differences of these allergic diseases prevalence rate between rural area and urban area. Methods A survey was conducted in adolescent. The cluster sampling was used. The subjects were required to fulfill the self-report questionnaires and also received physical examinations by doctors. Results A total of 8 113 individuals were included in eczema studis, in whom eczema were present in 810 with a morbidity of eczema of 10.0% (9.3% after standardized). The prevalence rate of eczema in males and females were 8.1% and 11.2%, respectively (Plt;0.01). The prevalence rate of eczema in urban area was the same as that in rural area (10.0%). A total of 8 113 people were included in the urticaria study, in whom urticaria were found in 513. The prevalence rate was 6.3% (6.5% after standardized). The prevalence rate of urticaria in males and females were 4.5% and 7.6%, respectively (Plt;0.01), and were 6.9% and 4.9% respectively in rural area and urban area (Plt;0.01). A total of 7 977 people were included in AR studis. AR was present in 741 people, and the prevalence rate of AR was 9.3% (9.1% after standardized). The prevalence rate of AR in males and females were 9.4% and 9.2% respectively (Pgt;0.05), and were 10.1% and 9.0% respectively in urban area and rural area (Pgt;0.05). A total of 7 741 people were included in BA study, and BA were present in 296 people. The prevalence rate of BA were 3.8% (4.0% after standardized). The prevalence rate in males and females were 3.2% and 4.2% respectively (Plt;0.05), and were 2.9% and 4.1% respectively in urban area and rural area (Plt;0.05). Conclusion The prevalence rate of these commom allergic diseases in adolescent of Liangshan district was obtained. The females have a higher prevalence rate of eczema, urticaria and BA than that in the males; the prevalence rate of AR in males is similar to which in the females. A higher prevalence rate of eczema, urticaria and BA is found in rural area than that in urban area; the prevalence rate of AR in urban area is similar to which in rural area.

    Release date:2016-09-08 09:52 Export PDF Favorites Scan
  • 颈部管状胃、食管器械吻合在中上段食管癌手术中的运用

    目的总结中上段食管癌手术经验,探讨管状胃、颈部器械吻合在中上段食管癌手术中的运用。 方法纳入襄阳市一医院心胸外科2010年1月至2013年3月手术治疗的中、上段食管癌患者122例,根据重建消化道手术方式不同分两组:管状胃器械吻合组68例,男38例、女30例,年龄(63.5±11.2)岁;左胸径路、食管肿瘤切除后,胃管状成形由食管床提至左颈部,采用国产管状吻合器行胃、食管吻合;全胃手工吻合组54例,男32例、女22例,年龄(62.6±10.7)岁;左胸径路、食管肿瘤切除后,全胃由食管床提至左颈部与近端食管行手工单层、宽边吻合。比较两种手术方式下患者的临床效果。 结果全组无手术死亡。管状胃器械吻合组在游离后胃的长度明显长于全胃手工吻合组(t=10.60,P=0.000),吻合时间(t=32.92,P=0.000)、总手术时间(t=5.75,P=0.000)及平均住院时间(t=9.58,P=0.000)较全胃手工吻合组缩短,吻合口瘘(χ2=4.75,P=0.029)、吻合口狭窄(χ2=6.01,P=0.014)、呼吸循环并发症(χ2=5.34,P=0.021)发生率较全胃手工吻合组低,而两组乳糜胸发生率差异无统计学意义(χ2=5.34,P=0.753)。 结论在中上段食管癌手术中,胃管状成形并颈部器械吻合能有效降低术后并发症的发生,是较为理想的消化道重建方法。

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