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find Author "张铸" 6 results
  • Risk Factors of Postoperative Nosocomial Pneumonia after Lung Cancer Surgery

    Objective To investigate risk factors of postoperative nosocomial pneumonia in patients after lung cancer surgery, and propose corresponding preventive measures. Methods We retrospectively analyzed clinical records of 720 patients who underwent surgical resection for lung cancer in the First Affiliated Hospital of Xinjiang Medical University between June 2003 and June 2012. There were 460 males and 260 females with their average age of 60.37(17 to 83) years. Univariate analysis and multivariate non-conditional logistic regression analysis were performed to investigate independent risk factors of postoperative nosocomial pneumonia in patients after lung cancer surgery. Results Univariate analysis showed that postoperative nosocomial pneumonia was related to 9 risk factors:age eld than 60 years (χ2=26.67, P=0.000), diabetes mellitus (DM, χ2=34.46, P=0.000), chronic obstructive pulmonary disease (COPD, χ2=59.30, P=0.000), long-term history of heavy smoking (χ2=10.40, P=0.001), duration of antacid therapy (χ2=7.69, P=0.006), operation time (χ2=38.12, P=0.000), surgical strategy (χ2=4.22, P=0.040), duration of mechanical ventilation (χ2=21.86, P=0.000), and significant incision pain (χ2=19.69, P=0.000), while preoperative lung function, antibiotic prophylaxis and intraoperative blood loss were not related to postoperative nosocomial pneumonia.Multivariate analysis showed that 8 factors were independent risk factors of postoperative nosocomial pneumonia including age eld than 60 years (χ2=5.43, P=0.020), DM(χ2=8.61, P=0.003), COPD (χ2=9.15, P=0.002), long-term history of heavy smoking (χ2=5.48, P=0.019), long-term antacid therapy (χ2=13.21, P=0.000), operation time (χ2=5.36, P=0.021), duration of mechanical ventilation (χ2=5.72, P=0.017), and significant incision pain(χ2=3.87, P=0.049). Conclusion Patients after lung cancer surgery are susceptible to postoperative nosocomial pneumonia. Proper preventive measures targeting at the characteristics and risk factors of lung cancer patients may reduce the incidence of postoperative nosocomial pneumonia.

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
  • 肺部周围球形病灶误诊原因分析

    目的对行影像学检查后误诊的肺部球形病灶进行分析,以期提高对该类疾病的诊断正确率。方法回顾性分析新疆医科大学第一附属医院 2006年 5月至 2011年 4月误诊的 85例肺部球形病灶患者的临床症状及影像学表现,其中男 49例,女 36例;中位年龄 58(34~75)岁。病灶位于右肺 46例,左肺 39例,直径 2.0~ 5.6 cm。术前患者均经胸部正侧位 X线片检查,并在其后 1周内追加胸部 CT检查, 76例行 CT增强扫描。经手术组织病理学检查证实 69例,经支气管镜检查证实 9例,经穿刺组织病理学检查证实 7例。结果肺癌误诊为良性疾病 36例(肺结核 18例、炎性假瘤 12例、肺炎 4例、胸膜间皮瘤 2例);良性病变被误诊或误诊为肺癌分别为:结核球 32例被误诊为肺癌 23例、炎性假瘤 7例、肺错构瘤 2例;肺包虫 10例被误诊为肺癌 3例、肺结核 5例、炎性假瘤 2例;炎性假瘤 5例被误诊为肺癌 1例、肺结核 4例;肺错构瘤 2例被误诊为肺结核。结论仔细全面分析影像学特征并结合临床症状,合理应用检查方法,可减少肺部球形病变的误诊。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 贲门癌术前肿瘤切除可能性的评估

    目的探讨贲门癌尤其是晚期贲门癌的临床特点,术前较正确的估计肿瘤手术切除的可能性,减少不必要的探查手术。方法根据肿瘤是否能被切除,将427例贲门癌患者分为两组,手术切除组:377例,贲门癌完全被切除;手术探查组:50例,均行开胸探查术。两组患者术前均未行化疗、放疗和介入等治疗,对两组患者术前的各项临床资料行单因索和logistic多因素分析。结果logistic多因素分析结果显示当肿瘤有明显的外侵、临床表现有明显的呕吐、上胸背疼痛或腹痛、消化道X线钡餐片表现为胃底广泛增厚、胃小弯肿瘤浸润明显或有巨大软组织阴影、肿瘤〉7cm者手术切除率低。分化程度较低的腺癌手术切除率亦低。结论肿瘤外侵、呕吐和疼痛症状、消化道X线钡餐造影表现、肿瘤的大小及病理类型对贲门癌患者术前肿瘤可切除性的评估有意义。

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • 支气管异物的外科治疗

    目的总结支气管异物的外科诊治经验。方法回顾分析我科1972年1月~2004年7月经手术治疗的34例支气管异物患者的临床资料。结果34例中急诊手术5例,择期手术29例;行支气管肺修补术31例,肺叶切除术3例。术后发生肺不张4例,脓胸1例,切口感染2例,经处理后均痊愈,无死亡患者。结论对纤维支气管镜取异物失败者,可根据具体情况采取急诊或择期手术是治疗支气管异物的有效途径。

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
  • 先天性漏斗胸外科治疗36 例

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • Expert Consensus of Standard Diagnosis and Treatment Technology on Pulmonary Echinococcosis

    The high incidence of hydatid disease in seven northwestern provinces, is one of the reason of "Poverty due to illness, and return poverty due to illness" in China. The incidence of chest hydatid disease in China after hepatic hydatid disease ranks second. Department of thoracic surgery in the First Affiliated Hospital of Xinjiang Medical University is on the domestic leading position of the treatment of chest hydatid disease. Since 1956 the first case of pulmonary hydatid cyst were completed, we have successfully finished the surgical treatment of pediatric chest hydatid disease, chest hydatid disease complex, huge pulmonary hydatid cyst, mediastinal and pleural hydatid cyst, and rib hydatid in our department. To further standardize the treatment of chest hydatid disease, a special formulation of "technical specification for chest hydatid disease diagnosis expert consensus" by our department were produced, in order to help clinicians treat chest hydatid disease by more suitable strategies. This consensus was released in July 2015, for the original version. The definition, diagnosis, treatment principle, and prevention of chest hydatid disease were elaborated and clinical experiences of 60 years were combined with in this consensus, in order to help the clinicians for diagnosis, treatment, and prevention of hydatid disease.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
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