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find Author "曹宽" 4 results
  • 原发性十二指肠肿瘤118例临床分析

    目的总结原发性十二指肠肿瘤的临床特点,探讨其诊断及治疗方法。 方法回顾性分析徐州医学院附属医院2009年1月至2014年5月期间收治的118例原发性十二指肠肿瘤患者的临床资料,其中良性5例,恶性113例。 结果本组患者的临床表现缺乏特异性。各种检查方法的检出率胃十二指肠内镜为90.8%(69/76)、ERCP为92.3%(24/26)、MRCP为88.1%(37/42)、CT为68.7%(46/67)、B超为38.3%(41/107)。好发部位为十二指肠降部。良、恶性肿瘤的主要病理类型分别为腺瘤和腺癌。5例良性肿瘤均行手术切除,术后3年均健在。113例恶性肿瘤中,行手术治疗93例,术后3年生存率为45.2%(42/93);另外20例患者拒绝治疗,3年内患者均死亡。 结论对原发性十二指肠肿瘤,在临床工作中,需结合内镜、影像学和实验室检查,早发现、早诊断。综合考虑患者基础情况及肿瘤生长情况,选择最有利于患者的治疗方案,从而改善患者预后,提高生活质量。

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  • 腹腔脏器转位伴胆管变异合并急性梗阻性化脓性胆管炎1例报道

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  • Clinical analysis on 18 cases of retroperitoneal ganglioneuroma

    ObjectiveTo Summarize the clinical features of retroperitoneal ganglioneuroma.MethodsA total of 18 cases of pathologically confirmed retroperitoneal ganglioneuroma, who received surgery in The Affiliated Hospital of Xuzhou Medical University from May 2013 to July 2016, were collected to reviewe the clinical features, imaging findings, pathologic characteristics, treatments, and prognosis of retroperitoneal ganglioneuroma.Results① Clinical symptoms. Of the 18 cases, 8 cases were found by physical examination, and had no symptoms; 6 cases showed abdominal pain and discomfort; 3 cases had hypertension; 1 case had bulge and discomfort in the lower abdomen. ② Imaging performance. All of the 18 cases underwent color Doppler ultrasonography, 16 cases showed clear hypoechoic mass, and hypoechoic masses showed irregular shape in 2 cases; homogeneous echo in 12 cases and inhomogeneous echo in 6 cases could be seen. Seventeen cases underwent CT scan, and homogeneous low density in 14 cases, uneven density in 3 cases, scattered calcification in 3 cases could be seen. Fifteen cases underwent CT dynamic contrast-enhanced scan, 2 cases showed no significant enhancement both in dynamic and venous phase, 8 cases showed no significant enhancement in arterial phase, 11 cases showed heterogeneous enhancement in venous phase. Three cases underwent MRI scan, T1WI images of 3 cases showed uniform low signal; T2WI images showed high signal in 1 case, T2WI images showed high signal with moderate intensity in 2 cases. ③ Surgery and prognosis. Fifteen cases underwent laparoscopic retroperitoneal tumor resection,3 cases underwent open surgery, and all the tumors were completely resected. All cases had good postoperative recovery and no significant complication occurred. All cases were followed up for 6 to 32 months with a median of 20 months, no recurrence or distant metastasis was found during follow-up period.ConclusionsRetroperitoneal ganglioneuroma has nonspecific clinical manifestation. Imaging examinations are the most effective adjuvant ways preoperatively, but patholoy is still the gold standard of final diagnosis for ganglioneuroma. Radical tumor resection is the most effective therapy with satisfactory prognosis for ganglioneuroma.

    Release date:2017-09-18 04:11 Export PDF Favorites Scan
  • Influencing factors of pancreatic fistula after pancreaticoduodenectomy and significance of pancreatic fistula risk score system on selection of main pancreatic duct drainage after pancreaticoduodenectomy

    Objective To explore the influencing factors of pancreatic fistula after pancreaticoduodenectomy (PD), and to compare the incidence of pancreatic fistula after pancreaticoduodenectomy with internal drainage of main pancreatic duct and external drainage according to the pancreatic fistula risk score (FRS) system, to provide the basis for the best drainage scheme in clinic. Methods The clinical data of 76 patients with PD who treated in the Affiliated Hospital of Xuzhou Medical University from January 2016 to December 2017 were analyzed retrospectively, to explore the risk factors of pancreatic fistula. Single factor analysis was based on group chi-square test or Fisher exact probability method, and multivariate analysis was based on unconditioned logistic regression model. According to the results of FRS, the difference of pancreatic fistula in different risk groups was explored. The statistical method was chi-square test. Results The incidence of pancreatic fistula after PD was 31. 5% in 76 patients.Univariate analysis showed that the diameter of the main pancreatic duct and the texture of the pancreas were the related factors affecting the occurrence of pancreatic fistula after PD (P<0.05), and the soft pancreas was the independent risk factor for the occurrence of pancreatic fistula after PD (OR=3.886, P=0.011). There was no significant difference in the incidence of postoperative pancreatic fistula between the internal drainage group and the external drainage group (P>0.05). There was no pancreatic fistula occurred in the patients with negligible risk. The incidence of postoperative pancreatic fistula in patients with high risk of external drainage group was only 12.5%, comparing with patients in internal drainage group (63.6%), the difference was statistically significant (P=0.026). There was no significant difference in the incidence of postoperative pancreatic fistula between patients in the external drainage group with moderate risk and low risk compared with the corresponding patients in the internal drainage group (P>0.05). Conclusions Pancreatic texture was an independent risk factor for pancreatic fistula after PD. External drainage maybe more effective than internal drainage in preventing pancreatic fistula after PD in patients with high risk of FRS.

    Release date:2019-01-16 10:05 Export PDF Favorites Scan
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