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find Author "杨海瑞" 3 results
  • Peutz-Jeghers综合征肠道息肉恶变的临床分析

    目的探讨Peutz-Jeghers综合征肠道息肉恶变的临床诊治经验。 方法对2005~2015年期间所诊治的221例Peutz-Jeghers综合征患者中11例息肉恶变患者的临床病理资料进行回顾性分析。 结果11例PeutzJeghers综合征息肉恶变患者确诊时的中位年龄为31.36岁。行肠镜20例次,胃镜8例次,双气囊电子小肠镜19例次,胶囊内镜1例次。手术原因依次为肠梗阻、肠套叠、息肉恶变和消化道出血。癌变息肉分别位于十二指肠(4例)、小肠(4例)和结直肠(3例)。病理类型以管状腺癌(5例)和黏液腺癌(5例)最多见。本组11例患者均无手术死亡,1例术后发生腹部切口感染,经伤口换药等处置后出院。术后3例患者接受XELOX方案化疗,其余未作特殊治疗。1例术后失访,10例随访1个月至7年(中位随访期2.12年),其中4例术后1~3个月死于十二指肠癌肝肺转移、空肠腺癌肝转移和结肠癌肝肺多发转移,其余患者定期复查消化内镜或消化道造影等检查至今。 结论PeutzJeghers综合征息肉恶变患者年龄较小,早诊断、早治疗、定期复查可提高患者的检出率和临床治疗效果。

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  • 全部甲状旁腺切除加胸锁乳突肌内自体移植术治疗继发性甲状旁腺功能亢进症(附 45 例报道)

    目的 探讨全部甲状旁腺切除加胸锁乳突肌内自体移植术治疗继发性甲状旁腺功能亢进症(SHPT)的疗效及技巧。 方法 总结空军总医院普通外科 2008 年 1 月至 2016 年 5 月期间 45 例 SHPT 行全部甲状旁腺切除加胸锁乳突肌内自体移植术患者的临床资料和随访结果,对其手术前后血磷、血钙和全段甲状旁腺素(iPTH)水平以及手术并发症和远期疗效进行分析。 结果 45 例患者手术均顺利完成,平均手术时间 116 min。45 例患者共切除甲状旁腺 173 枚,其中 40 例患者各切除 4 枚甲状旁腺,3 例各切除 3 枚,2 例各切除 2 枚。术后无喉返神经损伤、出血等严重并发症发生。术后病理结果显示 173 枚甲状旁腺良性增生或腺瘤样增生,其中 1 例合并甲状旁腺癌。术后1 周、6 个月及 1 年血磷、血钙及 iPTH 水平均明显低于术前(P<0.05)。在术后 1~2 周,全部患者的骨痛、皮肤瘙痒等症状均明显好转,食欲改善。术后 1 年复发 1 例(2.22%),口服药物治疗后症状控制,未行手术治疗。 结论 全部甲状旁腺切除加胸锁乳突肌内自体移植术治疗 SHPT 在临床上是安全、有效的。

    Release date:2018-03-13 02:31 Export PDF Favorites Scan
  • Preliminary study on the clinicopathological features and clinical subtypes of Peutz-Jeghers syndrome: a report of 295 Chinese cases

    Objective To investigate the clinicopathological features and clinical subtypes of Peutz-Jeghers syndrome (PJS) in Chinese cases. Methods The clinical and pathological data of 295 patients with PJS who were treated in Air Force General Hospital from Nov. 1994 to Aug. 2017 were retrospectively analyzed and a multifactor statistical study was carried out on. Results Two hundreds and ninety-five patients with PJS belonged to 7 nationalities and came from 26 provinces and urban areas. 99.0% (292/295) of the patients had black spots on the lip and buccal mucosa, and the median occurrence time was 2 years old (0–33 years). The median age of inital diagnosis and treatment was 15 years old (1–45 years). The median interval time between the occurrence of black spots and abdominal symptoms was about 10 years (0–45 years). PJS hamartoma polyps were found in alimentary canals of 293 patients (99.3%), and 96.9% distributed in the duodenum and small intestine (n=284), 90.4% distributed in the colorectal (n=265), 79.9% distributed in the stomach (n=234). Patients of black spot appearing at age <3 years and (or) initial treatment at age <14 years were classified as early-onset subtype, otherwise they could be included in delayed-onset subtype. Conclusions The clinical features of PJS are prominent and the harm of PJS hamartoma polyps is serious. The black spots on the lip and buccal mucosa can be used as an early warning signal to divide the PJS patients into 2 clinical subtypes, which should be differentiated in clinical therapy and follow-up strategy.

    Release date:2018-07-18 01:46 Export PDF Favorites Scan
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