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find Author "田伯乐" 26 results
  • 48例肝损伤的诊治体会

    Release date:2016-08-28 05:11 Export PDF Favorites Scan
  • 胰十二指肠切除术后胰瘘及预防

    【摘要】 胰瘘是胰十二指肠切除术后最常见最严重的并发症之一,如何有效预防胰瘘是保证手术成功、降低患者病死率的重要环节。现就胰十二指肠切除术后胰瘘的发生及其预防作一综述。

    Release date:2016-09-08 09:24 Export PDF Favorites Scan
  • 慢性胰腺炎的疼痛及其治疗策略

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  • 包裹性胰腺坏死被误诊为胰腺囊实性肿瘤的原因分析:附 12 例报道

    目的 探讨包裹性胰腺坏死(walled-off pancreatic necrosis,WOPN)误诊为胰腺囊实性肿瘤(pancreatic cystic neoplasm,PCN)的原因。 方法 回顾性分析 2009–2013 期间华西医院胰腺外科收治的术前诊断为胰腺 PCN 而术后病理学诊断为 WOPN 的 12 例患者的临床资料。 结果 12 例患者术前诊断为胰腺 PCN,而术后病理学诊断为 WOPN。其中女 2 例,男 10 例;年龄 36~68 岁、(47.1±10.7)岁;病程 0.5~48.0 个月,中位数为 1.0 个月;主要临床表现:腹痛 12 例,体质量减轻 7 例;术前 1 例总胆红素水平增高,2 例血淀粉酶水平增高,4 例癌胚抗原(CEA)水平增高,4 例 CA19-9 水平增高,4 例 CA-125 水平增高。8 例行腹部增强 MRI 检查,7 例行腹部增强 CT 检查,1 例行正电子发射计算机断层显像(PET-CT)检查,提示 7 例包块位于胰头,5 例位于胰尾;肿块最大径 1.8~11.0 cm、(4.9±2.9)cm,其中 4 例最大直径超过 5 cm;3 例腹腔内发现肿大淋巴结;4 例肿块内部分隔;8 例呈类肿瘤表现。 结论 WOPN 与 PCN 的鉴别需要根据临床、实验室检查及影像学特点进行综合判断,影像学检查是主要的鉴别方法,但同时也是误诊的主要原因。此外,男性患者可能更易误诊。

    Release date:2018-01-16 09:17 Export PDF Favorites Scan
  • Application of multi-subjects and multi-modes intervention in the enhanced recovery afterpancreaticoduodenectomy

    Objective The objective of this study is to evaluate the effect of enhanced recovery after surgery (ERAS) in the perioperative period of pancreatoduodenectomy. Methods This article conducted the forward-looking analysis on the information of 227 patients undergoing the pancreatoduodenectomy in West China Hospital from January 2016 to June 2017, and then compared the differences between the patients subjected to ERAS (ERAS group) and thosesubjected to regular measures (control group) with respect to time of setting in sickbed, time of mobilizing out ofsickbed, time of starting drink water, time of resumption of diet, exhaust time, defecation time, the time of nasogastric tube, postoperative hospitalization duration and expenses, postoperative complications, and postoperative pain scores. Results ① Postoperative indexes: by comparison of the ERAS group and the control group, it was found that the ERAS group had shorter (or lower) time of setting in sickbed, time of mobilizing out of sickbed, time of starting drink water, time of resumption of diet, exhaust time, defecation time, the time of nasogastric tube, postoperative hospitalization duration and expenses (P<0.05). ② Postoperative complications: of all postoperative complications, including pancreatic fistula, postoperative hemorrhage, delayed gastric emptying, biliary fistula, abdominal infection, incision complication, lung infection, and heart complication were without statistically significant differences (P>0.05) between the 2 groups.③ Reoperation and readmission: there was no significant difference on the incidences of reoperation and readmission between the 2 groups (P>0.05). ④ Postoperative pain scores: except 22 : 00 of the 6-day after operation, the pain scores in the ERAS group were all lower than those in the control group at 2 h and 8 h after operation, and the time points of 1–6 days after operation (8 : 00, 16 : 00, and 22 : 00), with statistically differences (P<0.05). Conclusion Without increasing the incidence of complications, ERAS may speed up the rehabilitation of patients undergoing the pancreatoduodenectomy and mitigate the pain of patients.

    Release date:2018-06-15 10:49 Export PDF Favorites Scan
  • 胰腺癌可切除性的评估标准及其演变

    Release date:2018-06-15 10:49 Export PDF Favorites Scan
  • Advances in Basic Research and Clinical Progress in Hereditary Pancreatitis

    Objective To study the basic and clinical achievements in diagnosis and therapy of hereditary pancreatitis. Methods Related literatures of recent years were reviewed. Results Hereditary pancreatitis was a rare type of pancreatitis, with an estimated penetrance of 80%, and was believed to be caused by a mutation in the cationic trypsinogen gene. Patients with hereditary pancreatitis had a high frequency of pancreatic cancer.Conclusion The progress has been made on hereditary pancreatitis and has given us many useful suggestions for a better understanding about this difficult medical problem.

    Release date:2016-08-28 04:47 Export PDF Favorites Scan
  • TREATMENT OF PANCRATIC INFECTED NECROSIS BY LUMBO-POST PERETONEAL DRAINAGE AND POSTOPERATIVE LAVAGE (REPORT OF 20 CASES)

    目的 探讨急性胰腺炎继发感染的治疗方法。方法 分析总结我院1998~1999年收治的20例胰腺感染患者,采用经后上腰腹膜后引流及灌洗方法治疗的资料。结果 术后并发症: 残余脓肿2例,消化道出血1例,肠瘘4例,胰瘘6例,经治疗后患者全部治愈。结论 该治疗方法残余感染及死亡率低。

    Release date:2016-08-28 05:30 Export PDF Favorites Scan
  • CHANGES AND CLINICAL SIGNIFICANCE OF PLASMA ENDOTOXIN LEVEL IN ACUTE SEVERE PANCREATITIS

    The purpose of this study was to determine the contribution of endotoxin (ET) in ocurrence and progression of acute pancreatitis (AP). The results indicated that correlation of ET changes with multiple organ damage in AP. The degree of ET elevation correlated well with the severty of AP. The level of plasma ET of severe AP patients was much higher than that of mild AP patients (P<0.05). The chance of multiple organ damage got greater while the plasma ET level got higher. Moreover, the severety change of severe AP correlated with the change of plasma ET level. In other words, the ET level was reduced while the disease was recovering, elevated while it was becoming worse and maintained high level in dead cases. We think that plasma ET level can be used as a reference for differenciating mild AP with severe AP and a predictor for the prognosis of AP.

    Release date:2016-08-29 09:20 Export PDF Favorites Scan
  • 罕见阑尾畸形1例报告

    Release date:2016-09-08 01:59 Export PDF Favorites Scan
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