【摘要】 目的 探讨癫痫患者注意功能受损的特点。 方法 2008年12月-2009年12月选取69例癫痫患者作为病例组，35例正常人作为对照组，分别用持续操作任务实验（continuous performance test，CPT）、斯特鲁普实验（Stroop）和双任务实验测查持续注意、选择注意和分散注意功能。 结果 与对照组相比，病例组CPT反应时延长，漏报率增加（Plt;0.05）；Stroop实验冲突条件下反应时延长，冲突、一致和中性条件下错误率增加，冲突和中性条件下的反应时干扰量和错误率干扰量增加（Plt;0.05）；双任务比单任务划销方格数目减少，字符串正确率减少，双任务减退程度增加（Plt;0.05）。 结论 癫痫患者的持续注意、选择注意和分散注意功能均受损。【Abstract】 Objective To observe the damages of attentive function in the patients with epilepsy. Methods From December 2008 to December 2009, 69 patients with epilepsy and 35 healthy people were selected as the patients group and control group. All the selected ones underwent continuous performance test (CPT), Stroop test and dual task, respetviely, to assess their sustained attention, selected attention and divided attention. Results In CPT, the reaction time prolonged and the omission rate increased significantly in the patient group compared with those in the control group (Plt;0.05). In Stroop test, the reaction time in the patients group prolonged under incongruous condition, and error rate increased under incongruous, congruous and neutral conditions. The reaction time interfered effects and error interfered effects increased under incongruous and neutral conditions (Plt;0.05); the boxes crossed and right rate of digit strings decreased and decrement increased during dual task than single task in the patient group (Plt;0.05). Conclusion The sustained attention, selected attention and divided attention of patients with epilepsy are impaired.
Objective To explore the relationship between the HBsAg positive patients suffering from hepatocellular carcinoma (HCC) and HBV DNA genotype. Methods By using PCR type-specific primers combined with sequencing of genotype, we analyzed the genotype of HBV DNA in the serum of 500 patients with positive HBsAg in our hospital. Among them, 150 cases suffered from HCC. Results Genotype B and C were both predominant genotypes in HBsAg positive patients. But in HCC group, the rate of genotype C was 65.33% （98/150）, which was significantly higher than that in non-HCC group (88/350, 25.14%), while genotype B, in contrast, was 28.67% （43/150） and 68.86% （241/350）， χ2=75.45， Plt;0.05. The distribution of HBV DNA genotype B or genotype C in different gender or different age groups were not statistically significantly different in cases of HCC (Pgt;0.05). Conclusion Genotype C of HBV DNA is more common in patients with HCC, and maybe there is relationship between genotype C and the occurrence of HCC.
ObjectiveTo explore the feasibility and characteristics of three-port laparoscopic cholecystectomy (LC) in the treatment of cholecystitis with gallbladder calculi incarceration. MethodsThe clinical data of 160 patients with gallbladder calculi incarceration treated by three-port LC between July 2010 and December 2014 were analyzed retrospectively. Among the patients, there were 104 cases of calculi incarcerated in the gallbladder neck area, 20 cases in the cystic gall duct, and 36 cases in the gallbladder ampullar region. Elective operations were carried out for 120 patients and 40 underwent emergency operation. ResultsThree-port LC was successfully completed in 154 patients (96.25%), and the other 6 patients were converted to open surgery among whom 2 underwent elective operation (1.67%) and 4 underwent emergency operation (10.00%). Two converted patients in the elective operation group had Mirizzi syndrome and gallbladder carcinoma respectively; all the 4 converted patients in the emergency operation group had a disease course of about one week with compacted triangle structure and gallbladder edema thickening of 1.0 cm, causing difficult separation under laparoscope. Seventy patients had varying degrees of enlargement and edema of gallbladder, 60 had varying degrees of gallbladder atrophy, and 30 had almost normal gallbladder. There were 80 cases of dark green thick bile, 10 of purulent bile, 40 of white bile, and 30 of empty gallbladder and no bile. No complications were found during the follow-up of 6 to 36 months, except that one patient was found to have secondary common bile duct stones three months after discharge, and the patient was cured by endoscopic retrograde cholangiopancreatography. Conclusions Elective or emergency three-port LC is safe and feasible for gallbladder calculi incarceration as long as the operator had skilled technique and made the right decision on opportunity of conversion.
ObjectiveTo evaluate the safety and efficacy of unconventional abdominal drainage after laparoscopic hepatectomy.MethodsThe clinicopathologic data of patients who underwent laparoscopic hepatectomy for liver tumors in the Mianyang Central Hospital from June to December 2019 and met the inclusion criteria were retrospectively collected. Based on whether drainage tube was placed in the abdominal cavity during operation, the patients were divided into non-catheterized group (without drainage tube) and catheterized group (with drainage tube). The intraoperative data and postoperative complications (e.g. intraabdominal hemorrhage, bile leakage, abdominal infection, and liver failure) were compared between the two groups. Then, the intraoperative data and postoperative conditions of liver cancer and non-liver cancer patients with or without abdominal drainage tube were compared and analyzed.ResultsA total of 117 eligible patients were included in the study. The non-catheterized group had 59 patients and the catheterized group had 58 patients. The patients with liver cancer had 84 patients (44 non-catheterized patients and 40 catheterized patients) and the patients without liver cancer had 33 patients (15 non-catheterized patients and 18 catheterized patients). ① On the whole, the groups were comparable in the baseline data between the non-catheterized group and the catheterized group, such as gender, age, HBV infection, body mass index, hepatic function index, liver stiffness value, disease category, etc. (P>0.05). Compared with the catheterized group, the non-catheterized group had earlier off-bed activities and earlier flatus time (P<0.001), and shorter postoperative hospital stay (P=0.030). However, no statistically significant differences were found in other indicators between the two groups (P>0.05). ② Whether the patients had liver cancer or not, the non-catheterized patients still had earlier off-bed activities and earlier flatus time as compared with the catheterized patients (P<0.001). Among the patients with liver cancer, no difference was found in postoperative hospital stay. However, among the patients without liver cancer, the non-catheterized patients had shorter postoperative hospital stay than the catheterized patients (P=0.042). No statistically significant differences were found in other indicators between the catheterized patients and non-catheterized patients (P>0.05).ConclusionFor technologically skilled laparoscopic hepatectomy center, selectively not placing peritoneal drainage tube after surgery might better promote the health of patients.
ObjectiveTo explore the value liver resection combined with intraoperative radiofrequency ablation during the same period in the treatment of multiple liver cancer. MethodsWe retrospectively analyzed the clinical data of 33 patients with multiple liver cancer treated between January 2005 and April 2013. All the patients were treated by liver resection combined with intraoperative radiofrequency ablation in the same period. There were 91 tumor foci in 33 patients, among which 39 tumor foci were surgically removed, and 52 tumor foci were radiofrequency ablated. Ultrasonography and enhanced CT/MRI were performed for the patients 1 year, 2 years and 3 years after surgery. ResultsNo bleeding or death occurred during the operation. It was observed that the transient liver function was damaged after surgery, but it quickly returned to A level after treatment. All the patients had no perioperative death or other serious complications. Tumor recurrence rate was 16.1% in the first year, 48.4% in the second year and 93.5% in the third year after surgery. ConclusionLiver resection combined with intraoperative radiofrequency ablation for multiple liver cancer in the same period is feasible and safe, without increasing the average length of hospital stay, operative mortality rate and postoperative tumor recurrence rate.
ObjectiveTo investigate the prevention and control measures and procedures for surgical operation safety during the outbreak of new coronavirus pneumonia.MethodsAfter interpreting the diagnosis and treatment plan of new coronavirus pneumonia, the prevention and control plan of new coronavirus pneumonia, and the technical guidelines for prevention and control of new coronavirus pneumonia infection in medical institutions, we formulated and improved the prevention and control measures and procedures for surgical safety in our hospital.ResultsA total of 567 patients were operated in our hospital from January 22, 2020 to February 10, 2020, including 501 were operated in the surgical center and 66 were operated in the interventional center. Among all the cases, there were 303 emergency operation and 264 scheduled or limited operation. In the emergency operation, the top three were 130 cases of caesarean section (42.9%), 63 cases of abdominal digestive system operation (20.8%) and 31 cases of skull operation (10.2%). In the scheduled or limited operation, the top four were 65 cases of benign diseases of the eye (24.6%), 57 cases of tumor (21.6%), 53 cases of orthopedic surgery (20.1%), and 25 cases of coronary angiography (9.4%). All the patients were successfully completed the operation and recovered well after the operation. No serious surgical complications or infection-related complications occurred.ConclusionDuring the outbreak of new coronavirus pneumonia, surgery and epidemic prevention and control can be carried out by adjusting and optimizing measures and procedures.
【Abstract】Objective To study the clinical application of laparoscopic operation. Methods The clinical findings from 13 840 cases of laparoscopic surgery in this hospital from 1992 to 2005 were reviewed retrospectively.Results Laparoscopic operation were performed successfully in 13 653（98.6%）,187 cases were transferred to open operation. Complications were occurred in 115 cases, including common bile duct injury in 3 cases. Combined treatment with laparoscope and endoscope were performed in 162 cases. Eleven thousand three hundred and fiftytwo patients had been succeeded in followup survey. Over 90.0 percent of patients recovered smoothly. Conclusion Laparoscopic operation may be applied in a more extensive scope. The major complications can be reduced by strict procedures of laparoscopic operation. The combined treatment of laparoscope and endoscope should be further studied and widely used.
Objective To explore the contribution of obstructive sleep apnea hypopnea syndrome(OSAHS) in the variations of blood pressure in the evening to morning and possible mechanisms.Methods In Sleep and Breathing Disorders Centre，from September 2003 to September 2007，adult patients whose Epworth sleeping scoregt;9 were undergone polysomnography(PSG) and divided into 4 groups according to apnea hyponea index(AHI).The levels of blood pressure were monitored and compared between evening and morning.Correlations between PSG indexes and variations of the systolic blood pressure(SBP) and diastolic blood pressure(DBP) were analyzed in OSAHS patients.Results 1 528 patients were enrolled in this study.There was no significant difference between the evening and morning blood pressure in the non-OSAHS group(AHIlt;5，n=172)，whereas DBP rised about 1.73 mm Hg in the mild OSAHS group(AHI≤20，n=435)，SBP and DBP rised about 3.52 and 3.71 mm Hg respectively in the moderate OSAHS group(AHI≤40，n=307)，and SBP and DBP rised about 3.72 and 4.22 mm Hg respectively in the severe OSAHS group(AHIgt;40，n=614).The variation of SBP during the night correlated positively with the arousal index in the mild OSAHS group（r=0.25，Plt;0.05），but with the body mass index (BMI) in the moderate OSAHS group（r=0.25，Plt;0.05）.In the severe OSAHS group，the variation of SBP during the night correlated positively with BMI and the longest apnea time (LA)（r=0.26，0.25，both Plt;0.05），the variation of DBP during the night correlated positively with AHI and mean apnea duration(MA)（r=0.22，0.17，both Plt;0.05），and the variation of mean arterial pressure during the night correlated positively with AHI and MA（r=0.25，0.20，both Plt;0.05）.Conclusion OSAHS may induce mild rises of the blood pressure at night.The relevant factors that influence the blood pressure are different in different severity of the OSAHS.