目的 探讨外科治疗克罗恩病的手术时机及手术方式。方法 回顾性分析了1998～2012年期间笔者所在医院收治的13例克罗恩病手术患者的临床资料。结果 13例患者中行急诊手术6例，择期手术7例；行左半结肠切除术2例，回盲部并小肠切除术4例，部分小肠切除术4例，右半结肠切除术2例，全结肠切除回肠造口术1例。本组仅7例获随访，随访时间12～48个月，平均38个月，有2例患者分别于术后16个月和31个月死亡，死亡原因为营养不良，消化道出血，多脏器功能衰竭；另外5例预后良好。结论 对克罗恩病正确把握手术时机及选择手术方式，围手术期结合激素及免疫抑制剂治疗是取得满意治疗效果的关键。
ObjectiveTo summarize the changes and interaction of the cytokine in severe acute pancreatitis associated lung injury. MethodsThe published literatures at domestic and aboard in recent years about severe acute pancreatitis associated lung injury were collected and reviewed. ResultsThe cytokines had a chain effect, and influenced each other when severe acute pancreatitis with lung injury attacked. ConclusionsRelated cytokines play important roles in severe acute pancreatitis associated lung injury. Researching the related cytokines will contribute to the diagnosis and treatment for severe acute pancreatitis with lung injury.
Objective To summarize the change in the cytokine network, the classification of various cytokines, interaction, and systemic impact on patients with acute pancreatitis (AP). Methods The recently published literatures in domestic and abroad about advancement of cytokines in AP were reviewed. Results Cytokines had a complex network and interactions. There were a variety of regulatory mechanisms. The tumor necrosis factor-α (TNF-α) and interleukin cytokines played important roles in the progress of AP. Conclusions Change of cytokines during AP is a complex process. Any separate regulation for the release of sigle factor has no significant effect on the disease. The treatment according to immune balance should be a better direction.
ObjectiveTo summarize the therapeutic effect and clinical significance of reduced volume lesion resection combined with drug therapy for end-stage alveolar hepatic echinococcosis.MethodClinical data of 46 patients with end-stage alveolar hepatic echinococcosis who received treatment of reduced volume lesion resection combined with drug therapy at Department of General Surgery of Qinghai Provincial People’s Hospital from March 2013 to October 2019 were retrospectively analyzed.ResultsAmong the 46 patients, 3 patients were lost to follow-up and 43 patients received follow-up. The follow-up time ranged from 3 to 79 months, with the median of 40 months. Fifteen patients died during the follow-up period, of which 5 patients with cerebral hydatid disease died during 16–36 months due to acute seizures and cerebral edema, 4 patients with multiple systemic metastases died during 9–36 months due to multiple organ failure, 2 patients with pulmonary echinococcosis died due to acute pulmonary embolism, 4 patients died in 2 years after operation due to recurrent biliary tract infection, other patients survived during follow-up period without distant organ metastasis.ConclusionReduced volume lesion resection combined with drug therapy in treatment of end-stage alveolar hepatic echinococcosis can improve the patient’s quality of life, reduce the hospital cost, reduce the occurrence of postoperative complications, and shorten the length of hospital stay.