Twenty-one patients(male 18 cases,femal 3 cases)died of primary liver cancer after operation are reviewed.The liver tumors were located in the right lobe(13 cases),left lobe(3 cases),middle position of liver(4 cases)and hepatic hilum(1 cases).The average diameter of the tumors were 9.0cm.All the patients had suffered from liver cirrhosis and were operated on (most of them partial hepatectomy).The times of death were about 7 days,7-14 days later after operation.The data suggest that causes of death were different from the different stage after operation.The relations between partial hepatectomy and hepatic failure,and the liver cirrhosis and liver regeneration are discussed.
３０ ｐａｔｉｅｎｔｓ ｗｉｔｈ ｐｒｉｍａｒｙ ｃａｒｃｉｎｏｍａ ｏｆ ｇａｌｌｂｌａｄｄｅｒ ｗｅｒｅ ｔｒｅａｔｅｄ ｓｕｒｇｉｃａｌｌｙ ｆｒｏｍ １９８７ ｔｏ １９９４． Ｔｈｅ ｒｅｓｕｌｔｓ ｓｈｏｗｅｄ ｔｈｅ ｍｉｓｄｉａｇｎｏｓｉｓ ｒａｔｅｓ ｏｆ ｇａｌｌｂｌａｄｄｅｒ ｃａｎｃｅｒ ａｎｄ ｏｆ ｃａｎｃｅｒ ｗｉｔｈ ｇａｌｌｂｌａｄｄｅｒ ｓｔｏｎｅｓ ｗｅｒｅ ｈｉｇｈ． Ｍｏｓｔ ｏｆ ｐｒｉｍａｒｙ ｃａｒｃｉｎｏｍａ ｉｎ ｔｈｉｓ ｓｅｒｒｉｅｓ ｗｅｒｅ ａｄｅｎｏｃａｒｃｉｎｏｍａｓ． Ａｌｓｏ ｐｒｉｍａｒｙ ｇａｌｌｂｌａｄｄｅｒ ｃａｒｃｉｎｏｍａ ｃｌｏｓｅｌｙ ｒｅｌａｔｅｄ ｗｉｔｈ ｇａｌｌｂｌａｄｄｅｒ ｓｔｏｎｅｓ．
目的 了解本院病原菌分布及其耐药性趋势，为临床合理使用抗菌药物提供依据。 方法 对2011年1月－2012年1月门诊和住院患者送检的临床标本1 643份进行细菌培养及药物敏感性检测，并对其细菌耐药性进行分析。 结果 1 643份细菌培养标本中共检出致病菌750株，检出阳性率为45.6%；病原菌中，G+球菌242株，占32.3%，以金黄色葡萄球菌、凝固酶阴性葡萄球菌、肠球菌属为主。G−杆菌382株，占50.9%，以大肠埃希菌、铜绿假单胞菌、克雷伯菌属、肠杆菌属、鲍曼不动杆菌为主。耐甲氧西林金黄色葡萄球菌占金黄色葡萄球菌的59.0%。金黄色葡萄球菌对青霉素、头孢唑啉耐药率均为100.0%。肠球菌属中分离率最高的为粪肠球菌和屎肠球菌，粪肠球菌对青霉素的耐药率为35.3%。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶检出率分别为77.6%和56.7%；非发酵菌以铜绿假单胞菌和鲍曼不动杆菌为主，耐碳青酶烯类鲍曼不动杆菌分离率占鲍曼不动杆菌37%。鲍曼不动杆菌、铜绿假单胞菌对亚胺培南的耐药率分别为46.3%、28.3%。 结论 本院细菌耐药性较高，应加强抗菌药物的合理应用，应谨慎使用第三代头孢菌素等β-内酰胺类抗菌药物，以减轻抗生素的选择性压力、防止耐药菌株在医院内播散。