Objective To discuss the early diagnosis and surgery of intestinal necrosis caused by superior mesenteric venous thrombosis （SMVT）. Methords The clinical data of 32 patients with intestinal necrosis caused by SMVT were reviewed retrospectively and analyzed, which included 6 cases of primary SMVT, 26 cases of secondary SMVT, 9 cases with pylethrombosis, 24 patients had been dignosed definitely as SMVT by imageology examination before surgery. All the patients accepted surgery therapy, within which 9 patients accepted Fogarty catheter, and anticoagulation and thrombolytic therapy were administrated postoperatively. Results All patients had recovered except for one with short bowel syndromle and one died. Conclusions SMVT is a rarely ischemic intestinal disease, which has complicated pathogenesis and difficulty in early diagnosis. Intestinal necrosis often occurs as a result of delayed treatment and the effective way is to cut off necrotic intestines in time. Intra-and postoperative anticoagulation and thrombolytic therapy could reduce recurrency effectively.
目的 总结颈动脉体瘤的诊断和外科手术治疗的经验。 方法 分析我院1991年9月至2009年2月期间手术治疗的16例颈动脉体瘤患者的临床资料。 结果 术前均行彩色多普勒超声检查，9例行CT检查，6例行数字减影血管造影检查。3例首诊时误诊为其他疾病。11例行单纯瘤体切除； 5例采用大隐静脉行颈动脉重建。术后1例出现声音嘶哑，1例出现伸舌右偏，1例出现呼吸困难。10例获得7个月～15年（平均67个月）随访，未见复发和转移。 结论 临床医师应提高对颈动脉体瘤的认识,注意选择合适的检查方法以免误诊，外科手术切除是首选的治疗措施，大隐静脉重建颈动脉是一种较安全、有效的治疗方法。
目的 探讨肢体假性动脉瘤的病因、发病机理以及手术方式的选择，评价各种手术的治疗效果，以提高对假性动脉瘤的诊治水平。方法 30例假性动脉瘤患者（股动脉18例，腘动脉7例，肱动脉2例，桡动脉3例），其中8例为感染或破裂性假性动脉瘤，1例肢体坏死。30例患者均行外科手术治疗,其中11例行假性动脉瘤破口修补术，2例行股动脉结扎术，2例行血管端端吻合术，8例行自体大隐静脉移植术，6例行人工血管移植术，1例行截肢术。结果 30例患者术后恢复顺利，除1例行下肢截肢术外，其余29例术后效果良好。随访7个月～8年,平均(4.4±2.3）年； 行人工血管移植术者4例移植段发生血栓，经溶栓治疗后好转，其余血供状况良好。结论 外科手术治疗肢体假性动脉瘤是一种有效的方法。
ObjectiveTo observe the ocular manifestations of presumed ocular tuberculosis in patients with pulmonary tuberculosis. MethodsOne hundred and fifty nine patients with pulmonary tuberculosis received examinations of visual acuity, slit lamp microscopy and indirect ophthalmoscopy. Those patients with retinochoroidal inflammatory lesions, retinal hemorrhages or detachments underwent fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) to determine whether the presumed ocular tuberculosis was involved. There were 9 patients (16 eyes, 5.67%) of presumed ocular tuberculosis, including 5 males and 4 females. The age was ranged from 19 to 64 years old, with an average of 35.12 years. Seven patients were affected bilaterally and 2 patients affected unilaterally. There were 8 patients (15 eyes, 93.75%) with uveitis and 1 patient (1 eye, 6.25%) with central retinal vein occlusion (CRVO). The blood laboratory tests were negative in all cases. ResultsThe corrected vision was from light sensation to 0.15 in 6 uveitis eyes, 0.8 to 1.0 in 10 eyes. The anterior segment change was found in 10 eyes, which including granulomatous uveitis (8 eyes) and non-granulomatous uveitis (2 eyes). Granulomatous uveitis eyes had iris nodules, posterior synechia of the iris and mutton-fat keratic precipitates (KP). Non-granulomatous uveitis eyes had KP only. Choroidal tubercles were found in 7 eyes in which 3-7 off-white lesions of varying sizes were found with local retinal detachment. FFA revealed hypo-fluorescence with obscure boundary in arterial phase and arterial and venous phase, and hyper-fluorescence with obscure boundary in later phase. OCT showed retinal pigment epithelium uplift. There was 1 eye with CRVO, which had punctate, splinter and linear hemorrhage, white lesions in some hemorrhagic focus. ConclusionThe presumed ocular tuberculosis eyes showed mainly granulomatous inflammation and multiple choroid tubercles, and CRVO sometime.