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消化道吻合器在颈部胃食管吻合中的应用

目的 总结食管癌切除后采用消化道吻合器行颈部胃食管吻合术治疗食管癌患者的临床经验，以降低术后吻合口瘘和吻合口狭窄的发生率，提高手术疗效。 方法 125例食管癌患者，根据采用的手术术式不同分为两组，器械吻合组：行食管癌切除后采用国产常州WGWB-26型吻合器进行颈部胃食管吻合；手工吻合组，行食管癌切除后采用手工方法进行颈部胃食管吻合。 比较两种手术术式的胃食管吻合时间、术后吻合口瘘和吻合口狭窄的发生率。 结果 全组无手术死亡。器械吻合组吻合时间少于手工吻合组（30±5min vs. 55±5 min, Plt;0.05），近期吻合口瘘和吻合口狭窄发生率明显低于手工吻合组（0% vs. 4.8%, 0% vs. 9.5%,Plt;0.05）；器械吻合组随访1～15个月食管X线钡餐检查证实无吻合口狭窄。 结论 使用吻合器行胃食管器械吻合，能增加吻合的可靠性，减少术后并发症，包括吻合口瘘和吻合口狭窄的发生。

巨大右房壁瘤伴房间隔缺损一例

Leading medical joint discipline + operation integrated development practice under the background of government-hospital cooperation

Under the background of a series of national policies, various forms of medical association have been established in recent years. The purpose of the medical association is to promote the coordination and integration of medical services and the rational distribution of medical resources. However, the implementation effect varies greatly. In the process of construction, there are problems such as the unsynchronized coordination and operation between the upper and lower levels, the inadequate integration of resources, the differences and conflicts in information standards and even cultural concepts, which limit the construction effect of the medical association to a certain extent. In order to solve these problems and explore a better path for the construction of medical association, this paper summarizes and analyzes the integrated development and construction measures of “discipline+operation” of the First People’s Hospital of Ziyang under the “government-hospital cooperation”, hoping to provide experience and reference for the construction of medical association to a certain extent through the summary and analysis, thus contributing to the better development of the construction of medical association.