【摘要】 目的 探讨颈椎手术并发症原因及预防措施，以提高手术成功率。 方法 对2000年5月-2009年5月实施颈椎前路手术的脊髓型颈椎病患者201例中20例发生并发症患者的临床资料及随访情况进行回顾性分析。 结果 20例并发症患者获得随访时间3个月～10年，平均5.5年。近期并发症11例，发生率5.47%；远期并发症9例，发生率4.48%。 结论 充分认识脊髓的损伤类型，仔细评估患者的全身情况，熟练的手术操作，良好的术后护理是手术成功的关键。【Abstract】 Objective To investigate the reasons of and prevention for surgical complications of anterior cervical spine. Methods The clinical data of 20 patients with surgical complications in 201 patients who underwent anterior cervical surgery from May 2000 to May 2009 were analyzed retrospectively. Results The patients with complications were followed up for 3 months to 10 years with an average of 5.5 years. The rate of 11 patients with short-term complications was 15%, and the rate of nine patients with long-term complications was 4.48%. Conclusion The key of a successful surgery for anterior cervical spine inludes full realization of type of cervical spinal cord injury, careful evaluation of the patient’s general condition, skilled operation, and good post-operative care.
Objective To investigate the clinical features, diagnosis, treatment and prognosis of ectopic adrenocorticotropic hormone (ACTH) syndrome caused by bronchopulmonary carcinoid. Methods Twenty patients (13 males and 7 females) with ectopic ACTH syndrome caused by bronchopulmonary carcinoid confirmed by surgical pathology were selected from March 2007 to May 2016 in our hospital. We collected and arranged the important clinical data of 20 patients and analyzed carefully. Results The mean age of 20 patients including 14 patients of typical carcinoid and 6 patients of atypical carcinoid was 38.85±15.31 years ranged 13-70 years. All patients had the typical clinical manifestation of Cushing's syndrome. All the thoracic lesions were located by thoracic computed tomography (CT) eventually. The concentration of serum cortisol and ACTH significantly decreased after surgery. Postoperative complications in 3 patients (15.00%) were severe pulmonary infection. Eighteen patients including 13 patients of typical carcinoid and 5 patients of atypical carcinoid were followed up. The median time of follow-up was 31.5 (12-122) months. There were 7 patients of stage Ⅰa, 1 patient of stage Ⅰb, 2 patients of stage Ⅱa and 8 patients of stage Ⅲa in the patients followed up. One patient underwent postoperative radiotherapy, and 4 patients with postoperative chemotherapy. During the follow-up period, one patient relapsed and there was no death. Conclusion Ectopic ACTH syndrome caused by bronchopulmonary carcinoid is a very rare disease. It is every difficult for clinicians to make early diagnosis and draw up plans of treatment without multidisciplinary collaboration. Chest CT is an important method of finding lesions and assessing the viability of surgery. Surgical treatment in early stage will be effective for this disease. And almost all of patients can achieve long-term survival after complete resection of tumors early.
With the broad application of high-resolution computed tomography (CT) and high rates of early lung cancer screening, the number of patients diagnosed with synchronous multiple primary lung cancer (sMPLC) has been increasing. It becomes of great prominence to distinct sMPLC from intrapulmonary metastases in clinical practice. An increasing number of studies have developed high-throughput sequencing based genetic approaches to specify the molecular characteristics of sMPLC, which contributes to a better understanding of its tumorigenesis. The genetic profile of sMPLC also benefits its diagnosis, which mainly relies on its clinicopathological criteria. Here, we summarize the progresses on the diagnostic criteria for sMPLC, and also molecular features of sMPLC from the perspective of clonality analysis.