目的 研究完全腹膜外腹腔镜腹股沟疝修补术对睾丸血流灌注及体积的影响。 方法 2009年7月－2011年5月，对62例行完全腹膜外腹腔镜单侧腹股沟疝修补术男性患者进行自身前后对照研究，比较术前、术后患侧睾丸的睾丸动脉（TA）、睾丸包膜动脉（CA）、睾丸内动脉（ITA）血流参数[收缩期峰值血流速度（PSV）、舒张未期血流速度（EDV）及血管阻力指数（RI）]、睾丸体积（TV）及血清睾酮的变化情况。 结果 患者获随访7～24个月，平均15.6个月，无复发患者。术前及术后3、6个月时患侧TV分别为（9.91 ± 3.72）、（10.23 ± 4.18）和（10.16 ± 3.94）cm3，同期血浆睾酮水平分别为（544.25 ± 123.72）、（532.89 ± 145.66）和（565.65 ± 138.13）μg/L，手术前后比较患侧TV（F=1.350，P=0.263）、血浆睾酮水平（F=1.673，P=0.192）无统计学意义，血浆睾酮水平均在正常范围内。术后3、6个月患侧TA、CA和ITA的EDV明显高于术前，RI较术前明显降低，差异均有统计学意义（P＜0.05）；PSV与术前比较差异无统计学意义（P＞0.05）。术后3个月患侧睾丸各动脉PSV、EDV、RI与术后6个月比较差异无统计学意义（P＞0.05）。 结论 完全腹膜外腹腔镜腹股沟疝修补术后患侧睾丸血流灌注情况可能会有所改善，不影响TV及血清睾酮水平。
【摘要】 目的 探讨腹部手术史对急性阑尾炎腹腔镜阑尾切除术（LA）的影响。 方法 2005年1月-2010年9月，将既往有腹部手术史并行LA的111例患者纳入观察组，同期随机抽取无腹部手术史行LA的220例患者纳入对照组。入选患者排除多次手术史、免疫功能低下、肝肾功能不全及血液病。比较两组中转开腹率、手术时间、术中出血量、术后并发症及住院时间的差异。 结果 两组均未出现术中并发症及死亡，两组患者的中转开腹率、手术时间、术中出血量、术后并发症及住院时间比较，差异均无统计学意义（Pgt;0.05）。 结论 即往腹部手术史对急性阑尾炎LA没有明显影响。【Abstract】 Objective To investigate the effect of previous abdominal surgery on appendectomy under laparoscope for acute appendicitis. Methods From January 2005 to September 2010, 111 patients with a history of abdominal surgery who had undergone laparoscopic appendectomy due to acute appendicitis were in the observe group and 220 patients selected randomly from the patients without a history of previous abdominal surgery who had undergone laparoscopic appendectomy were in the control group. The patients with a history of multiple operations, immunodeficiency, liver and kidney dysfunction, and hematopathy were excluded. The data were collected retrospectively and the differences of conversion rate, operative time, intraoperative blood loss, postoperative complications, and hospital staying were compared between the two groups. Results There were no death or intraoperative complications in both of the two groups. The differences in the conversion rate, operative time, intraoperative blood loss, postoperative complication rates, and hospital staying between the two groups were not significant (Pgt;0.05). Conclusion Previous abdominal surgery has no significant effect on laparoscopic appendectomy for acute appendicitis.
【摘要】 目的 探讨远端胃癌根治术后早期经口进食的可行性、安全性及术后早期康复情况。 方法 将2009年5月-2011年1月收治的62例远端胃癌根治术患者随机分为早期经口进食（early oral feeding，EOF，30例）组及传统进食（traditional feeding，TF，32例）组。比较两种营养支持方法对患者术后并发症、胃肠功能恢复及血清蛋白的影响。 结果 EOF组术后早期经口进食耐受率达90%（27/30），两组术后并发症发生率相比差异无统计学意义（χ2=0.046，P=0.830）。EOF组术后首次肛门排气及排便时间均早于TF组（P=0.000）。术后8 d时EOF组血清前清蛋白和转铁蛋白明显高于TF组（P=0.028，0.013）。 结论 远端胃癌根治术后早期经口进食是安全、可行的，能促进患者的早期恢复。【Abstract】 Objective To discuss the feasibility and safety of early oral feeding after curative surgery for distant gastric cancer, and investigate whether it has an effect on early recovery of the disease. Methods From May 2009 to January 2011, 62 distal gastric cancer patients with open radical resection were divided into the early oral feeding group (EOF group, n=30) and traditional feeding group (TF group, n=32) randomly. We compared the complication rate, gastrointestinal function recovery, serum protein change before and after operation between the two groups. Results Early oral feeding can be tolerated by as much as 90% (27/30) of the patients in EOF group. There was no significant difference in the postoperative complication rate between the two groups (χ2=0.046, P=0.830). The EOF group had a faster onset of flatus and defecation than the TF group (P=0.000). The serum pre-albumin and transferrin were significantly higher in the EOF group than those in the TF group 8 days after operation (P=0.028,0.013). Conclusion Early oral feeding after curative surgery for distal gastric cancer is safe and feasible, and can promote early rehabilitation of the patients.