Objective To explore the effect, operational essential, and clinical meaning of transilluminated powered phlebectomy for patients with varicose vein of the lower extremity. Methods In the study, 255 patients with 363 lower extremities of varicose vein in our hospital between May 2006 and November 2009 were treated by transilluminated powered phlebectomy. According to revised clinical etiology anatomic and pathophysiological classification system (CEAP), there were 104 limbs in C2, 53 limbs in C3, 155 limbs in C4, 34 limbs in C5, and 17 limbs in C6. The patients were followed up to observe postoperative complications. Results All varicose vein labeled before operation were resected. Surgical time was (100±20) min in unilateral lower extremity and (147±19) min in bilateral lower extremities. Total 221 patients (302 lower extremities) were followed up in 4 to 46 months, median follow up time was 24.5 months. Total 167 cases (247 lower extremities) had accepted the operation more than 1 year, 154 cases (229 lower extremities) in which were followed up. In the 229 lower extremities above, recurrences occurred in 11 extremities, small amounts of residual small varices were observed in 2 extremities, the recurrence rate was 5.68% （13/229）. Twenty-one limbs with ulcer were healing in 3 to 6 weeks after operation. Postoperative complications: there was paresthesias or pain of ankle area in 16 limbs, which was improved in 3 to 6 months after physical therapy; there was ecchymosis of skin of leg in 112 limbs, which disappeared in 3 to 5 weeks after operation; there was light edema in 37 limbs, which disappeared in 1 to 2 weeks after operation; there was local hematoma in 2 limbs, incision light infection in 5 limbs, skin and subcutaneous tissue necrosis above medial malleolus in one limb, and back of knee popliteal skin lesion in 2 limbs, which were all cured by the symptomatic treatment. Conclusions Surgical treatment of varicose veins is actually the combination of various surgical procedures. Varicose vein extraction using transilluminated powered phlebectomy is safe, efficacious, and cosmetically satisfactory.
目的 探讨儿童气道异物的诊断、治疗及并发症发生的原因，以减少误诊及降低并发症的发生率。 方法 回顾分析2009年1月－2010年8月经病史、症状、体征及辅助检查（胸部X线检查或CT扫描）初诊为气道异物的317例患儿的临床资料。所有患儿均行支气管镜检查，明确有异物者行异物取出术，对术中、术后并发症的原因和处理方法进行总结。 结果 本组患者中有105例（33.1%）患儿曾被误诊为支气管肺炎或其他呼吸系统疾病，经支气管镜检及异物取出术后，出现并发症者共35例，包括：喉痉挛8例（22.8%），支气管痉挛6例（17.1%），支气管黏膜出血12 例（34.3%），皮下气肿8例（22.8%），死亡1例（2.8%）。 结论 儿童气道异物一经确诊或高度怀疑，应尽快行支气管镜检查，以保持呼吸道通畅。手术操作应轻柔准确，并注意观察患儿全身状况，是减少并发症的关键。