例行

Methods:32 patients of TCPC were reviewed: the average age was 10 years,ranged from 5 to 24 years and the average weight was 28 kilogramme,ranged from 13 to 55 kilogramme.18 patients underwent lateral tunnel and 1 patient underwent extracardiac conduit TCPC with hypothermic cardiopulmonary bypass and heart arrest,and 10 patients were treated by extracardiac conduit technique with normothermic CPB and without heart arrest and 2 patients without CPB,and 1 patients underwent two-step operation.

回顾性分析32例全腔静脉肺动脉连接术患者的临床资料：年龄5～24岁，平均（10±5）岁，体重13～55 kg，平均（28±11） kg，病种包括单心室16例，右心室双出口并完全性心内膜垫缺损6例，完全性大动脉转位并完全性心内膜垫缺损3例，三尖瓣闭锁6例，二尖瓣闭锁1例。其中，在低温体外循环心脏停跳下18例行右房内侧隧道法，1例行心外管道法，常温体外循环心脏跳动下10例行心外管道法，非体外循环下2例行心外管道法，1例行分次全腔静脉肺动脉连接术。

objectiveto investigate the diagnosis and treatment of traumatic duodenal rupture.methodthe clinical data of 13 patients with traumatic duodenal rupture hospitalized from may 1991 to december 2008 were retrospectively analyzed,and the material cause was automobile accident mainly.resultsin these 13 patients,after hospitalization,6 cases were diagnosed in 3 hours,4 cases were diagnosed in 24～72 hours,and 3 cases were diagnosed after 72 hours.three cases with duodenal cleft repair,2 cases with duodenal ostomy,2 cases with duodenum and jejunum roux-en-y anastomosis,1 case with duodenal diverticular surgery,1 case with meliorative duodenal diverticular surgery,1 case with duodenal broken ends closure and anastomosis of stomach with jejunum,1 case with duodenal distal closure and anastomosis of duodenal local with jejunum,and 2 cases with resections of pancreas duodenum.after the operation,6 cases (46.2%) appeared some complications of wound infection,duodenal fistula,digestive tract hemorrhage,pancreatic fistula,abdomen infection and so on.two cases (15.4%) died from multiple system organ failure and septic shock.conclusionthe early diagnosis and correct operation style selection are the keys for duodenal rupture.

目的：探讨外伤性十二指肠破裂的诊断和治疗方法。方法：回顾分析外伤性十二指肠破裂患者13例临床资料。结果：入院后3 h内确诊6例，24～72 h内确诊4例，72 h后确诊3例。3例行十二指肠裂口修补，2例行十二指肠造瘘，2例行十二指肠空肠roux-en-y吻合，1例行十二指肠憩室化手术，1例行改良十二指肠憩室化手术，1例行十二指肠两断端关闭、胃空肠吻合，1例行十二指肠远端关闭、近端与空肠端侧吻合，2例行胰十二指肠切除术。术后6例(46.2%)出现切口感染、十二指肠瘘、消化道出血、胰瘘或腹腔感染等并发症，2例(15.4%)患者死亡，分别死于多器官系统衰竭和感染中毒性休克。结论：早期诊断与正确的术式选择是成功救治外伤性十二指肠破裂的关键。

The time from injury to admission was between 2 monthes214 monthes except 1patient who underwent emergency operation 4 hours after injury ,and 1 patient was treated with debridment and epineurial neurorrhaphy ,7 cases with nerve trunk grafting ,6 cases with nerve cable grafting ,4 cases with neurolysis ,1 case with arthrodesis of ankle.

伤后至入院手术时间除1 例为4 h 外，其余均为2～14 个月。1 例行清创、神经外膜对端吻合术，7 例行神经全干移值术，6 例行神经电缆式移植，4 例行神经松解术，1 例行踝关节融合术。

Results All cases underwent surgical treatment; of them, local excision, partial pancreatectomy, pancreaticoduodenectomy, internal drainage and biopsy occurred in 14, 7, 3, 2 and 2 cases, respectively. Only 2 cases developed pancreatic fistula.

结果 28例非功能性胰岛细胞瘤术前定位和手术切除，其中14例行局部切除，7例行胰体尾部切除，3例行胰十二指肠切除，2例行囊肿内引流术，2例行活检术；全组术后并发胰瘘2例(7.1%)。

Methods we performed knee arthroscopy in 60 cases,in which 45 cases adopted knee joint cavity clean-up surgery, 5 adopted repair of meniscal suture, 6 adopted synovial plica excision, 3 adopted excision of loose bodies, and 1 adopted knee fracture fixation removal.

膝关节镜手术60例，其中45例行膝关节腔清理术、5例行半月板修补缝合术、6例行滑膜皱襞切除术、3例行游离体切除术、1例行膝关节骨折内固定取出术。

Results Among 12 cases, there were 5 male and 7 female cases, and age ranged from 14 to 56 years old. Six patients had the history of delayed defecation. Two cases were misdiagnosed as sigmoid torsion and 6 cases were admitted as acute intestinal obstruction. Colostomy was performed first in 7 cases. Surgical procedures included Swenson operation in 3, Duhamel in 2, Rehbein in 3, Soave operation in one and stapler anastamosis in 2 cases.

结果 男5例，女7例，年龄14～56岁，6例有胎粪排出延迟病史，2例误诊为乙状结肠扭转，6例诊断为急性肠梗阻，其中7例行结肠造瘘，3例行Swenson手术，2例行Duhamel手术；3例行Rehbein手术；1例行Soave手术；外院术后复发2例，Swenson手术1例术后出现骶前感染肛周瘘管，余术后排便功能良好。

Six patients had the history of delayed defecation. two cases were misdiagnosed as sigmoid torsion and 6 cases were admitted as acute intestinal obstruction. colostomy was performed first in 7 cases. surgical procedures included swenson operation in 3, duhamel in 2, rehbein in 3, soave operation in one and stapler anastamosis in 2 cases. presacral infection and perianal fistula occurred in one case with swenson operation.

结果 男5例，女7例，年龄14～56岁，6例有胎粪排出延迟病史，2例误诊为乙状结肠扭转，6例诊断为急性肠梗阻，其中7例行结肠造瘘，3例行swenson手术，2例行duhamel手术；3例行rehbein手术；1例行soave手术；外院术后复发2例，swenson手术1例术后出现骶前感染肛周瘘管，余术后排便功能良好。

Methods: Thirtythree patients were reported. Clinical manifestation,imaging findings including the computer tomography, magnetic resonance and digital substruction angiography were analyzed.

对33例椎基底动脉系统脑梗死患者的临床资料进行回顾性分析。1例行CT检查，32例行头颅核磁共振检查。2例行CT血管成像检查，2例行磁共振血管成像检查，4例行脑血管数字减影检查。

Results Conservative treatment was carried out for 4 patients, ureteroureterostomy for 7 patients, ureteroneocystostomy for 22 patients, bladder valve-ureter anastomosis for 2 patients, vermiform appendix-ureter replacement for 2 patients, and nephrectomy for 1 patients.

结果 4例行双J管保守治疗，7例(9侧)行输尿管端端吻合术，2 2例行输尿管膀胱再植术，2例行膀胱壁瓣输尿管吻合术，2例行阑尾代右侧部分输尿管术，1例行肾切除术。

Results The most common symptom was melena in four cases (including one case with hematemesis). Upper abdominal pain occurred in one case, and one case's mass was detected under gastroscopy. All the six cases underwent surgical operation and were confirmed by immunohistochemistry. Partial gastrectomy was performed in four cases, distal gastric curative resection in one case, and local wedgy resection in one case. All the cases survived after operation.

结果 以黑便为首发症状4例（其中1例伴呕血）；上腹疼痛1例；1例行胃镜检查时发现；全部病例均经手术治疗，切除标本经病理检查及免疫组化证实；4例行胃大部分切除术（其中2例行近端胃大部分切除＋幽门成形术，2例行远端胃大部分切除术），1例行远端胃癌根治术，1例行病灶楔形切除术。

Plunder melds and run with this jewel!

掠夺melds和运行与此宝石！

My dream is to be a crazy growing tree and extend at the edge between the city and the forest.

此刻，也许正是在通往天国的路上，我体验着这白色的晕旋。