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We observed 20 cases patients with laparoscopeand 16 cases patients who received celiotomy.

选择20例腹腔镜组、16例剖腹手术组进行比较。

Result:2 cases were made definite diagnosis among celiotomy exploratory, 1 case was diagnosed next day after injury, Another 3 cases weren't made definite diagnosis until 5~25 days later. 3 cases were taken ureter or ureter to renal pelvis end-to-end one-stage anastomosis early,2 cases were taken urinary cyst resection and ureter end-to-end anastomosis three months later,1 case performed extravsation of urine drainage only.

结果:2例在早期剖腹探查中明确诊断,1例于伤后d2明确诊断,另3例在伤后5~25d才明确诊断。3例早期行一期输尿管或输尿管肾盂端端吻合术,2例于损伤3个月后行尿液性囊肿切除输尿管端端吻合术,1例行单纯尿液引流。

Results 155 patients had surgical site infections in total 1 589 patients undergoing general surgery and the infection rate was 9.75%. The infection rates were hightest in those undergoing celiotomy or colon surgery. 56 patients appeared with postdischarge surgical site infection, accounting for 36.13% in the whole infection public. Most postdischarge surgical site infection happened in class Ⅰ and class Ⅱ surgery. Albumin and hemoglobin abnormity, emergency surgery, bleeding, incision type and eduction were risk factors of surgical site infection by multivariate Logistic regression analysis.

结果 1 589例次手术患者中,155例次手术部位发生感染,感染率为9.75%;不同手术类别相同危险指数的手术以剖腹探查手术和结肠手术感染发生最高;有56例患者在出院后发生手术部位感染,随访感染占总感染例数的36.13%,随访感染以Ⅰ、Ⅱ类手术为主;经单因素及多因素Logistic回归分析得出,白蛋白及血红蛋白值异常、急诊手术、失血、切口类型、引流为手术部位感染的危险因素。

The case number of duodenopancreatectomy,cholecystojejunostomy, cholecystoduodenostomy, gastrojejunostomy, cholecystostomy, choledochoduodenostomy, choledochjejunalostomy, exploration of the common bile duct, and T tube drain were 43, 20, 3, 19, 4, 4, 21, 18, 7 respectively.

行胰十二指肠切除术43例,胆囊空肠吻合术20例,胆囊十二指肠吻合术3例,胃空肠吻合术19例,胆囊造瘘术4例,胆总管十二指肠吻合术4例,胆总管空肠吻合术21例,胆总管探查、T管引流18例,剖腹探查术7例。

Results Preoperative diagnostic rate was53.6%,and operative resection rate was71.4%,simple cholecystectomy in6cases,cholecystectomy and exploration of the biliary passage in4cases,gallbladder and regional lymphadonectomy in2cases,gallbladder and liver wedge resection and regional lymphadonectomy in6cases,gallblad-der and liver wedge resection and regional lymphadonectomy and right hemicolectomy in1case,and gallbladder and liver wedge resection and regional lymphadonectomy and subtotal gastrectomy and right hemicolectomy in1case.Unre-sectable rate were28.6%,gastro-jejunostomy in2cases,cholecystostomy in1case.Laparotomy exploration only in5cases.

结果 术前确诊率仅为53.6%(15/28),手术切除率为71.4%(20/28),单纯胆囊切除术6例(占21.4%),胆囊切除+总胆管探查4例(占14.3%),胆囊切除+区域淋巴结清扫2例(占7.1%),胆囊+肝楔状切除+区域淋巴结清扫6例(占21.4%),胆囊+肝楔状切除+区域淋巴结清扫+右半结肠切除1例(占3.6%),胆囊+肝楔状切除+区域淋巴结清扫+胃大部切除+右半结肠切除1例(占3.6%),未切除率为28.6%,胃-空肠吻合术2例(占7.1%),胆囊造瘘1例(占3.6%),仅做剖腹探查术5例(占17.9%)。

The reoperation styles as follows: choledochocholedochostomy,Roux en y choledochojejunostomy,laparotomy of hematischesis,EST, choledocholithotomy. 19 cases were all cured by operations without severe neopathy.

再手术方式分别为胆总管端端吻合术、胆总管空肠Roux en y吻合术、剖腹止血术、EST、胆总管切开取石术。19例均经手术治愈,未出现严重并发症。

Abdominal examination found rectal rupture which was managed by Harttman+ cystostomy followed by anti-infection treatment.

剖腹探查见直肠破裂,遂行Harttman手术加膀胱造瘘术和抗感染治疗。

C Image obtained with enteroclysis performed through a long intestinal tube shows an SBO.

c通过长导管灌肠造影显示小肠梗阻(SBO,三角形箭头所指处),CT检查11天后进行了剖腹手术。

Results: The positive rate of angiography, radionuclide scanning, double intestinal air-barium contrast examination, enteroscope, exploratory laparotomy and intraoperative colonoscopy...

小肠出血的诊断首选选择性肠系膜动脉造影;再行核素扫描,尤其是少量小肠出血对核素扫描较敏感;小肠气钡双重造影对小肠微小的隆起和凹陷性病变诊断价值较高;小肠镜的技术有待进一步提高;剖腹探查用于上述辅助检查均未能明确,且排除了上消化道和大肠病变而又有大量出血和反复出血者。应将小肠认为是中消化道而大肠是下消化道。

At laparotomy performed 31 hours after CT, adhesion between the gastrocolic ligament and the transverse mesocolon was found.

剖腹手术31小时后CT扫描,胃结肠韧带和横结肠系膜见粘连。

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