剖腹手术

Adult male Sprague-Dawley ratsunderwent subcostal laparotomy surgery under isoflurane anesthesiaor received anesthesia without surgery.

成年雄性 SD 大鼠于异氟烷麻醉下行肋下剖腹术或仅接受麻醉未手术。

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%）。

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。

Results One case with transverse mesocolon pore hernia, one with obturator hernia and one with paracecal hernia were confirmed by exploratory laparotomy. There were six cases whose hernias resulted from the fall of export jejuna into import jejuna after Billroth II anastomoses in front of colons, five from the pelvic bottoms' peritoneal fissure and four from the fissure appearing between descending colon and lateral abdominal wall after Miles' operation, one from greater omental adhesion to sigmoidal wall after sigmoidostomy, and one from inflammatory adhesion on the basis of Meckel's diverticulum. The other 17 cases' hernias (48.7%) were caused by the fissure among celiac adhesive bands, peritonea, celiac organs, enteric walls and intestines.

结果 剖腹探查手术证实为横结肠系膜裂孔疝1例；闭孔疝1例；盲肠旁疝1例；毕Ⅱ式结肠前吻合术后输出段空肠疝入输入段空肠与横结肠系膜间隙6例；Miles术后盆底腹膜裂开所致内疝5例；Miles术后降结肠与侧腹壁形成的间隙致内疝4例；大网膜与乙状结肠造口肠壁粘连形成内疝1 例；1例在梅克尔憩室基础上发生炎性粘连形成腹内疝；因腹腔粘连带与腹膜、腹腔脏器、肠壁、肠与肠之间的孔隙改变形成内疝17例（48.7%）。

Results All17patients had reiteratively blood in stools.The longest medical history of these patients is of3years,the shortest is of2months.8cases showed symptoms of stomachaches;2cases showed symptoms of peritonitis.3cases resulted in positive tests in the radioactive scanning.Of the rest of the patients,1case showeda positive test in the selective arterial angiographies.Of the17patients,12recovered completely after the operation.And no recurrence was found in the following3～5years.5patients died of the recurrence of tumor and metastasis.

结果 17例均有反复次便血，病史最长3年，最短2月，8例伴有腹痛，2例伴有腹膜炎体征，3例伴有腹块。3例核素扫描检查均是阳性，4例选择性血管造影1例阳性。17例病员无1例术明确原发病，其中15例剖腹探查直接找到病因，2例术中结合内镜找到出血原因。17例中12例经手术治疗痊愈，随访3～5年无复发。5例死于肿瘤复发转移。

Acute hemorrhage of abdomen or thoraces can be cured by endoscopic technology which is aiming at early diagnosis and treatment.

电视内窥镜手术系统同样适用于急性胸、腹腔内出血的病人，能达到早诊断、早治疗的目的，其治疗效果明显优于剖胸或剖腹治疗。

After stratification (myoma size, number of myomas,and surgeon), patients were randomized to either laparoscopy( n = 19) or laparotomy ( n = 21) and received a standardizedanesthesia and patient-controlled analgesia for 24 h after surgery.

在对肌瘤大小、数量和手术医生分层后，病人被随机分在腹腔镜组（ n = 19）或剖腹组（ n = 21），并且接受标准化的麻醉和术后24小时的病人自控镇痛。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。