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The criteria for diagnosis is still uncertain, the most approbatory technique is laparoscopic full-thickness intestinal biopsy or resected surgical specimens with HE stain or Ache stain, additional immunohistochemical staining is used to identify the dysplasia nerve cells.

目前国内对1ND的认识仍不足,一般根据临床表现或结合钡剂灌肠检查就予诊断并进一步手术治疗,随着经肛门手术的广泛开展和手术年龄提前至新生儿和婴幼儿期,单凭临床表现和钡灌肠可误将部分单纯型IND诊断为HD而手术治疗。

The result shown that the lived experience of first tri- mester unmarried women could be divided into 7 themes ,which according to time sequence could be divided into three parts ,including pre-abortion ,during abortion ,and post-abor -tion.The themes of pre-abortion are "shock and not know what to do","confusion and conflict in making decision whether to have an abortion or not",and loss and depression when the decision has been made .

资料分析结果,未婚女性於第一孕期接受人工流产手术的经验历程,依时间序列归纳成手术前、手术中及手术三个阶段,手术前的主题包括:「对怀孕的震惊与不知所措」、「抉择过程的迷惘与冲突」及「抉择后的失落与抑郁」等。

objective to discuss perioperative complication and management of patient with high risk copd following esophagectomy.methods 45 patients with high risk copd underwent esophagectomy with epidural block combined with general anesthesia.perioperative treatment included smoking cessation,chest physiotherapy,prevention and control of infection of air way and appropriate bronchodilators of air way,breathing exercises,nutrition support and oxygen therapy.painkiller was instilled after surgery,early exercises,ensuring unobstruction of the air way,mechanical ventilation was applied when needed.results 3 had hypoxaemia in operation.after surgery,all patients had spo2 somewhat declined.6 had lung infection.6 were removed of bronchial secretion by bronchoscope.2 were supported by ventilator by using intubation.2 underwent tracheotomy.1 had disturbances of acid base balance and treated by using hydrochloric acid muriatic acid.all patients recovered rather smoothly and discharged from hospital.conclusion high risk copd is not the absolute contraindication of esophagectomy.active management before and after surgery ensures the safety and recovery of patients.

目的 探讨重度慢性阻塞性肺疾病简称慢阻肺病人食管切除术围手术期常见并发症及其处理。方法 45例重度慢阻肺的病人在全麻联合硬膜外阻滞下进行开胸食管切除手术,围手术期处理包括术前戒烟、胸部理疗、预防和控制呼吸道感染、解痉化痰、呼吸功能锻炼、营养支持和氧疗;术后硬膜外镇痛、早期锻炼、保持呼吸道通畅,部分病人予以呼吸支持。结果术中3例出现低氧血症。术后所有病人pao2均有不同程度的下降,6例出现肺部感染,6例行纤维支气管镜吸痰,2例通过气管插管给予呼吸机支持,2例行气管切开术,1例酸碱平衡紊乱使用盐酸精氨酸治疗。所有病人均痊愈出院。结论重度慢阻肺病人并非开胸食管切除手术的绝对禁忌证,积极的术前准备和严格的术后管理可减少和控制术后急性发作,有助于确保此类病人的围手术期安全和康复。

The post-operational patient on liquid or semiliquid diet injected insulin subcutaneously before three meals,applied inˉsulin according to blood sugar level until end of perioperative period.

目的 探讨糖尿病对耳鼻咽喉—头颈外科患者手术后并发症的影响以及糖尿病患者的围手术期治疗方法对51例接受耳鼻咽喉及头颈部不同类型手术的糖尿病患者,观察其围手术期并发症,并于术 3天改三餐前0.5h皮下注射速效胰岛素治疗,根据血糖的测定结果,开始剂量约为4~8U;对术后禁食需要补液的患者,按葡萄糖3~4g/胰岛素1U的比例给药,并每日监测血糖指标;术后进流质或半流质饮食的患者,于三餐前皮下注射胰岛素,按血糖测定情况给药,直至围手术期结束。

In the virtual surgery system, the virtual scalpel could be manipulated on 3D liver mould with PHANTOM. The simulating effect was the same as the clinic operation for auxiliary partial orthotopic liver transplantation. Plane visualization of hepatic resection and intrahepatic vessel cutting was achieved by adjusting the transparency of the resection part. Life-like could be felt and power feeling could be touched during virtul operation. Conclusion ① The visualized liver mould reconstructed is 3D and verisimilar, and it is helpful to design reasonable scheme for liver transplantation.

在建立的虚拟手术系统的虚拟环境中,使用力反馈设备PHANTOM操纵"虚拟手术刀"模拟了辅助性部分原位肝移植的手术过程,其结果符合临床手术的效果;通过控制肝脏模型切除部分的透明度,使肝脏手术切割平面可视化以及肝脏内部管道手术切断平面可视化;手术模拟过程逼真,形象,且有"力"的感受。

Thoracoabdominal aortic aneurysm is a hazardous vascular disease,of which the operation is complex and difficult,and associated with high morbidity and mortality rate.

胸腹主动脉瘤是一种凶险的血管疾病,手术操作复杂、难度大,手术病死率和并发症发生率高,血管外科医师们为提高手术的治疗效果在不断探索新的手术方法,本文简要介绍胸腹主动脉瘤手术方法的变迁,包括分型,手术方法,效果及优缺点。

The transabdominal-hiatal approach to the resection of the advanced proximal gastric cancer is an effective and safe alternative to the standard thoracoabdominal technique.

结论经腹、膈肌裂孔途径手术切除近侧部进展期胃癌是替代胸腹途径手术的合理手术方法,避免剖胸手术对病人的创伤。

AIM: To study the relieve pain effect in ophthalmologic operation with unnarcotic analgesic, in order to get more comfortable duration.

本文通过对眼科局麻手术中辅助镇痛的研究,发现其最佳的适应证、应用方法,使得患者在手术过程消除紧张焦虑、疼痛域值提高,从而使患者手术过程舒适,又不影响手术效率及眼科局麻手术的其他优势。

Results 706 soldiers(3.47%) had oculopathy who didn't met the standard of health examination.57 soldiers(8.67%) had oculopathy among 658 recruits who did myoporthosis operation;649 soldiers(3.30%) had oculopathy among 19662 recruits who didn't do the operation.and the morbidity of the sight unqualified,complication of operation,eye bottom disease and glaucoma was higher than those who didn't do myoporthosis operation.the contrast of the two had striking statistical meaning.

结果 706人(3.47%)发现眼部疾患,均不符合军人体检标准。其中行近视矫正手术658名新兵中,57人(8.67%)发现眼部疾患;未行近视矫正手术19662名新兵中,649人(3.30%)发现眼部疾病。并且,还发现行近视矫正手术的新兵在视力不合格、手术并发症、眼底疾病以及青光眼等疾病方面的患病率明显高于未行近视手术的新兵,二者对比有显著的统计学差异。

This set of theories includes microanatomy, steoroanatomy, dynamic anatomy, body surface location, acupotome entering method in closed surgery, operational route in closed surgery, methods in closed surgery and the tool for closed surgery------acupotome.

这套理论包括微观解剖学、立体解剖学、动态解剖学、体表定位学、闭合性手术的进针刀方法、闭合性手术的手术入路、闭合性手术方法以及适合于闭合性手术的工具--针刀。

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