止血法

Methods: 1. Experimental laparoscopic liver resection: We selected pigs as experimental models aiming to approach human beings physiological and anatomical condition. After CO2 pneumoperitoneum was established, the ligaments around liver were dissociated. Livers were cut off by the methods such as clamp dissection, microwave tissue coagulator, ultrasound dissector, Ligsure dissection, hand-assisted, short abdominal incision laparoscopy-assisted, and Endo-GIA switcher. The operation time and bleeding volume were compared between different methods of laparoscopic liver resection. The advantages and limitations of different methods were summarized. 2. Clinical laparoscopic liver resection: 15 cases with tumors in segment V of anterior right lobe or segments II, III of left lateral lobe or segment IV of left internal lobe were selected in this study. The liver diseases included hepatocellular cancer, hepatic cavernous hemangioma and hepatic focal nodular hyperplasia. The ligaments around liver were dissociated after CO2 pneumoperitoneum established. Laparoscopic liver resection were carried out by some of the methods combined such as clamp dissection, microwave tissue coagulator, hand-assisted, short abdominal incision laparoscopy-assisted, ultrasound dissector, rotation and suction dissector.

1、实验性腹腔镜肝切除：以猪为实验动物，旨在接近人体的生理、解剖环境下进行实验，建立操作空间后游离肝脏周围韧带，采用钳夹分离切肝法、微波刀切肝法、超声刀切肝法、Ligsure切肝法、手辅助腹腔镜肝切除法、小切口腹腔镜辅助切肝法、Endo-GIA切肝法等方法实施腹腔镜下肝切除，比较不同切肝方法的手术时间、出血量，总结各种方法的优越性及其局限性。2、临床腹腔镜肝切除：选择肿瘤位于肝右前叶第Ⅴ段、肝左外叶第Ⅱ、Ⅲ段及左内叶第Ⅳ段的15例患者，病种包括原发性肝癌、肝海绵状血管瘤、肝脏局灶性增生，建立气腹后游离肝脏周围韧带，采用钳夹分离断肝、微波刀固化后断肝、手辅助腹腔镜肝切除、小切口腹腔镜辅助肝切除、超声刀断肝、旋吸断肝等多种方法分离切线肝组织，暴露管道结构，再采用高频电凝、钛夹夹闭、缝扎止血、止血纱布覆盖、氩气刀止血、生物胶止血、Endo-GIA处理等多种方法相结合处理肝断面，统计手术完成情况、手术时间、手术出血量、术后并发症及术后住院时间等，评价腹腔镜肝切除的可行性及安全性。

The patients of control group(n=68) were treated by Famotidine, PAMBA and/or Pituitrin iv drip or iv and received circulative volume effectively. The patients of treatment group (n=68) were received to thrombin 1000～2000 u added to normal salt 10～20 ml, P.

对照组68例仅补充有效血容量及静注法莫替丁、止血芳酸和/或垂体后叶素，治疗组68例在对照组治疗的基础上应用凝血酶1000～2000 u溶在温生理盐水10～20 ml中，口服或灌注，每1～3小时1次，每日连用3～4次，连续2～3日。

The presacral haemostatic thumbtack projector is more quickly and has better therapeutic effect than tradition thumbtack in controlling presacral bleeding, and this new appliance could be used and advocated in clinic step by step.

使用骶前止血钉发射器对骶前大出血的止血速度比钉堵法快，止血效果好，是一种临床上可逐步应用与推广的新型止血器械。

Objective To investigate the cause of native arterio-venous fistula aneurysm and prevention measures. Methods There were 7 cases with snuff-box arteriovenous fistula and 53 cases with brachiocephalic fistulas. Among them, 14 patients had to made second fistulas in the same arm .Spring tape around the arm was used to stop bleeding after dialysis.

目的 研究血液透析患者动静脉内瘘动脉瘤形成的原因及预防措施方法选取我科透析患者60例，其中鼻咽窝7例，左右臂内瘘53例（第二次同侧手臂手术14例）；穿刺方法绳梯式穿刺和局域穿刺；止血方法主要采用弹力绷带压迫法。

RESULTS Duodenal ulcer was the first cause of upper gastrointestinal hemorrhage. Gastric ulcer, cirrhosis, Mallory-Weiss syndrome or acute gastric mucous lesion was the second cause of the illness alternatively. The rate of endoscopy and emergent endoscopy has been going up year after year and got up to 80% in 1998. Bleeding and active hemorrhage, respectively were found in 24.3% and 14.9% of the patients underwent endoscopy before medication. Endoscopic hemostasis was performed in 108 patients by spraying hemostatics and a good response was achieved subsequently. Hemostatics were mainly cimetidine and yunnan baiyao before 1994. Reptilase, pPI, famotidine and ranitidine were used increasingly while cimetidine and yunnan baiyao were used decreasingly. Octreotide was used in patients with cirrhosis commonly. The length of hospital stay and the period from admission to bleeding cease tended to be shorter year by year, but the reduction rate was small. The uses of ranitidine, famotidine, pPI, reptilase, octreotide, early endoscopy and endoscopic therapy may play a role in improving the therapeutic effect of hemostasis, reducing the hospitalization and the mortality.

结果 十二指肠球部溃疡是历年上消化道出血的首要原因，胃溃疡、肝硬变、Mallory -Weiss综合征、急性胃粘膜病变则交替成为第2位出血原因；内镜诊断率和急诊内镜率逐年提高，1998年达到80%，内镜下见出血者占内镜检查的24.3%，而见到活动性出血者仅占内镜检查者的14.9%；内镜下止血108例次，成功率100%；1994年前治疗药物主要为云南白药和甲氰咪胍，之后，随着立止血、质子泵抑制剂、法莫替丁、雷尼替丁等药物使用的逐渐增多，前二者的使用逐渐减少，善得定多用于肝硬变出血；住院天数和止血天数呈逐年下降的趋势，但幅度微小；雷尼替丁、法莫替丁、PPI、立止血、善得定的使用以及及时的内镜检查和内镜下治疗在提高止血效果、缩短住院天数、降低死亡率方面可能起到了一定作用。

Methodes: 72 cases of large hemorrhage caused by cirrhosis combined esophageal and fundal varices were divided into 2 groups randomLy during 2001.1-2003.12, treated by Somatostatin and Sengstaken-Blackmore Tube to observe the effect and the side action.

对2001年1月至2003年12月共收治的72例肝硬化并食道胃底静脉曲张破裂大出血患者随机分为两组，分别使用生长抑素和三腔二囊管压迫法治疗，观察两组的止血效果和副作用。

Angiography determined correct diagnosis in 10 patients (10/10, 100%). the most involved vessels are peripancreatic arteries. eight patients were managed by trans-catheter arterial embolization as "one point"(a proximal point of the pseudo-aneurysm).

受累血管主要为胰周血管。8例&一点法&栓塞后获得止血，2例&两点法&（动脉瘤出血血管的近端和远端）血管栓塞成功。

Results: Up to date, most of the found chemical compostition of Flos Lonicerae conclude essential oil, flavonoid, organic acid, triterpenoid and microelement; The pharmacal researches show that it can antagonize pathogenic microorganism, anticatarrhals,...

结果 ：至目前为止，已发现的化学成分主要有挥发油、黄酮类、有机酸、三萜类、无机元素等；药理研究表明金银花具有抗病原微生物、抗炎、解热、保肝、抗生育、止血、免疫调节、降血脂、中枢兴奋等作用；临床上主要用于多种感染、各种炎症、高热症、高脂血症、肿瘤放疗、化疗口干症等；金银花质量标准主要以其主要成分绿原酸为指标，检测方法多采用薄层色谱法和高效液相色谱法。

To pay attention to carry out effective cardiopulmonary resuscitation, hemostasis by compression and deep vein intubation rapidly in the initial stage of emergency. The carotid shunt tube plays an important role in severe carotid injury and re-establishment process. We use external jugular vein to transplant and re-establish,which are rung with artificial blood vessels for the long distance carotid injury and achieved the best result. We expose as fully as possible for the hepatic venae and the posthepatic post caval injury,and adopt effective methods to stop bleeding and repair. The application of blood shunt pump could raise the success rate for those severe patients. The self-double vastransplantation with both ends being all trousers-style one opening solve some problems such as there are no suitable caliber self-transplantation blood vessels and the artificial blood vessels are easy to occur obliteration for long-term and so on for the great or middle blood vessels.We use improved Fogarty duct and anterograde intubation to eliminate thrombus could eliminate thrombus effectively and avoid accessory injury for the deep vein injury and extensive thrombosis.

抢救初期要注意进行有效的心肺复苏、压迫止血和快速进行深静脉插管；颈动脉转流管在严重颈动脉损伤重建过程中有重要作用；对长距离颈动脉损伤用颈外静脉移植外环包人造血管重建，可取得最佳效果；对肝静脉及肝后下腔静脉损伤，要充分暴露，采用有效方法止血和修复，对病情极危重的凶险性出血者，血液转流泵的应用可提高成功率；对大、中血管损伤，两端均为裤式单开口自体双血管移植，解决了无适宜口径自体移植血管和应用人造血管远期易闭塞等问题；对深静脉损伤并广泛血栓形成者，应用改进的Fogarty导管和顺行插管取栓法，可有效取栓并避免了副损伤。

To pay attention to carry out effective cardiopulmonary resus-citation,hemostasis by compression and deep vein intubation rapidly in the initial stage of emergency.The carotid shunt tube plays an important role in severe carotid injury and re-establishment process.We use external jugular vein to transplant and re-establish,which are rungwith artificial blood vessels for the long distance carotid injury and achieved the best result.We expose as fully as possible for the hepatic venae and the posthepatic post caval injury,and adopt effective methods to stop bleeding and repair.The application of blood shunt pump could raise the success rate for those severe patients.The self-double vastransplantation with both ends being all trousers-style one opening solve some problems such as there are no suitable caliber self-transplantation blood vessels and the artificial blood vessels are easy to occur obliteration for long-term and so on for the great or middle blood vessels.We use improved Fogarty duct and anterograde intubation to eliminate thrombus could eliminate thrombus effectively and avoid accessory injury for the deep vein injury and extensive thrombosis.

抢救初期要注意进行有效的心肺复苏、压迫止血和快速进行深静脉插管；颈动脉转流管在严重颈动脉损伤重建过程中有重要作用；对长距离颈动脉损伤用颈外静脉移植外环包人造血管重建，可取得最佳效果；对肝静脉及肝后下腔静脉损伤，要充分暴露，采用有效方法止血和修复，对病情极危重的凶险性出血者，血液转流泵的应用可提高成功率；对大、中血管损伤，两端均为裤式单开口自体双血管移植，解决了无适宜口径自体移植血管和应用人造血管远期易闭塞等问题；对深静脉损伤并广泛血栓形成者，应用改进的Fogarty导管和顺行插管取栓法，可有效取栓并避免了副损伤。

On the other hand, the more important thing is because the urban housing is a kind of heterogeneity products.

另一方面，更重要的是由于城市住房是一种异质性产品。

Climate histogram is the fall that collects place measure calm value, cent serves as cross axle for a few equal interval, the area that the frequency that the value appears according to place is accumulated and becomes will be determined inside each interval, discharge the graph that rise with post, also be called histogram.

气候直方图是将所收集的降水量测定值，分为几个相等的区间作为横轴，并将各区间内所测定值依所出现的次数累积而成的面积，用柱子排起来的图形，也叫做柱状图。