瘘

Methods From 1989 to 1997,69 hypospadias fistulae in 54 patients were repaired with different methods.

报告54例69个瘘孔采用不同修补方法修复尿道下裂术后尿瘘的结果。

Treatment of 6 cases of traumatic cerebrospinal rhinorrhea in frontal sinus by intranasal endoscopic surgery was reported. We adopt a procedure to open and enlarge the nasofrontal duct under direct vision by intranasal endoscopic surgery firstly and find the fistula, then repair it with its own smashed muscle, and support it with muscular membrane and gelfoam,iodoform pledget.

经鼻内窥镜外科治疗外伤性额窦脑脊液鼻漏6例，利用经鼻内窥镜外科技术开放和扩大鼻额管，在直视下找到瘘口，应用自体碎肌肉覆盖瘘口，外加肌膜和明胶海棉、碘仿纱条填塞，对于单纯内窥镜下手术有困难者，结合眉弓小切口联合额窦切开进行修补。

We adopt a procedure to open and enlarge the nasofrontal duct under direct vision by intranasal endoscopic surgery firstly and find the fistula, then repair it with its own smashed muscle, and support it with muscular membrane and gelfoam,iodoform pledget.

经鼻内窥镜外科治疗外伤性额窦脑脊液鼻漏6例，利用经鼻内窥镜外科技术开放和扩大鼻额管，在直视下找到瘘口，应用自体碎肌肉覆盖瘘口，外加肌膜和明胶海棉、碘仿纱条填塞，对于单纯内窥镜下手术有困难者，结合眉弓小切口联合额窦切开进行修补。

Objective To investigate the nursing intervention in preclusion of post-urethroplasty urinary fis-tula of hypospadia.Methods 70urethroplasty cases were randomly divided into2groups,the urethral stents were douched with0.9%N.S in the cotrol group,and the integrated nursing interventionwas applied in the treatment group,the INI includerays the use of10ml0.9%N.S plus80000units gentamicin for douche,swabbing genitals with nitrofurazone solution and infrared rays exposure of genitals.

目的 采用护理干预手段预防尿道下裂术后尿瘘的发生方法选择尿道下裂带蒂皮瓣正位开口期尿道成形术患者70例随机分 2组：一组是常规用生理盐水冲洗尿道支架管方法；另一组是生理盐水10ml加庆霉素8万U冲洗新尿道支架管，呋喃西林溶液擦拭外阴部以及红外线伤口局部照射的护理干预方法综合护理，观察尿瘘的发生率。

Methods:clinical data of 23 cases of left-sided colonic carcinoma undergoing one-stage resection and primary anastomosis were analyzed respectively.intraoperative colonic lavage were performed in all cases.for the 14 cases which were considered to be dangerous,preventive ceostomy was performed.results:23 cases were performed one-stage resection and primary anastomosis,all patients had not any complications such as anastomatic leakage and infection of the peritoneal cavity.conclusions:have a strict control over operation indication,perform postoperative care properly, one-stage resection and primary anastomosis for acute obstruction of left hemicolonic carcinoma is safe and workable.

回顾性分析我院五年来23例左半结肠癌并急性梗阻一期切除吻合术的临床资料，所有病例均术中结肠灌洗，而认为有危险性的14例同时行预防性盲肠造瘘。结果：23例一期切除吻合术，无一例发生吻合口漏、腹腔感染等并发症。结论：严格掌握手术适应症，积极术前准备，充分结肠灌洗，对认为有危险性吻合口实行预防性盲肠造瘘，正确术后处理，左半结肠癌并急性梗阻一期切除吻合术是安全可行的。

Coronary artery bypass graft, Off-pump coronary artery bypass or minimally invasive direct coronary artery bypass were utilized to correct the myocardial bridging and coronary artery aneurysm. Reimplantation of the anomalous orifice of coronary artery and Takauchi procedure were used to repair coronary artery anomalous origin from pulmonary artery.

其中冠状动脉起源于肺动脉手术采用冠脉开口移位于主动脉1例，Takauchi手术1例；冠状动脉瘘体外循环下修补6例、冠状动脉下瘘口切线缝扎1例，非体外循环下左前降支－肺动脉之间瘘管结扎1例；左前降支心肌桥行MIDCAB 4例，OPCAB 8例，体外循环下行心肌桥松解术2例；冠状动脉瘤采用体外循环下CABG术2例，OPCAB 8例，其中冠状动脉瘤成形术1例，冠状动脉瘤切除术1例。

the top digit complex anus fistula is refers tothe multi- pipelines many moves towards complex outside,内口 the position passed through includes a e myo- in-depth anal tube on clinical awkwardly to govern.

高位复杂性肛瘘是指多外口、多管道走向复杂，内口位置穿过外括的肌深层的肛管直肠瘘，临床上较为难治。

Methods There were five patients underwent transcatheter ICA occlusion, aged from 15 to 55 years. One patient suffered uncontrol nasopharyn bleed after nasopharyn carcinoma radio-treatment detriment.

共5例患者，1例鼻咽癌行放疗后清创术，并发难以制止的鼻咽部大出血，双侧后鼻孔填塞无效；1例巨大颈内动脉眼段动脉瘤，无法手术夹闭；3例外伤后颈内动脉海绵窦瘘，单纯闭塞瘘口失败。

Results In all these cases, there are 83 cases origin from mucous membrane which include inflammation, tumor and anabrosis; 24 cases origin below mucous membrane which include interstitialoma, lymphoma and scleroderma;38 cases mainly changed in the shape, structure and position of organs which include hiatus hernia, Oblique inguinal hernia, diverticulum, malrotation of intestine and megacolon; 29 cases mainly changed in the power and function of organs which include functional disorder of esophagus, mesentery-compressed syndrome funtional disorder of small intestine and irritable colon; 17 cases' performance caused by the factor outside intestinal canal which include mesentery shift, stomach shift and small intestine shift, and other cases which include fistula between esophagus and mediastinum, rectovaginal fistula, foreign body in esophagus and small intestine ascariasis.

结果：197例患者中，源于黏膜的病变83例，源于黏膜下的病变24例（包括间质瘤、淋巴瘤、硬皮病），以器官形态、结构、位置改变为主的病变38例（包括食管裂孔疝、腹股沟斜疝、憩室、肠旋转不良、巨结肠），以器官动力、功能改变为主的病变29例（包括食管功能紊乱、肠系膜压迫综合征、小肠功能紊乱、结肠过敏），因管腔外因素的影响而引起的改变17例（包括食管移位、胃移位、小肠移位），其他病变6例（包括食管纵隔瘘、直肠阴道瘘、食管异物、小肠蛔虫症）。

Surgical strategies included: 23 cases with meso-caval shunt, 8 cases with splenectomy and spleno-renal vein shunt, 1 case with porta-caval shunt, 2 cases with paraumbilical vein-jugular vein shunt, 3 cases with portal azygous disconnection, 1 cases with splenectomy and portal azygous disconnection, 1 case with sigmoidostomy and closed the fistula of sigmoid six months later, 1 case with resection of part of small intestine due to acute extensive thrombosis of portal vein system, 4 cases with selective superior mesenteric artery and splenic artery thrombolytic infusion therapy, 2 cases remained no-surgical option and underwent conservative treatment.

行肠系膜上静脉-下腔静脉分流术23例；脾切除、脾静脉-肾静脉分流术8例；门静脉-下腔静脉分流术1例；附脐静脉-颈内静脉分流术2例；门奇静脉断流术3例；脾切除、门奇静脉断流术1例；乙状结肠暂时性造瘘，6个月后闭瘘1例；大部分小肠切除术1例；经股动脉插管溶栓4例；未行手术2例，仅给予护肝及对症治疗。

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。