瘘的

Results 4 cases were treated by thoracic close drainage as long term treatment; 6 cases were cured with exclusive thoracic close drainage; 123 cases of bronchopleural fistula were treated with decortication or thoracoplasty after their symptoms of ardent fever, cough and expectoration vanished due to drainage ; 23 cases of hronchopleural fistula were treated with thoracic close drainage, cleaning up focus of infectionrestoring fistulae-splanchnic wall decortication and repeated chest drainage ,4 cases were cured and the extent of operation and thoracic deformity in 19 cases were diminished.

结果 4例不能耐受进一步手术者采用闭式引流术作为永久性的治疗；6例单纯引流治愈；123例因支气管胸膜瘘等经引流后高热、咳嗽、咳痰等症状消失，择期行胸膜纤维板剥脱术或胸廓成形术；23例合并支气管胸膜瘘拟行胸廓成形术的患者，经引流、病灶清除-瘘修补-脏层纤维板剥脱术、再引流，4例治愈，19例减小了手术范围及胸廓畸形的程度。

Abstract］ objective to discuss the influencing factors of healing up of anastomosis between traditional and morden ideas and question the more reasonable method of intestinal tract preparation in stage one operation.methods twenty-six patients with colon cancer were divided into 3 groups:colostomy group（8 cases）,washing group (9 cases) and suction group (9 cases).all the patients underwent colectomy plus stage one anastomosis and exteriorization with different interoperative preparation with which we compared the healing up of anastomosis within the three groups.results there were 3 cases having fistula in the colostomy group （8 cases）;one case in the washing group,but all the patients in the suction groups gained stage one healing up.conclusion as a method of emergency interoperative peparation,stool suction has a better healing up of anastomosis than colostomy and washing;it is advantageous to observe the healing up of anastomosis through colectomy plus stage one anastomosis and colon-outlying.

目的 探讨影响吻合口愈合因素的传统与现代观念并进一步探讨一期手术中更为合理的肠道准备方式。方法 26例降结肠癌分为造瘘组（8例）、冲洗组（9例）和粪便吸引组（9例）三组，术中分别采用3种不同方式行紧急肠道准备，所有病人均采用结肠切除一期吻合加外置的方法，对比观察三组病人的吻合口愈合情况。结果造瘘组（8例）有3例发生瘘，冲洗组有1例发生瘘，粪便吸引组全部一期愈合。结论粪便吸引作为一种术中紧急肠道准备方法，其吻合口愈合情况优于前两组；结肠一期吻合加外置的方法有利于观察吻合口的情况。

Objective: To discuss the method of percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy to set up the way of enteral nutrition.

目的：探讨经皮内镜胃造瘘术和经皮内镜小肠造瘘术建立肠内营养的方法。

Objective To assess the effects of self-expandable metallic stents (covered-SEMS) and percutaneous endoscopic gastrostomy in the treatment of tracheoesophageal fistulas.

目的 评估内镜下食管覆膜自膨式金属支架植入术与经皮内镜下胃造瘘术在气管食管瘘治疗中的应用价值。

objectiveto investigate the diagnosis and treatment of traumatic duodenal rupture.methodthe clinical data of 13 patients with traumatic duodenal rupture hospitalized from may 1991 to december 2008 were retrospectively analyzed,and the material cause was automobile accident mainly.resultsin these 13 patients,after hospitalization,6 cases were diagnosed in 3 hours,4 cases were diagnosed in 24～72 hours,and 3 cases were diagnosed after 72 hours.three cases with duodenal cleft repair,2 cases with duodenal ostomy,2 cases with duodenum and jejunum roux-en-y anastomosis,1 case with duodenal diverticular surgery,1 case with meliorative duodenal diverticular surgery,1 case with duodenal broken ends closure and anastomosis of stomach with jejunum,1 case with duodenal distal closure and anastomosis of duodenal local with jejunum,and 2 cases with resections of pancreas duodenum.after the operation,6 cases (46.2%) appeared some complications of wound infection,duodenal fistula,digestive tract hemorrhage,pancreatic fistula,abdomen infection and so on.two cases (15.4%) died from multiple system organ failure and septic shock.conclusionthe early diagnosis and correct operation style selection are the keys for duodenal rupture.

目的：探讨外伤性十二指肠破裂的诊断和治疗方法。方法：回顾分析外伤性十二指肠破裂患者13例临床资料。结果：入院后3 h内确诊6例，24～72 h内确诊4例，72 h后确诊3例。3例行十二指肠裂口修补，2例行十二指肠造瘘，2例行十二指肠空肠roux-en-y吻合，1例行十二指肠憩室化手术，1例行改良十二指肠憩室化手术，1例行十二指肠两断端关闭、胃空肠吻合，1例行十二指肠远端关闭、近端与空肠端侧吻合，2例行胰十二指肠切除术。术后6例(46.2%)出现切口感染、十二指肠瘘、消化道出血、胰瘘或腹腔感染等并发症，2例(15.4%)患者死亡，分别死于多器官系统衰竭和感染中毒性休克。结论：早期诊断与正确的术式选择是成功救治外伤性十二指肠破裂的关键。

Pancreatic leak was verified in 8 out of 13 cases with pancreatic enucleation, 6 out of 10 cases with distal pancreatectomy with or without splenectomy and I out of 6 cases with central pancreatectomy.

摘除术13例中8例发生胰瘘，胰体尾脾切除术8例中6例发生胰痰，保留脾的胰体尾切除术2例均未发生胰瘘，中段胰腺切除术6例中有1例发生胰瘘。

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。

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。

Transverse scan obtained following enteroclysis demonstrates ileoileal and ileosigmoidal fistulae.

图8 为一位37岁女性回结肠克罗恩病的CT图像，灌肠后横轴位CT图像显示回肠0-回肠瘘及回肠-乙状结肠瘘。

According to the type of surgery, the patients were divided into five groups: fenestration for sylvian arachnoid cysts group, intraventricular arachnoid cyst resection group, septum pellucidum fistulization group, third ventriculostomy group, and choroid plexus coagulation group. the characteristics of postoperative febrile response in all the groups were summarized and analyzed.

将病人按手术方式分为5组：外侧裂蛛网膜囊肿造瘘组、脑室内蛛网膜囊肿切除组、透明膈造瘘组、第三脑室底造瘘组、脉络丛烧灼术组，分别总结各组病人的术后发热反应特点。

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。