胃空肠吻合术

Fifteen patients underwent operation, including gastrostomy (6 cases), gastrotomy (4 cases), partial gastric fundus resection (2 cases), others operations (2 case), and laparotomy exploration (1 case); among them four patient died.

手术治疗15例，包括胃切开减压、胃造口术（6例），胃切开减压后再缝合创口（3例），胃切开减压、胃造口、空肠造口术（1例），胃底部分切除术（2例），十二指肠空肠吻合术（1例），空肠造口术（1例），开腹探查术未切开胃壁（1例），死亡4例(26.7%)。

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。

Continues CHIP was performed over 60 minutes on postoperative canines in anaesthesia. The changes of inferior segment of esophagus, heart rate, respire, mean arterial pressure, and central venous pressure were observed. In addition, the temperature of physic liquor, perfusion and take suction were recorded.

在麻醉下行胃空肠吻合术或横结肠吻合术，持续1h腹腔循环热灌注并监测食道下段温度、心率、呼吸、平均动脉压和中心静脉压，记录药液温度、灌注温度和抽取温度的变化。

Three types of reconstruction procedures, including Orr-type Roux-en-Y esophagojejunostomy, P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy, were performed.

全胃切除后消化道重建分别采用全胃切除术后消化道重建Orr式Roux-en-Y食管空肠吻合术、P型空肠袢食管空肠Roux-en-Y吻合术和远端空肠反口贮袋的Roux-en-Y食管空肠吻合术。

The case number of duodenopancreatectomy,cholecystojejunostomy, cholecystoduodenostomy, gastrojejunostomy, cholecystostomy, choledochoduodenostomy, choledochjejunalostomy, exploration of the common bile duct, and T tube drain were 43, 20, 3, 19, 4, 4, 21, 18, 7 respectively.

行胰十二指肠切除术43例，胆囊空肠吻合术20例，胆囊十二指肠吻合术3例，胃空肠吻合术19例，胆囊造瘘术4例，胆总管十二指肠吻合术4例，胆总管空肠吻合术21例，胆总管探查、T管引流18例，剖腹探查术7例。

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%）。

Methods Eighteen majority medical fitness mongrel canines were randomly divided into three groups: Group A (gastrojejunostomy or colocolic anastomosis + CHIP), Group B and group C (only gastrojejunostomy or colocolic anastomosis).

将成年健康杂种家犬18只随机分为三组：A组（胃空肠吻合术或横结肠吻合术＋腹腔热灌注组）、B组和C组，每组6只。

The decision was made to insert a percutaneous gastrojejunostomy under fluoroscopic guidance.

决定在透视下行经皮胃空肠吻合术。

Results The incidence of gastroparesis was higher in patients with chronic outlet obstruction before the operation or malignancy, andpatients receiving Whipple procedure or non-gastrectomy gastrojejunostomy.

结果：本组中，术前长期流出道梗阻、恶性肿瘤、胰十二指肠切除术后、无胃切除的胃空肠吻合术的患者发病率较高，胃镜、上消化道造影是诊断本病有价值的方法，经保守治疗后胃肠动力一般可在术后5周内恢复正常。

Results The incidence of gastroparesis was higher in patients with chronic outlet obstruction before the operation or malignancy, andpatients receiving Whipple procedure or non-gastrectomy gastrojejunostomy. Gastroscopy and upper gastrointestinal series served as a valuable measurement in diagnosis. In general, GI motility could be restored after 5 weeks of conservative therapies.

结果：本组中，术前长期流出道梗阻、恶性肿瘤、胰十二指肠切除术后、无胃切除的胃空肠吻合术的患者发病率较高，胃镜、上消化道造影是诊断本病有价值的方法，经保守治疗后胃肠动力一般可在术后5周内恢复正常。

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。