The purpose of this study was focused on the imaging features of the chest trauma and its relation to clinical characteristics. All the injured patients were from the Yushu Earthquake areas on days April 14 - 23,2010....The purpose of this study was focused on the imaging features of the chest trauma and its relation to clinical characteristics. All the injured patients were from the Yushu Earthquake areas on days April 14 - 23,2010. After an initial treatment,the injurers were rapidly transported from Yushu at an altitude of 4 000 m via air to Xining at 2 260 m within 6~8 h,and promptly admitted to Qinghai Provincial People’s Hospital. A total of 130 wounded injurers who had high suspicion of chest injuries all had examinations of Chest X-ray and computed tomography(CT)images. Of them 63 injurers presented at least one of the features of the chest trauma in imaging with a positive rate of 48.5 %. Of these,37 cases (28.5 %) were multi-system with multiple injuries ,33 cases (25.4 %) were chest trauma with multi-injury types,which included thoracic fractures in 54 cases (85.7 %),pleural injury in 56 cases (88.9 %),lung injury in 54 cases (85.7 %),lungs complications in 37 cases (58.7 %),and extrapulmonary complications of 35 cases (55.6 %). The radiological data were analyzed retrospectively. The features of chest trauma in Yushu Earthquake,the complications of chest injuries,and the relation between imaging findings and clinical manifestations,as well as the differences of chest trauma between Yushu Earthquake and Wenchuan Earthquake were discussed in detail.展开更多
Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of...Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of 120 cases of carotid body tumors in Peking Union Medical College Hospital from 1949 to May, 2011. Results Surgical excision was successfully performed in 111 cases with 117 tumors. In all those cases, 50 underwent simple tumor resection, 42 underwent resection of tumors and ligation of the external carotid arteries, 7 underwent co-resection of tumors and common carotid arteries, internal carotid arteries, as well as external arteries without vascular reconstruction, and the other 12 cases experienced tumor resection and vascular reconstruction as internal carotid arteries were involved. After operation, 3 cases developed cerebral infarction, 30 cases showed cranial nerve palsy, including 15 cases of hypoglossal nerve damage, 10 cases of vagus paralysis, and 5 cases of Horner's syndrome. Conclusion It is essential to make a proper surgical strategy, which can reduce postoperative com- plications.展开更多
Objective: To present a batch of data of transected pancreatic neck injuries and to sum up the experience in surgical interventions for the injuries.Methods: We analysed 13 patients with a transected injury to the pan...Objective: To present a batch of data of transected pancreatic neck injuries and to sum up the experience in surgical interventions for the injuries.Methods: We analysed 13 patients with a transected injury to the pancreatic neck from Jan. 1995 to Dec. 2000. External drainage was performed in all patients. Pancreatoduodenectomy was conducted in 2 patients with a transected injury to the pancreatic neck associated with duodenal ruptures, and TPN was administered immediately after operation. Proximal closure of the transected margin and distal pancreaticojejunostomy was performed in 4 patients. Proximal closure of the transected margin and distal pancreaticojejunostomy plus splenectomy was performed in 7 patients associated with contusion of pancreatic body or tail plus spleen rupture. Results: 12 patients healed and one patient died of anesthetic accident during the course of restoration of the dislocation of his right hip joint. Complications occurred in 7 patients.Conclusions: The operation should be performed according to the degree of the injuries and associated duodenal injuries. Routine drainage and nutrient support should be recommended.展开更多
Objective: To study the influence of traumatic subarachnoid hemorrhage on secondary intracranial damage in GCS 13 15 head injuries and prognosis. Methods: One hundred and twenty eight patients with mild head injury, i...Objective: To study the influence of traumatic subarachnoid hemorrhage on secondary intracranial damage in GCS 13 15 head injuries and prognosis. Methods: One hundred and twenty eight patients with mild head injury, including 64 with subarachnoid hemorrhage and 64 without subarachnoid hemorrhage, were selected and analyzed according to the changes of their conditions after injury. Results: Intracranial abnormality was found in 14 patients ( 21.87 %) with subarachnoid hemorrhage and only in 4 patients ( 6.25 %) without subarachnoid hemorrhage (P< 0.01 ). In the 14 patients, 4 were given surgical treatment. Mild disability was in 2 patients and 2 completely recovered. The rest were conservatively treated and achieved complete recovery at last. Conclusions: Traumatic subarachnoid hemorrhage, as a factor of intracranial complications in mild head injury should be given much attention. Early drainage of bloody cerebrospinal fluid by lumbar puncture is an effective method for prevention and treatment of complications in mild head injury.展开更多
Aneurysm of gastroduodenal artery (CDA) is rare. Most reported cases are due to pancreatitis and atherosclerosis; however, those following pancreatic trauma have not been reported. We encountered GDA aneurysm in a p...Aneurysm of gastroduodenal artery (CDA) is rare. Most reported cases are due to pancreatitis and atherosclerosis; however, those following pancreatic trauma have not been reported. We encountered GDA aneurysm in a patient of blunt abdominal trauma, who had pancreatic contusion and retroduodenal air on contrast enhanced computed tomography of abdomen. Emergency laparotomy for suspected duodenal injury revealed duodenal wall and pancreatic head contusion, mild hemoperitoneum and no evidence of duodenal perforation. In the postoperative period, the patient developed upper gastrointestinal hemorrhage on day 5. Repeat imaging revealed GDA aneurysm, which was managed successfully by angioembolization. This case highlights, one, delayed presen- tation of GDA aneurysm after blunt pancreatic trauma and two, its successful management using endovascular technique.展开更多
Objective: To summarize the experience of the treatment of traumatic hepatorrhexis. Methods: The clinical data of 209 cases of liver trauma treated in the three affiliated hospitals of the Third Military Medical Unive...Objective: To summarize the experience of the treatment of traumatic hepatorrhexis. Methods: The clinical data of 209 cases of liver trauma treated in the three affiliated hospitals of the Third Military Medical University from 1989 to 1999 were retrospectively analyzed. Among the 209 patients, 108 ( 51.7 %) had Grade III or more severe liver injury. Operative treatment was performed in 186 cases and preservative treatment in 23. Results: In the operated group, 169 patients were cured. The complications occurred in 18 patients and 17 of them died. In the non operated group, the complications occurred in 22 patients and only 1 of them died. Conclusions: Severe injury and delayed treatment are two major factors leading to death from liver injuries. Surgical intervention is still the principal measure to treat traumatic hepatorrhexis. The indications for non operative treatment should be carefully selected.展开更多
Objective: To evaluate the surgical methods and the outcome of management for traumatic arterial aneurysm (TAA) and traumatic arterioveneus fistula (TAVF).Methods: A total of 121 patients with TAA or TAVF were treated...Objective: To evaluate the surgical methods and the outcome of management for traumatic arterial aneurysm (TAA) and traumatic arterioveneus fistula (TAVF).Methods: A total of 121 patients with TAA or TAVF were treated by surgery. Clinical, operative and postoperative data were collected and analyzed retrospectively.Results: The surgical techniques includedaneurysmectomy and arterial end-to-end anastomosis or vascular grafting or artery ligation, aneurysm ligation and bypass, vascular repair, fistula excision and vascular ligation or vascular grafting or repair and so on. One patient died (0.83%). The follow-up rates of TAA and TAVF were 65.7% and 60% respectively.Conclusions: Complicated TAA and TAVF in different sites should be treated with different methods.展开更多
基金Project of Qinghai Development of Science and Technology (No.2011-N-150)
文摘The purpose of this study was focused on the imaging features of the chest trauma and its relation to clinical characteristics. All the injured patients were from the Yushu Earthquake areas on days April 14 - 23,2010. After an initial treatment,the injurers were rapidly transported from Yushu at an altitude of 4 000 m via air to Xining at 2 260 m within 6~8 h,and promptly admitted to Qinghai Provincial People’s Hospital. A total of 130 wounded injurers who had high suspicion of chest injuries all had examinations of Chest X-ray and computed tomography(CT)images. Of them 63 injurers presented at least one of the features of the chest trauma in imaging with a positive rate of 48.5 %. Of these,37 cases (28.5 %) were multi-system with multiple injuries ,33 cases (25.4 %) were chest trauma with multi-injury types,which included thoracic fractures in 54 cases (85.7 %),pleural injury in 56 cases (88.9 %),lung injury in 54 cases (85.7 %),lungs complications in 37 cases (58.7 %),and extrapulmonary complications of 35 cases (55.6 %). The radiological data were analyzed retrospectively. The features of chest trauma in Yushu Earthquake,the complications of chest injuries,and the relation between imaging findings and clinical manifestations,as well as the differences of chest trauma between Yushu Earthquake and Wenchuan Earthquake were discussed in detail.
文摘Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of 120 cases of carotid body tumors in Peking Union Medical College Hospital from 1949 to May, 2011. Results Surgical excision was successfully performed in 111 cases with 117 tumors. In all those cases, 50 underwent simple tumor resection, 42 underwent resection of tumors and ligation of the external carotid arteries, 7 underwent co-resection of tumors and common carotid arteries, internal carotid arteries, as well as external arteries without vascular reconstruction, and the other 12 cases experienced tumor resection and vascular reconstruction as internal carotid arteries were involved. After operation, 3 cases developed cerebral infarction, 30 cases showed cranial nerve palsy, including 15 cases of hypoglossal nerve damage, 10 cases of vagus paralysis, and 5 cases of Horner's syndrome. Conclusion It is essential to make a proper surgical strategy, which can reduce postoperative com- plications.
文摘Objective: To present a batch of data of transected pancreatic neck injuries and to sum up the experience in surgical interventions for the injuries.Methods: We analysed 13 patients with a transected injury to the pancreatic neck from Jan. 1995 to Dec. 2000. External drainage was performed in all patients. Pancreatoduodenectomy was conducted in 2 patients with a transected injury to the pancreatic neck associated with duodenal ruptures, and TPN was administered immediately after operation. Proximal closure of the transected margin and distal pancreaticojejunostomy was performed in 4 patients. Proximal closure of the transected margin and distal pancreaticojejunostomy plus splenectomy was performed in 7 patients associated with contusion of pancreatic body or tail plus spleen rupture. Results: 12 patients healed and one patient died of anesthetic accident during the course of restoration of the dislocation of his right hip joint. Complications occurred in 7 patients.Conclusions: The operation should be performed according to the degree of the injuries and associated duodenal injuries. Routine drainage and nutrient support should be recommended.
文摘Objective: To study the influence of traumatic subarachnoid hemorrhage on secondary intracranial damage in GCS 13 15 head injuries and prognosis. Methods: One hundred and twenty eight patients with mild head injury, including 64 with subarachnoid hemorrhage and 64 without subarachnoid hemorrhage, were selected and analyzed according to the changes of their conditions after injury. Results: Intracranial abnormality was found in 14 patients ( 21.87 %) with subarachnoid hemorrhage and only in 4 patients ( 6.25 %) without subarachnoid hemorrhage (P< 0.01 ). In the 14 patients, 4 were given surgical treatment. Mild disability was in 2 patients and 2 completely recovered. The rest were conservatively treated and achieved complete recovery at last. Conclusions: Traumatic subarachnoid hemorrhage, as a factor of intracranial complications in mild head injury should be given much attention. Early drainage of bloody cerebrospinal fluid by lumbar puncture is an effective method for prevention and treatment of complications in mild head injury.
文摘Aneurysm of gastroduodenal artery (CDA) is rare. Most reported cases are due to pancreatitis and atherosclerosis; however, those following pancreatic trauma have not been reported. We encountered GDA aneurysm in a patient of blunt abdominal trauma, who had pancreatic contusion and retroduodenal air on contrast enhanced computed tomography of abdomen. Emergency laparotomy for suspected duodenal injury revealed duodenal wall and pancreatic head contusion, mild hemoperitoneum and no evidence of duodenal perforation. In the postoperative period, the patient developed upper gastrointestinal hemorrhage on day 5. Repeat imaging revealed GDA aneurysm, which was managed successfully by angioembolization. This case highlights, one, delayed presen- tation of GDA aneurysm after blunt pancreatic trauma and two, its successful management using endovascular technique.
文摘Objective: To summarize the experience of the treatment of traumatic hepatorrhexis. Methods: The clinical data of 209 cases of liver trauma treated in the three affiliated hospitals of the Third Military Medical University from 1989 to 1999 were retrospectively analyzed. Among the 209 patients, 108 ( 51.7 %) had Grade III or more severe liver injury. Operative treatment was performed in 186 cases and preservative treatment in 23. Results: In the operated group, 169 patients were cured. The complications occurred in 18 patients and 17 of them died. In the non operated group, the complications occurred in 22 patients and only 1 of them died. Conclusions: Severe injury and delayed treatment are two major factors leading to death from liver injuries. Surgical intervention is still the principal measure to treat traumatic hepatorrhexis. The indications for non operative treatment should be carefully selected.
文摘Objective: To evaluate the surgical methods and the outcome of management for traumatic arterial aneurysm (TAA) and traumatic arterioveneus fistula (TAVF).Methods: A total of 121 patients with TAA or TAVF were treated by surgery. Clinical, operative and postoperative data were collected and analyzed retrospectively.Results: The surgical techniques includedaneurysmectomy and arterial end-to-end anastomosis or vascular grafting or artery ligation, aneurysm ligation and bypass, vascular repair, fistula excision and vascular ligation or vascular grafting or repair and so on. One patient died (0.83%). The follow-up rates of TAA and TAVF were 65.7% and 60% respectively.Conclusions: Complicated TAA and TAVF in different sites should be treated with different methods.