壶腹部癌合并急性胆管炎的治疗选择

目的 探讨壶腹部癌合并急性胆管炎的治疗方法。方法 对比分析 12年间收治的壶腹部癌合并急性胆管炎的临床资料。其中采用一期切除手术 2 5例 ,先作胆道引流二期行切除手术 12例。结果 一期手术组通过非手术治疗 ,术前的体温和白细胞均比入院时明显降低 (P <0 .0 5 ) ,基本达到二期手术组二期切除的术前水平 ( P >0 .0 5 ) ,而总胆红素和清蛋白水平无明显变化 ;与二期组比较 ,一期组切除术前准备期明显缩短 (P <0 .0 5 ) ,手术时间和术中出血量减少 ,虽然术后感染性并发症发生率和术后住院天数增加 ,但再手术率和手术死亡率相似。结论 壶腹部癌合并急性胆管炎可先给予非手术治疗 。

腹腔持续循环热灌注化疗治疗癌性腹腔积液的临床研究

目的:观察腹腔持续循环热灌注化疗治疗癌性腹腔积液的临床疗效。方法:将癌性腹腔积液患者57例随机分为两组,腹腔持续循环热灌注化疗组27例;腹腔灌注化疗组30例。每周做治疗1次,共做3次。然后评估疗效及不良反应。结果:腹腔持续循环热灌注化疗组有效率(23/27)明显高于腹腔灌注化疗组[(17/30)(P=0.019)],而两组的不良反应发生率无显著性差异(P>0.05)。结论:腹腔持续循环热灌注化疗安全、有效、操作简单,是控制恶性腹腔积液的有效方法。

Complications of high intensity focused ultrasound in patients with recurrent and metastatic abdominal tumors

AIM： To analyze the local and systemic complications of high intensity focused ultrasound （HIFU） for patients with recurrent and metastatic abdominal tumors. METHODS： From Aug 2001 to Aug 2004, 17 patients with recurrent and metastatic abdominal tumors were enrolled in this study. Real-time sonography was taken, and vital signs, liver and kidney function, skin burns, local reactions, and systemic effects were observed and recored before, during, and after HIFU. CT and MR/were also taken before and after HIFU. RESULTS： All 17 patients had skin burns and pain in the treatment region; the next common complication was neurapraxia of the stomach and intestines to variable degrees. The other local and systemic complications were relatively rare. Severe complications were present in two patients; one developed a superior mesenteric artery infarction resulting in necrosis of the entire small intestines, and the other one suffered from a perforation in terminal ileum due to HIFU treatment. CONCLUSION： Although HIFU is a one of noninvasive treatments for the recurrent and metastatic abdominal tumors, there are still some common and severe complications which need serious consideration.