关键词： 胃镜   插管小肠双重造影   小肠疾病   诊断  

摘要： 小肠疾病的检出率随着胶囊内镜、双气囊套管小肠镜的应用而提高,但由于经济、操作等原因胶囊内镜、双气囊套管小肠镜还不能普及.小肠气钡双对比造影仍是诊断小肠疾病的最常用方法,传统采用导管法小肠灌肠造影,由于该方法操作烦琐,插管成功率低,临床上难以推广.我们自1998年起应用胃镜下插管小肠双重造影诊断小肠疾病,取得较满意效果.现总结报告如下.

关键词： 肠疾病   提取物   药物防治   便秘   茶叶   哺乳动物   保健食品   胡萝卜   无花果   干燥   蒸馏水   口香糖   有益菌   制成  

摘要： 将萝卜、茶叶、胡萝卜、无花果、洋葱、梅、杏等洗净，切成碎片，粉碎并干燥。将干燥的药粉或药汁与5～20倍蒸馏水或乙醇混合，于70～120℃下加热1～5次，每次1～5h，冻干或干燥提取物并制成粉状。用于防治哺乳动物肠疾病和便秘，也可制成保健食品(如粉末、颗粒、片剂、胶囊、面包、曲奇饼、果酱、糖果、口香糖、饮料和酸奶酪)。本品抑制肠内有害菌的生长，对有益菌无影响。

关键词： 小肠疾病   腹腔镜术  

摘要： 目的探讨腹腔镜技术在小肠疾病诊治中的应用.方法总结分析2000年5月至2004年2月解放军总医院收治的33例小肠疾病患者行腹腔镜探查和手术治疗的效果. 结果 33例患者手术均顺利完成,平均手术时间65 min,术中出血量平均30 ml.术后疼痛轻微,排便、排气时间平均32 h,平均住院时间7 d.术后病理检查诊断为小肠间质瘤24例(其中6例为低度恶性间质瘤),美克尔憩室5例,小肠恶性淋巴瘤4例.所有患者均痊愈出院,随访10～36个月未见复发.结论腹腔镜技术在小肠疾病诊治中具有良好效果,腹腔镜小肠手术是一种安全、有效的微创手术方法,值得临床推广应用.

关键词： 基因多态性   幽门螺杆菌   肿瘤坏死因子   淋巴毒素   胃癌  

摘要： 目的:研究我国湖北汉族人群肿瘤坏死因子(Tumor Necrosis Factor,TNF)基因多态性与胃十二指肠疾病及幽门螺杆菌(Helicobacter Pylori,Hp)感染的关系,探讨宿主遗传因素对Hp感染在胃十二指肠疾病尤其是非贲门胃癌的作用.方法:采用病例对照研究和PCR-RFLP方法,检测210例胃十二指肠疾病患者(包括73例慢性胃炎、78例十二指肠溃疡及59例非贲门胃癌患者)和264例正常对照者的TNF-α 308、LT-α Nco Ⅰ、AspH Ⅰ双等位基因型分布.Hp感染检测血清Hp Ab-IgG.结果:胃十二指肠疾病患者的Hp阳性率90.5%,显著高于正常对照组62.1%(P＜0.000 1,Odds ratio=5.793,95%CI:3.431～9.780).LT-α Nco Ⅰ A/G基因型在Hp阳性非贲门胃癌患者(64.0%)高于Hp阳性的正常对照组(46.0%),差异有显著性意义(P=0.029 7,OR=2.026,95%CI:1.080～3.803),该基因型与其他胃十二指肠疾病无相关性.TNF-α 308、LT-α AspH Ⅰ与Hp感染及胃十二指肠疾病亦无相关性.结论:LT-α Nco Ⅰ A/G基因型与中国湖北汉族人群非贲门胃癌Hp阳性相关.

关键词： 腹腔镜手术   机器人系统   术中失血量   结肠脾曲   腔镜组   传统腹腔镜   术前准备时间   神经丛   熟练度   腔镜技术  

摘要： PURPOSE: In the last ten years, several robotic systems have been developed to overcome the loss of the three-dimensional view and dexterity characteristic of laparoscopic surgery. The aim of this study was to compare the traditional laparoscopic approach and robotic techniques in the treatment of colorectal diseases. METHODS: The study compares a consecutive series of patients treated surgically for colorectal disease from June 2001 to May 2003 with the da VinciTM robotic system (Intuitive Surgical) and a matched number of patients who underwent conventional laparoscopy during the same time interval. The factors analyzed were the time required to prepare the patient and the room, total time of surgery, length of specimens, number of lymph nodes retrieved, blood loss, complications, and postoperative results. RESULTS: The study included 106 patients (53 in each group). No differences were observed in total time of surgery (laparoscopic group, 222 ±77 minutes vs. robotic group, 240±61 minutes), specimen length (laparoscopic group, 29 ±11 cm vs. robotic group, 27 ±13 cm), or number of lymph nodes retrieved (laparoscopic group, 16 ±9 vs. robotic group, 17 ±10). It took significantly longer to prepare the operating room and patient in the robotic group (24 ±12 minutes) than in the laparoscopic group (18 ±7 minutes). There were three conversions to laparotomyin the laparoscopic group; in the robotic group, two cases were converted to laparoscopy and three to hand-assisted laparoscopy. No significant differences were observed between the two groups in terms of recovery of bowel function and postoperative hospital stay. CONCLUSIONS: Robot-assisted surgery proved to be as safe and effective as laparoscopic techniques in the treatment of colorectal diseases. Because of its dexterity and three-dimensional view, the da VinciTM system was particularly useful in specific stages of the procedure, e.g., takedown of the splenic flexure, dissection of a narrow pelvis, identificatio

关键词： 手术后疼痛   护理对策   肛肠疾病   2001~2005年   人体疼痛   心理状态   疾病患者   肛周脓肿   自我暗示   止痛药物   混合痔   调节法   止痛剂  

摘要： 人体疼痛的阈值差异很大,不同心理状态下同一患者对疼痛的反应亦不同.2001～2005年,我们对103例肛肠疾病患者(混合痔68例,肛周脓肿20例,肛裂15例)采用以自我暗示为主的心理调节法进行护理,患者术后疼痛明显减轻,81例患者术后感觉疼痛轻微,未用止痛剂;10例口服止痛药,仅4例注射了止痛药物.

关键词： 小肠疾病   临床应用   查新   病检   炎症性疾病   传统观念   小肠肿瘤   小肠出血   少见病  

摘要： 传统观念一直认为小肠疾病是少见病,无论是小肠肿瘤、小肠炎症性疾病、小肠出血,还是其他小肠疾病,在临床上均不常见.

关键词： 会议   小肠疾病  

摘要： 受中华医学会和中华消化内镜学分会小肠病组委托,由山西省人民医院承办的第二届全国小肠疾病会议,将于2006年8月23-27日在文化古城山西省太原市召开。本次会议旨在大力提高全国基层医院的消化医师对于小肠疾病的印象和认识,提高各医院的诊断水平,以及内镜医生的操作技巧,更好的服务广大患者群体。此次会议通过讲座和病例讨论。

关键词： 医学影像学   螺旋CT   三维成像   仿真内镜   结肠  

摘要： 总结螺旋CT仿真结肠内窥镜(CTVE)、纤维结肠镜及钡灌肠造影临床应用结果,研究其在临床应用中的意义。对临床具备指征的一组患者,首先充分做好检查前肠道准备工作,对兴趣区进行薄层螺旋CT扫描,将采集的数据转至工作站后进行后期处理。全部资料均有纤维结肠内镜及钡灌肠造影对照资料,并将3种检查结果结合部分手术、病理检查结果作对照分析,比较3种检查方法临床应用价值(特别是CTVE),从而提高结肠疾病的影像诊断与临床的符合准确率。

关键词： 疾病患儿   免疫反应   细胞密度   组织学检查   食物过敏   前肠   细胞亚群   免疫应答   反复发作者   免疫性疾病  

摘要： Aim :Recently,we reported typical endoscopic findings and an increment in γδ+ Tcells in the foregut among children with food-sensitive enteropathy other than coeliac *** find outthe extend to which the upregulation of the local immune response might explain gastrointestinal (GI)complaints of the foregut,we sought to exam ine by the increm ent in γδ+ T cells a 1-y consecutive series of children referred for recurrent G I com plaints to a ter- tiary-levelhospital.M ethods:A 1-y cohort of 102chil- dren scheduled for gastroduodenoscopy were exam ined for m ucosalhistology and the densities ofCD3+,αβ+ and γδ+ T-cell subsets from m id-duodenal specim *** final diagnostic categories were used in analysing the data. Results:Fifteen subjects showed villous atrophy and a high γδ+ T-cell density;the finding being com patible with coeliac disease (CD ).Atthe otherextrem e,20subjects in whom diagnostic G I diseases were ruled out showed low densities and served as *** subjects reporting GI symptom s after an open food challenge with m ilk and /or cereals (n = 18)as well as children rem ittingwith am ilk-or cereal-elim inating diet but not responding to a challenge (n = 23)also expressed significantly higher densities ofγδ+ T cells than the *** all,45of102 children could be considered to have an elevated γδ+ T-cell density as an indication of locally activated im m une re- sponse. Lack of villous architecture and lym phonodular hyperplasia of the duodenal bulb as an endoscopie finding and atopic derm atitis but not the presence of D Q2alleles showed a close association with these increased densities. Conclusion:Considering thatan elevated incidence ofj6+ T cells is an indication of m ucosal response against lum inal antigens,up to halfthe children with prolonged G I sym p- tom s have im m une m ediated disorder;CD and food allergy being the m ostobvious clinicalentities.