Emergency treatment and nursing for patients with serious abdominal injury / 中国实用护理杂志

Objective To summarize the emergency treatment and nursing for patients with serious abdominal injury. Methods Preoperative emergency nursing care, postoperative intensive care, observation and nursing care of all kinds of complications were performed in 58 cases of patients with serious abdominal injury. Results 55 cases were rescued successfully, the success rate was 94.83%, 3 cases died, the death rate was 5.17%. 1 case died of hepatic failure, 2 cases died of hemorrhagic shock. Conclusions It's necessary to pay attention to preoperative emergency treatment for serious abdominal injury, preoperative monitoring of respiratory function, central venous pressure, urine volume and color and volume of the drainage fluid should be strengthened.

Clinical comparison of laparoscope versus laparotomy total mesorectal excision with anal sphincter preservation for low rectal cancer / 中国医师进修杂志

Objective To compare the results of laparoscope and laparotomy total mesorectal excision(TME)with anal sphincter preservation in the treatment of low rectal cancer.Methods From January 2006 to June 2008,106 patients with low rectal cancer which the distance from the lowest margin of tumor to the dentate line ranged from 3.0 to 7.0 cm underwent TME with anal sphincter preservation.Among them,51 patients received laparoscope operation(laparoscope group)and the other 55 patients received laparotomy(laparotomy group)according to their wills.Results Two groups had no serious complications and death case.after surgery,the rate of sphincter preservation was 100%.Blood loss was(20.2±5.7)ml inlaparoscope group,which was significantly less than that in laparotomy group(P ＜ 0.01),aerofluxus,time to eat half-flow food and hospital stay were(2.4±0.6),(5.4±0.6)and(9.2±3.2)days respectively,which were significantly shorter than those in laparotomy group(P ＜ 0.01 or ＜ 0.05).Bowel function was back to normal in 35 patients of laparoscope group(68.6%)and 39 patients of laparotomy group(70.9%)within 1 month.All patients were followed-up from 6 to 36 months,there were no recurrence in situ local recurrence and mortality in the both groups.Conclusion Laparoscope TME with anal sphincter preservation can be achieved the same effect of oncological clearance,it is feasible and it is a minimal invasive and perspective technique with the benefits of much less blood loss during operation,higher rate of sphincter preservation,earlier return of bowel function and shorter hospitalization.

The role of single-shot TSE imaging at 0.5 T MR in the diagnosis of biliary obstructive diseases / 中华放射学杂志

Objective To evaluate the diagnostic accuracy of half-Fourier single-shot TSE MR cholangiopancreatography (HASTE-MRCP) of 0.5 T MR scanner, and to assess its imaging advantage and clinical value by comparing with 3D-TSE-MRCP MIP. Methods All 95 patients were examined by HASTE-MRCP and 3D-TSE-MRCP with respiratory-triggering (Philips 0.5 T T5-NT). The results, including anatomies and diseases, were evaluated after operation. Results By HASTE-MRCP, common bile ducts, 1-3 branches of hepatic ducts, gallbladder, and pancreatic ducts were demonstrated in 100.0%, 94.7%, 74.1%, and 63.2% of the cases. Stones, malignant diseases, and postoperative stenosis were revealed in 100.0% of the cases. Compared with 3D-TSE-MRCP, the demonstrating rates of 4-5 hepatic ducts,neck of the gallbladders,and calculi,especially mud calculi, were higher in HASTE-MRCP, and there was significant difference between the two ways. Stones displayed as low signal in the bile ducts. Block obstruction and mass contour were revealed in malignant diseases. Conclusion Comparing with 3D TSE-MRCP, HASTE-MRCP was better and faster, especially in serious patients or in cases with small and mud calculus.