الملخص
Objective To study the value of postmortem imaging on the diagnosis of intestinal perforation.Method Postmortem imaging(PMCT and PMCTA)data of 2 intestinal perforation deaths(and 4 controlled cases)were reviewed retrospectively.Diagnosing capacities of intestinal perforation by postmortem imaging method were further investigated.Results PMCT is sensitive in detecting the free air and liquid induced by intestinal perforation.PMCT can sometimes detect the gravity-dependent purulent secretions in the abdominopelvic cavity.PMCTA can visualize the extravasation of contrast agent from the perforation,which can be used to locate the accurate perforation region.Conclusion Postmortem imaging method(PMCT and PMCTA)is an important tool for the diagnosis of intestinal perforation,which can not only be used as a forensic diagnosis method,but is also useful to locate the perforation site before an forensic autopsy.
الملخص
Objective To investigate the protective effect of RLN revealed for RLN in high -risk thyroid surgery,and the clinical value of detecting nerve,thus to provide a reference for clinical treatment.Methods 132 patients of thyroid high -risk surgery were selected,according to whether to explode recurrent laryngeal nerve,they were divided into exposed group (80 cases)and non -exploded group(52 cases).The recurrent laryngeal nerve damage rate,clinical indicators of operation time were compared between the two groups.In the explode group,80 patients according to whether implementation of the nerve monitoring,were divided into the monitored group (36 cases)and non -monitored group(44 cases).The hours to find the nerve,recurrent laryngeal nerve injury rates and other indicators were compared.Results The operative time of the exploded group was (133.66 ±21.48)min,which was significantly longer than the non -exploded group,difference was statistically significant (t =3.994,P =0.025 ).The exposed group had similar incidence of hypocalcemia compared with the other groups,there was no statistically significant difference (P >0.05).The revealing recurrent laryngeal nerve injury rate of the exposed group was 2.50%,which was significantly lower than the non -exploded group,difference was statistically significant (χ2 =5.794,P =0.008).The recurrent laryngeal nerve positioning time of the monitoring group was (4.78 ±0.94)min,which was significantly shorter than the unmonitored group,difference was statistically significant (t =7.168,P =0.001).The recurrent laryngeal nerve injury rate of the monitoring group was 2.78%,showed no significant difference (χ2 =0.911,P =0.338).Conclusion In a high risk thyroid surgery,explode recurrent laryngeal nerve can reduce the rate of recurrent laryngeal nerve damage,nerve monitoring can effectively speed up the nerve localization time,but has no significant effect on reduce the rate of recurrent laryngeal nerve injury.