摘要
Source control of intra-abdominal infections is an important part in the treatment of intra-abdominal sepsis,which mainly includes drainage,elimination of necrotic tissue,control of sepsis as well as restoration of anatomy and function of gastrointestinal tract.Source control should be taken immediately after ascertaining intra-abdominal infections.Specific measures of source control include percutaneous drainage,surgery,open abdomen and antimicrobial therapy.The key to percutaneous drainage is accurate location and adequate drainage.When performing surgical drainage,extent of trauma should be restricted while accurate location and avoiding omissions.Accurate timing of open abdomenand definitive abdominal closure,proper selection of temporary abdominal closure method,avoiding complications of OA,and enteral nutrition are essentials of successful definitive abdominal closure and reduction of complications.Effective antimicrobial therapy relies on time,type selection and avoiding antibiotic abuse.Factors should be searched for rigorously after failure to control intra-abdominal sepsis.Comprehensive global treatment is not only the basis but also the countermeasure of source control.
摘要
OBJECTIVE:To investigate the effects of Butylphthalide and sodium chloride injection on neurological function and prognosis of elderly patients with hypertensive intracerebral hemorrhage(HICH)after trepanation and drainage surgery. METH-ODS:During Jan. 2015 to Jun. 2016,80 elderly HICH patients were selected from our hospital and then divided into control group and observation group according to random number table,with 40 cases in each group. Both group received trepanation and drain-age surgery. Control group was given routine treatment. Observation group was given Butylphthalide and sodium chloride injection 100 mL,ivgtt,bid,on the fifth day after surgery,on the basis of control group. Both groups received treatment for 14 d. Clinical efficacies of 2 groups were observed. CSS scores were compared between 2 groups before surgery and 28 d after operation;volume of encephaledema,serum levels of homocysteine(HCY)and substance P(SP)were compared between 2 groups before surgery and 14 d after operation. RESULTS:The total response rate of observation group was 87.5％,which was significantly higher than 67.5％ of control group, with statistical significance (P0.05). CSS scores 28 d after operation, SP levels 14 d after operation were significanthy increased,volume of encephaledema and serum levels of HCY in 2 groups were significantly decreased,and the observation group was significantly better than the control group,with statistical significance(P<0.05). CONCLUSIONS:Butylphthalide and sodium chloride injection can significantly improve clinical efficacy and hepatic func-tion damage,relieve postoperative encephaledema,reduce serum levels of HCY and increase SP levels in elderly HICH patients af-ter trepanation and drainage surgery.
摘要
Objective Investigate the effective treatment for the stable subdural hematoma.Methods About the patients need for surgical treatment,for the treatment of hole drainage surgery,and according to the retrospective to be analyzed.Results The 68 cases of patients with surgical indications,under local anesthesia to surgery with the method of hole drainage surgery,achieve the desired results and objectives.Conclusions The hole drainage surgery is a simple way,and little chance of complications.As long as select the appropriate cases,during the surgery with standardized operation and at the end of surgery use standardized management,select the method of hole drainage surgery to treat the stable subdural hematoma is feasibility.
摘要
·AIM: To investigate the efficacy and security of the silicone membrane implant through observing intraocular pressure, filtering blebs and histopathologic results.·METHODS; Forty rabbits were randomly divided into 4 groups. Each group consisted of 10 rabbits. Trabecu-lectomy and silicone membrane implantation were performed in one eye of each rabbit, while the other eye was only performed trabeculectomy as control. The change of intraocular pressure, filtering blebs were observed postoperatively. And each eye had undergone histopathologic examination.·RESULTS:The duration of low intraocular pressure and existence of filtering blebs in implanted eyes was longer than that in controlled eyes. Light microscopy revealed that patent drainage tract and biting site could be seen in silicone membrane implanted eye. The activity and regularity of fibroblast proliferation in implanted eyes and controlled eyes were similar. Excessive expression of fibroblast proliferation was not induced by silicone membrane.·CONCLUSION: Characterized by safety, effectiveness and simplicity, silicone membrane implantation can act as a new drainage surgery.KEYWORDS: silicone membrane; drainage surgery;intraocular pressure