Objective: To observe the clinical efficacy and mechanism of Kangyanling (KYL) in treating patients with systemic inflammatory reaction syndrome and multi-organ dysfunction syndrome (SIRS/MODS) after abdominal surgery. Methods: Eighty-two patients of SIRS/MODS after abdominal surgery were divided into two groups according to admission time, the KYL treated group (n=35) and the control group (n=47). The levels of serum C-reactive protein (CRP), plasma tumor necrosis factor α (TNFα) and interleukin-6 (IL-6) were measured at the 1st, 3rd and 7th days post-operationally. Results: The levels of CRP, TNFα and IL-6 decreased gradually after surgical operation in both groups, but the reducing velocity was shorter in the KYL group than that in the control group, so the comparison of the levels in the two groups showed significant difference on the 3rd day after operation. Conclusion:KYL could inhibit the release of inflammatory mediator and relieve the inflammatory response so as to treat post-operational SIRS/MODS effectively.

Hemirachischisis is commonly-seen in clinic. Many patients complaining of lumbago are often found to have this disease shown by radiography. The common methods of treatment in Western medicine are surgical operation and administration of analgesics. In recent years, the authors have adopted acupuncture and moxibustion for the treatment, with quite good therapeutic results reported as follows.Clinical DataOf the 48 cases in this series, 32 were male and 16 female; ranging in age from 16 to 67 years; with course of illness from 1 month to 32 years. All the patients had the chief complaint of lumbago, and were diagnosed as having hemirachischisis by radiography.

Objective.To assess patients' knowledge,attitudes,and concerns regarding anesthetic management.Method.A survey of 55 items was developed and administered preoperatively to 500 patients including 190 men and 310 women in our hospital.Patients were interviewed on their knowledge of the role of anesthesiologists,their preferences regarding anesthetic management,and also their concern about potential anesthetic complications.Results.Patients' perceptions of anesthesiologists' training and role have reached a certain level.Most significant preoperative concerns regarding the anesthesiologists focused on experience,qualifications,and presence or absence during the anesthesia.Patients' concerns also included the possibility of not being waken up following anesthesia,experiencing postoperative pain,and becoming paralyzed.The variations of concerns depended partially on patients' sex,type of anesthesia,and proposed surgical procedure,partially on their education and living environments.Conclusion.It is suggested that anesthesiologists address significant patient concerns during the preoperative visit to enhance their effectiveness in patient care.Efforts to educate the public on the anesthesiologists' role in preoperative care would improve patients' confidence.

经导管介入结合外科手术镶嵌治疗小儿先天性心脏病的护理

近年来,随着介入技术的迅速发展,先天性心脏病(CHD)的治疗模式逐渐发生改变,即由单纯的外科或单纯的介入治疗转向两者相互联合的镶嵌治疗.

重视肝硬变对外科手术的影响

外科手术操作对于机体并不是简单的局部创伤过程,无论手术大小,都会引起不同程度的全身性应激反应.同样.病人全身状况对手术结果也会产生重要的影响,维持各主要器官的正常功能是手术成功的保证.其中,肝功能的状态对于外科手术显得特别重要.肝功能不良者的术中意外和术后并发症的发生率都非常高,轻者伤口愈合不良、伤口裂开,重者则可发生术中大出血,术后出现吻合口漏、休克或肝昏迷,等等.忽视肝硬变的影响,将会因此而付出代价.同样,肝硬变对创伤病人的影响也非常明显,Wahlstrom[1]报道"创伤严重度(ISS)”相同的两组创伤病人,肝硬变组的病死率比对照组高4倍,达到44%,并发症发生率高达71%.肝硬变是创伤病人病死率的独立危险因素.Ziser[2]回顾性分析Mayo Clinic 10年内接受各种外科手术的肝硬变病人计733例,其围手术期(术后30天之内)病死率及并发症发生率都相当高,分别达到11.6%及30.1%.原发性肝癌都有肝硬变基础,手术的风险不言而喻.肝硬变者的择期手术死亡率为8.7%,较正常肝的手术死亡率(1.0%)高得多[3].总之,肝硬变病人在创伤或手术时都会发生许多问题,有时在处理上还相当困难.因此,总结、交流这方面的经验和教训很有必要.

室间隔缺损手术治疗52例临床分析

1981年12月～2000年9月我院手术治疗室间隔缺损(VSD)52例,治愈50例,死亡2例分析.讨论本组病例临床特点和手术治疗如下.

术后诊断脑囊尾蚴病一例

患者,女,32岁,农民,江苏籍.因间歇性头痛2个月,于2003年5月14日在当地医院作颅脑核磁共振(MRI)检查,诊断为"左额叶占位性病变,胶质瘤可能".后因头痛加重,住入上海某医院,行左额叶占位性病变切除术.

AIM: Music relieves anxiety and psychotic tension. This effect of music is applied to surgical operation in the hospital and dental office. It is still unclear whether this music effect is only limited to the psychological aspect but not to the physical aspect or whether its music effect is influenced by the mood or emotion of audience. To elucidate these issues, we evaluated the music effect on pain threshold by current perception threshold (CPT) and profile of mood states (POMC) test. METHODS: Healthy 30 subjects (12 men, 18 women, 25-49 years old, mean age 34.9) were tested. (1)After POMC test, all subjects were evaluated pain threshold with CPT by Neurometer (Radionics, USA) under 6 conditions, silence, listening to the slow tempo classic music, nursery music, hard rock music, classic paino music and relaxation music with 30 seconds interval. (2)After Stroop color word test as the stresser, pain threshold was evaluated with CPT under 2 conditions, silence and listening to the slow tempo classic music. RESULTS: Under litening to the music, CPT sores increased, especially 2 000 Hz level related with compression, warm and pain sensation. Type of music, preference of music and stress also affected CPT score. CONCLUSION: The present study demonstrated that the concentration on the music raise the pain threshold and that stress and mood influence the music effect on pain threshold.

外科手术后肺动脉栓塞的诊治

肺动脉栓塞(Pulmonary Embolism,PE)是西方国家常见疾病,也是手术后常见的并发症.据近年流行病学调查,美国每年PE新发病例数约60万人,每年有6万人死亡,是疾病死亡的第三位原因,仅次于肿瘤和心肌梗塞[1],其中约1/5发生于手术后,占手术后死亡总数的15%～25%[2].

外科术后并发下肢深静脉血栓18例分析

深静脉血栓形成(DVT)多发生于下肢,轻者可酿成下肢血栓形成后遗症,重者可因肺栓塞(PE)而致命,我院1991年1月至2003年12月行外科手术3704例,术后并发DVT18例,占0.41%,现报道如下: