In order to preserve more normal tissue in situ in case of severe traumatic rupture of spleen, simultaneous ligation of splenic artery and vein was performed successfully on animals and then was applied for clinic use. The preserved splenic tissue all survivied and functioned well. Patients with severe traumatic rupture of spleen grade Ⅳ-Ⅴ were all cured by ligation of both the splenic artery and vein at the same time.
To comprehend the present situation in diagnosis and treatment of traunatic hepatorrhexis in this country,693 patients with traumatic rupture of the liver in 31 hospitals where to be located in Sichuan,Zhejiang,Guizhou,Yunnan,Fujian,Heilongjiang,Gguangxi and Hebei province in this country were collected through questionnaire and analysed.The data showed that male to female ratio was 4.17 to 1,with an average of 39.3 years.Closed injury accounted for 74.5% and 53.9 percent of them were injured in traffic accident.47.4% of the patients were admitted to the hospital within 4 hours after injury.Hemorrhagic shock was present high up to 61.9%.During exploratory laparotomy,hematoperitoneum was greater than 1000ml accounted for 61.5%,injury to the right lobe of liver 70.0%,and hepatorrexis associated with other organs and tissues injuries were 19.8%.45.5% of the patients was in third degree or more according to the AAST classificatino.All of the patients were treated by surgery,83.7% percent of them with debridement and suture and omentum packing for hemostasis,49 patients undergone partial hepatectomy.The postoperative complication rate was 22.2% and mortality was 8.7%.The authors consider that to perfect the emergency treatment system,enrich the knowlege and skill of the basic personnel so that the injured can be properly treated is cruical to improve the cure rate and reduce the mortality.
ObjectiveTo comparatively observe optical coherence tomography (OCT) image features between traumatic macular hole (TMH) and idiopathic macular hole (IMH). MethodsA retrospective clinical study. A total of 174 patients (174 eyes) with macular hole (MH) diagnosed at Shantou International Eye Center from December 2008 to May 2024 were included in the study. Among them, there were 75 patients (75 eyes) with TMH and 99 patients (99 eyes) with IMH, and they were divided into the TMH group and the IMH group accordingly. All the affected eyes underwent best corrected visual acuity (BCVA) and OCT examinations. The BCVA was examined using a standard logarithmic visual acuity chart, and was converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. The minimum diameter and basal diameter of the MH, as well as the average, nasal, superior, inferior, and temporal center retinal thickness (CRT) around the MH were measured by OCT. The independent-sample t test was used to compare the logMAR BCVA, hole diameter, and CRT at the hole margin between the groups. ResultsThere were significant differences in age (t=−15.857) and gender ratio (χ2=28.154) between the TMH group and the IMH group (P＜0.05), while there was no significant difference in logMAR BCVA (t=1.962, P＞0.05). The minimum diameter of the hole in the TMH group was smaller than that in the IMH group, but the basal diameter was larger, with significant differences (t=−3.322, 2.570; P＜0.05). The thickness of the neuroepithelial layer at the hole margin in the TMH group was thinner than that in the IMH group, with significant differences in the superior (t=−2.747), inferior (t=−2.316), and nasal (t=−2.851) regions (P＜0.05), and no significant difference in the temporal region (t=−1.586, P＞0.05). In the TMH group, the number of eyes with macular cystoid edema (CME), posterior vitreous detachment (PVD), retinal atrophy, subretinal hemorrhage, choroidal laceration, and focal neuroepithelial detachment was 36 (48.00%, 36/75), 4 (5.33%, 4/75), 4 (5.33%, 4/75), 15 (20.00%, 15/75), 8 (10.67%, 8/75), and 19 (25.33%, 19/75) eyes, respectively. In the IMH group, the number of eyes with CME and PVD was 95 (95.96%, 95/99) and 94 (94.95%, 94/99) eyes, respectively. ConclusionCompared with IMH, TMH has a larger basal diameter, a thinner CRT at the hole margin, a lower incidence of CME and PVD, and a higher incidence of subretinal hemorrhage, focal neuroepithelial detachment, choroidal laceration, and retinal atrophy.
ObjectiveTo evaluate the clinical feasibility of retroperitoneal necrosectomy using percutaneous nephroscope in management of post-traumatic pancreatitis. MethodsSix patients with post-traumatic pancreatitis were treated by percutaneous nephroscopic necrosectomy in our hospital. ResultsThere were no operative mortality and morbidity except that 1 patient developed hemorrhage in 11 days after operation. ConclusionPercutaneous nephroscopic necrosectomy has the advantage of small operation wound, little postoperative discomfort, and preventing relaparotomy. It is an ideal method for treating post-traumatic pancreatitis.
ObjectiveTo investigate the safety and feasibility of the treatment of laparoscopic splenectomy for patients with traumatic splenic rupture. MethodsBetween October 2006 and October 2009, 48 cases of traumatic splenic rupture underwent laparoscopic splenectomy were analyzed in this hospital. According to the differrent styles of splenic stalk, different operative methods were taken， including titanic clipping in 12 cases， titanic clipping combining silk suture ligation in 8 cases， snare combining titanic clipping in 10 cases， LigaSure in 8 cases， and EndoGIA in 8 cases. ResultsLaparoscopic splenectomy was successfully completed in 32 cases; Handassisted laparoscopic splenectomy was applied in 14 cases, and 2 cases were converted to laparotomy because of tight spleen adhesion with surrounding tissues and bleeding rupture of the short gastric vessels. The operation time was 120－170 min with an average 140 min; the estimated intraoperative amount of blood loss was 300－1 200 ml with an average 800 ml. No postoperative complication occurred such as gastric fistula, pancreatic fistula or hemorrhage. Conclusion According to the differrent styles of splenic stalk, individual operative method can improve mission success rate in the laparoscopic splenectomy in traumatic splenic rupture.
ObjectiveDetermine the effect of Semen ziziphi spinosae decoction combined Sodium valproate (VPA) sustained-release tablets on treating patients with Post-traumatic epilepsy (PTE).Methods30 patients are chosen among the patients who were hospitalised in Epilepsy Department of Kunshan Traditional Chinese Medicine Hospital from Jan 2017 to Jan 2019. The age ranges from 31 to 75, averaging at (42.5±13.5) years old, and composed of 16 male samples and 14 female, randomly divided into experimental group (Semen ziziphi spinosae decoction combined VPA, n=15) and control group (VPA, n=15). In general, imaging data and EEG data are collected. Regular follow-up is also carried out for these 30 patients. The results are analysed to determine the effect of treatment.ResultsAfter 9-months treatment of Semen ziziphi spinosae decoction combined VPA, morbidity of experiment group is significantly lower than that of the control group. It is also found that the differenes of imaging data and EEG data of patients were of no statistical significance.ConclusionIt is demonstrated that Semen ziziphi spinosae decoction combined VPA has superior performance in treating patients with PTE. The efficiency of Semen ziziphi spinosae decoction combined VPS in treating PTE is 93.3%, higher than the 80% of VPA. It can serve as reference for clinical diagnosis and treatment.