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板层巩膜切除手术治疗葡萄膜渗漏综合征的疗效观察

51例老年胰十二指肠切除术患者的观察护理

胰十二指肠切除术，手术复杂难度大，手术持续时间较长，再加之高龄患者合并症多，手术风险高，术后护理的复杂性和难度大，本文回顾性分析了51例老年胰十二指肠切除术后的病情观察及护理对策。结果显示全组无手术死亡，所有患者均未因护理并发症而延迟出院。因此，我们认为正确的护理措施对老年胰十二指肠切除术后的顺利康复起到十分重要的作用。

ANALYSIS OF THE COMPLICATION ABOUT SILICONE GEL IMPLANTS IN AUGME NTATION MAMMAPLASTY

Along with the wide application of silicone gel implants in augmentation mammaplasty, more complications appeared. The author reported 24 cases of complicationssince 1989, including one case of heamtoma, one case of infection, two cases of injury of the sensory nerves to the nipple, four cases of asymmetric breast (as ymmetry in position and size), three cases of deformed appearance, six cases of constracture of the fibrous coating membrane, one case of rupture of prosthesis,one case of sinus formation and three cases of abnormal milk secretion. The causes of the complications and their prevention were discussed.

先天性视盘小凹合并先天性视盘缺损一例

Diagnosis and Treatment of The Complications of Laparoscopic Cholecystectomy

目的 探讨腹腔镜胆囊切除术（LC）并发症的诊断及治疗。方法 回顾性分析我院1994年3月至2009年3月行LC的1 634例患者的临床资料，对术中及术后并发症的发生原因及诊断和治疗进行分析。结果 本组发生并发症22例，发生率为1.35%。术中胆管损伤4例（0.24%），胃肠道损伤2例（0.12%），均行中转开腹手术。术后漏胆8例（0.49%），均行开腹手术; 腹腔出血4例（0.24%），行开腹手术2例，腹腔镜探查止血2例; 严重皮下气肿1例（0.06%），反复行抽吸治疗; 胆总管残余结石3例（0.18%），行开腹手术2例，消炎利胆药物治疗1例。全组病例经上述治疗后均治愈出院。结论 胆管损伤、漏胆、胆总管残余结石、腹腔出血以及胃肠道损伤是LC手术的主要并发症，及时诊断和治疗并发症是提高治愈率的关键。

带状疱疹性葡萄膜炎并前房积血二例

股骨粗隆间骨折内固定并发症原因分析

目的 总结股骨粗隆间骨折内固定手术引起的常见并发症和产生的原因。 方法 2002 年1 月－2007 年10 月，股骨粗隆间骨折内固定手术后17 例出现并发症。其中男15 例，女2 例；年龄31 ～ 82 岁。均为闭合性骨折；新鲜骨折16 例，陈旧性骨折1 例；粉碎性骨折15 例。Evan’s 分型Ⅰ型2 例，Ⅱ型5 例，Ⅲ型7 例，Ⅳ型3 例。伤后至就诊时间1 ～ 6 h，平均2.5 h。采用动力髋螺钉固定7 例，动力髁螺钉固定6 例，股骨近端交锁髓内钉固定1 例，2 枚空心钉固定2 例，外院转入麦氏鹅头钉固定1 例。 结果 术后出现断钉后髋内翻3 例、头颈钉突出股骨头5 例、骨折复位不良4 例、感染导致慢性骨髓炎内固定失败1 例、患肢短缩3 例、患肢延长1 例。无股骨干骨折、股骨头坏死等并发症。 结论 股骨粗隆间骨折内固定术后并发症，主要由于内固定方式选择不当，术中骨折复位不良、固定不牢靠、术后处理不当等引起。

糖尿病患者的血糖水平对玻璃体手术并发症影响的观察

后颅凹广泛静脉畸形致水肿误诊为视盘血管炎一例

Glaucoma and anterior chamber angle changes after intravitreal silicone oil injection for complicated retinal detachment

Objective To evaluate glaucoma and anterior chamber angle changes after intravitreal silicone oil injection(SOI). Methods The intraocular pressure(IOP) and anterior chamber angles of 34 e yes(33 patients)undergone pars plana vitrectomy and SOI were observed. Results Glaucoma occurred in 9 eyes(26%),in which silicone oil glaucoma(SOG) accounted for 77%(7/9).The changes of the superior part of anterior chamber angle were peripheral anterior synechiae in 11 eye(32%) and SO emulsification droplets in 22 eyes(64%) in 1～4.5 months after surgeries.Glaucoma occurred in 6 eyes of 7 eyes undergone peripheral iridectomy at the inferio r part of the iris after the closure of iridectomy holes (plt;0.05). Conclusion High incidence of glaucoma was found in this series of patients after intravitreal silicone oil injection,and the main causes of SOG were closure of the inferior iridecomy hole and silicone emulsification. (Chin J Ocul Fundus Dis, 2001,17:105-107)