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Surgical treatment of severe acute pancreatitis

Pancreatitis, in which focal necrosis in 38 cases, extensive necrosis in 14 cases, pathologically confirmed pancreatic necrosis. 1.2 Methods 2O cases of 52 patients within 24 hours of surgery, 22 patients 48 to 72 hours operation, 1O cases 3 days after surgery. Taken on 48 cases of abdominal incision, 4 cases of upper abdominal transverse incision line decompression of pancreatic capsule, pancreatic bed loose, multi-tube drainage of peripancreatic, local necrotic tissue removal, gallbladder stones underwent cholecystectomy plus common bile duct .. tube drainage, 2 cases of pancreatic duct lithotomy. 2 results within 24 hours of surgery 2O cases and 2 deaths; 48 to 72 hours of surgery in 22 cases, 7 died; 72 hours after surgery none 1O cases death, the case fatality rate was 10%, 31.8%, O%, 17.3% of total mortality. 3 to discuss the timing of operation for severe acute pancreatitis have been differences, 2O 8O century, many advocates of early surgery before the age, The indications for surgery are also differences, some of the shock as indication for the indication of some of the peritonitis. 2O century era of severe acute pancreatitis 9O many advocates of early non-surgical treatment. In recent years, many advocates of individual severe acute pancreatitis treatment. Severe acute pancreatitis, oncoming danger, inflammatory pancreatic juice on the body toxins caused by multiple organ or system, varying degrees of damage, cause of death and the complications and multiple organ dysfunction related. Therefore, once diagnosed with severe pancreatitis should be considered positive early surgery, the incidence of 3 to 5 days are early, surgery although not complex, but for early decompression of the pancreas, improving pancreatic blood circulation, reduce pancreatic tissue necrosis, adequate drainage of harmful substances, can reduce organ damage and concurrent produce disease. Meanwhile, early surgery to reduce the financial burden and psychological stress in patients with great benefits. Surgical treatment of severe acute pancreatitis was only a measure of the treatment, more importantly, postoperative intensive care, keep the airway open, maintain a high the partial pressure of oxygen, control of blood glucose, and pancreatic secretion of digestive juice inhibited the full and effective decompression, shunt patency in particular, continued to wash to attract, are the guarantee of successful operation with severe acute pancreatitis. transverse abdominal incision above incision is better, can fully reveal the pancreas, convenient, complete surgical drainage, is conducive to the removal of necrotic pancreatic tissue and reduce the incidence of pancreatic abscess. (Received 2004-03-12) (Zhou Jigui edit) limbal stem cells conjunctival transplantation for recurrent pterygium Liude Shen Li Wen Li (Central Hospital, Binzhou, Shandong Huimin 251700) [Key words] Corneal Diseases; pterygium; transplantation [CLC] R772.2 [Document code ] B [Article ID] 1008-6633 (2004) 04-0497 O2 Pterygium is a common one eye, postoperative complications, recurrence is common. Castroviejo reported recurrence rate was 25% ~ 45% J,[link widoczny dla zalogowanych], relapse of pterygium recurrence rate even higher re-operation, to prevent recurrence of pterygium recurrence after surgery,[link widoczny dla zalogowanych], we apply the limbal stem cells and conjunctival transplantation, treatment of 32 patients with recurrent pterygium, postoperative follow-up observation, the effect is satisfactory,[link widoczny dla zalogowanych], the report is as follows . 1 Data and methods 1.1 General Information The group of 32 patients (36 eyes) were male and 8 patients (8 eyes) and 24 females (28 eyes); aged 35 to 72 years old, average 57.5 years old. for the first time Surgical recurrence of 27 patients (30 eyes), secondary and multiple surgical recurrence in 5 patients (6 eyes). pterygium occurred in the nasal area, the head invade the limbus 2 ~ 6mm, two operations are in the 6 months interval above, all patients had eyelid adhesion. 1.2 surgical procedures were carried out under the operating microscope, using 1% tetracaine topical anesthesia and 2% lidocaine local anesthesia. surgical procedures: ① lesion excision of pterygium Organization: First mention conjunctival pterygium neck, full separation of the conjunctiva in the pterygium body at the Ministry of reach lacrimal caruncle, disposable blades carefully separated pterygium head and body, the surface of the cornea and sclera lesions clean and stripped to the lacrimal caruncle, in the lacrimal caruncle at the cut off head and neck and most of the pterygium body, stump not be processed, and angle, scleral surface residual lesions shave with disposable scalpel, the wound to keep the cornea and sclera pterygium tissue residue-free and smooth, burning hemostasis; ② graft preparation: one-time blades take the same moment or the temporal below the corneal limbal stem cells and combined conjunctival epithelial tissue, long 6 ~ 10mm, width 2 ~ 5mm (depending on lesion size), not associated subconjunctival fascia; ③ graft suture: The paved graft, epithelial-oriented, but with a 10-0 suture the graft side of the limbus and the limbal side of the alignment of planting beds, and the central slit in both ends of the 1 needle, the graft conjunctiva and pterygium were physically isolated from the Ministry of conjunctival bit as far as possible, ask off suture 5 to 6-pin, which should be fixed in the shallow ends of Gong
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