1.Diagnosis and treatment of spontaneous colorectal rupture
Clinical Medicine of China 2010;26(9):969-971
Objective To retrospectively investigate the cause of spontaneous rupture of the large intestine,pathology, diagnosis, treatment and prognosis of the relevant factors. Methods The collection of domestic medical records of 155 cases of spontaneous rupture of the large intestine in last decades,combined with 5 cases collected in our hospital since 2002. All the cases underwent emergency surgery confirmed the preoperative diagnosis of straight,colon rupture in 25 cases. Surgical repair for rupture in 5 cases,rupture of an external repair in 5 cases,rupture of the proximal colostomy repair combined with single or dual-chamber in 43 cases of ruptured bowel resection and anastomosis of the proximal intestine fistula combined with single or dual-chamber in 61 cases ruptured bowel resection stump of dual-chamber fistula in 6 cases, rupture of bowel resection and anastomosis in 5 cases, rupture of intestine directly fistula 9 cases. Surgical presentation in the remained cases were unknown. Results One hundred and seventeen patients cured, 43 cases died. Conclusions Most spontaneous colon rupture occurred in elderly patients,and is rare disease. The diagnosis rate is low and easy to delay in the treatment. Moreover, the intraabdominal infections caused by pollution would leed to a direct life-threatening toxic shock. Therefore, prompt diagnosis and timely surgery is important to improve the cure rate.
2.Continuous renal replacement therapy for patients with renal failure after liver transplantation
Jianxing WANG ; Yaling LIU ; Changan DI ; Xin WANG ; Lu WANG ; Jinning LIU ; Shichun LU
Chinese Journal of Hepatobiliary Surgery 2015;21(1):39-43
Objective To study the therapeutic effect of continuous renal replacement therapy (CRRT) in renal failure after liver transplantation.Methods Renal function in 82 patients who underwent CRRT in the perioperative period of liver transplantation were retrospectively analyzed.Results There were significant differences in ALT,TB,BUN and Cr before and after the treatment (P < 0.05).The differences were significant in glutamic-pyruvic transaminase (ALT),creatinine phosphate kinase (CPK) and C reactive protein (CPR) before and after the treatment (P <0.05).There were significant improvements in K+,Na+,Cl-,HCO3-and CVP before and after the treatment (P < 0.05),while the differences were not significant in other biochemical parameters (P > 0.05).This research also looked at the effect of timing of CRRT on renal function recovery.Based on the RIFLE classification of AKI,the ratio of renal function recovery in RIFLE-Ⅰ was significantly higher than RIFLE-F (P < 0.05).Conclusion CRRT treatment significantly improved the prognosis of patients with acute renal failure after liver transplantation.