1.The Diagnosis and Treatment of Colon Cancer Presenting Appendicitis
Liming JIN ; Jiangwen ZHENG ; Xiaofeng ZHU
Journal of Zhejiang Chinese Medical University 2006;0(02):-
[Objective]To investigate the reasons of misdiagnosis of colon cancer complicated with appendicitis and to sum up the experience of diagnosis. [Methods] Between May 1995 and September 2005, 1060 cases with appendicitis were undergone appendectomy. However, of them, 9 cases complicated with colon cancer had confirmative diagnosis during the operation or after, performed successfully suitable operations. [Results] All of 9 cases were misdiagnosed as appendicitis and undertook appendectomy for similar clinical traits. According to the signs of exploration in the appendectomy and the analysis of patient history, clinic characteristic and some radiologic features, we acquired confirmative signs of carcinoma and put up reasonable surgical intervention. [Conclusion] There are some imperative measures to decrease misdiagnosis by analyzing clinical manifestations comprehensively, observation dynamically, exploration in the appendectomy, and effective examination. Among them, the key to reduce misdiagnosis rate is exploration during the period of appendectomy.
2.Effect of different puncture needle models on the risk of bleeding after renal puncture
Luquan ZHENG ; Xiaoyu CHEN ; Jia'nan ZHOU ; Xiaoming ZHANG ; Lirong LIN ; Jiangwen REN
Chongqing Medicine 2024;53(4):532-536
Objective To study the effect of different types of renal puncture needles on the risk of bleeding after renal puncture.Methods A retrospective analysis was performed on 428 patients who under-went renal biopsy in the Third Affiliated Hospital of Chongqing Medical University and Jiulongpo District People's Hospital of Chongqing from January 2020 to December 2022.Different types of puncture needles were used to compare the occurrence of postoperative bleeding complications(hematoma,hematuria).Results The incidence of bleeding complications after renal puncture in 428 patients was 21.0%(90/428),of which the incidence of hematoma was 18.9%(81/428),the incidence of hematuria was 2.1%(9/428),the median decrease in hemoglobin(Hb)was 5 g/L,and the incidence of serious complications such as blood transfusion and interventional therapy was 0.7%(4/428).The patients with different types of renal puncture needles were grouped(16G group,18G group).There was no significant difference in baseline data and distri-bution of renal pathological types between the two groups(P>0.05).The incidence of postoperative bleeding in 16G group and 18G group was 22.4%(52/232)and 19.4%(38/196),respectively.The incidence of hema-toma was 20.6%(48/232)and 16.8%(33/196),respectively.The incidence of hematuria was 1.7%(4/232)and 2.6%(5/196),respectively.The decrease of Hb was 6(0,16)g/L and 4(0,17)g/L,respectively.There was no significant difference(P>0.05).There was no significant difference in the incidence of serious compli-cations such as blood transfusion,interventional therapy and Hb decrease>10 g/L between the two groups(P>0.05).Conclusion Ultrasound-guided renal biopsy is safe and has a low incidence of serious complica-tions.There was no significant relationship between different puncture needle types and postoperative bleeding risk.