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yxfbbiedtj · Wysłany: Sob 13:54, 05 Mar 2011

High-dose epinephrine to improve the success rate of cardiopulmonary resuscitation

B-show hepatomegaly, intrahepatic bile duct dilatation, hilar mass in 4 cases; bifurcation has been narrow in 2 cases. All patients were checked for the PTC said the expansion of intrahepatic bile duct, tail cut off and the tail side of stars like change. No swelling after surgical removal of liver cancer metastasis outside the pedicle. Removal of leg bag 5 while hungry, combined left liver resection in 2 cases, right liver, liver quadrate lobe, and 1 case of resection of the right trefoil a bile duct reconstruction by the side of the hepatic duct and the air two ROUX - Y anastomosis in 4 cases left right hepatic duct and jejunum dual-port 2 side RoUx-Y anastomosis, postoperative recovery are well embedded. Followed up for 5 to 40 months. In addition to the right clover l routine resection 4 months after surgery died of liver dysfunction, the other existing Yao 2 to 3 years, and significant improvement in quality of life, and able to participate in the general labor. Experience: to determine the possibility and extent of tumor resection method is: 0 Next intraoperative swelling gangrene Aberdeen tin exploration in and around Baptist La Shao-bit level, fully reveal the hepatic portal and hepatic ligament structure. @ With PTC or intraoperative bile duct puncture under the old imaging superconducting gf decided to remove signs of Fan weeks. @ Intraoperative bile duct puncture cut liver surface expansion of the intrahepatic bile ducts, into the blocked bile duct neoplasms microscope to determine removal of parts of the range kitchen ceiling. The decision to remove. Catheter from here into the thick of the internal standard block area to do the elbow rage palpable Ti l hepatectomy liver catheter tube,[link widoczny dla zalogowanych], and then cut off the hepatic duct. Kiss of liver jejunal tone silicone tube placed in the catheter or shelf proscenium arch jump f flow. If this group than with the bifurcation method of hepatic surgery. After careful exploration abdominal tumor location and extent of the sea around the dip. Fully reveal the liver and liver ligament structure set, the removal of the liver under the direction of left and right hepatic duct found; if Bin hepatic duct cancer confined to the bifurcation, that line about hepatic duct, hepatic duct, gallbladder, bile expansion of the total business In addition to left; if cancer bile duct invasion and a hire two or more, you can add half the liver resection,[link widoczny dla zalogowanych], resection of the lesions were made after the gall bladder operation R0ux-Y jejunal reconstruction. Lying on the bifurcation of the advantages of hepatic resection of liver quadrate lobe of liver left after the camp to find. If the control line cutting】 l dance half the liver, the first cut will be built side of the bile duct, bile duct caudal reveal - along the posterior wall of separation between the interest rates on the side door and side vein branch henbane half liver resection of tumor can not stay off left hepatic duct in addition to The head executioner with jejunostomy and drainage, Bin expansion set for the block-bit support for the liver Shuo; f flow of a nephritic syndrome of lung hemorrhage in 1 case in former times Qufu City People's Hospital Fan new to Xiufang capsule male patient transport, 2s years. Oliguria due to fatigue, dizziness plus days. Hemoptysis admitted o20 days 9 hours ago. Fatigue for no apparent reason, oliguria. Vision blur when, anorexia, nausea, vomiting; nearly l weeks sicker, and back pain occurs,[link widoczny dla zalogowanych], the next win edema, nephritis treatment outside the hospital was no better Zhu; 9 hours ago suddenly felt chest tightness, shortness of breath. Well cough slightly past the blood of about ~ 00mIo apnea and. History of cardiovascular disease. Physical examination; T37.4, P85 times / min, R30 mention / min, BP24/i8kPao anemic appearance, eyelid swelling coarse breath sounds of both lungs, right lung and heard the end of dry and wet rales. Heart, abdomen a) o a call-in cancer, kidney area, two Department of significantly depressed ankle swelling. Fundus said: retinal edema, macular vein dilation are Qichu. The remaining normal. Experimental Vision Inspection WBC13 × 10 '/ LlN0.89, L0.11. ESR25mm / a ~ Blood K, Na, cI a,[link widoczny dla zalogowanych], c0, a cP in the normal range,[link widoczny dla zalogowanych], BUN7.2mmol / L, bile Si alcohol, normal blood glucose; Hong protein (thirty), WBC a little, RBC (+). ECG normal. Sputum smear covered with RBC. Jagged yellow tangled with Taiwan compatriots Tian Qi swallow. x-ray showed patchy shadows in both lungs in the right lung to the, around the lung hilum was more intensive radiation to the distribution. Ren diagnosed as pulmonary hemorrhage after admission to a nephritic syndrome full set of adrenal corticosteroids, antibiotics and symptomatic treatment claims, increased cough condition deteriorated the next day, lungs rales more than bloody sputum. Urine set by _ ~ TOOml / d. BUN rose to 18.7mmoVL. Day 4 slipper hemoptysis, died from a pulmonary hemorrhage biopsy confirmed renal death syndrome. Analysis: pulmonary hemorrhage in a Comprehensive Desk levy kidney nephritis in the lung before the performance. Illness factors may be acting on the glomerular basement membrane before. Formation of anti-GBM antibodies, the circulation of its alveolar basement membrane antibody and reaction occurs due to acne-free Cross. Difficulties here. Glomerular basement membrane basement membrane injury hold lung injury earlier in the post. Manganese on the bed first, nephritis table as edema, oliguria, hypertension, low back pain, anemia, etc., until the disease progressed to alveolar basement membrane antibody and immune response occurs when the cross-pulmonary symptoms. This case was misdiagnosed as complex nephritis 20 days, after finding a large number of applications in the embedded smear hemosiderin cells, pulmonary hemorrhage party to consider a comprehensive platform nephritis symptoms. There is no specific treatment of this disease. Some patients with large adrenal glucocorticoid home agent have a certain role in mitigation. Efficacy of immune agents share plus possible stability.