Objective To improve the diagnosis and treatment of concealed penis in children. Methods From August 1998 to January 2004, 43 cases of concealed penis in children were treated with Huang Lugang’s procedure aging aged 2-14 years (7 years on average). Eight children are obesity. The albuginea tissue were fixed to the lateral Buck’s fascia at the base of the penis. Removal of the excessive suprapublic fat was given in 2 cases of obesity type. Results All patients were followed up from 3to 24 months. The results were satisfactory in 35 (81.4%).The penile contour were dissatisfactory in 8 patients with obesity including 2 patients given removal of the excessive suprapublic fat. Conclusion The Huang Lugang’s procedure was simple and can achieved satisfactory results, but it should be used carefully in case of obesity type.
Severe psychomotor developmental delay resulting from early postnatal (within 3 months) seizures can be diagnosed as Early-Infantile Developmental and Epileptic encephalopathies (EIDEE). Its primary etiologies include structural, hereditary, metabolic and etc. The main pathogenesis may be related to the inhibition of normal physiological activity of the brain by abnormal electrical activity and the damage of the brain neural network. Ohtahara syndrome and Early Myoclonic Encephalopathy (EME) are typical types of EIDEE. The principle of treatment is to improve the cognitive and developmental function by controlling frequent seizures. When the seizure is difficult to control with drugs, surgical evaluation should be performed as soon as possible, and surgical treatment is the first choice for patients suitable for surgery. The types of surgery can be divided into excision surgery, dissociation surgery, neuromodulation surgery and etc. The current status of surgical treatment of EIDEE was described, and the curative effect of surgical treatment was explored, so as to help clinicians choose appropriate treatment methods.
目的 探讨肝外伤的早期诊断与治疗效果。方法 回顾性分析采用不同手段治疗的各种肝外伤52例患者的临床资料。结果 男30例，女22例，腹部开放性伤18例(34.6%)，腹部闭合性伤34例(65.4%)，腹腔穿刺阳性率为92.3%(48/52)，超声检查阳性率为88.9%(40/45),CT检查阳性率为100%(50/50)。非手术治愈16例； 手术治疗36例(包括3例因非手术治疗而中转手术)，手术方式包括单纯缝合止血、大网膜填塞+缝合止血、明胶海绵填塞+缝合止血、清创性肝切除、腹腔镜探查+缝合止血。治愈率为96.2%(50/52)，死亡率为3.8%(2/52)。2例死于肝内血管损伤大出血。结论 CT检查进行肝损伤分级和血流动力学状态是决定治疗方式的关键，腹腔镜探查是明确诊断的良好微创方法。
目的 探讨非手术治疗外伤性脾破裂的可行性及适应证。 方法 回顾分析1998年以来山东省聊城市第二人民医院非手术治疗88例外伤性脾破裂的临床资料及其治疗效果。结果 88例均经B超检查确诊脾破裂，Ⅰ级损伤19例，Ⅱ级损伤57例，Ⅲ级损伤12例，其中16例患者合并肋骨骨折，11例合并肝外伤，9例合并肾挫伤，4例合并颅脑损伤，3例中转手术。结论 有选择地采用非手术治疗外伤性脾破裂安全、有效，轻度的肝肾损伤、腹腔外器官合并伤及患者的年龄并不影响非手术治疗的疗效。
目的探讨成人Ⅰ型胆总管囊肿的诊断和治疗。方法回顾性分析1997年1月至2004年7月期间收治的8例成人Ⅰ型胆总管囊肿的临床资料。结果5例行胆总管囊肿全切除、RouxenY肝管空肠吻合术； 2例行囊肿部分切除、RouxenY囊肿空肠吻合术； 1例行囊肿部分切除、 RouxenY肝管空肠吻合术，术中常规行胆道镜检查，无一例手术死亡。8例患者术后平均随访2．8年(1~7年)，未发现胆道恶性肿瘤。1例行囊肿部分切除的患者，在术后出现3次右上腹绞痛，1次急性胆管炎表现，均经支持、对症、抗感染等治疗后好转。 结论 成人Ⅰ型胆总管囊肿的诊断主要依靠B超、逆行胰胆管造影(ERCP)或磁共振胆胰管造影（MRCP）检查，囊肿全切除、RouxenY肝管空肠吻合是安全、有效的手术方式，其疗效比较满意； 囊肿部分切除、RouxenY囊肿空肠吻合术虽疗效不及完整囊肿切除令人满意，但对于在技术上难以作到囊肿完全切除者，部分囊肿切除是明智的选择，建议术中常规胆道镜检查。