RESUMEN
Of 1290 cases of hydatidosis hospitalized, 907 (70.3%) cases of hepatic hydatid cyst (HHC) were treated surgically (1954-1990). Of the 907 cases, 484 (53.3%) were males and 423 (46.7%) females. Hepatic hydatid cysts were single in 54%, multiple in 21.2% and complicated with hydatid cysts of other organs in 24.8%. 67.5% of the cysts were in the right lobe of the liver, 15.6% in the left lobe, 16.9% in both lobes. 79.0% were situated in the right lower part of the liver, 21.0% on the dome of the liver. Rupture of the cysts into biliary system, peritoneal cavity, the thorax (pulmonary-bronchial tree) and the pericardial sac were 35 (30%), 50 (42.6%), 31 (26.5%) and 1 case (0.9%) respectively. There were 5 deaths. Our experiences include: (1) routine intravenous drip of corticosteroids to alleviate the possible occurrence of allergic reaction during the operation and postoperative hyperpyrexia. (2) mebendazole or albendazole (ABZ) 20 mg/kg/d for one week before operation and 1-2 courses (1 course = 30 days) after operation to destroy the protoscoleces left in the body during operation. (3) antibiotics administration in complicated cases. (4) closure of intrahepatic biliary fistula.
Asunto(s)
Equinococosis Hepática/cirugía , Adolescente , Corticoesteroides/uso terapéutico , Adulto , Anciano , Albendazol/uso terapéutico , Niño , Preescolar , Equinococosis Hepática/tratamiento farmacológico , Femenino , Humanos , Masculino , Mebendazol/uso terapéutico , Persona de Mediana Edad , Premedicación , Procedimientos Quirúrgicos Operativos/métodosRESUMEN
This paper reported the results of prospective study on the effects of standard continuous total parenteral nutrition (S-TPN) and cyclic total parenteral nutrition (C-TPN) in 20 hospitalized patients with moderate catabolism. The study course continued for 20 days. The results were evaluated by 48 indexes, and all data were processed statistically. The study results showed that the effects of S-TPN and C-TPN on metabolism of glucose, protein and fat, immune functions, functions of vital organs, and body weight were about the same. The authors came to the conclusion that S-TPN is a good way of nutritional support for hospitalized patients, while C-TPN has its advantage for home use.
Asunto(s)
Glucemia/metabolismo , Colesterol/metabolismo , Nutrición Parenteral Total , Albúmina Sérica/metabolismo , Adulto , Bilirrubina/sangre , Femenino , Humanos , Fístula Intestinal/metabolismo , Fístula Intestinal/terapia , Masculino , Persona de Mediana Edad , Nutrición Parenteral en el Domicilio , Estudios Prospectivos , Distribución AleatoriaRESUMEN
Plasma aminogram changes were prospectively studied in 95 patients with external enteric fistula and intraabdominal infection who were under total parenteral nutrition (TPN) therapy with anfuming 14s. Plasma amino acids and albumin were determined before the administration of TPN, weekly and at the end of the therapy or 2 to 5 days before death of patients. In patients with sepsis and starvation, the aminogram showed remarkably low total free amino acids before TPN therapy. In survivors, free amino acids increased gradually to normal in 2 weeks after use of TPN and in the dead increased rapidly to a significantly high peak at the terminal stage. In both survivors and deceased, phenylalanine level remained high during the study. In response to infection, proline was also elevated but to a lesser degree; the ratio of branched chain amino acid (BCAA) to aromatic amino acid (AAA) was lower than normal and the decrease of arginine was parallel to the severity of infection. We conclude that the ideal amino acid preparation for the starved, septic patients should be high in BCAA and arginine but low in phenylalanine; the administration of inappropriate exogenous amino acids in metabolically decompensated septic patients may bring about more harm than benefit; and in septic patients the persistently elevated level of plasma phenylalanine and proline along with decrease of arginine is a useful prognostic sign.