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Esophageal and gastric cardia elderly perioperative

, While the elderly are extremely sensitive to blood loss. A 76-year-old in this group of patients, that is more because of bleeding after surgery induced atrioventricular block and death. Therefore, on the high side should pay attention to correct the bleeding, while paying attention to cardiac function. The other deaths after ~ 7d, has been transferred to general wards. Condition has become stable, sudden heart attack deaths, a general ward for continuous ECG monitoring is not stripping. We learn later. Where there is heart disease before surgery prompted the elderly patients in intensive care unit to observe when you hear a timely observation of heart rate, blood pressure, ECG changes, since no similar incidents. Bu. * 29 old age is not a contraindication to surgery, the key is to pay attention to the Many elderly patients reported in the literature with low immunity, poor tolerance and well-differentiated tumor cells, slow growth, the condition is relatively limited and so on. Resection rate and prognosis were significantly higher in the young group. The patients surgical resection rate 98.1%, far higher than the operation of the young group 89.9%. Postoperative hospital stay longer than the young group there is no much difference. Nan this we believe that patients with As long as strict screening out disease. Careful preoperative preparation, intraoperative management do when, after timely treatment of elderly patients with reasonable care by the same procedure is not difficult to obtain good results. Early diagnosis of atypical ectopic pregnancy (34 cases) 7 / Ren, 2k9 (24400O) and Child Health Hospital, Tongling,[link widoczny dla zalogowanych], Anhui Hao Xiaohua ectopic pregnancy is a common disease Obstetrics and Gynecology, a clear upward trend in recent years. ... 199o in our hospital from January to December 1997 115 cases of ectopic pregnancy were treated, dichotoma in 34 cases of atypical ectopic pregnancy, is now used for retrospective analysis in order to learn to teach 』I, to improve early diagnosis. 1Il 1.1 Li-bed general information data of 34 cases in this group, the annual sales to compete in the 20 ~ 45 years old, 25 to 35 years old dichotoma in 38 cases, 23 cases of married, unmarried 1l cases, birth of a child for the 2o cases, no growth l4 patients with history of cesarean section in 13 cases, 17 cases of induced abortion. The number of abortion 1 to 4 times, placed IUD in 17 cases, dichotoma it to contraceptive methods, or 17 cases. 1.2 The main clinical manifestations of this group of 34 down in the history of 5 cases of menopause, menopausal time in 36 to 60 days, the rest appeared as irregular vaginal bleeding, bleeding time after the first period for the 20d at the latest before the King for the 34d,[link widoczny dla zalogowanych], for 14 - 42d. The main abdominal pain lower abdominal bulge, bulge anal pain. 6 down acute abdominal pain, abdominal pain, duration of 6h - 15d, Fu check and found B-14 pelvic masses down. B-Tip 1 sad tubal thickening in 6 patients, no abnormal in 8 cases, feces HcG negative in 22 cases, 12 cases of suspected positive. Blood B-H ∞ 50,3 ~ 284.3MIU, - 1.3 Results 1.3.1 Diagnosis and treatment for at least 3 times, up to 8 times (including hospital treatment) by diagnostic curettage in 14 cases. 1,[link widoczny dla zalogowanych],32 for the first time diagnosis of corpus luteum rupture in 4 cases,[link widoczny dla zalogowanych], 1O cases of dysfunctional uterine bleeding, pelvic mass in 6 cases, 6 cases of threatened abortion in order to receive surgery in 4 cases of appendicitis. Medical diagnosis of acute gastroenteritis in 2 cases, 2 cases of chronic gastritis. 34 down, in addition to 4 cases were found in surgery, the others were hospitalized and the hospital received the diagnosis of 72h. 1.3.3 Treatment: The surgery l8 down. Tubal abortion patients found in 8 cases, 8 cases of ruptured, survival has not yet ruptured gestational sac 2 guillotine. Part of the Department of interstitial pregnancy in 4 cases, 6 cases of the isthmus, ampulla 7 cases, house corner l cases. After more than conservative treatment dichotoma HOG blood to normal, pelvic mass was significantly reduced or disappeared. Vaginal bleeding stopped. 34 patients were cured without l complications. 2 discussion of ectopic pregnancy as a common gynecological disease diagnosis is not difficult, but not the typical history and signs, tend to make patients and medical staff have oversight, resulting in misdiagnosis and delayed diagnosis should be based on high alert. Through this analysis of 34 cases of 21, should learn the following lessons 21.1 must pay attention to irregular 'road bleeding, 5 cases of this significant addition to the history of menopause, the 29 patients showed irregular vaginal bleeding. In addition there are still cases of intrauterine contraceptive ring l5, so that patients do not think that pregnancy, but the irregular menstruation is often delayed treatment. Part of the medical staff to have patience and official functions bleeding attributed to intrauterine bleeding or bleeding 【. 212 gynecological examination can not be ignored. For patients with vaginal bleeding is not done in a timely manner most of Obstetrics and Gynecology examination. Reasons: ① part of patients for the first child. Requirements of birth, fear of examination. ② medical staff to increase the chances of infection and not be afraid to check. ③ rely solely on the additional tests. Because of delays in diagnosis and treatment of blindness. 213 patients with the early response a small number of stomach disorders mistake, not in time to treatment and treatment in obstetrics and gynecology, surgical, and other physicians
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