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find Author "张陈" 4 results
  • The Experience of Modified Single-Port Laparoscopic Appendectomy by Using Traditional Instrument in 52 Cases

    目的 探讨应用传统器械经脐行改良单孔腹腔镜阑尾切除术的临床价值。方法 回顾性分析笔者所在医院2010年1月至2012年2月期间行经脐单孔腹腔镜阑尾切除术的52例阑尾炎患者的临床资料,总结手术经验。结果 52例患者均顺利完成手术,平均手术时间为39.2min (18~70min),术后平均住院时间为5d (3~12d)。其中,45例患者成功完成经脐单孔腹腔镜阑尾切除术,2例中转开腹,2例行两孔LA术,3例行三孔LA术。术后2例患者发生切口感染。29例患者获访,随访时间4~18个月,平均12个月,无出血、切口疝、腹腔残余感染、粘连性肠梗阻、阑尾残端瘘等并发症发生。结论 应用传统器械经脐行改良单孔腹腔镜阑尾切除术简单、安全、可行、患者恢复快、并发症少、美容效果较好,但操作难度相对更高。应严格掌握手术适应证,必要时及时增加戳孔或中转开腹。

    Release date:2016-09-08 10:24 Export PDF Favorites Scan
  • Anatomy of mortis corona vascular and its clinical significances in laparoscopic total extraperitoneal hernia repair

    Objective To study anatomy of mortis corona vascular and analyze its characteristics and clinical significances in laparoscopic total extraperitoneal hernia repair (TEP). Method The clinical data of 45 patients with inguinal hernia underwent laparoscopic TEP from July 2013 to October 2015 in the Fourth People’s Hospital of Zigong City were collected. Results ① There were 45 patients with inguinal hernia a total of 52 bilateral inguinal hernias (15 direct hernias, 37 oblique hernias). The total appear rate of corona mortis vascular was 61.5% (32/52). The appear rate of corona mortis artery was significantly higher than that of the corona mortis vein〔46.2% (24/52)versus 34.6% (18/52),P<0.05〕, the diameter of the corona mortis artery was significantly smaller than that of the corona mortis vein〔(3.2±0.3) mmversus (3.4±0.4) mm,t=2.231,P<0.05〕. ② The appear rates of corona mortis artery and vein in the male patients were significantly higher than those of the female patients (P<0.05). Compared with the female patients, the age of onset was older (P<0.05), thickness of abdominal wall was thinner (P<0.05), diameter of corona mortis vascular was bigger (P<0.05) in the male patients. ③ The total appear rate of corona mortis vascular in the patients with direct hernia was significantly lower than that of the patients with oblique hernia (P<0.05). The age of onset of the patients with direct hernia was significantly older than that of the patients with oblique hernia (P<0.05). Conclusions There is a higher appear rate of corona mortis vascular in patients with oblique hernia, which in male patients is higher as compared with female patients. Age of onset of male patient with inguinal hernia is older than that of female patient with inguinal hernia. It suggests that appear of corona mortis vascular might be associated with degeneration of abdominal wall. It has a certain role for localization and avoidance of corona mortis vascular in TEP.

    Release date:2017-02-20 06:43 Export PDF Favorites Scan
  • 单孔腹腔镜下注射针头协助弧形弯钩的小儿腹股沟疝结扎术 180 例临床分析

    目的探讨经脐单孔腹腔镜下注射针头协助弧形弯钩带线治疗小儿腹股沟疝的临床应用价值。方法对 2014 年 2 月至 2018 年 12 月期间自贡市第四人民医院普外一科经脐单孔腹腔镜手术的 180 例腹股沟疝患儿的临床资料进行回顾性分析。结果所有患儿均顺利完成采用经脐单孔腹腔镜下注射针头协助弧形弯钩带线手术治疗。术中发现对侧隐匿性疝 62 例,给予一并处理。手术时间(不包括麻醉时间和建立气腹置入 Trocar 时间)单侧 5~10 min、(5.7 ± 0.5)min,双侧 8~15 min、(11.0 ± 0.5)min。术后未见皮下积血、无阴囊积气和积液、无戳孔疝、无线结异物反应等并发症出现。术后出现上呼吸道感染有 2 例经对症治疗后 6 h 进食和下床活动。术后 24~72 h、(24±0.7)h 出院,全组病例均按临床路径流程进行。术后 2 周术区皮肤瘢痕不明显。术后最少随访 6 个月以上,复发 1 例,经再次手术术中发现 7 号丝线断裂线头松开导致;其余患者未见复发也无其他并发症。结论经脐单孔腹腔镜下注射针头协助弧形弯钩带线治疗是一种治疗小儿腹股沟疝安全有效的微创手术方法,操作简便,手术时间短,创伤小,术后瘢痕小,病情恢复快,并发症少,减轻了患儿痛苦,缩短了住院时间。

    Release date:2020-06-04 02:30 Export PDF Favorites Scan
  • Open Surgery Repair for Incision Hernia of Abdominal Wall

    目的探讨腹壁大切口疝和巨大切口疝治疗经验。方法对我院采用补片行开放式腹壁大切口疝和巨大切口疝修补术的51例患者临床资料进行回顾性分析。结果采用肌前补片修补法3例,肌肉间补片修补法3例,肌后腹膜前补片修补法39例,腹腔内补片修补法6例。 手术时间109~195 min,平均135.2 min; 术中出血15~90 ml,平均35.6 ml;术中无血管和内脏损伤等并发症。 术后3~7 d(平均4.9 d)下床活动; 住院时间7~19 d,平均9.7 d。 2例患者术后出现浆液肿,经穿刺抽吸、负压吸引和腹带加压包扎后治愈。51例患者随访12~36个月(平均24.5个月),3例(5.9%)患者复发,后行开放式腹腔内补片修补手术,恢复良好,无再复发。所有病例无慢性疼痛。结论应用补片行开放式腹壁大切口疝和巨大切口疝修补术是一种安全、可靠的方法,复发率低。

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
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