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find Keyword "缝合" 138 results
  • MEDIUM-TERM EFFECTIVENESS OF BOTH SIDE STEREO SUTURE FOR MENISCUS BUCKET HANDLE TEAR UNDER ARTHROSCOPY

    ObjectiveTo investigate the medium-term effectiveness of both side stereo suture for meniscus bucket handle tear under arthroscopy. MethodsBetween January 2009 and December 2012, 38 patients with combined injury of meniscus bucket handle tear underwent arthroscope surgery by the method of both side stereo suture. There were 26 males and 12 females with an average age of 32 years (range, 19-42 years). The injury causes included sports injury in 21 cases, traffic accident injury in 11 cases, and other trauma in 6 cases. The left knee was involved in 15 cases and the right knee in 23 cases. The interval between injury and operation was 2 days to 6 months (mean, 2.5 months). MRI examination showed meniscus injury at grade Ⅲ, including 22 cases of internal injury and 16 cases of lateral injury. The Barrett standard, Lysholm score of knee joint, and joint mobility were used to assess the function recovery of the knee joint. ResultsAll incisions healed primarily with no complication. All cases were followed up 24.5 months on average (range, 18-36 months). Based on the Barrett standard, meniscus bucket handle tear was successfully repaired in all cases. The Lysholm scores and range of motion of the knee at 6 months, 12 months, and last follow-up were significantly better than preoperative ones (P<0.05). ConclusionThe both side stereo suture of meniscus bucket handle tear under arthroscopy has an excellent medium-term effectiveness, with the advantages of firm suture and high healing rate.

    Release date:2016-08-25 10:18 Export PDF Favorites Scan
  • Application of Abdominal Wall Closure Measure Without Suturing Subcutaneous Fat Layer in Abdominal Surgery

    Objective To compare the efficacy of incision healing by abdominal wall closure measure without suturing subcutaneous fat layer and the traditional abdominal wall closure measure. Methods Four hundreds patients underwent operation of abdominal median incision and abdominal paramedian incision from Sep. 2010 to Sep. 2012 in our department were randomly assigned to observation group (n=199) and control group (n=201). The patients in obser- vation group underwent abdominal wall closure measure without suturing subcutaneous fat layer, and those of control group were subjected to abdominal wall closure by traditional layer suture technique. Comparison of efficacy of incision healing in the 2 groups was performed. Results The incidences of fat liquefication 〔1 (0.5%) vs.18 (9.0%)〕, incision swelling 〔3 (1.5%) vs.16 (8.0%)〕, incision induration 〔1 (0.5%) vs.15 (7.5%)〕, and dehiscence of wound 〔0 (0) vs.9 (4.5%)〕 in observation group were significantly lower than those of control group (P<0.01), but there was no significant difference in incidence of subcutaneous hematoma 〔2 (1.0%) vs.0 (0), P>0.05〕. The rate of primary healing in obser-vation group was significantly higher than those of control group 〔199 (100%) vs.186 (92.5%), P<0.01〕. Duration of abdominal closure 〔(13.0±1.6) min vs.(18.0±2.2) min〕 and postoperative hospital stay 〔(7.7±1.3) days vs.(9.6±1.9) days〕 were all shorter than those of control group (P<0.01). Conclusion The abdominal wall closure measure without suturing subcutaneous fat layer is obviously more effective to the traditional layer suture technique, which is a suture way worthy to spread.

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  • Auto-Surgery in the Reconstruction of Gastrointestinal Trac

    Release date:2016-08-28 04:43 Export PDF Favorites Scan
  • SUTURE OF PEDICLE GREATER OMENTUM FOR 91 CASES OF LIVER TRAUMA

    目的 探讨应用带蒂大网膜治疗严重肝创伤的方法。方法回顾性地对1986~1999年收治的严重肝创伤应用带蒂大网膜填塞覆盖缝合术91例的临床资料进行分析。结果 治愈81例(89.0%),死亡10例(11.0%)。术后近期出血、胆汁渗出4例(4.4%),胆漏3例(3.3%),膈下脓肿5例(5.5%)。结论 带蒂大网膜在救治严重肝创伤中有着重要的作用,对肝创面彻底清创、止血、妥善缝扎创口和胆管等是应用带蒂大网膜缝合术的先决条件。

    Release date:2016-08-28 05:30 Export PDF Favorites Scan
  • Application of A Silicone Guiding Tube for Endoscopic Linear Stapling Device in Complete Video-Assisted ThoracoscopicLobectomy and Segmentectomy

    Abstract: Objective To investigate the application of a silicone guiding tube for endoscopic linear stapling device in complete video-assisted thoracoscopic lobectomy and segmentectomy,so as to improve the safety and efficiency of manipulating the endoscopic linear stapling device. Methods We retrospectively analyzed clinical data of 178 patients with peripheral non-small cell lung caner and 26 patients with benign lung lesions who underwent surgical resection in First Affiliated Hospital of Nanjing Medical University from October 2009 to December 2011. There were 85 males and 119 females with their average age of 62±11 years. A total of 172 patients underwent complete video-assisted thoracoscopic lobectomy and 32 patients underwent segmentectomy. We designed a silicone guiding tube to facilitate the use of endoscopic linear stapling device. With the help of the tube, a1l pulmonary arteries, veins, bronchus and interlobar fissure involved were managed with endoscopic linear stapling devices. Results Three patients (1.47%)underwent conversion to thoracotomy because of dense lymph node adhesion, and all other complete video-assisted thoracoscopic surgeries were successfully performed. There was no blood vessel injury, severe postoperative complications or perioperative death. The use rate of the tube was 95.6% (303/317), 66.9% (115/172), 22.7% (39/172) and 78.5% (255/325) in pulmonary arteries, veins, bronchus and interlobar fissure stapling for lobectomy respectively, and 94.4% (34/36), 77.3% (17/22), 25.0% (8/32), 33.1% (45/136) in pulmonary arteries, veins, bronchus and interlobar fissure stapling for segmentectomy respectively. For lobectomy, a total of 986 staples were used with an average of 5.7 staples for each patient, the average operative time was 192.5±54.0 min and average intraoperative blood loss was 118.1±104.1 ml. For segmentectomy, a total of  226 staples were used with an average of  7.1 staples for each patient, the average operative time was 193.7±37.4 min and average intraoperative blood loss was 60.9±78.0 ml. Conclusion Using a silicone guiding tube can facilitate the application of endoscopic linear stapling device, shorten the learning curve of complete video-assisted thoracoscopic lobectomy and segmentectomy, and improve the safety, convenience and economical efficiency of endoscopic linear stapling device.

    Release date:2016-08-30 05:51 Export PDF Favorites Scan
  • Application of Endoscopic Linear Stapling Device in Com plete Video-assisted Thoracoscopic Lobectomy

    Objective To investigate the application and techni ques of endoscop ic linear stapling device in complete video-assisted thoracoscopic lobectomy, a n d to improve the safety and quality of the operation. Methods From September 2006 to January 2008,sixty consecutive complete video-assisted thoracoscopic lo b ectomies were performed. The patients include 30 men and 30 women with average a ge of 59.8 years old. Eight patients suffered from benign lung lesions, and 52 p atients suffered from primary lung cancers or other pulmonary malignancy. The op erations were performed under general anesthesia with doublelumen intubation a nd complete thoracoscopy.The procedures include 12 right upper lobectomies, 10 right middle lobectomies, 14 right lower lobectomies, 8 left upper lobectomies a nd 16 left lower lobectomies. All arteries, veins, bronchus involved were manag ed with endoscopic linear stapling devices. Results All the pr ocedures were successful with one conversion case(1.67%) due to tense lymph no des adhesion, no severe complications, as active bleeding, continuous air leak, foreign body reac tion or operation related death occured. Endoscopic linear stapling devices were used for stapling in 381 different procedures with average of 6.35 per case, am ong which 124 (2.06 per case)were for pulmonary arteries, 66(1.10 per case) for pulmonary veins, 60 for lobar bronchus and 131 for interlobar fissures.A period of 11.3 months (2-18 months) follow-up of all patients shows no dela yed bleeding, bronchialpleural fistula, pyothorax or pneumonia. Concl usion The application of endoscopic linear stapling device is one of th e major difficulty in complete video-assisted thoracoscopic lobectomy. Careful manipulation under some specific principles is the key for the security of the operation.

    Release date:2016-08-30 06:09 Export PDF Favorites Scan
  • Giant Left Ventricular Aneurysms: Early and Long-term Results of Two Types of Repair

    Abstract: Objective To evaluate the early and long-term results for the management of giant left ventricular aneurysm with comparison of different surgical ventricular restructive approaches. Methods Between January 1992 and December 2004, 148 consecutive patients underwent repair of giant left ventricular aneurysms and were divided into two groups, conventional group: 89 patients were submitted to linear repair; modified group: 59 patients were submitted to endocardium encircle suturing remodeling(EESR). There were no significant difference in New York Heart Association (NYHA) class Ⅲ /Ⅳ , left ventricular dysfunction before operation, aortic clamp time and number of coronary bypass grafts in two groups. Results Five patients died after operation (3. 4%), 4 cases in conventional group and 1 case in modified group, the hospital mortality rate was 4.5% vs. 1.7% (P=0. 320). The major morbidity were low cardiac output syndrome and ventricular fibrillation. One hundred and thirty-four patients (93.7 % ) were followed up, during a mean follow-up of 51.4± 27.0 months (range 1-120 months), 21 patients had died. The NYHA class more than m in the early stage after operation was the independent risk factor for late death (P= 0. 000). Actuarial survival rates were 91.6% of modified group vs. 76.3% of conventional group at 5 years (P=0.040), and 91.6% vs. 61.4% at 8 years(P=0.000). At late follow-up the meanNYHAclass, left ventricular end-diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) were significant improved (P = 0. 000)in both groups. The rate of re-dilatation of LVEDD was higher in conventional group than that in modified group ( 38.8% vs. 16.7%, P= 0. 030). Conclusion The technique of repair of postinfarction dyskinetic giant left ventricular aneurysms should be adapted in each patient to the cavity size and shape, and the dimension of the scar. The EESR achieves better results with respect to perioperative mortality, late functional status and survival than linear repair.

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • 主动脉瓣膜置换术弧形连续缝合的合理性

    目的通过观察主动脉瓣的解剖特点,评价主动脉瓣置换术时对人工瓣缝合圈采用弧形连续缝合的合理性。方法对32例非心脏原因死亡患者的未固定的新鲜人体心脏主动脉瓣环直径、瓣叶高度、弧长以及距冠状动脉开口下缘的高度分别进行测量。结果瓣叶附着瓣环处最低点(谷底)与最高点(交联)相差12mm左右,冠状动脉开口下缘距瓣环的谷底左冠状动脉为14mm,右冠状动脉为15mm。结论主动脉瓣置换术时采用弧形连续缝合法,即按照主动脉瓣的自然弧形在人工瓣瓣裙各进针点也呈弧形均匀分布,其对合严密,缝线张力小,具有合理性;弧形连续缝合主动脉根部不会发生皱缩,瓣环谷底在原位不抬高,冠状动脉开口处保留足够的空间,人工瓣坐落后不会发生冠状动脉开口堵塞。

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
  • 新鲜自体心包在心脏手术中的应用

    目的总结新鲜自体心包在心脏手术中应用的临床经验. 方法 1992年12月~1998年12月,在230例先天性心脏病、风湿性心脏病和心脏肿瘤等患者的心脏手术中,应用新鲜自体心包作为修复材料. 结果术后早期死亡13例,手术死亡率5.7%.室间隔缺损修补术后发生轻度残余漏2例.随访175例(76%),无术后溶血、栓塞、感染性心内膜炎、补片钙化和心包片瘤样膨出等并发症. 结论新鲜自体心包是心脏手术中优良的修复材料.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 可吸收线胃食管分层连续缝合法行胃食管吻合术

    目的 为了减少食管、贲门癌切除、胃食管吻合术后吻合口瘘和吻合口狭窄的发生率,总结可吸收线胃食管分层连续缝合法的经验. 方法 食管、贲门癌切除后,采用国产3-0带针可吸收线在食管不同平面分层连续缝合行胃食管吻合术40例. 结果 全组无死亡,发生吻合口瘘1例,经治疗痊愈;轻度吻合口狭窄3例,进软食无梗阻,经行吻合口扩张后能正常进食. 结论 采用可吸收线分层连续缝合法行胃食管吻合术是可行的,吻合口瘘发生率低,吻合口狭窄发生少、程度轻.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
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