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find Keyword "适应证" 48 results
  • Clinical Analysis of Laparoscopic Procedure in Treatment of 1356Cases of the Adnexal Masses

    目的:探讨腹腔镜诊治附件包块的有效性与安全性。方法:回顾性分析四川大学华西第二医院2004年1月至2005年12月妇科收治的1356例附件包块行腹腔镜治疗的病例。结果:手术适应证主要为异位妊娠、卵巢宫内膜囊肿及卵巢良性畸胎瘤,手术方式主要为输卵管造口取胚术、输卵管切除术、卵巢囊肿剥除术及患侧附件切除术,手术成功率98.45%,无严重并发症发生。术中发现可疑病例78例(5.8%),病理检查提示交界性及低度恶性包块共9例(0.66%),其中4例在腹腔镜下完成手术。既往有腹部手术史85例,77例在腹腔镜下完成手术。结论:腹腔镜技术在诊治妇科良性附件占位方面是安全有效的。

    Release date:2016-09-08 10:14 Export PDF Favorites Scan
  • Indication of Splenectomy in Radical Resection for Advanced Proximal Gastric Cancer

    Objective To investigate the reasonable indication of splenectomy in radical resection for advanced proximal gastric cancer (APGC). Methods Fifty patients with APGC were studied and classified into total gastrectomy with splenectomy (TGS) group (n=18) and total gastrectomy without splenectomy (TG) group (n=32). The operation time, hospitalized duration, complications, and lymphe node metastasis at the spleen hilus were compared between two groups. Results The operation time, hospitalized duration and subphrenic infection rate in the TGS group were significantly higher than those in the TG group (Plt;0.05). The rate of lymph node metasitasis of No.10 and No.11 in the TG group was not different from that in TGS group (Pgt;0.05). Conclusion Direct spleen and its vessel invasion are the reasonable indication of splenectomy in radical resection for APGC.

    Release date:2016-09-08 10:50 Export PDF Favorites Scan
  • Surgical Indications of Polypoid Lesions of the Gallbladder

    Release date:2016-08-28 04:49 Export PDF Favorites Scan
  • Clinical Analysis of 100 Consecutive Completely Thoracoscopic Lobectomy

    Objective To investigate the safety and efficacy of completely thoracoscopic lobectomy and the indications of this procedure. Methods Between Sep. 2006 and Jun. 2008, 100 consecutive patients(46 men,54 women, median age60.1±12.5 years,range from 18 to 82 years) underwent completely thoracoscopic lobectomy. All candidates were either peripheral pulmonary nodules suspected of lung cancer (85 pts.) or benign lesions (15 pts.) localized within single lobe who needed to receive lobectomy. The lobectomy was completed through three tiny incisions in the intercostal space. Anatomic lobectomies were carried out in all cases and systemic lymph node dissection was performed in malignancies. This group consisted of lobectomies of right upper lobe (n=25), right middle lobe (n=14), right lower lobe (n=22), left upper lobe (n=18), and left lower lobe (n=21). Results All procedures were successfully completed except for 3 conversions to thoracotomy. Postoperative diagnosis were primary lung cancer (n=81), lymphoma (n=1), metastasis of clear cell carcinoma from kidney (n=1), and, benign lesions (n=17). Five patients had mild complications in which two had atelectasis, one needed temperately echanical ventilation, one had pneumonia and one had chylothorax. All were treated conservatively without reoperation. No operative mortality or serious complications occurred in this group. The operative duration was 186.4±52.9min (range from 60 to 300 minutes). The blood loss was 233.9±275.9ml(range from 50 to 750ml), and only one case needed blood transfusion. Chest drainage time was 7.1±3.0 days. Postoperative hospital stay was 9.5±3.2 days. Followedup time was for 1 to 27 months, metastasis happened in two patients with primary lung cancer 15 and 3 months separately after operation. Conclusion The completely thoracoscopic lobectomy is a safe and feasible surgical procedure with minimal invasiveness. The advocated indications include selected peripheral typed early stage lung cancer and benign pulmonary lesions which need lobectomy.

    Release date:2016-08-30 06:04 Export PDF Favorites Scan
  • 聚左旋乳酸可吸收肋骨钉治疗重症肋骨骨折患者的适应证探讨

    摘要: 目的 探讨聚左旋乳酸可吸收肋骨钉治疗重症肋骨骨折患者的适应证,总结其应用经验。 方法 2005年6月至2008年8月,我科对46例(男31例,女15例;年龄15~61岁,平均年龄38岁)合并多根多段肋骨骨折、连枷胸、大出血和胸内外复合伤患者行开胸手术治疗,根据骨折特点分类,用聚左旋乳酸可吸收肋骨钉固定骨折肋骨,同时处理相应的胸内外复合伤。 结果 围术期死亡1例,术后第3 d死于突发腹腔大出血。44例患者术后胸壁稳定,自主呼吸,排痰良好。随访45例,随访时间6个月~3年,随访期间有39例胸壁稳定,胸部X线片示:固定处无透明带,对位愈合良好;有4例患者出现可耐受的胸痛;7例患者有13处固定后肋骨移位,分别出现在gt;3 cm劈裂或斜形骨折、老年皮质较薄、多发性肋软骨骨折和双侧肋骨骨折患者中。 结论 断面相对较整齐有移位的横形骨折、3cm以内较短的劈裂或斜形骨折、合并线性胸骨骨折是采用可吸收肋骨钉固定骨折肋骨首选的适应证;对粉碎性骨折和gt;3 cm较长的劈裂斜形骨折,不宜采用;软骨部、老年骨皮质较薄骨折应慎重选用。

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • 中老年继发孔型房间隔缺损的外科治疗

    目的 总结中老年(年龄≥40岁)继发孔型房间隔缺损的外科治疗经验。 方法 回顾性分析昆明市延安医院2000年1月至2007年9月手术治疗89例年龄大于40岁继发孔型房间隔缺损患者的临床资料,年龄40~68岁(平均年龄47.8岁),其中上腔型房间隔缺损23例、下腔型房间隔缺损31例,中央型房间隔缺损29例,混合型6例。全组均在全身麻醉低温体外循环下施行手术,均予涤纶补片修补房间隔缺损,合并三尖瓣关闭不全者同期行三尖瓣成形术。 结果 全组无死亡及严重并发症发生,术后平均住院时间13 d(9~37 d),术后1周复查右房室内径较术前明显缩小,随访3个月~8年,心功能及健康状况良好。 结论 中老年继发孔型房间隔缺损手术治疗效果良好;如无介入封堵术指征或伴中度以上三尖瓣关闭不全者均应手术治疗,补片修补及术中积极处理合并的三尖瓣关闭不全有利于术后恢复。

    Release date:2016-08-30 06:05 Export PDF Favorites Scan
  • Bidirectional superior cavopulmonary anastomosis

    Bidirectional superior cavopulmonary anastomosis(BCPA)is a palliative method used in the single ventricular repair. It mainly includes bidirectional Glenn shunt and hemi-Fontan operation. The indications of BCPA are those as an intermediate option of total cavopulmonary anastomosis, partial biventricular or 1 1/2 ventricle repair and a practical approach to complex congenital heart surgery. The choise of age,influence on pulmonary artery maturation,remain of additional pulmonary flow,formation of collaters and time to Fontan are demand of study.

    Release date:2016-08-30 06:28 Export PDF Favorites Scan
  • 心肾联合移植的现状

    对同时患有终末期心脏和肾脏疾病的患者,心肾联合移植(CHKT)是一种切实可行的选择,术后疗效良好.该手术的适应证为合并由器质性肾脏疾病导致的肾功能衰竭的心脏移植患者,合并严重心功能不全的肾移植患者.CHKT术后心脏移植排斥发生率较单纯心脏移植术低,但机制尚不确定;肾移植排斥发生率较单纯肾移植术显著降低,这可能与较短的冷缺血时间和较强的免疫抑制治疗有关.行CHKT患者的生存率与单纯心脏移植者无明显差别.若严格把握手术适应证,CHKT术可在临床上安全、合理地应用,但移植物和患者的长期存活率还有待多中心的进一步观察.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 食管金属支架治疗食管良、恶性狭窄

    目的 通过对124例食管良、恶性狭窄患者的治疗,探讨食管金属支架治疗的临床效果、适应证、并发症以及治疗过程中存在的问题.方法 食管狭窄患者在内窥镜和食管X线透视下进行食管金属支架治疗.分别置入镍钛记忆合金支架83例次,带膜不锈钢支架47例次.结果 金属支架操作均一次性完成,位置良好,支架扩张内径1.2~1.6cm,吞咽困难程度由术前的3.35%下降至1.05%,患者恢复正常饮食.并发症为下胸痛、反流性食管炎、上消化道出血等,无食管穿孔和手术死亡.结论 食管金属支架治疗食管狭窄操作简单、效果确切,能提高晚期食管癌、贲门癌患者的生存质量,但对贲门失弛缓症等良性疾患的金属支架治疗需慎重,要掌握适应证.

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • INTERNAL FIXATION TREATMENT OF MULTIPLE RIB FRACTURES WITH ABSORBABLE RIB-CONNECTINGPINS/

    Objective To study the indications, methods, and therapeutic effect of absorbable rib-connecting-pins fixation in the treatment of multi ple rib fractures. Methods Between March 2007 and September 2009, 40 patients with multiple rib fractures received internal fixation with absorbable rib-connecting-pins, including 8 one-side flail chest and 1 twoside flail chest. There were 32 males and 8 females with an average age of 39.8 years (range, 25-72 years). The injury was caused by traffic accident in 32 cases, fall ing from height in 6 cases, and blunt hitting in 2 cases. Preoperatively, imaging data of the chest X-ray or spiral CT three-dimensional (3D) examination showed that all patients had multiple ribs fractures and displacement. The number of fractured ribs was 4-10 (median, 6), and the fracture location ranged from the 2nd to the10th ribs. Of them, 28 cases were accompanied by hemathorax, pneumathorax or hemopneumothorax; 5 cases by thoracic organ injury; and 10 cases byother part trauma. The time from injury to hospital ization was less than 1 day in 26 cases, 1-3 days in 12 cases, and 3-6 days in 2 cases, and the time from hospital ization to operation was 3 hours to 3 days (mean, 1.2 days). Results The median fixation rib number was 5 (range, 3-8). The mean operative time, the time in bed, and hospital ization days were 32 minutes (range, 15-50 minutes), 4.5 days (range, 2-7 days), and 11.2 days (range, 5-18 days), respectively. All incisions healed by first intention. No pulmonary infection, pulmonary atelectasis, intrathoracic infection or other compl ications occurred. All cases were followedup 6-12 months (mean, 8 months). PaO2 [(86.6 ± 2.2) mmHg (1 mm Hg=0.133 kPa)] and SpO2 (97.2% ± 0.6%) at 2 hours after operation were obviously improved when compared with preoperative ones [PaO2 (53.6 ± 4.7) mm Hg and SpO2 (86.2% ± 1.8%)], showing significant differences (t=2.971, P=0.005; t=2.426, P=0.020). The chest X-ray films or spiral CT 3D indicated that fracture of rib healed within 3-6 months (mean, 4.5 months) after operation. Conclusion Severe collapsed chest wall orflail chest caused by fracture of multiple ribs should be treated by absorbable rib-connecting-pins, which is a simple, firm, and effective method.

    Release date:2016-08-31 05:41 Export PDF Favorites Scan
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