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find Author "闫开旭" 2 results
  • 胸壁入路腔镜甲状腺手术中喉返神经的显露与保护

    目的探讨胸壁入路腔镜甲状腺手术中喉返神经显露的技巧,预防喉返神经医源性损伤。 方法回顾性收集2013年8月至2014年12月期间于兰州军区兰州总医院行胸壁入路腔镜甲状腺手术的45例患者的临床资料。手术时利用甲状腺下动脉、气管食管沟及甲状软骨下角显露喉返神经。 结果45例患者中,行单侧腺叶大部切除18例,行单侧腺叶切除22例,行双侧腺叶大部切除5例;手术时间108~125 min、(120±7)min,术中出血量18~25 mL、(23±4)mL。术后均无不适,无并发症发生。术后所有患者均获访,随访时间6~12个月,平均9个月。随访期间出现甲状腺功能减退2例,其余均正常,且2例甲状腺乳头状癌患者均未复发。 结论术中显露喉返神经有利于避免喉返神经损伤。

    Release date:2016-12-21 03:35 Export PDF Favorites Scan
  • Clinical Study of Early Oral Feeding after Laparoscopic Radical Distal Gastrectomy

    ObjectiveTo investigate safety and feasibility of early oral feeding after laparoscopic radical distal gastrectomy. MethodsOne hundred and fifty patients with gastric cancer admitted to hospital from May 2015 to Feb-ruary 2016 were divided into early oral feeding (EOF) group and traditional feeding (TF) group by a randomized contro-lled way. The relevant postoperative indicators, including postoperative complications (wound infection, inflammatory intestinal obstruction, anastomotic leakage, pulmonary infection, gastric retention), feeding tolerance (nausea, vomiting, and reinserting of gastric tube), nutritional status (serum albumin, prealbumin), immune function (IgA, IgG, IgM), recovery of gastrointestinal function (postoperative the first anal exhaust time and defecation time), hospitalization time, and hospitalization expenses, were observed and analyzed. Results① One hundred and thirty-nine patients were included in this study, there were 72 cases in the EOF group, 67 cases in the TF group. The gender, age, boby mass index, etc. had no statistic significances between these two groups (P>0.05). ② All the patients of the two groups were cured and discharged, no patients died during perioperative period. The postoperative the first anal exhaust time, defecation time, and hospitalization time of the EOF group were significantly less than those of the TF group (P<0.05). The operative time, intraoperative blood loss, and postoperative hospitalization expenses had no significant differences between these two groups (P>0.05).③ The levels of serum albumin, prealbumin, and IgA on day 7 after operation in the EOF group were significantly higher than those in the TF group (P<0.05). The levels of IgG and IgM on day 7 after operation had no significant differences between these two groups (P>0.05). ④The tolerance rates of oral feeding of the EOF group and TF group patients was 91.7% (66/72) and 94.0% (63/67) respectively, the difference was not statistically significant (χ2=0.044, P=0.833). While 2 patients needed to be inserted gastric tube again due to nausea and abdominal distention in the EOF group, the symptoms were cured with conservative treatment about 3 d.⑤ The postoperative complications of the EOF group were 10 cases, TF group were 10 cases, the difference was not statistically significant (χ2=0.173, P=0.677). And postoperative complications were cured and discharged after active conservative treatment. Postoperative follow-up of 102 (102/139) cases were completed, follow-up time was 1-6 months, no patients admitted to hospital again for postopera-tive complications. ConclusionEarly oral feeding after laparoscopic radical distal gastrectomy is safe and feasible, which don't only increase incidence of complications, but also improve nutritional status of patients, and promote recoveries of immune function and intestinal function, and shorten postoperative hospitalization time.

    Release date:2016-11-22 10:23 Export PDF Favorites Scan
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