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find Keyword "小切口" 97 results
  • Effects of Laparoscopic and Minilaparotomy Approaches to Rectal Cancer on Cellular Immune Functions

    目的 探讨腹腔镜与小切口直肠癌根治术对患者机体细胞免疫功能的影响。方法 选取2010年1月至2011年6月期间我院行腹腔镜及小切口直肠癌根治患者102例,其中腹腔镜组53例,小切口组49例。 采用流式细胞仪测定患者术前1d及术后第1及第5天外周血中CD3、CD4+、CD8+、CD19及NK细胞比例的变化,研究不同手术方式对患者细胞免疫功能的影响。结果 术后第1及第5天,腹腔镜组和小切口组患者的CD3、CD4+、CD8+、CD19及NK细胞比例(数)均较术前明显降低(P<0.05)。同腹腔镜组比较,小切口组术前及术后CD3、CD4+、CD8+、CD19及NK细胞比例(数)的差异均无统计学意义(P>0.05)。结论 腹腔镜与小切口直肠癌根治对患者机体细胞免疫功能的无明显影响。

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  • Appendectomy Through Mini-Incision: Experience in 247 Cases

    目的通过对247例小切口阑尾切除术临床体会的总结,探讨以小切口作阑尾切除术的优点、手术适应证、禁忌证以及手术注意事项。方法对247例小切口阑尾切除术病例在手术要点、手术时间、切口长度、术后恢复情况、并发症等方面进行分析,结合文献资料加以总结。结果在手术中开腹、寻找阑尾及关腹均有其特定要求; 手术时间平均18 min,术后拆线及术后住院时间平均分别为4.8 d和4.6 d; 伤口愈合: 甲级235例,乙级9例,丙级2例。结论小切口阑尾切除术具有切口小、外观美、创伤小、恢复快以及经济节省、加快病床周转等诸多优点,是一个值得推广的手术。

    Release date:2016-08-28 04:20 Export PDF Favorites Scan
  • Treatment of Incarcerated Circular Mixed Hemorrhoid by Small Incision, External Dissection and Internal Ligation and Sclerosing Agent Injection (Report of 30 Cases)

    目的 探讨嵌顿环状混合痔的手术治疗方法。 方法 回顾性总结我院1998年1月至2002年1月采用小切口外剥内扎硬注术治疗嵌顿环状混合痔30例临床经验。 结果 30例患者手术过程顺利,手术时间平均50 min,平均住院时间10 d,术后并发肛门Ⅰ度水肿4例,术后当天排尿困难1例,经对症治疗后痊愈出院。本组病例术后随访1年均无复发。 结论 该术式能迅速减轻患者痛苦,且疗效满意。

    Release date:2016-08-28 04:43 Export PDF Favorites Scan
  • Unilateral Exploration in Primary Hyperparathyroidism (Report of 26 Cases)

    目的探讨原发性甲状旁腺机能亢进(PHPT)小切口单侧探查的适应证和探查经验。方法对我科1992年1月至2001年12月所作的26例小切口单侧探查病例的临床病理资料进行回顾性分析。结果小切口单侧探查26例,成功25例。结论对诊断明确且准确定位者先采取定位侧小切口; 冰冻切片证实为甲状旁腺肿瘤,且病理学特点与其临床表现、实验室检查和定位诊断相符者可仅行单侧探查。

    Release date:2016-08-28 04:49 Export PDF Favorites Scan
  • Comparison between Minimally Invasive Mitral Valve Replacement via Right Minithoracotomy and Traditional Mitral Valve Replacement

    Objective To compare clinical outcomes and safety between minimally invasive mitral valve replacement via right minithoracotomy (mini-MVR) and traditional mitral valve replacement (MVR). Methods Clinical data of 68 patients with valvular heart diseases who underwent mini-MVR from February 2009 to December 2011 in Wuhan Asia Heart Hospital were retrospectively analyzed. There were 36 males and 32 females in this mini-MVR group with their mean age of 34.2±11.2 years. Preoperatively, there were 21 patients with mitral stenosis (MS), 17 patients with mitral insufficiency (MI), 30 patients with MS and MI, and 19 patients with tricuspid insufficiency (TI). Another 200 patients with valvular heart diseases who underwent traditional MVR during the same period were included as the control group. There were 86 males and 114 females in the control group with their mean age of 49.4±13.2 years. Preoperatively, there were 85 patients with MS, 66 patients with MI, 49 patients with MS and MI, and 76 patients with TI. Hospital mortality, aortic crossclamp time, length of intensive care unit (ICU) stay, postoperative chest tube drainage, reexploration for bleeding and postoperative morbidities were compared between the two groups. Results There was no in-hospital death in the mini-MVR group. There was no statistical difference in hospital mortality, cardiopulmonary bypass time, incidence of reexploration for bleeding, postoperative arrhythmias, dialysis-requiring acute renal failure and wound infection between the two group (P>0.05). Aortic crossclamp time of the mini-MVR group was significantly longer than that of the control group. But postoperative mechanical ventilation time (10.2±3.1 h vs. 15.2±7.1 h, P=0.008), chest tube drainage(92.0±28.0 ml vs. 205.0±78.0 ml, P=0.000), blood transfusion (0.8±1.6 U vs. 1.9±2.1 U, P=0.006), length of ICU stay (14.0±8.0 h vs. 26.0±12.0 h, P=0.003) and length of hospital stay (14.8±4.6 d vs. 19.7±3.2 d, P=0.006)of the mini-MVR group were significantly shorter or less than those of the control group. Conclusion The safety of mini-MVR is comparable to that of traditional MVR without causing higher postoperative morbidities, while the postoperative recovery after mini-MVR is better than traditional MVR.

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
  • 右侧开胸小切口清除多次心脏术后感染性心内膜炎赘生物一例

    Release date:2016-08-30 05:46 Export PDF Favorites Scan
  • Quality of Life after Video-assisted Thoracoscopic Surgery or Minimal Incision Thoracotomy for Early Stage Non small Cell Lung Cancer : A Prospective, Randomized Controlled Trial

    Abstract: Objective To evaluate video-assisted thoracic surgery(VATS)and minimal incision thoracotomy(MIT)lobectomy for early stage non-small cell lung cancer patients and the impact upon postoperative quality of life(QOL). Methods A prospective randomized controlled trial was conducted. From January 1, 2008 to December 10, 2011, the qualified patients with early stage NSCLC were recruited and randomized to VATS group (57 patients)and MIT group(49 patients), totally 106 patients,57 males and 49 females, aged 57.60 years. The quality of life was assessed using Lung Cancer Symptom Scale (LCSS) before operation and at 1,3,6,9,12 months after operation. Results There were no significant differences between the 2 groups in age, sex, the location of tumor, tumor pathologic stage, pathological types, postoperative complications, tumor size, operative time, operative bleeding and air leak days. There were no symptoms after operation at the VATS group worse than the leve before operation. Five major symptoms, including appetit(1.04±0.71 vs.2.00±0.83, F=6.357,P=0.021), fatigue (4.55±1.17 vs.10.19±2.10, F=4.721,P=0.043), dyspnea(2.18±0.86 vs.10.26±2.05, F=10.020,P=0.005), normal activity(5.16±1.70 vs.17.60±3.17, F=12.319,P=0.002)at the MIT group were deteriorated significantly at 1 month after the operation (P<0.05). Conclusion The VATS will lead to better quality of life for the patients with early stage NSCLC after surgery and lead to a smooth postoperative recovery.

    Release date:2016-08-30 05:49 Export PDF Favorites Scan
  • 右腋下小切口体外循环心内直视手术270例

    目的 总结右腋下小切口在常见先天性心脏病手术中的应用经验。 方法 回顾性分析济宁医学院附属医院2009年10月至2011年6月采用右腋下小切口经第4肋间进胸,在体外循环下施行心内畸形矫治手术270例患者的临床资料,其中男132例,女138例;年龄3个月~9岁 (3.0±1.6) 岁,行室间隔缺损(VSD)修补术132例,房间隔缺损(ASD)修补术50例,ASD修补术+部分型肺静脉异位引流(PAPVC)矫治术12例,部分型房室管畸形(PECD)矫治术15例,VSD+ASD修补术26例,法洛四联症根治术35例。 结果 全组无手术死亡,无二次开胸止血,平均住院时间9 d,平均住ICU 1.6 d。发生右肺不张3例,右侧气胸2例,阵发性室上性心动过速1例,Ⅱ°房室传导阻滞1例。术后全部患者均获得随访,随访时间1~16个月,随访期间3例VSD术后发生小于2 mm的残余漏,其余患者恢复良好。 结论 对具有该术式适应证的患者经右腋下小切口行心内直视手术,有安全可靠、创伤小、美观等优点。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 微创小切口肋骨内固定术治疗多根多处肋骨骨折及连枷胸

    目的 总结微创小切口肋骨内固定术治疗多根多处肋骨骨折及连枷胸的临床经验。 方法 回顾性分析2009年1月至2010年1月上海交通大学附属第六人民医院奉贤分院54例胸部创伤患者行爪型钛板微创小切口肋骨内固定术的临床资料,其中男39例,女15例;平均年龄48.7 (19~75)岁。4例患者入院即刻手术,50例于入院1~9 d内手术。手术方式:行单纯肋骨内固定手术34例,同期固定胸骨2例,行肺修补手术6例,膈肌修补术1例,肺叶切除术1例,心包开窗手术1例,骨科手术9例。经肩胛骨下、内侧切口手术16例,侧胸壁切口手术31例,前胸壁切口手术7例。切口长度4~20 cm,肋骨骨折固定范围第2~12肋骨。 结果 本组患者无死亡,均在术后1~3 d内拔除气管内插管,全部治愈出院。术后发生肺部感染4例,气管切开1例,精神障碍1例,经相应的处理治愈。平均住院时间20.6 (12.0~38.0) d。术后随访47例。随访时间3~6个月,骨折全部愈合,无肋间神经压迫症状,患者恢复正常生活和工作;失访7例。 结论 采用爪型钛板进行肋骨内固定,不苟于传统,根据骨折部位采用微创小切口,钛板不接触骨折处,不破坏骨折处局部血运,不影响骨折愈合,可对包括第2肋骨在内的所有部位的肋骨骨折进行内固定。如骨折处位于胸骨或胸椎体结合部,则不宜用钛板固定。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 右侧腋下小切口先天性心脏病直视手术的临床应用

    目的 总结右侧腋下小切口心脏直视手术临床应用的经验。 方法 回顾性分析2010年5月至2011年8月大坪医院采用右侧腋下小切口施行心脏直视手术83例先天性心脏病患者的临床资料,其中男27例,女56例;年龄7个月~59 (8.0±9.1)岁;行房间隔缺损修补术21例(心脏不停跳18例、同期行三尖瓣成形术3例、二尖瓣成形术1例),行室间隔缺损修补术60例(同期行右心室流出道疏通术4例),完全性肺静脉异位引流矫治术1例,右心室双出口矫治术1例。 结果 全组患者均顺利完成手术,体外循环时间21 ~ 185 (66.9±32.3) min,升主动脉阻断时间5 ~ 122 (32.5±25.5) min。 早期死亡1例(1.2%),死亡原因为低心排血量。门诊随访80例,失访3例。无残余漏、Ⅲ○房室传导阻滞等并发症发生。 结论 右侧腋下小切口选择性应用于先天性心脏病直视手术,安全可靠、创伤小,切口美观;但应强调适应证的合理选择、充分的术野显露、可靠的体外循环以及术中准确的手术操作。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
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