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find Author "王军" 58 results
  • 4岁小儿瓣膜置换术后低心排血量左心转流治疗一例

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • Clinical Application of Pedicle Screw System in Thoracic and Lumbar Fractures of Patients for Wenchun Earthquake

    目的:探讨后路椎弓根螺钉固定在地震伤胸腰椎骨折中的应用及优点。方法:对19例胸腰椎骨折的地震伤患者行后路椎弓根螺钉内固定术。结果:本组病例的手术时间70~115分钟,平均出血量约280mL,两例病员术中出血超过400mL进行输血,复位椎体前缘高度由术前平均57.5%恢复到术后平均93.6%,后突角由术前平均21°矫正到术后平均3°,术后3~7天转往外地继续治疗,Frankel分级平均提高0.4。结论:后路椎弓根螺钉固定具有省时、节约医疗资源、提高救治效率、减轻患者痛苦的优点,尤其适用于大批伤病员的紧急救治。

    Release date:2016-09-08 10:01 Export PDF Favorites Scan
  • Steel Wire Internal Fixing Sternal Fractures through Midsternal Incision Approach: A Clinical experience of 16 Patients

    目的探讨钢丝缝合固定胸骨骨折的治疗效果。 方法回顾性分析2010年1月至2014年12月我院使用钢丝缝合固定胸骨骨折患者16例的临床资料,其中男15例、女1例,年龄30~74(46.3±7.1)岁,采用胸部正中切口达骨折处,上下骨折端适当游离后,用成人型带针钢丝从下骨折端缝入2针,翻转上下骨折端后从上骨折端对应部位出针,骨折复位后扭紧钢丝,14例单处骨折均用此法固定,2例2处骨折用8字缝合固定。 结果16例患者均治愈,术后骨折部疼痛明显减轻,切口愈合良好。单纯性胸骨骨折手术时间50~90(68.46±12.31)min,手术费4 414~6 765(5 495.77±786.36)元。骨折复查发现1例对位稍差,其余患者对位对线均良好,无钢丝断裂及钢丝割裂胸骨病例。 结论钢丝缝合固定能快速恢复胸廓的稳定性,方法简单、安全、费用低、效果好,值得在基层医院推广应用。

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  • Exploration and practice of performance management system for day surgery

    As an advanced mode of diagnosis and treatment, day surgery is widely carried out in foreign countries. Although it started late in China, it has been gradually valued and vigorously promoted in medical and health field in recent years. The effective implementation of day surgery in hospital cannot be separated from the strong support of performance management system. Through introducing the performance management experiences in promoting day surgery mode in West China Hospital of Sichuan University, this article discusses how to construct an effective whole-course performance management system for day surgery combined with operation management through three mechanisms: the management committee mechanism, the operation management mechanism and the performance assessment mechanism, which are based on the structure-process-outcome dimensions of quality management system, at the three levels of hospital, department and position, so as to provide a reference for developing day surgery in China.

    Release date:2020-03-25 09:12 Export PDF Favorites Scan
  • 开放前热血加甘露醇灌注在危重心脏瓣膜疾病患者术中的应用

    目的 为了较好地进行心肌保护,研究主动脉开放前热血加甘露醇灌注在危重心脏瓣膜病患者体外循环术中的应用。 方法 选取我院1998年6月~1999年6月间80例心脏瓣膜病患者,随机分为实验组和对照组,每组各40例,常规行二尖瓣和/或主动脉瓣置换术。两组均采用中度低温含血心肌保护,实验组于主动脉开放前给予热血加甘露醇灌注。比较两组患者体外循环术后心功能恢复情况。 结果 在自动复跳率、主动脉开放后体外循环时间、24小时内心排血指数恢复速度、肌酸激酶下降幅度等指标实验组明显优于对照组(P<0.05),在术后呼吸机支持时间、ICU滞留时间、正性肌力药物使用率、手术死亡率等方面两组无明显差异(P>0.05)。 结论 主动脉开放前热血加甘露醇灌注能明显减轻再灌注损伤,加快术后早期心功能恢复。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • NCCN 食管和食管胃结合部癌临床实践指南 2018 V1 版主要更新点解读

    Release date:2018-07-27 02:40 Export PDF Favorites Scan
  • 全腔静脉-肺动脉连接术后肺循环无搏动血流对内皮素分泌的长期影响

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • Evaluation of Cardiopulmonary Bypass Technique in Treating Descending Aortic Aneurysms

    Objective To investigate the clinical effects and the brain protection effect of different cardiopulmonary bypass in treating descending aortic aneurysms. Methods From January 2001 to December 2008, 65 patients were diagnosed to have descending aortic aneurysm with magnetic resonance imaging (MRI) in our hospital. Among them, there were 56 males and 9 females whose age was between 15 and 71 years old with an average of 48.1 years. The disease process ranged from 6 days to 4 months (19.0±6.5 d ). Preoperative diagnosis showed that there were 41 cases of DeBakey type Ⅲinterlayer, 9 cases of Marfan syndrome with postoperative complications of type Ⅲ interlayer, 7 cases of pseudoaneurysm and 8 cases of true aneurysm. We adopted artificial blood vessel repair patch to repair the damaged point of the descending aorta in 2 cases, performed vascular aneurysm resection and artificial vessel replacement on 63 patients, and carried out descending aorta replacement and intercostal artery grafting in 18 cases. Results Among the 65 cases of cardiopulmonary bypass patients, there were 13 cases of left heart bypass, 12 cases of heart bypass, 30 cases of deep hypothermic circulatory arrest (DHCA) with total body retrograde perfusion (TBRP) and 10 cases of modified separate perfusion of upper and low body. Cardiopulmonary bypass time, DHCA time, retrograde perfusion time, upper body circulatory arrest time and low body circulatory arrest time were respectively 51-212 min, 18-75min, 18-73 min, 21-31 min, and 39-67 min. No death occurred during the operation, and there were no brain complications or complications of paralysis among all the patients. Two patients died after operation because of renal failure. Conclusion Good results can be achieved by selecting different method of cardiopulmonary bypass based on the anatomical location and range of the thoracic descending aortic aneurysms. The selection criteria should be favorable to the surgical operation and organ protection.

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • Application of Multi-slice Spiral CT in the Diagnosis of Gastrointestinal Perforation

    目的 探讨胃肠道穿孔的多层螺旋CT(MSCT)表现及诊断价值。 方法 收集2010年3月-2011年3月18例经手术证实为胃肠道穿孔患者的临床及MSCT资料,回顾性分析了胃肠道穿孔及穿孔部位的MSCT表现。 结果 18例患者中,MSCT明确诊断穿孔17例,对穿孔部位准确定位11例。其中术后诊断胃穿孔4例、十二指肠球部穿孔9例、小肠穿孔3例、结肠穿孔1例、阑尾穿孔1例。MSCT表现有腹腔游离气体,肠壁周围局限性积气、腹腔积液及肠袢积液、肠壁增厚、肠腔周围脂肪间隙密度增高(条纹征)。 结论 MS CT有利于显示腹腔游离气体、胃肠道穿孔部位及其肠壁周围的变化情况,对胃肠道穿孔术前的定性及定位诊断有较明显的优势 ,可为临床提供更多有价值的诊断信息。

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
  • Clinicopathological features and guiding significance for radiotherapy of pT1-2N1M0 breast cancer with different molecular subtypes

    Objective To investigate the prognostic differences and decision-making role in postoperative radiotherapy of four molecular subtypes in pT1-2N1M0 stage breast cancer. Methods The clinicopathological data of 1526 patients with pT1-2N1M0 breast cancer treated at West China Hospital of Sichuan University between 2008 and 2018 were retrospectively analyzed. χ2 test was used to compare the clinicopathological features among patients with different molecular subtypes. Kaplan-Meier survival analysis and log-rank test were used to draw the survival curves and compare the overall survival (OS) and breast cancer-specific survival (BCSS) among patients with different molecular subtypes. Cox regression model was used to determine the influencing factors of OS of patients after radical mastectomy. Results Among the 1526 patients with pT1-2N1M0 breast cancer, there were 674 cases (44.2%) of Luminal A subtype, 530 cases (34.7%) of Luminal B subtype, 174 cases (11.4%) of human epidermal growth factor receptor 2 (Her-2) overexpression subtype, and 148 cases (9.7%) of triple-negative subtype. The 5-year OS rates of Luminal A, Luminal B, Her-2 overexpression and triple negative patients were 98.6%, 94.3%, 95.5% and 91.2%, respectively (χ2=11.712, P=0.001), and the 5-year BCSS rates were 99.3%, 94.6%, 95.5% and 92.5%, respectively (χ2=18.547, P<0.001). Multiple Cox regression analysis showed that menstrual status [hazard ratio (HR)=0.483, 95% confidence interval (CI) (0.253, 0.923), P=0.028] and whether endocrine therapy [HR=2.021, 95%CI (1.012, 4.034), P=0.046] were prognostic factors for the 5-year OS rate of breast cancer patients after radical mastectomy (P<0.05). However, it failed to reveal that Luminal subtypes and postoperative radiotherapy were prognostic factors for the 5-year OS rate (P>0.05). Conclusions In pT1-2N1M0 breast cancer patients, the 5-year OS rate and 5-year BCSS rate in triple-negative patients are the lowest. The relationship between Luminal classification, postoperative radiotherapy and survival in patients after radical mastectomy needs further study in the future.

    Release date:2025-01-23 08:44 Export PDF Favorites Scan
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