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find Keyword "联合手术" 7 results
  • Combined Splenorenal Shunt with Portoazygos Devascularization for Portal Hypertension

    Objective To evaluate the effects of combined splenorenal shunt with portoazygos devascularization for portal hypertension. MethodsA retrospective analysis of the clinical data of combined splenorenal shunt with portoazygos devascularization for portal hypertension in 58 cases was made. They were 41 male, 17 female and average age was 42.5 and posthepatitic liver cirrhosis in 51 cases, schistosomiasis cirrhosis in 7 cases, and Child A in 26 cases, B in 28, C in 4. There was selective operation in 39 cases (Child A 20, Child B 18, Child C 1), early operation in 10 (Child A 3, Child B 6, Child C 1) and emergency operation in 9 (Child A 3, Child B 4, Child C 2).ResultsAll but two (3.4%) Child C cases died after emergency operation, the others recovered. Esophagus varicoses disappeared or had a great improvement in all cases. There were liver function damage with different degree in 19 cases and subdiaphramatic effusion or infection or pleural effusion in 23 and all were cured by conservative therapy. Followed up for 5-10 years in 48 cases, there were rebleeding in 2 cases (3.5%) and postmeal encephalopathy in 2 (3.5%).ConclusionCombined splenorenal shunt and portoazygos devascularization are the first choice for portal hypertension at present.

    Release date:2016-08-28 05:11 Export PDF Favorites Scan
  • COMBINED ANTERIOR AND POSTERIOR SURGERIES FOR LUMBARSACRAL JUNCTION TUBERCULOSIS

    To explore the advantage and indication of combined anterior and posterior surgeries for lumbarsacral junction tuberculosis. Methods Eleven cases of the lumbarsacral junction tuberculosis were treated with combined anterior (radical debridement and autograft) and posterior (instrumentation and fusion) surgeries in one stage between January 2002 and December 2006. There were 9 males and 2 females with the age of 20-56 years old. The courseof disease was 4 to 15 months, 6 months on average. The lessons were located at L5, S1 in 7 patients, at L4,5, S1 in 2 patients and at L5, S2 in 2 patients. The involved vertebral bodies were at 2 segments in 7 patients; and 3 segments in 5 patients. The preoperative kyphosis was 5 to 8° with an average 9°. The sinus was associated in 3 patients, 3 patients had radiculopathy; 4 had paeumonophthisis and 9 had abscess. Results The followed-up period was from 6 months to 3 years, 18 months on average. According to Chen score, among the 11 cases, there were excellent in 9, good in 2. All incisions were healed up primarily. After operation, spinal fusion was achieved in 10 cases within 5 months to 7 months, 6 months on average, and pseudoarthrosis in 1 case was found by the CT examination. The postoperative kyphosis was 0 to 4° with the mean of 2° and the radiculopathy in 3 cases all got nerve function recovery. Conclusion Lumbarsacral junction tuberculosis treated with this surgical technique can achieve a high satisfactory rate with restoring the spinal stabil ity, arresting the disease early, providing early fusion, correcting the kyphosis and preventing progression of kyphosis particularly if lumbosacral spine tuberculosis is associated with sinus or preoperative diagnosis cannot exclude suppurative spondyl itis.

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • MODIFIED POSTERIOR-ANTERIOR OPERATION FOR TREATMENT OF SERIOUS LUMBAR FRACTURE ANDDISLOCATION

    Objective To evaluate the cl inical outcomes of modified posterior-anterior operation in the treatment of serious lumbar fracture and dislocation. Methods From January 2002 to February 2006, 24 patients, 17 males and 7 females aged 22-69 years, underwent reduction of posterior spatium intermuscular approach combined with modified anterioroperation. Nine cases were caused by fall ing and 15 by traffic accident, involving: L1 in 5 cases, L2 in 10 cases, L3 in 4 cases, L4 in 2 case, L1,2 in 1 case and L3,4 in 2 cases. According to the Frankel grade, there were 5 cases for grade A, 11 for grade B, 7 for grade C and 1 for grade D. The recovery of neurological function was evaluated. The imageology examination was appl ied to evaluate the condition of internal fixation and bone union. The Cobb’s angle was measured by X-ray film before operation, 3 days after operation and at the final follow-up, and the difference was estimated. Results Nineteen patients were followed up for 8-52 months, 28.4 months on average. Among the 2 cases of grade A, one improved to C and the other had no improvement. Among the 9 cases of grade B, 5 improved to C, 2 improved to D, and other two had no improvement. Among the 7 cases of grade C, 5 improved to D and 2 improved to E. One case of grade D improved to E. The average Cobb’s angle was (—11.5 ± 4.6)° preoperatively, (4.2 ± 4.7)° 3 days after operation and (4.0 ± 4.8)° at the final follow-up, indicating there was a significant difference between preoperation, 3 days after operation and the final follow-up (P lt; 0.001), but no significant difference between 3 days after operation and the final follow-up (P gt; 0.05). The position of internal fixation was good during follow-up. The compl ications such as disruption, loosening and collapse were not observed. Conclusion Reduction of posterior spatium intermuscular approach combined with modified anterior operation in the treatment of serious lumbar fracture and dislocation could complete the reduction, decompression, grafting and internal fixation in one stage, and protect the paraspinal soft tissue and minimize the trauma caused by surgery. It has the merits of short time of operation, small amount of intraoperative hemorrhage, sol id union of internal fixation and satisfactory cl inical outcome.

    Release date:2016-09-01 09:16 Export PDF Favorites Scan
  • Clinical Analysis of 98 Cases of Combined Laparoscopic Procedures

    目的探讨腹腔镜联合手术的优越性和临床应用价值。方法回顾性分析2005年6月至2010年6月期间在我院行腹腔镜联合手术的98例患者临床资料。结果98例均顺利完成联合手术,无中转开腹。一期胆总管缝合病例中有2例患者术后第2天出现漏胆,3 d后停止,超声检查无异常、拔管出院。所有患者平均下床活动时间13 h,随访3~48个月(平均35个月),无严重并发症发生。结论腹腔镜联合手术能安全、有效地处理腹腔内多个病灶,扩大了腹腔镜的手术领域,值得推广。

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
  • The Clinical Value of Combined Laparoscopic Cholecystectomy for General and Gynecologic Surgery

    ObjectiveTo investigate the feasibility and advantages of general laparoscopic cholecystectomy and gynecologic uterus and attachment surgery at the same time. MethodsSixty patients with gallbladder stones combined with ovarian cysts, benign gynecological disease or fallopian tube adhesions aged between 35 and 55 were chosen from the department of General Surgery and Gynecology and Obstetrics to be the study subjects between January 2009 and December 2013. The inclusion criteria included: gallbladder stones; gallbladder wall thickness <0.5 cm; non-acute inflammation; symptomatic gynecological diseases; and tumor size between 5.0 and 10.0 cm. Based on similar age, body mass, and histological type, the patients were divided into laparoscopic surgery (GLS) group and staging surgery group (control group) according to the will of the patients. The anesthesia time, surgery time, the number of abdominal perforations, length of hospital stay, and total costs were detected for comparison between the two groups. ResultsThe first-time operation was successful in all the patients in the CLS group, with two cases of abnormal liver function, which were cured within 5-6 days. In the control group, 2 cases of reoperation were transferred to laparotomy due to umbilical and peritoneal adhesions, and both of them were cured and discharged from hospital without incision infection or iatrogenic tissue and organ damage. CLS group had significant advantages in anesthesia time, surgery time, the number of abdominal perforations, length of hospital stay, and total costs over the control group (P<0.05). ConclusionThe combined gynecologic laparoscopic surgery is feasible, safe, mini-invasive, and economical.

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  • 主单髂支架植入联合股股动脉转流复合技术治疗复杂腹主动脉病变

    目的总结主单髂支架植入联合股股动脉转流复合技术治疗复杂腹主动脉病变的疗效。 方法2004年1月-2012年9月,采用主单髂支架植入联合股股动脉转流复合技术治疗复杂腹主动脉病变12例。其中男9例,女3例;年龄36~79岁,平均61.7岁。病程4h~30d,中位时间10d。腹主动脉下腔静脉瘘2例,多发性腹主动脉及髂动脉瘤1例,腹主动脉瘤合并一侧髂动脉严重狭窄3例,腹主动脉瘤合并一侧髂动脉严重扭曲1例,腹主动脉瘤合并远端瘤颈夹层1例,Schumacher分型为Ⅱa型腹主动脉瘤且远端瘤颈狭窄2例,急诊腹主动脉瘤破裂2例。 结果患者均痊愈出院,未出现手术并发症。12例均获随访,随访时间3个月~7年,中位时间52个月。腹主动脉CT血管造影检查示支架位置良好,动静脉瘘消失,动脉瘤瘤体隔绝良好,无内漏,双侧股动脉转流吻合口通畅、无狭窄。随访期间无再发腹主动脉瘤及动静脉瘘,双下肢血供正常。 结论主单髂支架植入联合股股动脉转流复合技术治疗复杂腹主动脉病变具有较好的手术安全性和成功率,临床疗效满意。

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  • 单侧双通道脊柱内镜下后方减压联合颈椎前路椎间盘切除融合术治疗多节段混合型颈椎病二例

    目的 总结单侧双通道脊柱内镜下颈椎后路椎间孔切开减压术(unilateral biportal endoscopic posterior cervical foraminotomy,UBE-PCF)联合颈椎前路椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF)治疗2例多节段混合型颈椎病的经验。方法 2022年2月及3月收治2例多节段脊髓型颈椎病、神经根型颈椎病及退行性颈椎滑脱患者。男、女各1例;年龄分别为59、66岁。患者上肢感觉减退、Hoffmann征阳性,影像学检查示颈椎不稳、椎间盘突出以及左侧椎间孔狭窄。全身麻醉下对相应病变节段行ACDF以及UBE-PCF。结果 2例手术时间分别为186、145 min,术后切口Ⅰ期愈合。患者均获随访3个月。术后2 d及3个月疼痛视觉模拟评分(VAS)、颈椎功能障碍指数(NDI)均较术前下降,日本骨科协会(JOA)评分较术前上升。影像学复查示治疗节段神经减压彻底,未出现颈椎不稳。结论 对于伴退行性颈椎滑脱的多节段混合型颈椎病,ACDF联合UBE-PCF能选择性处理不同节段病变,最大程度保留脊柱功能,获得良好近期疗效。

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