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find Author "胡坚" 26 results
  • Current Status of Postoperative Pulmonary Complications

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  • 胸外科 ERAS 多环节全程管理体系的建立与实践

    Release date:2017-06-02 10:55 Export PDF Favorites Scan
  • 育龄女性心瓣膜置换术后的抗凝治疗

    目的 探讨心瓣膜置换术后抗凝治疗对妊娠分娩、月经量过多、避孕失败后人工流产手术等的影响,调整抗凝方案。方法 回顾我院1989年2月至1998年2月292例15~40岁育龄女性心瓣膜置换术后的抗凝治疗,术后随访时间0.5~9年,比较不同抗凝方案对育龄女性术后的生理影响。结果 调整育龄女性心瓣膜置换术后抗凝方案,减少华法林用量,调控凝血酶原时间比值(PTR)为1.3~1.5,国际正常比值(INR)为2~3(国际敏感指数ISI=2.4校正),既能有效预防血栓栓塞,又能提高术后妊娠分娩的安全性。结论 调整抗凝方案,减少华法林用量,能有效改善心瓣膜置换术后育龄女性的生活质量。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • Da Vinci Robotic Lung Segmentectomy and Thoracoscopic Lung Segmentectomy: A Case Control Study

    ObjectiveTo evaluate the curative and economic effect of da Vinci robotic lung segmentectomy. MethodWe retrospectively analyzed clinical data of 13 patients who underwent robotic lung segmentectomy (as a robotic group) and 35 patients who underwent thoracoscopic lung segmentectomy (as a thoracoscopic group) in our hospital between September 2014 and April 2015. There were 4 males and 9 females at age of 43-73 (59.1±8.9) years in the robot group and 17 males and 18 females in the thoracoscopic group at age of 30-79 (59.1+12.0) years. Effects of the two groups were compared. ResultsPostoperative hospitalization time in the robotic group was shorter than that in the thoracoscopic group (4.4±0.8 d vs. 6.3±2.5 d, P<0.05). But the cost of hospitalization in the robotic group was higher than that in the thoracoscopic group (P<0.05). The surgery indwelling catheter time and incidence of complications in the robotic group were lower than those in the thoracoscopic group with no statistical difference (P=0.053, 0.081). ConclusionRobotic lung segmentectomy is a safe and feasible operation method. With the further accumulation of clinical experience and decrease of the cost of materials, the robot will play a more important role in the future of minimally invasive thoracic surgery.

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  • Application and development of electromagnetic navigation bronchoscopy in the view of artificial intelligence

    The coming out of electromagnetic navigation bronchoscopy gives exciting solution for diagnosis and even treatment of peripheral pulmonary nodules. It breaks the barriers of traditional bronchoscopy, and gives live visible imaging guidance for operators during biopsy of peripheral pulmonary nodules. The electromagnetic navigation bronchoscopy system can intelligently recognize and reconstruct the bronchial tree of the patients, and generate visible data and virtual guidance for the operators. It can perceive real-time magnetic localization of the signal, so as to precisely guide the navigational or biopsy tools. This review introduced the artificial intelligence configuration of the electromagnetic navigation bronchoscopy system based on the Veran system, and gave some improvement advices based on the defects of the system. In this way, we hope to promote the development and better clinical application of electromagnetic navigation bronchoscopy system.

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  • Harmonic scalpel in thoracoscopic surgery for lung cancer: A case control study

    Objective To evaluate the clinical effects of harmonic scalpel application in thoracoscopic surgery for lung cancer, which may guide its reasonable application. Methods We retrospectively analyzed the clinical data of 145 lung cancer patients receiving thoracoscopic surgery from January to March 2017 in our hospital. There were 57 patients with thoracoscopic pulmonary wedge resection, and harmonic scalpel was used in 34 patients (8 males, 26 females at age of 59.68±10.91 years), and was not used in 23 patients (13 males and 10 females at age of 59.13±11.21 years). There were 88 patients receiving thoracoscopic pulmonary lobectomy, among whom harmonic scalpel was used in 80 patients (36 males and 44 females at age of 59.68±10.91 years), and was not used in 8 patients (5 males, 3 females at age of 61.63±5.60 years). We recorded the perioperative outcomes of all patients. Results In the 34 patients undergoing thoracoscopic pulmonary wedge resection by harmonic scalpe, the operation time was 90.09±43.52 min, the blood loss was 21.32±12.75 ml, the number of lymph nodes resected was 5.12±4.26, duration of drainage was 3.15±1.16 d, volume of drainage was 535.00±291.69 ml, the length of postoperative hospital stay was 4.56±1.40 d, and no postoperative complication was observed. In the 80 patients receiving thoracoscopic pulmonary lobectomy by harmonic scalpel, operation time was 131.88±41.82 min, blood loss was 42.79±31.62 ml, the number of lymph nodes resected was 13.54±8.75, duration of thoracic drainage was 4.47±2.30 d, drainage volume was 872.09±585.24 ml, the length of postoperative hospital stay was 5.81±2.26 d, and 20 patients had postoperative complications. No complication occurred in the 8 patients without harmonic scalpel. Conclusion Harmonic scalpel showed satisfactory effectiveness and safety in lung cancer thoracoscopic surgery.

    Release date:2017-12-29 02:05 Export PDF Favorites Scan
  • 胸腔镜纵隔手术中超声刀的规范及强化应用

    目的 探讨胸腔镜纵隔手术中超声刀的规范及强化应用的临床效果。 方法 回顾性分析本中心 2015 年 6 月至 2017 年 6 月胸腔镜纵隔手术中使用超声刀患者182例的临床病理资料,其中中转开胸 10 例,其余 172 例均在胸腔镜下成功完成手术,男 81 例、女 91 例,年龄(51.48±12.86)岁。 结果 2015 年 6 月至 2016 年 6 月中转开胸 7 例,1 例为超声刀相关的术中出血,强化超声刀技术性应用后 2016 年 7 月至 2017 年 6 月中转开胸 3 例。胸腔镜下使用超声刀行纵隔手术 172 例,手术时间(80.19±31.51)min,术中出血量(21.98±17.81)ml,胸腔引流管留置时间(2.81±1.04)d,胸腔引流量(338.05±204.64)ml,术后疼痛评分(2.39±0.86)分,术后住院时间(4.27±1.51)d,围手术期并发症 15 例(8.72%),超声刀相关并发症 2 例(1.16%)。 结论 在胸腔镜纵隔手术中规范使用超声刀对患者术后加速康复有积极作用,在规范应用基础上强化技术性应用可发挥超声刀更大作用。

    Release date:2017-12-29 02:05 Export PDF Favorites Scan
  • Clinical outcomes of harmonic scalpel in esophageal cancer surgery

    Objective To assess the outcome of harmonic scalpel (HS) in esophageal cancer surgery and to provide evidence for the role of HS in the enhanced recovery after surgery (ERAS) and short-term prognosis after esophageal cancer surgery. Methods We collected the clinical data of 81 esophageal cancer patients receiving surgery by HS between January 1 and December 31, 2016 and successfully followed up in our department. There were 67 males and 14 females with an average age of 64.07±7.52 years. Sweet approach was adopted in 16 patients, Ivor-Lewis approach in 23 and McKeown approach in 40. Intrathoracic anastomosis was completed in 41 patients and cervical anastomosis in 40. The length of total hospital stay and postoperative hospital stay, operation time, intraoperative blood loss, duration and volume of thoracic drainage and perioperative complications were recorded and compared in patients with different surgical approaches and anastomosis sites. Results For these 81 patients, the operation time was 276.7±70.4 min, and the intraoperative blood loss was 115.9±69.7 ml. The postoperative duration of thoracic drainage, postoperative complication rate and the drainage volume were 12.3±5.3 d, 35.80% and 1 411.9±1 199.5 ml, respectively. During the follow-up, 15 patients died and the cumulative survival rate was 81.48%. There was no obvious HS-related complication. The operation time of Sweet approach was shorter than that of Ivor-Lewis or McKeown approach (P=0.012) and the dissected lymph nodes were less in Sweet approach (P=0.035). There was no significant difference in perioperative indexes and postoperative short-term prognosis between intrathoracic anastomosis and cervical anastomosis. Conclusion HS is widely used in the surgery for esophageal cancer with safety and effectiveness, which is worthy of clinical application.

    Release date:2017-12-29 02:05 Export PDF Favorites Scan
  • Electromagnetic navigation bronchoscope-guided microwave ablation for treatment of peripheral pulmonary nodules

    Increasing peripheral pulmonary nodules are detected given the growing adoption of chest CT screening for lung cancer. The invention of electromagnetic navigation bronchoscope provides a new diagnosis and treatment method for pulmonary nodules, which has been demonstrated to be feasible and safe, and the technique of microwave ablation through bronchus is gradually maturing. The one-stop diagnosis and treatment of pulmonary nodules can be completed by the combination of electromagnetic navigation bronchoscopy and microwave ablation, which will help achieve local treatment through the natural cavity without trace.

    Release date:2020-07-30 02:16 Export PDF Favorites Scan
  • Prospect and hybridization of three-channel multi-mirror robot for early lung cancer diagnosis and treatment

    Nowadays, the development of the medical instrument industry makes rapid changes in clinical practice. Hybridization of latest technology is playing an increasingly important role in the diagnosis and treatment of disease. Especially, the trend of the integration of three-channel hybrid technology in diagnosis and treatment of early lung cancer has become increasingly obvious. This paper will focus on the technical advance of the three-channel multi- mirror robot and its application in the diagnosis and treatment of early lung cancer.

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