目的总结完全腹腔镜下胆管空肠Roux-en-Y吻合的适应证、禁忌证、技术要点、安全性、并发症的预防及治疗效果。 方法回顾性分析2008年6月至2013年12月期间于笔者所在医院科室接受腹腔镜下胆管空肠Roux-en-Y吻合术的67例患者的临床资料。 结果67例患者中,66例完全在腹腔镜下完成手术,1例于放置蓝蝶后在手助下完成。手术时间144~253 min,平均152 min;术中出血30~220 mL,平均70 mL;术后住院时间6~11 d,平均8.1 d;住院费用2.0~2.5万元,平均2.1万元。术后发生漏胆3例,均经引流后痊愈;术后无肠瘘、出血、腹腔感染、肠梗阻等发生。术后20例患者获访,随访时间5~20个月,中位数为13个月。随访期间发生胆管炎2例,无吻合口狭窄发生。 结论对胆总管囊肿、胆总管下端良性狭窄、胆总管结石伴胆管扩张、壶腹部周围癌等需行胆肠吻合患者施行腹腔镜胆总管空肠Roux-en-Y吻合术是可行的,其手术费用稍高,但患者术后恢复快,且具有微创优势。
Polyurethane materials have good biocompatibility, blood compatibility, mechanical properties, fatigue resistance and processability, and have always been highly valued as medical materials. Polyurethane fibers prepared by electrostatic spinning technology can better mimic the structure of natural extracellular matrices (ECMs), and seed cells can adhere and proliferate better to meet the requirements of tissue repair and reconstruction. The purpose of this review is to present the research progress of electrostatically spun polyurethane fibers in bone tissue engineering, skin tissue engineering, neural tissue engineering, vascular tissue engineering and cardiac tissue engineering, so that researchers can understand the practical applications of electrostatically spun polyurethane fibers in tissue engineering and regenerative medicine.