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目的:分析与总结腹腔镜胆囊切除术治疗合并肝硬化门静脉高压症的胆囊结石患者的临床疗效,为临床手术方案选择提供参考依据。方法对60例胆囊结石合并肝硬化门静脉高压症患者行腹腔镜胆囊切除术治疗,对围手术期和手术的处理方法、效果等进行分析总结。结果60例患者全部治愈,手术时间平均50 min,无胆道损伤、术后出血及腹腔感染等并发症发生,9例患者术后留置了腹腔引流管,住院时间8-15 d,平均12 d。结论术前行肝功能Child分级、行肝胆增强CT了解肝十二指肠韧带处血管情况,以及胆囊病变程度,采取积极的预防措施,改善肝功能,术中仔细操作,采用腹腔镜胆囊切除术治疗胆囊结石合并肝硬化门静脉高压症是安全可靠的,手术效果良好。 相似文献
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目的 探讨门静脉高压症合并胆囊结石的相关危险因素及手术治疗方法.方法 281例门静脉高压症患者分为两组,98例合并胆囊结石者为观察组,另183例单纯门脉高压症患者为对照组,回顾性分析两组患者一般情况、生化指标和超声参数等临床资料之间的差异.观察组中11例保守治疗,87例行手术治疗,其中44例行单纯胆囊切除术,43例行门静脉高压症手术联合胆囊切除术,比较两种术式患者的病死率和并发症情况.结果 观察组与对照组患者年龄、性别、肝硬化病因、酗酒、生化指标、胆囊壁厚度及腹水情况比较,差异无统计学意义(P> 0.05),而Chlid-Puhg分级、门静脉宽度≥1.3 cm患者比例均存在统计学差异(P< 0.05).观察组中单纯胆囊切除术患者与联合手术患者并发症发生率、病死率及住院时间比较均无统计学差异.结论 肝功能状况、门静脉宽度是影响门静脉高压症患者并发胆囊结石的主要因素.对具有手术适应证的患者同期行胆囊结石和门静脉高压症手术治疗是安全可行的. 相似文献
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门静脉高压症合并胆囊结石 总被引:4,自引:1,他引:3
目的 探讨门静脉高压症合并胆囊结石的治疗方法。方法 对因门静脉高压症合并胆囊结石46例的手术方法、治疗结果予以回顾性分析。结果 我科1988-1998年收治肝硬化门静脉高压症患者286例,合并有胆囊结石者46例(16.1%,其中2例伴有继发性胆总管结石);胆囊壁水肿增厚者145例(壁厚4-13mm),并发胆囊结石的46例患者的胆囊均增厚,本组在行脾切除和贲门周围血管离断术的同时一期切除胆囊者38例,治愈35例,死亡3例,另8例患者先行脾切除、贲门周围血管断术,3-6个月后二期行胆囊切除术,无1例死亡。结论 门静脉高压行脾切除、贲门周围血管离断术同时行胆囊切除术,可引起严重出血。故手术方式应根据病人肝硬化程度、肝门部血管扩张的程度、胆囊的炎症程度等进行选择。 相似文献
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胃癌合并肝硬化门静脉高压症手术治疗的体会 总被引:2,自引:0,他引:2
胃癌合并肝硬化门静脉高压症的发病率低,外科处理比较棘手,手术复杂难度大,并发症多[-2].我院自1992年1月至2007年1月对24例胃癌合并肝硬化门静脉高压症患者施行手术治疗,现总结如下. 相似文献
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肝硬化、门静脉高压症病人胆囊结石的发病率高达29%~59%[1],但该类病人是否采用同期手术治疗尚存在争议.笔者总结了深圳市第二人民医院肝硬化门静脉高压症并胆囊结石行同期手术治疗的经验,现报告如下. 相似文献
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一般性骨折愈合过程分为血肿机化演进期、原始骨痂形成期和骨痂改造塑形期;而骨质疏松性骨折愈合过程分为纤维骨痂期、软骨骨痂期和骨性骨痂期。骨质疏松性骨折愈合的组织学观察表明,纤维骨痂期主要是成纤维细胞合成Ⅲ型胶原;软骨骨痂期主要是成软骨细胞合成、分泌Ⅱ型胶原;骨性骨痂期主要是随着软骨内成骨的出现和发展,Ⅱ型胶原消失,逐渐由抗张力性能较强的Ⅰ型胶原所取代。一般来说,实验性骨质疏松性骨折的愈合方式与一般性骨折愈合方式相似,软骨内成骨和膜内成骨共同参与了骨质疏松性骨折的修复过程,但以软骨内成骨为主。 相似文献
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脊柱侧凸矫形手术早期并发症的处理及预防 总被引:2,自引:2,他引:0
随着脊柱外科的迅速发展,国内越来越多的医院已经或正在开展各类脊柱侧凸的手术治疗。但由于脊柱作为人体的支柱,其解剖关系复杂,邻近有许多重要组织和器官,因此手术相关并发症并不少见,也不容忽视。如何预防和减少手术并发症,已经是迫在眉睫的任务,需要我们不断研究和深入探讨。根据发生时间可将手术并发症分为术中、术后早期及术后晚期并发症。现对脊柱侧凸矫形手术中及术后早期并发症的的处理及预防进行分析。 相似文献
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2005年7月~2008年10月,我科对7例肱骨髁间粉碎性骨折患者进行切开复位+双钢板内固定治疗,取得满意疗效。
1材料与方法
1.1病例资料本组7例,男5例,女2例,年龄31—65岁:根据Riseborough分型:Ⅲ型2例,Ⅳ型5例(图1A)。1例术前有尺神经损伤症状。 相似文献
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半月板组织工程的研究进展 总被引:1,自引:1,他引:0
半月板损伤临床常见,据美国矫形外科学会2008年的统计资料,美国每年全膝关节置换手术>250000例,其中半月板损伤是骨性关节炎进展的关键因素。然而,半月板仅外周1/3有血液供应,发生于此部位的损伤采用缝合治疗可以愈合;而内侧缘2/3均为无血管区,损伤后自行愈合能力较差,目前临床上针对这类损伤多采用半月板部分切除或全部切除术。 相似文献
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Improved sexual behavior in male rats treated with a Chinese herbal extract: hormonal and neuronal implications 总被引:3,自引:0,他引:3
Zanoli P Benelli A Zavatti M Rivasi M Baraldi C Baraldi M 《Asian journal of andrology》2008,10(6):937-945
Aim: To investigate the influence of an extract obtained from five Chinese medicinal plants on sexual behavior of adult male rats. Methods: The extract was administered at doses of 30, 60 and 120 mg/kg by oral gavage, acutely (one time, 45 min before mating test) or subchronically (daily for 10 days) in sexually potent and sexually sluggish/impotent rats. Sexual behavior, serum levels of luteinizing hormone (LH) and testosterone (T) were evaluated in treated rats and compared with controls receiving vehicle. The effect of the extract on central dopaminergic neurotransmission was assessed in the nucleus accumbens using a microdialysis technique. Results: In sexually potent rats, both acute and subchronic treatment with the extract dosed at 30 and 60 mg/kg reduced mount latency and intromission latency. In sluggish/impotent rats, the acutely administered extract at the dose of 60 mg/kg shortened ejaculation latency, whereas subchronically administered at the doses of 30 and 60 mg/kg, reduced mount, intromission and ejaculation latencies, increasing also the percentage of mounting and ejaculating rats. The extract dosed at 60 mg/kg significantly increased LH and T following acute and subchronic administration and increased 3,4-dihydroxyphenylacetic acid levels in the nucleus accumbens, 30 min after the acute administration. Conclusion: The improvement in both appetitive and consummatory components of sexual behavior observed in male rats treated with the extract could be ascribed to increased serum T level in parallel with the activation of the central dopaminergic system. 相似文献
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Aim: To investigate the effects of 17β-estradiol (E2), Peganum harmala extract (PHE) and caloric restriction (CR) on various testis parameters during aging. Methods: Twelve-month-old male rats were treated for 6 months with either E2 or PHE, or submitted to CR (40%). Results: Our results show that estrogens and CR are able to protect the male gonad by preventing the decrease of testosterone and E2 levels as well as the decrease of aromatase and estrogen receptor gene expressions. Indeed, E2, PHE and CR treatments induced an increase in the superoxide dismutase activities and decreased the activity of testicular enzymes: gamma-glutamyl transferase, alkaline phosphatase, lactate deshydrogenase as well as the aspartate and lactate transaminases in aged animals. In addition, the testicular catalase and gluthatione peroxidase activities were enhanced in E2, PHE and CR-treated rats compared to untreated animals at 18 months of age. Moreover, the positive effects of estradiol, PHE and CR were further supported by a lower level of lipid peroxidation. Recovery of spermatogenesis was recorded in treated rats. Conclusion: Besides a low caloric diet which is beneficial for spermatogenesis, a protective antioxydant role of estrogens is suggested. Estrogens delay testicular cell damage, which leads to functional senescence and, therefore, estrogens are helpful in protecting the reproductive functions from the adverse effects exerted by reactive oxygen species (ROS) produced in large quanti- ties in the aged testis. 相似文献