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排序方式: 共有367条查询结果,搜索用时 31 毫秒
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Liselotte Mettler Maher Alhujeily 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2007,11(3):303-308
OBJECTIVES: We sought to define the role of laparoscopy in identifying the clinical significance, cause, and association between adhesions and chronic pelvic pain. METHODS: A retrospective chart review was conducted from October 2004 to July 2005, at the Kiel School of Gynecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Germany. Included in the study was the analysis of 462 laparoscopic procedures; 275 (59.5%) of the patients undergoing these procedures had pelvic or abdominal adhesions. Of these, 84 (30.5%) patients were admitted with the main complaint of chronic pelvic pain. Further evaluation and assessment of this group was carried out. RESULTS: Among those patients with adhesions, the second most frequent reason for admission was chronic pelvic pain (30.5%) (P<0.0005). In our study, adhesions were found in 79.2% (n=84) of patients (n=106) with chronic pelvic pain. These adhesions were thin-filmy (19.0%) or thick-fibrous (81.0%) adhesions containing blood vessels. Thick-fibrous adhesions were present in 50.0% of patients at multiple abdominopelvic sites (P<0.005). CONCLUSIONS: Thick-fibrous adhesions that extend beyond the pelvic sidewall can cause significant chronic abdominopelvic pain. 相似文献
4.
Christopher Sutton 《Lasers in medical science》1986,1(1):25-31
Adhesions and endometriosis are commonly encountered among patients presenting with pelvic or lower abdominal pain and also in a significant proportion of infertile patients. Laparoscopic investigation is usual in patients with these problems, and it has been possible to perform endoscopic surgery with special scissors and electrodiathermy. These methods can cause troublesome bleeding, and the diathermy produces high temperatures which can be hazardous if used in the vicinity of the bowel. The carbon dioxide laser can be used endoscopically to vaporize deposits of endometriosis and adhesions with great precision and virtually no bleeding. One hundred consecutive patients with endometriosis or adhesions were treated with the CO2 laser laparoscope and followed up for at least a year. Seventy-five per cent of patients with pain due to endometriosis were cured, and 68% of patients were better after laser laparoscopic adhesiolysis. Pregnancy rate in the previously infertile group with endometriosis was 64%. There were no complications due to the intra-abdominal use of CO2 laser energy under endoscopic control, although there is a need for a controlled trial. It appears that in the hands of an experienced laparoscopist this technique is safe and effective. 相似文献
5.
M. Snoj A. Ar'Rajab B. Ahrén K. Larsson S. Bengmark 《Zeitschrift für die gesamte experimentelle Medizin einschliesslich experimenteller Chirurgie》1993,193(1):117-122
The majority of intra-abdominal adhesions develop postoperatively or following peritonitis. We have previously shown thatl-phosphatidylcholine reduces postoperative peritoneal adhesions in rats. In the present study, we examined whether adhesion
formation after bacterial peritonitis is also reduced byl-phosphatidylcholine or bydl-α-phosphatidylcholine, which is degraded only 50% by phospholipase A2. Peritonitis was induced in the rat by caecal ligation and double puncture; cecotomy was performed 12, 15, or 18h later.
Adhesions were assessed blindly by a scoring system 7 days after cecotomy. When cecotomy was scheduled for 18h after caecal
ligation and puncture, the 7-day mortality was 90% (n=20). When cecotomy was performed at 12h, no mortality was seen; however, the adhesion score was low (2.3±0.7). When cecotomy
was performed 15h after caecal ligation and puncture, the mortality was 25% and the adhesion score was 4.3±0.9. This figure
was reduced significantly by intraperitoneal instillation ofl-phosphatidylcholine ordl-α-phosphatidylcholine for 3 subsequent days. However, the mortality increased byl-phosphatidylcholine (P<0.01), whereas mortality afterdl-α-phosphatidylcholine remained at 30%. We conclude that administration of bothl-phosphatidylcholine anddl-α-phosphatidylcholine decrease adhesion formation after bacterial peritonitis. 相似文献
6.
子宫切除术后盆腔包块30例分析 总被引:2,自引:0,他引:2
目 的探讨 因 良 性 疾病 行 子 宫 切除 术 后 盆 腔包 块 形 成 的原 因 、临床 特 征 及 治疗 。 方 法 收 集 并分 析30例 子 宫 切 除术 后 盆 腔 包 块 的 两 次 手 术 前 后 情 况 、包 块 的 性 质 、二 次 手 术 前 后 情 况 、包 块 的 性 质 、二 次 手 术方 式、治疗 效果 及 随访 结果 。 结果 30例 患者 在子 宫 切除 时 均保 留了 一 侧或 两侧 附 件,53% 病 例包 块 以 体 检或 自查 方式 发现 ,47% 有 症 状;大 多 数病 程长 、包 块 大、活动 差、以囊 性为 主 、用 抗 生素 治 疗 或 中药 治 疗 无 效;B超43% 有分 隔,CA 在 正常 范 围。70% 病 例与 粘 连性 囊 肿有 关,原子 宫 切除 时有 粘 连者11例 在 本次 手术 时 均有 粘连 ,38% 粘 125连 性囊 肿于 子 宫切 除术 后6个月 内 出现 包块 ,62% 术 后2年内 出现 包 块,卵巢 囊肿 均 为术 后1年以 上 发现 包块 。二 次手 术时 腹腔 镜 手术 比开 腹 手术 出血 量 少,但医 疗费 用 高,平 均 住院 日及 手 术时 间差 异 无显 著 性,总复 发率26% 。结论 粘 连性 包 块多 数术 后2年 内 发 现 ,卵 巢 囊肿 大 多1年 以 后 发 现;保 留附 件 是 再 次形 成 包 块 中 液体 的 相似文献
7.
目的探讨经皮经肝穿刺胆道引流管周围组织组织粘连情况及其与时间关系,以期为临床缩短经皮经肝胆道内镜(PTCS)治疗间期的可行性提供科学实验依据。方法雄性小家猪随机分为4组:即术后第3、5、7、14 d共4组。开腹逆行穿刺置管形成模型,观察引流管周围腹膜之间的组织组织粘连情况并分级。结果所有模型管周腹膜间出现组织粘连,注入美蓝未见变色,而除管周外其他腹膜间没有组织粘连。其中3 d组组织粘连以Ⅱ级为主;5 d后各组组织粘连以Ⅲ级为主。经秩和检验统计学分析示3 d组与其他各组比较,差异有统计学意义(D≥176.2,P<0.05);5 d组、7 d组及14 d组组间比较,差异无统计学意义(D<176.2,P>0.05)。结论经皮经肝穿刺胆道引流(PTCD)术后第5 d经皮肝穿刺胆道引流引流管周围己形成完整致密组织粘连。 相似文献
8.
《Journal of investigative surgery》2013,26(4):285-296
Tolmetin sodium in a hyaluronic acid carrier (tolmetin-HA) was previously shown to reduce adhesion formation and alter the kinetics and levels of cellular influx into the peritoneal cavity after surgery. In this study, the effect of tolmetin-HA on the level of protease activity in macrophage-conditioned media was determined. The level of collagenase activity in macrophage-conditioned media was supressed at 12 and 24 h after administration of tolmetin-HA. Alternatively, the peak level of elastase activity measured in macrophage-conditioned media was unchanged after tolmetin-HA treatment, but the kinetics of expression of maximal protease activity was delayed from 12 h in the control surgical rabbits to 24 h in tolmetin-HA-treated rabbits. Elevated plasminogen activator activity was detected in acid-treated conditioned media from the tolmetin-HA-treated rabbits when compared to control levels. However, no alteration in the level of plasminogen activator inhibitor activity was present in conditioned media of macrophages harvested from tolmetin-HA-treated rabbits compared to controls. These data suggest that tolmetin-HA treatment altered the levels of neutral protease activity secreted by postsurgical macrophages and may therefore elevate the fibrinolytic potential of the peritoneal cavity after surgery. 相似文献
9.
Most existing fish vaccines are presented in the form of oil-based emulsions delivered by intraperitoneal injection. Whilst very effective they are frequently associated with inflammatory responses that can result in clinically significant side-effects often involving the adipose tissue that is in direct contact with the vaccine. To explore the potential of immune gene expression changes in the adipose tissue of fish to be markers of vaccination efficacy or development of side-effects we have studied the response to a bacterial (Aeromonas salmonicida) vaccine administered with two different adjuvants. The first adjuvant was Montanide™ ISA 763A VG, thought to induce a mostly humoral response, and the second was Montanide™ ISA 761 VG that gives a more balanced humoral and cell mediated response. Following vaccination tissue samples were collected at days 3, 14 and 28 for RTqPCR analysis. Fifty immune genes were studied with a focus on a) pro-inflammatory associated molecules and b) adaptive immune response related molecules linked with possible Th1, Th2, Th17 and T-regulatory pathways, with the expression data analysed for associations with Speilberg post-vaccination side effect scores. The results showed that the adipose tissue is a particularly sensitive and discriminatory tissue for studying adjuvant effects. A clear upregulation of many immune genes occurred in response to both vaccine groups, which persisted over time and overlapped with the appearance of visible adhesions. Our analysis revealed a relationship between adipose tissue immune function and the development of vaccine-induced adhesions giving the potential to use immune gene expression profiling in this tissue to predict the side-effects seen. 相似文献
10.
R. López Grove A. Heredia Martínez M. Aineseder J.A. de Paula J.A. Ocantos 《Radiologia》2019,61(5):388-395
ObjectivesTo describe the most characteristic imaging findings for sclerosing encapsulating peritonitis, with an emphasis on the computed tomography findings.ConclusionThe incidence of sclerosing encapsulating peritonitis is low. The pathophysiology of this condition is unclear. Two types are recognized: idiopathic and secondary; the secondary type is generally a complication of peritoneal dialysis. Its nonspecific clinical presentation and the absence of blood markers mean that sclerosing encapsulating peritonitis is usually diagnosed late. Thus, it is important to know the imaging signs; these include thickening and calcification of the peritoneum and dilation of bowel loops with thickening and calcification of bowel walls, whether in isolation or in association with loculated ascites. Although ultrasonography allows the complexity of the collections to be evaluated, computed tomography is the most useful technique for the general assessment of the signs mentioned above. 相似文献