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排序方式: 共有10000条查询结果,搜索用时 31 毫秒
61.
G. I. C. Ingram M.D 《Haemophilia》1995,1(4):277-282
62.
63.
目的:评价宫腔镜对绝经后子宫出血的诊断价值。方法:对213例绝经后子宫出血患者进行宫腔镜检查。结果:有阳性发现者为171例,其中老年性子宫内膜炎68例,子宫内膜息肉38例,子宫粘膜下肌瘤21例,子宫内膜癌14例(经定位活检证实),宫内节育器(ICD)8例,宫颈管炎4例,宫颈管息肉18例,诊断阳性率80.3%。其中3例子宫内膜息肉和2例子宫粘膜下肌瘤行电视宫腔镜下电切术。结论:宫腔镜检查对绝经后子宫出血诊断阳性率高,与定位活检相结合可大大地提高宫腔内疾病诊断的准确性。而且宫腔镜下电切术具有操作简单、病人痛苦少、并发症少、术后恢复快的优点。 相似文献
64.
A retrospective analysis of treatment for endometrial carcinoma is reported here. From 1987 to 1989, 138 patients were referred to the oncology department following total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometrial cancer. Forty-seven patients were not prescribed postoperative radiotherapy; 31 had Stage I well differentiated adenocarcinoma with minimal myometrial invasion, while the remaining 16 patients were considered unfit for postoperative radiotherapy. There were no instances of local relapse amongst the 31 patients with minimal myometrial invasion.The remaining 91 patients all received external beam irradiation to the pelvis and, according to the preference of the individual therapist, 51 were prescribed additional intracavitary vault caesium-137. Patients receiving postoperative radiotherapy were analysed according to whether or not they received additional intracavitary vault caesium. The two groups were also analysed for incidence of vaginal vault recurrence and treatment related morbidity.In the group receiving additional intracavitary treatment more patients had Stage II or III disease (P<0.05), and had greater depth of myometrial invasion (P<0.05). Vaginal vault recurrence was not observed in patients receiving intracavitary therapy in addition to external beam therapy. Four patients (10%) receiving external beam therapy alone developed vaginal vault recurrence.The incidence of Kottmeier-Perez grade 2 or 3 bowel toxicity following treatment was significantly higher in those patients receiving combined treatment (18% vs. 2.5%; P<0.03). There was also a higher incidence of vaginal stenosis in the group receiving both external beam and intracavitary therapy (21% vs. 3%; P<0.05). There was only one instance of grade 2 bladder toxicity in the external beam and intracavitary treatment group and none in the external beam therapy alone group.In conclusion, postoperative radiotherapy for Stages I-III endometrial carcinoma was carried out in a non-randomized manner by two regimens; either external beam therapy alone or external beam therapy with additional intracavitary vaginal caesium. The combined therapy gave significantly better local control but resulted in significantly more late bowel and vaginal morbidity. 相似文献
65.
OBJECTIVE: Many patients with haemorrhoids are investigated because of the fear of missing colorectal cancer (CRC). The aim of this study was to determine whether a primarily clinical approach regarding the need for investigation was safe and did not miss patients with CRC. PATIENTS AND METHODS: Data was collected prospectively on 589 consecutive patients with the principle diagnosis of haemorrhoids at first clinic visit. All had clinical assessment including rigid sigmoidoscopy and were treated by phenol injection or banding. They were categorized for (1) no review unless symptoms persisted -'One Stop SOS' (2) outpatient review or (3) investigation. To check for the development of CRC they were contacted by postal questionnaire or telephone interview with a minimum of one year from diagnosis and treatment. All 589 patients were cross-referenced with the Pathology database and the Hospital Information Services System. RESULTS: Four hundred and sixty-nine (80%) answered the questionnaire; 352 patients (60% of the total group) fell in the 'one stop SOS' outpatient category; 95 (16%) patients were followed up to review response to treatment for large haemorrhoids; 105 (18%) were investigated with barium enema (12%), flexible sigmoidoscopy (4%), colonoscopy (1%) and miscellaneous (1%); 37 (6%) patients were either given a haemorrhoidectomy date or referred on with a different diagnosis. No patients selected for 'one-stop' treatment developed CRC. Five (0.8%) patients were diagnosed with CRC after appropriate investigation was instituted for suspicious symptoms. One patient with distal transverse colon cancer had a delayed diagnosis as she was investigated initially by flexible sigmoidoscopy. CONCLUSION: Most patients with the primary diagnosis of symptomatic haemorrhoids do not need investigation. 相似文献
66.
低体重先天性心脏病婴幼儿术后监护体会 总被引:1,自引:0,他引:1
目的 探讨低体重婴幼儿先天性心脏病的术后监护方法,以提高手术成功率。方法对142例15kg以下的先天性心脏病低体重婴幼儿(3岁以下)术后根据其生理特点,严密做好循环系统、呼吸系统、引流管、感染等监护措施,防止相关并发症的发生。结果 全组术后住院死亡6例,死亡率4.2%;术后并发症15例,发生率为10.6%,包括低心排出量综合征、呼吸衰竭、心律失常、肺部感染、出血等。结论 婴幼儿先天性心脏病术后根据其生理特点进行循环系统、呼吸系统、引流管、感染等监护,可有效降低术后并发症的发生,是提高手术成功率和治愈率的关键。 相似文献
67.
Summary Bronchus stump insufficiency following lung resection, with an average incidence of 4%, is a serious complication which carries a mortality of up to 90%. Operative transthoracic approaches have been largely unsatisfactory because of the high operative risk and rapidly spreading infection. In an experimental study on 18 pigs, endoscopic occlusion of infected bronchus stump fistulae was achieved with fibrin sealant (1 ml, 500 units/ml thrombin, 3500 units/ml aprotinin) applied via a flexible bronchoscope. During autopsy, all bronchus stump fistulae were found to have healed after the second postoperative week. Transitory local abscesses of the pleura could be prevented by high-dose systemic antibiotic therapy for 5 postoperative days but not by antibiotics added to the fibrin sealant. This endoscopic method has already been performed successfully in 3 clinical cases; additional sclerotherapy with (2–3 ml Ethoxysclerol applied around the fistula orifice was carried out before fibrin sealing to stimulate fibrosis. Endoscopic controls demonstrated fistula closure by granulation tissue after 2 weeks. This procedure could become the method of choice for infected postoperative fistulae of the bronchus stump and should be attempted in any case before operative approaches are considered. 相似文献
68.
R. Grundmann U. Szillat 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1989,374(2):84-91
Zusammenfassung Über ein Jahr wurden 1082 allgemeinchirurgische Planeingriffe prospektiv konsekutiv erfaßt und ihre Komplikationen mit einem Score bewertet. EinflußgröBen und die Komplikationsraten, die unter Umständen von der Kliniks-organisation abhängig sind, sollten analysiert werden. Es fand sich eine Beziehung zwischen Komplikationen und Wochentag, Operationsdauer sowie der Abweichung der tatsächlich benötigten von der geplanten Operationszeit. Mit höherer Auslastung der Operationssäle pro Arbeitstag stiegen die Komplikationsraten ebenfalls an.Keinen Einfluß auf die Komplikationsraten hatten Operationsbeginn und-monat sowie die monatliche Auslastung der Säle. Ob das Wetter einen Einfluß auf die Komplikationsraten nahm, konnte nicht entschieden werden: so fanden sich im Sommer- höhere Komplikationsraten als im Winterhalbjahr, jedoch war der Score von der Höhe der Außentemperatur und der Luftfeuchtigkeit unabhängig.
The influence of time of operation and hospital organization on postoperative complication rates
Summary During a 1-year period 1082 general surgical interventions were prospectively documented and their complication rates evaluated by a score system. Factors responsible for the complication rates and possibly depending on hospital organization should be analysed. The complication rates were influenced by the selection of the weekday, the length of operation time and the extent of discrepancy between planned and required operation time. Furthermore, the complication rates paralleled the extent of utilization of the operation theatre during a workday. The complication rates werenot affected by the beginning of operation and the operation month as well as the monthly utilization of the operation theatres. Whether the weather did influence the complication rates could not be decided: higher complication rates were found in the summer as compared to the winter period, but the complication score was independent of the level of the outside temperature and humidity.相似文献
69.
1142例胃癌切除术围手术期死亡因素分析 总被引:11,自引:0,他引:11
目的研究影响胃癌围手术期死亡的主要因素,为指导选择合理的切除范围和手术方式提供依据。方法回顾1989年1月至2004年3月胃癌手术后1142例患者的临床资料,按照不同年代分为3组,第1组:1989年1月至1994年1月,405例;第2组:1994年2月至1999年1月,377例;第3组:1999年2月至2004年3月,360例。比较3组间的围手术期死亡率,采用Logistic多因素回归分析研究影响手术死亡率的危险因素。结果全组患者术后并发症发生率和死亡率分别为11.2%(128/1142)和3.6%(41/1142)。第1、2、3组的术后并发症发生率依次为13.1%、10.1%和10.3%;3组比较,P>0.05。3组手术死亡率依次为4.7%、3.4%和2.5%,3组比较,P>0.05。术后最常见的并发症是吻合口瘘(24.2%,31/128),影响手术死亡的主要因素为临床Ⅳ期、姑息性切除术、联合脏器切除及术前合并症的存在(P<0.05)。Logistic多元回归分析显示淋巴结的清除范围和手术方式不是影响手术死亡的主要因素(P>0.05)。结论胃癌晚期患者手术死亡率高,对胃癌Ⅳ期患者行姑息性切除手术时应避免施行不必要的淋巴结清除及联合脏器切除术。 相似文献
70.
Aims and Objectives The significance of beaten copper appearance (BCA) on skull radiographs in children following surgery for isolated sagittal
craniosynostosis has not been studied. This study was designed to look for any correlation between BCA and symptoms suggestive
of intracranial hypertension in this group of patients.
Materials and Methods Forty-eight consecutive children, who were operated for isolated sagittal synostosis from1987 to 2000 and had postoperative
skull radiographs, were included. Patients were divided into: (a) BCA group (n = 20), consisting of children who had beaten copper appearance on skull radiographs at last follow up, and (b) Non-BCA group
(n = 28), consisting of children who did not have this finding. Records were reviewed to look for symptoms suggestive of intracranial
hypertension, such as headache, head banging, and irritability.
Results Median age at surgery was 4.8 months for BCA group and 4 months for the non-BCA group. Follow up ranged from 4 to 156 months
with a mean of 36.2 months. Total of 28.6% (n = 6) of the children with follow up radiographs done at ≤18 months of age had BCA. The incidence of BCA increased to 83.3%
in children with skull radiographs performed after 48 months of age. In 18 (90%) children, the BCA was ‘diffuse’ with 5 (25%)
children having the maximum possible score of 8. In the BCA group, 45% (n = 9) had symptoms compared to 10.7% (n = 3) in the control group (p = 0.0068).
Conclusions This study suggests a significant number of children with BCA on radiographs develop symptoms suggestive of raised ICP following
surgical treatment in infancy and prolonged follow up may be warranted in this group of patients. 相似文献