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81.
正多数下肢动脉栓塞病人在急性期内(发病6~8 h以内)行手术治疗可取得较好的治疗效果,但部分病人可能因医疗条件或个人原因而选择保守治疗(如仅使用抗凝药物等),下肢动脉部分开放或仅侧支开放,将疾病由急性期拖入了亚急性期,此时的血栓机化,并且与血管内膜粘连紧密不易分开。笔者团队自制可调节式内膜剥离器用于取出亚急性下肢动脉栓塞病人的陈旧性机化血栓。现报告如下。  相似文献   
82.
83.
PurposeThe purpose of this study was for an international panel of experts to establish consensus indications for distal rectus femoris surgery in children with cerebral palsy (CP) using a modified Delphi method.MethodsThe panel used a five-level Likert scale to record agreement or disagreement with 33 statements regarding distal rectus femoris surgery. The panel responded to statements regarding general characteristics, clinical indications, computerized gait data, intraoperative techniques and outcome measures. Consensus was defined as at least 80% of responses being in the highest or lowest two of the five Likert ratings, and general agreement as 60% to 79% falling into the highest or lowest two ratings. There was no agreement if neither threshold was reached.ResultsConsensus or general agreement was reached for 17 of 33 statements (52%). There was general consensus that distal rectus femoris surgery is better for stiff knee gait than is proximal rectus femoris release. There was no consensus about whether the results of distal rectus femoris release were comparable to those following distal rectus femoris transfer. Gross Motor Function Classification System (GMFCS) level was an important factor for the panel, with the best outcomes expected in children functioning at GMFCS levels I and II. The panel also reached consensus that they do distal rectus femoris surgery less frequently than earlier in their careers, in large part reflecting the narrowing of indications for this surgery over the last decade.ConclusionThis study can help paediatric orthopaedic surgeons optimize decision-making for, and outcomes of, distal rectus femoris surgery in children with CP.Level of evidenceV  相似文献   
84.
IntroductionAbdominal surgery uses various energy devices for vessel sealing, tissue dissection, and detachment. Currently, Acrosurg Revo® (Nikkiso Co., Ltd., Tokyo, Japan), a novel energy device using microwaves, has been developed for use in laparoscopic surgery. This report describes the early clinical experience of using this device in two cases of laparoscopic surgery.Presentation of caseCase 1 was of a 64-year-old woman who underwent laparoscopic abdominal incisional hernia repair. Case 2 was of a 56-year-old man with a diagnosis of ascending and sigmoid colon cancer who underwent laparoscopic right hemicolectomy and sigmoid colectomy with D3 dissection. Each surgery was completed using Acrosurg Revo® and an endoscopic electrosurgical unit. The postoperative course was uneventful, and both patients were discharged from the hospital without any complications.DiscussionWith this new and novel device, vessel sealing, hemostasis, coagulation, tissue dissection, and detachment were all possible. Notably, there was no spark or mist that hindered the surgical field of view. Furthermore, because microwave coagulation did not result in tissue carbonization, there was a considerable decrease in device tip contamination.ConclusionThe Acrosurg Revo® may be a useful energy device for laparoscopic surgery.  相似文献   
85.
A prospective study of biochemical changes after vertical banded gastroplasty for morbid obesity, in 94 patients (10 males and 84 females, ages ranging from 18 to 59 years) has been carried out. Liver function tests and electrolyte estimations were performed preoperatively, during hospitalisation for surgery, at 6 weeks and at 6 months postoperatively, and demonstrated no significant changes in liver function in these patients 6 months after surgery. The study concludes that there is no increase in the risk of liver damage or electrolyte disturbance after vertical gastroplasty, but that there may be subtle hepatic changes present as gall bladder disease developed in 18 patients postoperation (19%).  相似文献   
86.
目的 鉴别非典型梨状肌综合征与肢体缺血性疾病,提高诊断和治愈率。方法 对1985 ̄1998年收治的非典型梨状肌综合征误诊为肢体缺血病人22例进行临床分析,寻求鉴别要点。结果 22例中具有典型梨状肌综合征症状和体征仅6例(27%),非典型16例(73%),人武部病例均有含糊不清的臀腿痛,Doppler和阻抗血流检查有18例(82%)显示肢体供血不全。其中2例(9%)严重坐骨神经痛继发为血管器质  相似文献   
87.
目的 对自动经皮颈椎间盘切吸术治疗颈椎间突出症的适应证及疗效进行探讨。方法 在局麻下行颈前路经皮穿刺切吸术 ,4 8例以 4 0岁为限 ,小于 4 0岁为A组共 2 0例 ,大于 4 0岁为B组共 2 8例 ,术后随访 6~ 2 4个月。两组结果用 χ2 检验。结果 A组优良率为 95% ,B组优良率为 60 % ,其疗效比较有显著性差异 ,(P <0 .0 5)。结论 经皮颈椎间盘切吸术治疗颈椎病是一安全、有效的措施 ,严格掌握适应证是提高成功率的关键  相似文献   
88.
目的探讨残胃贲门癌手术切除,消化道重建的方法。方法总结1989年8月至1999年12月12例残胃贲门癌切除、空肠“9”字袢代胃及幽门重建术的治疗经验。结果无手术死亡,无倾倒综合征,无返流性食管炎。钡剂在“9”字环内有循环,下方重建凼门处有钡荆停留。全组均随访,随访时间最长4年3个月,最短4个月。其中1年内死亡2例,1~2年死亡4例,2~3年死亡2例,另4例生活良好。结论术后并发症少,有抗返流作用,利于营养支持,病人生活质量较高。  相似文献   
89.
Objective To observe and evaluate the efficacy and safety of quinacrine sterilization.Methods A total of 572 cases of quinacrine sterilization preformed during the 4 years from 1993to 1997in Jiangsu and Guizhou Provinces were employed in this study. The efficacy and safety of quinacrine sterilization in those case were studied and evaluated, with 588 cases of surgical sterilization performed at the same time being the control group.Results Both groups were with identical demographic and gynecological characteristics. The result of multiple decrement life table analysis showed the 12th gross cumulative failure rates for quinacrine sterilization was 3. 13% and serious side effects occurred in only 2 cases accounting for O. 35%. One was ectopic pregnancy (20 months after treatment). The other was due to anaphylaxis in 10 minutes after the second insertion). No difference in the liver and nephic functions was detected and no suspected cancer cells or cancer cells were found in the two groups. 99. 6% of the 572 women interviewed accepted the quinacrine sterilization.Conclusions Quinacrine sterilization method is with high acceptability but comparatively low effectiveness. It has been proved to be a safe method of contraception in short-term. However, the safety of long-term still needs further study.  相似文献   
90.
Flexible tantalum stents: Effects in the stenotic canine urethra   总被引:2,自引:0,他引:2  
Purpose Evaluate the effects of flexible tantalum stents (Strecker) implanted into stenotic canine urethras.Methods Eight conditioned, adult, German shepherd dogs, weighing 30–40 kg, were used. Strictures were created surgically in the bulbar urethra just proximal to the os penis. Two months postsurgery, strictures were documented radiographically and then balloon dilated. Following dilatation, a single Strecker stent was placed across the stricture. Stents were 7 mm in expanded diameter and either 2 or 4 cm in length. Retrograde urethrography was performed immediately after stent placement and then biweekly for up to 12 months. Two dogs were sacrificed at 2, 4, 6, and 12 months post-stenting, and necropsy was performed. The urethra was excised, fixed, and examined by scanning electron and light microscopy.Results Clinical success was achieved without complications in all animals. Hyperplasia of the urothelium was noted 4–6 weeks after stent placement and was most pronounced at 4–6 months. Mucosal folds were found between the stent struts. Restenosis occurred at the distal end of the stent in one dog. Histological alterations were noted in the deeper layers of the urethral wall.Conclusion Strecker stents were well tolerated in all animals and seem useful for the treatment of urethral strictures.Presented at CIRSE Annual Meeting and Postgraduate Course, Budapest, June 20–24, 1993  相似文献   
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