全文获取类型
收费全文 | 8379篇 |
免费 | 575篇 |
国内免费 | 1116篇 |
专业分类
耳鼻咽喉 | 943篇 |
儿科学 | 89篇 |
妇产科学 | 17篇 |
基础医学 | 153篇 |
口腔科学 | 43篇 |
临床医学 | 982篇 |
内科学 | 3285篇 |
皮肤病学 | 10篇 |
神经病学 | 465篇 |
特种医学 | 148篇 |
外科学 | 1834篇 |
综合类 | 1035篇 |
预防医学 | 236篇 |
眼科学 | 57篇 |
药学 | 392篇 |
23篇 | |
中国医学 | 49篇 |
肿瘤学 | 309篇 |
出版年
2024年 | 16篇 |
2023年 | 266篇 |
2022年 | 444篇 |
2021年 | 527篇 |
2020年 | 460篇 |
2019年 | 395篇 |
2018年 | 382篇 |
2017年 | 245篇 |
2016年 | 411篇 |
2015年 | 485篇 |
2014年 | 802篇 |
2013年 | 709篇 |
2012年 | 538篇 |
2011年 | 568篇 |
2010年 | 504篇 |
2009年 | 443篇 |
2008年 | 455篇 |
2007年 | 437篇 |
2006年 | 374篇 |
2005年 | 285篇 |
2004年 | 208篇 |
2003年 | 172篇 |
2002年 | 152篇 |
2001年 | 132篇 |
2000年 | 90篇 |
1999年 | 80篇 |
1998年 | 60篇 |
1997年 | 62篇 |
1996年 | 66篇 |
1995年 | 35篇 |
1994年 | 39篇 |
1993年 | 22篇 |
1992年 | 26篇 |
1991年 | 29篇 |
1990年 | 30篇 |
1989年 | 19篇 |
1988年 | 21篇 |
1987年 | 19篇 |
1986年 | 13篇 |
1985年 | 6篇 |
1984年 | 10篇 |
1983年 | 8篇 |
1982年 | 7篇 |
1981年 | 3篇 |
1980年 | 4篇 |
1979年 | 3篇 |
1978年 | 3篇 |
1977年 | 4篇 |
1976年 | 1篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
51.
内镜治疗老年总胆管结石30例体会 总被引:2,自引:0,他引:2
目的:探讨内窥镜治疗老年总胆管结石的安全性和有效性。方法:对我院普外科收治的30例70岁以上的老年总胆管结石患者进行回顾性分析,所有患者均经B超或螺旋CT明确诊断并接受内镜治疗,治疗方法包括逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP),鼻胆管引流(endoscopic nasobiliary drainage,ENBD),乳头括肌切开(endoscopic shincterotomy,est)和取石术,碎石术,测定患者内镜治疗前后的生化指标变化。结果:30例老年总胆管结石患者行ERCP检查,成功率100%,28例行EST,总胆管结石直径<1.0cm者成功率100%,结石直径1.0-1.5cm者成功率86%,结石直径≥1.5cm者需进行机械碎石取石,成功率75%;另有2例患者植入塑料支架作长期引流。1例患者发生与内镜有关的并发症,死亡例,30例患者治疗后各项生化指标较治疗前均有明显改善(P<0.001)。结论:内镜治疗老年总胆管结石成功率增高,避免了手术创新,安全性好,缩短住院时间,是当前治疗老年总胆管结石的首选方法。 相似文献
52.
Objective To describe the different imaging modalities used for the diagnosis and classification of hydrocephalus, their role in defining
the optimal treatment of hydrocephalus and to define the optimal preoperative diagnostics for endoscopic third ventriculocisternostomy
(ETV).
Methods An overview on available imaging modalities for hydrocephalus will be given and their pros and cons discussed. In addition,
different aspects of the treatment of hydrocephalus by shunts and by ETV will be highlighted.
Discussion The role of the technical aspects of performing an ETV, the role of the surgeon’s philosophy, the role of the urgency of the
procedure, and the role of informed consent on the requirements for the imaging of the hydrocephalus will be discussed.
Conclusion The authors conclude that MRI is a conditio sine qua non for ETV in elective surgical cases. 相似文献
53.
Grant R. Caddy MD MRCP Consultant Gastroenterologist Tony C.K. Tham MD FRCP Consultant Gastroenterologist 《Best Practice & Research: Clinical Gastroenterology》2006,20(6):1085
Symptomatic BDS commonly cause significant morbidity and attempt at stone removal should be attempted if possible. Complications of CBDS include biliary colic, jaundice, cholangitis and pancreatitis. Investigations aimed to predict the presence of stones within the bile duct include serum bilirubin, AST, ALP, common bile duct diameter and age as independent predictors of choledocholithiasis. TUS is a sensitive test in detecting bile duct dilatation but the sensitivity is reduced in its ability to detect choledocholithiasis. A NIH consensus statement found that ERC, MRC and EUS were comparable in their sensitivities, specificities and accuracy rates for detection of choledocholithiasis. ERC and stone removal using a balloon or basket is often performed following EST. EBD may be performed if patients have uncorrected coagulopathies but the risk of pancreatitis is higher than for EST (although the risk of bleeding complications is lower for EBD). ML is often required in difficult to remove CBDS and using this device, CBDS can be removed in 90–95% of cases. Other forms of lithotripsy including laser lithotripsy and EHL are confined to specialised centres and the evidence for their use is based on small studies. ESWL may clear stones from the bile duct in up to 93% of patients but frequently ERC and stone fragment removal is required post ESWL. The role of medical therapy in difficult to remove CBDS (or in CBDS in patients with severe co-morbid illness preventing ERC + stone removal) is still currently uncertain due to a lack of large randomised control trials. 相似文献
54.
Michelle Lucinda DeOliveira M.D. Tarcisio Triviño M.D. Ph.D. Gaspar de Jesus Lopes Filho M.D. Ph.D. 《Journal of gastrointestinal surgery》2006,10(8):1140-1143
Carcinoma of the papilla of Vater is classified as periampullary cancer representing 5% of all gastrointestinal tract malignancies.
Early and accurate diagnosis is important for those patients with a tumor of the papilla, as the prognosis is more favorable
than in other periampullary neoplasms. Endoscopically obtained biopsies from suspicious papillae can detect an early tumor,
although even for skilled pathologists it is often difficult to differentiate carcinomas from noninvasive lesions on the basis
of forceps biopsies. The purpose of this study was to assess the preoperative diagnostic accuracy of duodenoscopy appearance
and biopsy in all cases with suspicion of tumor. Thirty patients with suspicion of carcinoma of the papilla of Vater and with
final diagnosis established by pancreatoduodenectomy were included in this retrospective study. In each case, a comparison
was made between endoscopic biopsy and duodenoscopic appearance. Duodenoscopic appearance sensitivity and accuracy for malignancy
were 86% and 83%, respectively, whereas endoscopic biopsy sensitivity and accuracy were 65% and 67%, respectively. Although
preoperative diagnosis of carcinoma of the papilla of Vater is useful for making therapeutic decisions, the diagnostic value
of the endoscopic appearance was superior to endoscopic biopsy in this series.
Presented at the 2003 American Hepato-Pancreato-Biliary Association Congress, Miami, Florida, February 27-March 3, 2003.
Supported by FADA-CAPES/PROP 200J (M.L.D.). 相似文献
55.
胃肠道脂肪瘤的诊断与治疗 总被引:1,自引:0,他引:1
目的总结胃肠道脂肪瘤的诊断与治疗经验。方法回顾性分析1993年至2007年间收治的34例胃肠道脂肪瘤的临床资料。结果胃肠道脂肪瘤的临床表现无特异性,可并发肠套叠或肠梗阻,超声内镜的诊断准确率为93.8%。本组有12例行内镜下脂肪瘤切除术,22例行开腹手术(局部切除术及胃或肠部分切除吻合术),手术过程顺利,未出现并发症。28例(82.4%)获1-168个月随访,1例胃底多发的脂肪肉瘤于术后2年死于肿瘤转移,其余27例均无复发或转移,存活至今。结论超声内镜是诊断胃肠道脂肪瘤的有效方法,手术是治疗胃肠道脂肪瘤的常规手段,内镜下切除胃肠道脂肪瘤可行。 相似文献
56.
内镜黏膜下剥离术治疗直肠类癌 总被引:22,自引:1,他引:21
目的探讨内镜黏膜下剥离术(ESD)治疗直肠类癌的应用价值。方法肠镜发现直肠黏膜下肿块后进行微探头超声检查,对诊断为类癌者应用头端弯曲的针形切开刀进行内镜黏膜下剥离术治疗:(1)黏膜下注射生理盐水抬高病灶,使病灶与肌层分离;(2)预切开病灶周围黏膜;(3)剥离病变下方黏膜下层结缔组织,完整切除病灶。结果5例直肠类癌患者,肿瘤直径0.4~1.2(平均1.1)cm,均成功完成ESD治疗。ESD手术时间(自黏膜下注射至完整剥离病变)20-45(平均35)min;术中创面少量出血,均经电凝、氩离子血浆凝固和止血夹成功止血。不需再次肠镜下止血。1例剥离深至肌层,出现皮下气肿,保守治疗好转。术后全部经病理确诊。基底和切缘未见病变累及。1个月后肠镜复查,创面基本愈合。结论ESD是治疗直肠类癌的新方法.以往需要外科手术切除的肿瘤通过ESD可以达到同样的治疗效果。 相似文献
57.
58.
解剖因素致单纯鼻源性头痛的鼻内镜手术 总被引:2,自引:0,他引:2
目的 :探讨鼻内镜手术治疗解剖因素致单纯鼻源性头痛的方法和疗效。方法 :鼻内镜下切除或矫正鼻腔鼻窦区异常解剖结构。结果 :单一因素中鼻丘气房肥大 ,泡性中、上鼻甲及中隔偏曲分别为 7例、10例、12例 ,术后治愈率达 71.4 3%、6 0 .0 0 %、6 6 .6 7% ,合计治愈率达 6 5 .5 2 %。多因素者 4 4例 ,术后治愈率达38.6 4% ,与单一因素差异有显著性 (P <0 .0 2 5 )。患者治疗有效率达 10 0 %。结论 :鼻内镜手术是治疗解剖因素致单纯鼻源性头痛的有效方法之一 ,单一因素者疗效更佳。 相似文献
59.
60.
腔镜与开放式甲状腺手术的临床对照研究 总被引:1,自引:0,他引:1
目的:比较腔镜与传统开放式甲状腺手术的临床效果。方法:对66例腔镜和57例开放式甲状腺手术的临床资料进行比较,指标为手术时间、出血量、术后住院时间及术后并发症等。结果:两组的年龄、性别、病种等无明显差异,平均手术时间腔镜组为(178.3±32.4)min、开放组为(145.8±27.1)min,平均出血量腔镜组为(19.1±12.4)ml、开放组为(44.6±18.6)ml,2组差异有统计学意义(P〈0.01)。结论:腔镜甲状腺手术安全、可靠,与传统开放式手术相比具有切口小、不影响美观等优点。 相似文献