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101.
Hiroyoshi Komai Yasuaki Naito Keiichi Fujiwara Yasuzo Noguchi 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2002,50(2):55-58
OBJECTIVE: Since we developed the procedure in 1996, we have now performed 100 pediatric open heart operations using a lower midline skin incision and a minimal sternotomy approach. METHODS AND RESULTS: To elucidate the benefits of this approach, we analyzed these 100 cases retrospectively. There was no death, and no major complication, caused by this approach, and the resulting scarring in each patient is difficult to be seen under a common undershirt. CONCLUSION: This review shows that the technique of a lower midline skin incision and minimal sternotomy approach is a safe reliable and cosmetically advantageous method for a pediatric cardiac operation. 相似文献
102.
The efficacy of betanecholchloride in the postoperative treatment of bladder dysfunction is controversial. We therefore performed
a comparative study on the effect of this therapy for the prophylaxis of detrusor hypotonia after Wertheim-Meigs operation.
Forty patients with cervical cancer FIGO stage Ib/IIa were divided into two study groups. The control group (24 patients)
only received betanecholchloride if the residual urine persisted above 50 ml after the 10th postoperative day. The study group
(16 patients) received 50 mg betanecholchloride three times a day from the 3rd postoperative day onward. In this group postoperative
catheter treatment, and consequently hospital stay, were significantly shorter (9.6 versus 13.3 days and 15.5 versus 18.6
days). The residual urinary volume normalized faster (8.0 versus 13.0 days) and the rate of cystitis was lower (18.8 versus
25%). According to our study, a prophylactic application of the parasympathomimetic drug betanecholchloride diminishes postoperative
complications associated with bladder dysfunction after Wertheim-Meigs operation.
EDITORIAL COMMENT: Bladder dysfunction plays an important role after radical hysterectomy. The authors present data indicating
improved and quicker resumption of bladder function following radical hysterectomy with early administration of betanecholchloride,
versus use of the medication only when indicated by elevated postvoid residual. Although the study is not a double-blinded
placebo-controlled trial, the patients who received beta-necholchloride from postoperative day 3 had significantly decreased
postoperative catheter treatment, earlier resumption of adequate bladder emptying defined as a postvoid residual of less than
50 ml, decreased incidence of bladder infection and shorter hospital stay. This information is encouraging for this subset
of patients, who characteristically are at high risk for long-term bladder dysfunction. Further studies in this area are needed
to clarify therapeutic options to improve patients’ quality of life, specifically in regard to bladder function following
treatment of their cancer. 相似文献
103.
The aim of the study was to evaluate the effectiveness of transabdominal wedge colpectomy as surgical treatment for cystocele.
One hundred and sixty-three women with either first or second-degree cystocele (Beecham classification), rectocele and concomitant
stress urinary incontinence or benign pelvic masses were submitted for a combined operation. Transabdominal repair of the
cystocele was performed by wedge colpectomy employing two different absorbable sutures, Vicryl and PDS. The choice of suture
was not random but depended on the period at which surgery was performed. Data obtained were analyzed with Student’st-test and Fisher’s exact test. The cystocele cure rate was 90.2% (110 out of 122) at 3-year follow-up and was significantly
associated with the preoperative degree, being 95.5% and 76.5% in first and in second degree, respectively (P=0.003). At 1-year follow-up the cure rate was significantly associated with the type of the suture employed (P=0.01). At 2-year follow-up rectocele cure rate was 97.2% and vaginal vault prolapse appeared in 3.5% of cases. Stress urinary
incontinence relapsed in 10% of patients after Burch colposuspension. After the operation 94.1% of the women declared normal
coitus. In the present series wedge colpectomy was found to be effective in repairing first-degree cystocele, whereas a high
incidence of relapse was observed when second-degree cystocele was present preoperatively. The suture material employed influenced
the cure rate.
EDITORIAL COMMENT: Wedge colpectomy of the anterior vaginal wall has been described by Weinstein and Roberts (1949), Macer
(1978) and Drutz (1991) as a means of abdominally correcting anterior vaginal wall relaxation. Although the present authors
did not find as high a success rate with the procedure as the previous investigators, they do show that an abdominal approach
to cystocele repair is feasible. There are instances when such an approach would be advantageous to avoid repositioning for
a vaginal anterior wall repair. The danger of abdominal anterior wedge colpectomy lies in the dissection of the bladder base
from the underlying vaginal wall. Dissection in this area must proceed carefully to avoid trauma to the bladder, ureters and,
more distally, to the urethrovesical junction. Performed carefully, with attention directed at avoiding these structures,
the abdominal wedge colpectomy is a potentially useful procedure to add to the armamentarium of the urogynecologic surgeon. 相似文献
104.
用绘图法对15具尸体15对腓骨小头的胫腓关节面及桡骨腕关节面进行了解剖学的对比研究,观察关节面形态,测量其长径、横径、关节面倾斜角度、曲率半径,发现腓骨小头的胫腓关节面和桡腕关节面解剖相似。在此基础上,临床应用带血管腓骨近段移植重建桡腕关节4例收到良好的疗效,根据Green评分标准,腕关节评分为70~85分。 相似文献
105.
胃肠道肿瘤病人围手术期细胞因子及蛋白质代谢的变化 总被引:4,自引:0,他引:4
目的 :探讨胃肠道肿瘤病人手术后肿瘤坏死因子 α (TNF α)、白介素 6 (IL 6 )、白介素 10 (IL 10 )的变化以及与蛋白质代谢的关系。 方法 :用酶联免疫法 (ELISA)检测 19例胃肠道肿瘤根治术病人术前和术后 1、3、5天血清TNF α、IL 6和IL 10水平 ,同时检测蛋白质分解代谢相关指标、2 4h尿中尿素和肌酐排泄量。 结果 :胃肠道肿瘤根治术后病人TNF α呈下降趋势 ,术后第 1天较术前明显下降 (P <0 .0 5 )。IL 6和IL 10术后升高 (P <0 .0 1) ,尤以术后第 1天升高明显。术后 2 4h尿中尿素和肌酐排泄量明显升高。 结论 :胃肠道肿瘤根治术后病人IL 6和IL 10的升高支持手术应激导致的细胞因子释放变化 ,但TNF α呈下降趋势 ,可能与胃肠道肿瘤病人术前TNF α的高表达有关。术后蛋白质分解代谢增加 ,可能与细胞因子IL 6和IL 10的升高有关。 相似文献
106.
手术联合中药治疗激素性股骨头缺血性坏死的实验研究 总被引:5,自引:0,他引:5
目的 :初步探讨激素性股骨头缺血性坏死的发病机制 ,观察手术 +中药治疗本病的疗效。方法 :通过对新西兰大白兔联合应用马血清 +甲基强的松龙造模及手术处理 ,对正常组、模型组、手术组、手术 +中药组实验兔的血脂、血液流变学、血生化及股骨头标本切片观察 ,分析比较。结果 :手术 +中药治疗本病的疗效优于单纯保髋手术。结论 :手术 +活血化瘀补肾壮骨方法是股骨头缺血性坏死治疗的合理方法 相似文献
107.
余志敏 《安徽卫生职业技术学院学报》2005,4(6):48-49
目的:报告二尖瓣球囊扩张术(PBMV术)并发心脏压塞的抢救与护理.方法:主要从患者的术前准备、术中抢救与配合、术后护理介绍.结果:准备充分,抢救及时,护理得当,患者病情稳定后转心脏外科手术治疗.结论:二尖瓣球囊扩张风险大,心脏压塞是最危险、最常见的并发症之一,故加强术前准备,密切术中配合,及时抢救尤为重要. 相似文献
108.
目的:探讨筋膜内和筋膜外全子宫切除术对女性排便功能的影响。方法:76例全子宫切除患者分为筋膜外全切除组(A组)56例,筋膜内全子宫切除组(B组)20例,对两组术后病人的排便次数,难易程度的变化进行分析。结果:76例全子宫切除病人42.1%出现不同程度排便困难,A组52.62%,B组为10%,两组具有显著性差异(P<0.05)。结论:全子宫切除术后可影响女性排便功能,筋膜内全子宫切除术对排便功能影响小,是一种较好手术方式。 相似文献
109.
The popularization and application of cold storage red blood cells or whole blood at −80 °C of the Rh(D) negative patients in surgical operation 总被引:2,自引:0,他引:2
Summary The efficiency of cold storage red blood cells (CSRBC) or whole blood at −80 °C used in 27 Rh(D) negative patients during
surgical operation was reported. The Rh(D) negative patients received the transfusion of CSRBC or whole blood stored at −80
°C for 180 to 360 days. The changes in the indexes, such as blood TB, DB, K+, Na+, BUN, Cr, urine protein (URPO), UOB, Hb, HCT, serum total protein, relative to hemolytic reaction and blood volume before
and after transfusion were observed. The results showed that after transfusion of CSRBC or whole blood 27 cases were negative
for urine protein and UOB, and the levels of BUN and Cr were normal (P>0.05). Blood TB, DB, Hb, and HCT were increased, while pH, blood K+ and blood Na+ was normal with the difference being not significant before and after operation (P>0.05). Plasma protein was decreased, but there was no significant difference before and after operation (P>0.05). It was suggested that CSRBC or whole blood at −80 °C could be safely infused to the Rh(D) negative patients without
side effects during the surgical operation.
YU Zhongqing, male, born in 1957, Technician in Charge 相似文献
110.
有效中药复方研究的方法学探讨 总被引:11,自引:0,他引:11
从化学的角度探讨了临床有效中药复方研究的四个过程 ,简述了直接试验设计在全方药味筛选及化学模式识别中药质量控制中的应用 ,论述了复方有效部位和有效部位中主要有效成分的确定及化学计量学的应用和主要药效物质化学结构信息的计算机模拟方法 ,为中药复方研究提供一个范例。 相似文献