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排序方式: 共有1240条查询结果,搜索用时 156 毫秒
91.
C Sandoval G Stringel M F Ozkaynak O Tugal S Jayabose 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2000,4(2):117-120
OBJECTIVE: The aim of this study was to evaluate our experience with laparoscopic splenectomy in pediatric patients with hematologic diseases. METHODS: A retrospective chart review was performed to analyze the following: indication for splenectomy, pre- and peri-operative management, surgical technique, complications, duration of hospitalization, and outcome. RESULTS: Eleven patients underwent laparoscopic splenectomy for the following indications: recurrent thrombocytopenia (<10,000) in seven with chronic immune thrombocytopenic purpura; anemia in two with hereditary spherocytosis; and hypersplenism in one and recurrent splenic sequestration in another with homozygous hemoglobin S. The six girls and five boys had a median age of 7 years. The median operative time was 180 minutes, and the median hospitalization was 72 hours. Among the patients with immune thrombocytopenic purpura (median platelet count, 153,000), those patients (n=3) with platelet counts of <100,000 did not suffer any bleeding complications. The patient with hypersplenism and homozygous hemoglobin S required a small incision in the left lower quadrant to facilitate removal of a 558-gram spleen. This patient also underwent cholecystectomy for cholelithiasis. The operative time was 295 minutes, and he was hospitalized for 5 days because of atelectasis. CONCLUSIONS: Laparoscopic splenectomy is a safe and effective procedure in children with hematological disorders. 相似文献
92.
93.
H Mahmoudvand L Farivar I Sharifi M Fasihi Harandi V Moazed S Jahanbakhsh Z Babaei N Zia-Ali 《Iranian Journal of Parasitology》2012,7(3):99-102
Malaria is a major problem in tropical and sub-tropical countries, with high morbidity and mortality. Splenectomy makes patients more susceptible to serious bacterial and parasitic infections. We report for the first time in Iran a fatal case of Plasmodium vivax malaria, confirmed by microscopic and molecular (Semi-nested multiplex PCR) tests in a patient who had undergone splenectomy due to hemolytic anemia. 相似文献
94.
脾脏切除在长期发热伴脾脏肿大中的诊断价值 总被引:1,自引:0,他引:1
目的 探讨发热待查在临床上公有脾肿大供组织学诊断中行脾切除术的价值。方法 回顾分析了我院血液科1996年来以发热待查收住院,除发热、脾肿大外无其它阳性体征,且辅助检查也为阴性的14例患者的临床资料,行脾切除术后取脾脏作病理学检查。结果 14例患者中,霍奇金淋巴瘤3例,非霍奇金淋巴瘤5例,结缔组织病3例,恶性组织细胞病2例,脾陈旧性梗死1例。随访15-54个月,3例结缔组织病完全缓解;1例脾陈旧性梗死痊愈;淋巴瘤3例完全缓解,1例部分缓解。结论 发热待查而临床上仅有脾肿大时,应动员患者尽早地作诊断性脾切除术并送病理学检查,以免延误诊断和治疗。 相似文献
95.
目的:探讨腹腔镜脾切除术(laparoscopic splenectomy,LS)的临床应用。方法:我们2001年至2008年共实施LS63例,其中特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)42例,门脉高压继发性脾功能亢进11例,白血病5例。结果:全部病例均在腹腔镜下完成手术,无中转开腹。平均手术时间140min,术中平均失血120ml,术后出血1例,每天约20ml,保守治疗12d后痊愈;术后胃漏1例,手术缝合及引流后痊愈。术后平均住院6d。结论:LS具有创伤小,患者恢复快、痛苦轻和住院时间短等优点,适用于脾脏体积正常至中度增大的有切脾指征的各类患者。 相似文献
96.
Yuichi Endo Masayuki Ohta Kohei Shibata Seiichiro Kai Kentaro Iwaki Hiroki Uchida Masao Ogata Junji Ikewaki Kenji Kashima Seigo Kitano 《Surgery today》2008,38(12):1148-1151
A 45-year-old woman with previously diagnosed chronic type adult T-cell leukemia (ATL) presented with abdominal discomfort
and red eruptions on her arms and legs. Anemia, thrombocytopenia, hypercalcemia, and splenomegaly indicated progression to
acute-type ATL. Combined chemotherapy resulted in normalization of the serum calcium level and improvement in her symptoms.
However, the severe anemia and thrombocytopenia persisted, necessitating transfusions of red blood cells (RBC) and platelets
three times a week. We performed splenectomy in an attempt to reduce the total volume of malignant cells and improve the hypersplenism.
After the operation, the RBC and platelet counts increased gradually, and the transfusions were stopped on postoperative day
(POD) 3. Splenectomy should be considered as an optional treatment for hypersplenism caused by ATL when hypersplenism cannot
be controlled by chemotherapy in patients without a high surgical risk. 相似文献
97.
门静脉高压症脾切除术后患者血浆内皮素变化与门静脉血栓形成的关系 总被引:4,自引:0,他引:4
为探讨门静脉高压症患者脾切除术后血浆内皮素 (ET)水平变化及其临床意义 ,采用放免法测定了30例肝硬变门静脉高压症行脾切除术患者 (观察组 )术前及术后 1周血浆 ET水平 ,并设对照组比较。结果显示 ,观察组术前血浆 ET水平 (6 7.2 4± 2 4 .6 3pg/ml)明显高于对照组 (33.2 1± 11.0 5 pg/ml) ,P<0 .0 0 1;术后 1周明显下降 (37.2 4± 14 .4 7pg/ml) ,P<0 .0 0 1,与对照组 (32 .4 8± 10 .6 2 pg/m l)比较无显著差异 ,P>0 .0 5。脾切除术后门静脉血栓形成者 ET水平 (5 7.90± 2 1.70 pg/m l)明显高于非血栓形成者 (33.15± 8.2 9pg/ml) ,P<0 .0 0 1。认为ET在肝硬变、门静脉高压症发生中起重要作用 ,ET增高与门静脉血栓形成有关。脾切除术后血浆 ET明显下降 ,对改善肝脏功能、降低门静脉压力具有重要意义 相似文献
98.
肝细胞癌合并肝硬化患者肝切除联合脾切除的临床意义探讨 总被引:8,自引:0,他引:8
目的探讨肝细胞癌合并肝硬化患者肝癌切除时联合脾切除的临床意义。方法将我科收治肝癌合并肝硬化患者分成 2组 ,即切脾组 (11例 )和保脾组 (15例 ) ,比较 2组患者手术前后肝功能与血象改变。结果切脾组术后 14d白细胞和血小板计数分别为 (8 9± 1 6 )× 10 9/L、(310±32 )× 10 9/L ,明显高于保脾组 (3 7± 1 4 )× 10 9/L和 (10 4± 4 1)× 10 9/L(P <0 0 1)。术后第 7天切脾组血清总胆红素为 (2 4± 7) μmol/L ,低于不切脾组 (37± 13) μmol/L ,P <0 0 5。 2组间术后并发症发生率差异无显著意义。结论肝细胞癌合并肝硬化患者肝癌切除时联合脾切除提高白细胞和血小板计数 ,减轻术后肝脏胆红素代谢负担 ,但术后并发症发生率并未明显增加 相似文献
99.
Kenneth J Ransom Michael S Kavic 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2008,12(2):202-205
BACKGROUND: Grade III through V splenic injuries as defined by the American Association for the Surgery of Trauma (AAST) grading scale are associated with hemorrhage and nonoperative failure. Embolization has been reported to reduce splenic bleeding in 50% to 75% of patients with a high-grade injury. However, splenectomy following embolization may be necessary in patients who continue to bleed or develop splenic infarction with abscess formation. METHODS: We present the case of a 15-year-old female who demonstrated a Grade V splenic laceration with moderate hemoperitoneum following an all terrain vehicle crash. Central splenic artery embolization was performed. Because of signs of continued bleeding, laparoscopic splenectomy was performed. RESULTS: The patient had a satisfactory postoperative result and returned to normal activity in 2 weeks. CONCLUSION: Our experience suggests that in cases of high-grade splenic injury or angiographic extravasation associated with moderate to large hemoperitoneum, embolization may serve as a bridge to operative therapy and make laparoscopy a safe, less-invasive option for splenectomy. 相似文献
100.
化疗大鼠脾切除前后免疫功能改变的实验研究 总被引:2,自引:0,他引:2
目的 探讨接受化学药物治疗后脾切除前后免疫功能的变化。方法 本实验将72只大鼠随机分为3组:(1)对照组;)(2)激素负荷组;(3)免疫抑制组。脾切除前后测定多项免疫指标:T淋巴细胞增殖能力、NK细胞活性和中性粒细胞吞噬功能。结果 脾脏切除前激素负荷组和免疫抑制组,T淋巴细胞增殖能力、NK细胞活性和中性粒细胞吞噬功能皆明显低于对照组(P〈0.01);脾切除后对照组上述免疫指标下降(P〈0.01), 相似文献