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51.
报告37例主动脉窦瘤破裂手术治疗结果。着重介绍手术方法,主张采用主动脉根部和窦瘤破入心腔的双切口,切除、修补窦瘤的同时矫正合并畸形。伴主动脉瓣膜垂致中度关闭不全者,主张行主动脉瓣替换术。术后早期死亡1例,余35例随访6个月-14年,心功能恢复良好。 相似文献
52.
以296例胎膜早破(PROM)作为研究对象,并以350例无PROM作对照,探讨PROM对母婴的影响。结果显示:PROM组难产率为56.08%,产褥病率4.05%,早产率为5.40%,胎儿窘迫率为13.00%,新生儿窒息率为4.33%,新生儿肺炎发生率为3.66%,均明显高于对照组,统计学处理后有显著或极显著性差异(P<0.05,P<0.01)。而且,PROM隐惹期小于24小时的产褥病率为2.29%;大于24小时的产褥病率则为8.97%(P<0.05)。本文提示,应积极预防胎膜早破,一旦出现胎膜早破,宜在6小时内使用抗生素预防感染,并加强母儿监测。 相似文献
53.
W. -A. Cappeller R. Knitza J. Briegel H. Forst H. Stiegler L. Sunder-Plassmann E. Pratschke 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1992,377(2):100-103
Zusammenfassung Das HELLP-Syndrom (Hemolysis, Elevated Liver enzymes, Low Platelets) tritt als Komplikation einer Schwangerschaftspräeklampsie auf und kann zu ausgedehnten subkapsulären Leberhämatomen führen. Wegen der Rupturgefahr der Hämatome besteht eine lebensbedrohende Notfallsituation für Mutter und Ungeborenes. Anhand von 2 Fallbeispielen wird das interdisziplinäre Vorgehen diskutiert. Mit Diagnosestellung der subkapsulären Leberhämatome sollte die notfallmäßige Entbindung durch Sectio erfolgen. Dann kann die chirurgische Entscheidung für eine konservative, abwartende Therapie mit Intensivüberwachung oder für eine Notfalloperation im Falle einer Leberkapselruptur ohne vermeidbares Risiko getroffen werden.
Subcapsular liver hematoma with HELLP-syndrome — an interdisciplinary urgency
Summary The HELLP-syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets), known as a complication during pregnancy, is associated with preeclampsia and may cause subcapsular liver hematomas. In case of hepatic rupture the lives of mother and unborn are threatened. Therefore, an interdisciplinary diagnostic and therapeutic approach is discussed and compared to two examples. The diagnosis of subcapsular liver hematoma must lead to urgent delivery through Cesarean section. Thereafter, the surgeon may decide between observation on an intensive care unit and urgent operation in case of hepatic rupture, without endangering the unborn.相似文献
54.
Toshifumi Murashita Keishu Yasuda Yoshiro Matsui Norihiko Shiiya Shigeyuki Sasaki Makoto Sakuma 《Surgery today》1997,27(4):368-372
A successful replacement of the aorta from the ascending aorta to the supraceliac abdominal aorta in one operation is herein reported. The patient was 66-year-old woman who had DeBakey type I chronic aortic dissection with a pre-disseminated intravascular coagulation (DIC) condition. The image diagnosis revealed a markedly enlarged false lumen with a narrow true lumen in the ascending aorta extending to the diaphragm level while below the diaphragm level, the aortic dilatation was mild. The operation was performed through both a thoracoabdominal incision and a median sternotomy to expose the whole thoracic aorta, and the aorta was replaced from the ascending aorta to the supraceliac abdominal aorta. Selective cerebral perfusion was used for cerebral protection and this was a useful adjunct since no time limitations were thus required during repair of the aortic arch. Although the patient developed several complications postoperatively, she eventually recovered and was discharged from the hospital without any neurological disorders. 相似文献
55.
56.
Rupture of an intra-aortic balloon counterpulsator (IABCP) demands immediate removal. We report a case of thrombus formation within a Datascope IABCP secondary to IABCP rupture, necessitating surgical exploration for removal. There is a disturbing pattern of balloon ruptures with this type of IABCP. 相似文献
57.
目的探讨医源性小儿气管、支气管破裂的外科治疗方法.方法根据气管、支气管破损程度,分别采用颈部深筋膜切开14例,胸膜腔闭式引流10例,气管膜部修补5例,病肺切除术2例.结果本组31例患儿全部治愈.结论严密观察,及时处理,恰当选择外科手术方法是提高疗效的关键. 相似文献
58.
59.
Takemi Noda 《Virchows Archiv : an international journal of pathology》1984,404(4):381-392
Summary Pathomorphological and angioarchitectural characteristics of esophageal varices, mainly of ruptured varices, were studied in autopsy cases. Contrast medium was injected into the esophageal vein in 25 among 75 cases with varices, and in 4 cases without varices as a control. Out of the 75 cases with varices, rupture was confirmed in 8 cases. Ruptured points were recognized at the oral end of the longitudinal veins (these veins were called sudare-like veins in this study) in the lamina propria at the lower end of the esophagus in all of the 8 cases. This ruptured area was called the critical area. By morphometric examination, dilatation of these sudare-like veins was the most obvious in severe varices, and these veins were observed to penetrate the muscularis mucosae to connect to the submucosal veins at the critical area. This area seemed to be of the greatest significance in the pathogenesis of spontaneous variceal rupture. 相似文献
60.
Branches of the splenic artery and splenic arterial segments 总被引:2,自引:0,他引:2
Daisy Sahni A Indar Jit B Gupta CN Gupta DM Harjeet E 《Clinical anatomy (New York, N.Y.)》2003,16(5):371-377
In 200 adult autopsy specimens, the arterial supply to the pancreas and spleen was studied radiologically and by manual dissection. The splenic artery divided into two or three lobar arteries, which supplied its corresponding lobe; each lobar artery subsequently divided into two to four lobular branches. Six to twelve lobular branches were observed entering the splenic substance at the hilum. Lobar arteries did not anastomose with each other, hence, the lobes of the spleen are also termed segments. The lobules, however, were not found to be independent segments and the arteries of one lobule anastomosed with those of other lobules. The branching pattern of the splenic artery varied from one specimen to another, so much so that a prevailing pattern could not be identified. Polar arteries, particularly to the superior pole, arose quite proximal to the hilum in 51% of cases and were occasionally missed. In 45% of males and 40% of females, the posterior gastric artery arose from about the middle of the splenic artery. The splenic artery was not found to be tortuous in fetuses, newborns, and young children. Tortuosity was seen in only 10% of adults; thus, the characteristic tortuosity of the splenic artery appears to develop with age. 相似文献