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21.
关菁 《中国实用妇科与产科杂志》2022,38(11):1083-1088
输卵管因素不孕症占不孕人群的30%~35%。随着腹腔镜技术及微创手术原则的应用,生殖相关输卵管性疾病的微创手术治疗受到关注。手术治疗输卵管性不孕在评估输卵管功能,保留生育功能,改善患者自然妊娠或辅助生殖技术助孕的结局方面具有重要作用。文章主要对有生育要求的输卵管病变患者,腹腔镜手术保留及恢复生育功能的处理及临床结局进行阐述。 相似文献
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Oliver Stadler Christian Dettwiler Christian Meller Michel Dalstra Carlalberta Verna Thomas Connert 《The Angle orthodontist》2019,89(6):876
Objectives:To compare a fluorescence-aided identification technique (FIT) with a conventional light source (CLS) for removing composite during debonding of brackets with respect to time needed, composite remnants, and tooth substance loss.Materials and Methods:Twelve maxillary models with 10 bovine teeth each were digitally surface-scanned and metal brackets were bonded on each tooth with Opal Seal and Opal Bond. Two operators: an experienced orthodontist (A) and an undergraduate student (B) received six models each and were asked to remove the composite remnants with a tungsten carbide bur and Sof-Lex discs by both a conventional light source (CLS group, n = 3), and fluorescent inducing light (FIT group, n = 3). The time taken was recorded, and a postoperative scan was digitally superimposed on the preoperative scan to quantify number of teeth with composite remnants and volume and thickness of enamel loss and composite remnants. Chi-square test and independent t-tests were performed to compare methods with a significance level of 5%.Results:Compared to CLS, both operators needed significantly less time when using the FIT method and degree of enamel loss, height, and volume of composite remnants and total remaining composite remnants were significantly reduced. By FIT, the volume of enamel loss was significantly reduced for operator A only. Operator B removed the same enamel volume with either method.Conclusions:Cleanup after orthodontic debonding with the FIT was superior regarding time needed and removal of composite remnants. Total enamel loss reduction was operator-dependent. 相似文献
24.
�� ʢ�����Ӿ������� 《中国实用外科杂志》2019,39(2):143-145
肝门部胆管狭窄通常分为恶性狭窄和良性狭窄。如何有效处理肝门部胆管狭窄一直是胆道外科中的重点与难点。由于其涉及胆管系统、肝动脉系统、门静脉系统以及肝脏实质等,因此,对手术路径的选择至关重要。基于围肝门技术的肝门入路术式,能更好的显露肝门区各管道的解剖,并行精准处理,从而有效提高肝门部胆管癌的手术根治率,降低胆管狭窄的手术难度及手术风险。 相似文献
25.
Lane Thaut Wells Weymouth Branden Hunsaker Daniel Reschke 《The Journal of emergency medicine》2019,56(1):23-28
Background
Central vein catheter (CVC) placement using the modified Seldinger technique is a common procedure in the emergency department, but can be time consuming due to the multiple pieces of equipment included in central line kits and the number of steps in the procedure. Preassembled devices combine a needle, guidewire, dilator, and sheath into one unit and potentially simplify the process and reduce time required for CVC placement using the accelerated Seldinger technique.Objective
Our aim was to evaluate whether the use of combination central line devices and the accelerated Seldinger technique will reduce the time required to place a CVC and increase the ease of the procedure.Methods
This two-arm randomized crossover study comparing the accelerated Seldinger technique to the modified Seldinger technique was performed in a simulation setting. Subjects were selected from among emergency physicians, emergency medicine residents, interns, physician assistants, and medical students. Subjects were timed using the modified and accelerated Seldinger techniques. Ease of use and satisfaction data were collected after both procedures.Results
The use of the accelerated Seldinger technique with a combination CVC device was significantly faster compared to the modified Seldinger technique with a standard CVC kit. Procedure time was reduced by 35% (p = 0.001), and ease of use was increased by 7% (p = 0.046), without any increase in errors.Conclusions
In the simulated setting, the accelerated Seldinger technique using combination CVC devices is a faster and easier method for CVC placement compared to the modified Seldinger technique. 相似文献26.
中华医学会外科学分会 《中国实用外科杂志》2019,39(1):15
正胆道缝合重建是肝胆胰外科手术的最基本操作之一,建立胆汁引流通畅、无张力、血供充足的黏膜对黏膜吻合是胆道重建的基本要求。目前,胆道重建方式繁多,但根据所须重建胆道的病理生理状况选择合适的胆道缝合方法及缝合材料是保障胆道重建成功的关键因素。随着手术技术的进步及各种缝合材料的发展,胆道缝合技术越来越精细,高质量的胆道缝合重建是病人顺利康复及减少多次手术的关键。基于此,中华医学会外科学分会组织国内部分专家结合最新文献及胆道外科的最新进 相似文献
27.
目的 探讨Ilizarov技术与Masquelet技术治疗股骨感染性骨不连的疗效。 方法 回顾性分析2014年1月~2018年1月我院收治的63例股骨感染性骨不连患者的临床资料,根据不同手术方式分为Ilizarov组(n=34)与Masquelet组(n=29)。比较两组手术次数、治疗费用、生命质量评分、并发症、愈合时间及治疗效果。 结果〓两组治疗手术总次数无明显差异(P>0.05),但Ilizarov组治疗缺损手术次数更多(P<0.05),而Masquelet组患者治疗感染手术次数更多(P<0.05);Masquelet组治疗费用明显低于Ilizarov组(P<0.05);治疗后,两组患者生命质量评分均提高,且Masquelet组提高幅度大于Ilizarov组(均P<0.05);两组并发症发生率无明显差异(P>0.05);Masquelet组治愈时间明显短于Ilizarov组(P<0.05);治疗后,两组患者疗效总优良率无明显差异(P>0.05),但Ilizarov组治疗效果评级为优的患者明显多于Masquelet组(P<0.05)。 结论 Ilizarov技术可修复、重建较长骨段缺损,感染、复发率低,愈合时间短,但操作难度大,治疗费用高,对患者日常活动影响大;Masquelet技术适用于骨缺损长度较短且自体供骨量充足患者,操作简单,安全性好,但对软组织要求较高,因此应根据患者实际情况合理选择临床术式,帮助患者更好康复。 相似文献
28.
目的研究超声低频探头和低频探头联合高频探头检查在新生儿颅脑疾病诊断中的准确率和敏感性。
方法选取河源市妇幼保健院自2017年1月至2018年12月收治的有颅脑疾病高危因素(早产、低体质量、多胎妊娠、出生过程有缺氧窒息及产时感染)的新生儿90例作为研究对象。采用随机数字表法将所有新生儿平均分为2组,研究组(45例)给予低频探头联合高频探头进行探查,对照组(45例)仅给予低频探头进行探查。结合CT检查结果和临床治疗,比较2种检测方法的准确率和敏感性。
结果研究组检测新生儿缺氧缺血性脑病、脑室内出血和室管膜下出血诊断准确率分别为87.5%、100%、100%,高于相应对照组(15.38%、12.5%、0%),差异有统计学意义(P<0.05);研究组和对照组检测脑实质内出血和脑积水的诊断准确率分别为87.5%、100%以及42.85%、66.67%,差异无统计学意义(P>0.05)。研究组检测新生儿颅脑疾病的效率为82.22%,高于对照组(22.22%),差异具有统计学意义(P<0.05)。
结论使用超声低频探头联合高频探头的方法提高了缺氧缺血性脑病、脑室内出血、室管膜下出血等新生儿颅脑疾病诊断的准确率,在诊断新生儿脑实质内出血和脑积水的准确率没有差异,且对颅脑疾病诊断的敏感性较高,因此具有较为重要的临床意义。 相似文献
29.
Analysis of Heterozygous BRCA1 5382ins Founder Mutation in a Cohort of Egyptian Breast Cancer Female Patients Using Pyrosequencing Technique 下载免费PDF全文
Salwa H Gomaa MogahedYasser S HamedYassmin E Ibrahim MoursyMarwa H Mahomoud Saied 《Asian Pacific journal of cancer prevention》2020,21(2):431-438
Background: Up to half of the heritable mutations in breast cancer (BC) are attributed to BRCA1 and BRCA2 genes. The mutation prevalence is variable based on ethnicity and may be influenced by founder mutations. The aim of this pilot study is to determine for the first time, the prevalence of BRCA1 5382insC founder mutation in a cohort of Egyptian familial breast cancer patients (FBC). Methods: Female patients were selected to have familial type of breast cancer. Twenty healthy females were included as a control group. Peripheral blood samples were withdrawn from all studied females and were analyzed for BRCA1 5382insC founder mutation detection using pyrosequencing technique. Results: Eighty Egyptian FBC females were eligible to be enrolled in the study with a mean age of 48.31 ± 10.97years.We found a BRCA1 5382insC mutation carrier frequency of 5% of total studied FBC patients (4 out of 80 patients) with 95% confidence interval (1.61-12.99). There was a high statistical significant difference between carriers and non-carriers concerning the number of affected family members by BC, (p=0.001). Conclusion: BRCA1 5382insC founder mutation is not uncommon among Egyptian FBC females. The carrier frequency is comparable to that reported worldwide; however it is lower than those from previous Egyptian studies using different molecular techniques. The strong association between the mutation and the number of affected family members suggest wider screening of the mutation among high risk families using the reliable pyrosequencing technique. 相似文献
30.