大型、巨大型听神经瘤的显微手术配合

听神经瘤的手术一直被看作神经领域里难度大、死亡率高 ,并发症多的手术之一。随着显微神经外科技术的发展与应用 ,手术死亡率、并发症明显下降。我院神经外科 1990～ 2 0 0 0年采用显微手术治疗大型、巨大型听神经瘤 2 85例 ,现将手术配合报告如下1　临床资料男 192例 ,女 93例。年龄 7～ 6 9岁。诊为双侧听神经瘤 8例 ,大型 (直径 >4 0ｃｍ) 115例 ;巨大型(直径 >6 0ｃｍ) 5 8例 ,其中直径大于 8ｃｍ的超巨大型 12例。肿瘤完全为实质性的有 12 8例 (45 % ) ,小部分有囊性变的 131例 (46 3% ) ,大部分为囊性变的 2 5例 (8 7% )。 2 85例…     

后腹腔镜上尿路手术体位的研究进展

综述后腹腔镜上尿路手术体位的应用、摆放的原则和其各自的优缺点,以及后腹腔镜上尿路手术体位的改良方法和进展状况、手术医生的术姿疲劳程度的相关因素分析,探讨后腹腔镜上尿路手术的适宜体位,以提高病人安全舒适度并减轻医生手术操作的疲劳度,提高工作效率和工作质量。     

多媒体教学结合PBL教学法在手术室临床教学的效果研究

多媒体教学和以问题为基础的学习(简称PBL)各有优、缺点.我院手术室2010年6月～2011年6月,在实习护生的临床教学中,应用"多媒体教学结合PBL教学法"的教学模式,并对教学效果进行评价,为手术室的临床教学提供了更为科学和合理的教学方法.现报告如下.     

老年结直肠手术患者围手术期体温对压疮发生风险的影响分析

目的探讨老年结直肠手术患者围手术期体温异常对发生压疮风险的影响,为提高围手术期护理质量提供参考。方法选择2011年1月至2013年7月我院择期结直肠手术老年患者325例,对患者围手术期体温进行监测,按体温差异分为术中低体温组,术中正常体温组,术后低体温组,术后高体温组,术后正常体温组,比较各组术前、术后3dBarden评分,出院前记录压疮发生例数。分析各组Barden评分差异及压疮发生率差异。结果术中低体温组术后3dBarden低于正常体温组,压疮发生率高于正常体温组。术后低体温组术及术后高体温组术后3dBarden评分低于正常体温组,压疮发生率高于正常体温组。结论术中及术后低体温增加压疮发生风险,围手术期应采取合适护理措施,预防低体温发生。     

在麻醉诱导间实施优质护理的体会

<正>麻醉诱导间是为了减少接台手术准备时间而设立,可在此为接台手术患者进行静脉留置针置管、硬膜外置管、深静脉置管、动脉置管等,有效地提高手术的接台效率,缩短手术周转时间,节省手术医生等待手术的时间,提高手术间的周转率。但由于在麻醉诱导间进行这些操作之时,患者处于清醒状态,又没有亲人的陪护,同时由于接台手术时间的不确定,较长时间的禁食,患者容易出现紧张、焦虑、恐惧、烦     

Gene Transfection Mediated by Ultrasound and Pluronic P85 in HepG2 Cells

In order to assess whether gene transfection could be mediated by ultrasound in associa- tion with P85 and find the appropriate parameters of ultrasound irradiation, the effects of ultrasound with or without P85 on gene transfection of HepG2 cells were examined. The HepG2 cells were irra- diated by ultrasound at 1 MHz, 0.4-2.0 W/cm2 and 50% duty cycle with plasmid encoding enhanced green fluorescent protein (EGFP) as a report gene. Forty-eight h later, the expression of EGFP was detected under the fluorescence microscopy. Transfection efficacy was quantitatively assessed by flow cytometry, and cell viability was evaluated by trypan blue exclusion. The results showed that the transfection efficacy was increased with the increases in ultrasound output power and the ideal trans- fection efficacy was achieved in HepG2 cells irradiated by ultrasound at 0.8 W/cm2 for 30 s. The transfection efficacy in ulstrasound P85 group was three times higher than in single ultrasound group [(17.63±1.07)% vs (5.57±0.56)%, P<0.05]. The cell viability was about 81% and 62% in ultrasound group and ultrasound P85 group respectively. It was concluded that ultrasound in combination with P85 could mediate the gene transfection of HepG2 cells, ideal transfection efficacy was achieved by ultrasound irradiation at 0.8 W/cm2 for 30 s, and P85 could somewhat increase the damage to cells caused by ultrasound.     

Ultrasound and Microbubbles： Their Functions in Gene Transfer In Vitro

To examine the role of ultrasound in gene delivery in vitro, three cells lines were exposed to the low-frequency ultrasound of varying intensities and for different durations to evaluate their effect on gene transfection and cell viability of the cells. Microbubble （MB）, Optison （10%）, was also used to observe the role of the microbubbles in gene transfection. The results demonstrated that as the ultrasound intensity and the exposure time increased, the gene transfer rate increased and the cell viability decreased, but at high energy intensities, the cell viability decreased dramatically, which caused the transfer rate to decrease. The most efficient ultrasound intensity for inducing gene transfer was 1 W/cm^2 with duration being 20 s. At the same energy intensity, higher ultrasound intensity could achieve maximal gene transfer rate earlier. Microbubbles could increase ultrasound-induced cell gene transfer rate by about 2 to 3 times mainly at lower energy intensities. Moreover, microbubbles could raise the maximum gene transfer rate mediated by ultrasound. It is concluded that the low-frequency ultrasound can induce cell gene transfer and the cell gene transfer rate and viability are correlated with not only the ultrasound energy intensity but also the ultrasound intensity, the higher ultrasound intensity achieves its maximal transfer rate more quickly and the ultrasound intensity that can induce optimal gene transfer is 1 W/cm^2 with duration being 20 s, and microbubbles can significantly increase the maximal gene transfer rate in vitro.     

超声诊断肠管疝入膀胱1例

患者，男，３５岁。以车挤压腰部及骨盆致下腹疼痛伴血尿入院。 体检：下腹部深压痛，腹穿抽出不凝血，骨盆挤压征阳性。急诊行后尿道会师术＋膀胱修补术，手术顺利。诊断：①骨盆骨折；②膀胱破裂；③尿道断裂。术后４月余出现排尿障碍、下腹胀痛２天再次入院． Ｂ超所见：双肾轻度积水，左右侧肾盂分离前后径分别为１．８ｃｍ、２．０ｃｍ，双侧输尿管扩张，其内均未见异常光团回声；膀胱过度充盈，膀胱顶部偏左膀胱壁不完整，可见条索状回声穿行，膀胱内可见条索状高回声蠕动；另膀跳内充满细小回声，随高回声光带蠕动而翻动；肝肾间隙及…     

大型鞍结节脑膜瘤显微手术配合

鞍结节脑膜瘤是前颅底常见良性肿瘤。如肿瘤直径大于4cm的鞍结节脑膜瘤多已造成双侧视神经受压,与两侧颈内动脉、前交通动脉、穿质支、下视丘和大脑前动脉关系密切,并可能将第三脑室底推向上方[1]。此时手术难度大。显微手术能最大限度的保护神经功能的完善及切除病变[2]...