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1.
神经导航中一些应用技术的比较研究   总被引:18,自引:0,他引:18  
目的 对神经导航中的导航捧、注册技术、影像学资料应用技术进行比较研究。方法 对2000年8月~2002年7月间接受神经导航手术的85例颅内病变患者的临床资料进行回顾性分析。结果85例中导航手术成功82例,失败3例;导航系统误差:贴标记物(Mark)法平均为0.4mm,激光(Z-touch)法平均为1.2mm。结论神经导航技术的定位准确,可避免不必要的创伤,保护重要结构。采用各类导航技术相互组合,是一种高效、准确的微创治疗方法。  相似文献
2.
微创术治疗高血压脑出血的临床研究   总被引:12,自引:2,他引:10  
目的:探讨微创颅内血肿清除术在高血压脑出血治疗中的优越性。方法:保守组38例行内科综合治疗,开颅组38例在保守组治疗的基础上升骨瓣或骨窗,清除血肿,微创组36例在保守组治疗的基础上行CT片定位法微创颅内血肿清除术,比较三组治疗的有效率、死亡率和治疗前、后神经功能缺损评分,采用t和x^2检验比较。结果:保守组有效率42.1%,死亡率21.1%,开颅组有效率为55.3%,死亡率为10.5%,微创组有效率为91.7%,死亡率2.8%,微创组与开颅组和保守组比较均有显著性差异(P<0.05);微创组于治疗后第l天神经功能缺损评分即见明显减少,而开颅组和保守组均于治疗后第14天才有明显减少,微创组与开颅组和保守组比较均有显著性差异(P<0.05)。结论:微创颅内血肿清除术在高血压脑出血治疗中能提高有效率、降低死亡率、加快神经功能恢复。  相似文献
3.
微创技术在腹部外科中的应用进展和展望   总被引:12,自引:4,他引:8  
微创是21世纪外科发展的方向之一,以内镜、腔镜和介入技术为基础的微创技术在腹部外科的应用越来越广泛深入,有些技术已迅速取代传统剖腹手术,成为部分疾病治疗的首选。同时,开展过程中存在的一些问题和认识上的误区也要引起了我们足够重视,并予以妥善解决。多种微创技术的全面发展和组合应用是当前发展的潮流,而虚拟现实技术、手术机器人和远程微创手术的研发将是今后的方向。  相似文献
4.
Background Laparoscopy-assisted radical gastrectomy is gaining acceptance for treating early gastric cancer. However, few reports concerning the effectiveness of laparoscopy-assisted D2 radical distal gastrectomy (LADG) for advanced gastric cancer or data comparing the results obtained after open distal gastrectomy (ODG) are yet available. The aim of this study was to evaluate the method, feasibility and clinical result of LADG for advanced gastric cancer. Methods A retrospective study was performed comparing LADG and ODG for advanced gastric cancer. Seventy-eight patients who underwent LADG were compared with 90 patients who underwent ODG in terms of pathologic findings, operative outcome, and complications. Results There was no conversion to open surgery in the LADG group and no postoperative mortality of any patients. There were no significant differences between LADG and ODG in operative time ((245±35) vs (220±620) minutes), complication rate (7.7% vs 10.0%), and number of lymph nodes (23.5±6.0 vs 21.0±7.5), while the blood loss was less after LADG ((110±25) vs (196±30) ml, P 〈0.05). The time to postoperative flatus and postoperative hospital stay were shorter after LADG ((73.0±8.5) vs (102.0±10.5) hours, and (8.6±1.2) vs (12.1 ±2.5) days, P 〈0.05, respectively). Conclusion LADG for advanced gastric cancer is feasible, safe, and minimally invasive.  相似文献
5.
内镜与腹腔镜联合治疗结直肠良恶性息肉的价值   总被引:7,自引:0,他引:7  
目的探讨内镜与腹腔镜(双镜)联合治疗结直肠良恶性息肉的应用价值。方法尝试运用多种双镜联合的方式治疗结直肠良恶性息肉,比较其临床效果。结果46例双镜联合治疗患者,其中腹腔镜辅助内镜下治疗5例(10.87%),内镜定位腹腔镜切除30例(65.22%),内镜腹腔镜同步切除6例(13.04%),追加腹腔镜根治术5例。46例中息肉恶变21例(45.7%),其中浸润性癌6例,3例淋巴结转移。内镜协助腹腔镜手术41例无中转开腹,术后吻合口漏2例,吻合口出血1例。腹腔镜保护内镜治疗的5例无并发症发生。双镜联合患者随访时间1~21个月,息肉恶变者术后无一例复发。结论双镜联合增加了内镜治疗的安全性和适应证范围,减少了手术创伤,是结直肠良恶性息肉治疗的合理方法。  相似文献
6.
7.
Background The feasibility and safety of endoscopic thyroidectomy were evaluated by an approach of systematic review of published studies in the past decade.
Methods A database searching was performed on MEDLINE, Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials. Both comparative and non-comparative studies about endoscopic thyroidectomy were selected and analyzed. For the comparative studies, RevMan 4.2 was used for statistical analysis; and for the non-comparative studies, data analysis was performed by SPSS 13.0.
Results Seven comparative studies involving 367 patients (video-assisted thyroidectomy (VAT), 174 patients; conventional thyroidectomy (CT), 193 patients) were included in VAT-CT group. Age, gender, operative types, and pathological diagnosis were similar. Compared with CT, the mean operative time for VAT was significantly longer (VAT, 80.0 minutes; CT, 61.9 minutes, P 〈0.01), but the postoperative hospital stay was shorter (VAT, 1.7 days; CT, 2.5 days, P 〈0.01). The complication rate for VAT was 6.9%, while that for CT was 9.3% (P=0.35). Three studies analyzed the postoperative pain and cosmetic evaluation, and indicated that the VAT group was superior to the CT group, but there was no significant difference after a meta-analysis. Three comparative studies involving 273 patients (totally endoscopic thyroidectomy (TET), 145 patients; CT, 128 patients) were included in TET-CT group and the results generally resembled that of VAT-CT group. There were 18 and 14 non-comparative studies reporting the results of VAT and TET, respectively. The mean operative time for VAT was 76.8 minutes compared with 135.8 minutes for TET. The postoperative hospital stay was 1.8 and 3.8 days for VAT and TET respectively. The rates of conversion to open surgery for VAT and TET were similar (VAT, 2.8%; TET, 3.9%, P=0.105). The complication rate for VAT was 8.  相似文献
8.
模式化腹腔镜肝左外叶切除术:附71例临床应用报道   总被引:6,自引:0,他引:6  
目的介绍一套模式化腹腔镜肝左外叶切除方法。方法分7步:(1)患者取平卧位,4孔法操作;(2)按序离断肝周韧带脉,,断游肝离角肝度左偏叶左;(;3()6超)切声割刀闭粗合分器离离出断Ⅱ肝段左及静Ⅲ脉段;(血7)管处蒂理;(创4)面切,割留闭置合引流器,离取断出Ⅱ标/Ⅲ本段。血结管果蒂20;(035)年超7声月刀~2粗01分0年离8出月肝,左共完静成71例手术,无中转。手术时间75±30.8 min,出血量58±36.4 ml,术后平均住院4.8±1.5 d。术后腹水2例,胆瘘1例,保守治愈。结论本"模式化"方法简便,安全、可行,重复性好,术中出血及术后并发症少,术者腔镜技术要求低,适合各级医院借鉴,利于腹腔镜肝脏切除术的普及和推广。  相似文献
9.
老年重症高血压脑出血患者的微创治疗   总被引:5,自引:0,他引:5  
韩巨 《疑难病杂志》2006,5(1):16-18
目的探讨颅内血肿微创清除术(微创术)治疗老年重症高血压脑出血患者的疗效。方法对30例60岁以上、基底节区高血压脑出血、血肿量大于60ml的患者,采用脑CT片进行穿刺点定位,YL1型颅内血肿粉碎穿刺针对血肿进行穿刺、液化、引流,评估其病死率、好转率及治疗3周时神经功能评分,并与单纯药物治疗组(30例)进行比较。结果微创术治疗组死亡8例,病死率26.7%,好转22例,好转率73.3%;保守组死亡15例,病死率50.0%,好转15例,好转率50.0%。治疗组病死率显著低于单纯药物治疗组(P<0.01),好转率则显著高于单纯药物治疗组(P<0.01);治疗3周时微创术组神经功能评分(16.52±4.76)分,单纯药物治疗组(22.47±5.83)分,2组差异有非常显著意义(P<0.01),提示微创术治疗组患者神经功能恢复程度好于单纯药物治疗组。结论微创术治疗老年重症高血压脑出血患者效果较好,值得临床应用。  相似文献
10.
下鼻甲位置不良对鼻通气功能的影响   总被引:5,自引:1,他引:4  
目的:探讨下鼻甲位置不良对鼻通气功能的影响,并介绍下鼻甲外移术的方法。方法:将204例不同疾病伴有“鼻塞”患者与21例健康受试者的下鼻甲骨行CT冠状位扫描,进行解剖学研究。通过204例经下鼻甲外移手术患者分析鼻通气功能改善的状况。结果:204例患者中107例下鼻道宽敞而下鼻甲骨位置靠近鼻中隔;55例下鼻甲居中但总鼻道狭窄,42例下鼻甲骨骨质增厚。21例健康受试者中15例下鼻甲骨居中,其余略偏向下鼻道,总鼻道宽敞。经下鼻甲外移手术所有患者的鼻通气功能均明显改善。结论:下鼻甲骨位置不良是引起鼻阻塞的主要原因,故传统的“慢性鼻炎“诊断概念有待改进。  相似文献
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