改良式宫腔镜下宫颈电切术治疗慢性宫颈炎120例疗效观察

2005年7月～2006年6月,我院应用改良式宫腔镜下宫颈电切术（TCRC）治疗慢性宫颈炎120例,疗效较好。现报告如下。     

改良式经皮气管切开术在ICU中的应用

目的分析改良式经皮气管切开术在ICU应用的疗效情况。方法对142例ICU病人采用改良式经皮气管切开术进行回顾性分析。结果手术操作时间为3～10min,平均（5.2±2.4）min,141例成功,1例术中寻找气管困难改行传统的气管切开术。5例切口少许渗血;1例切口感染发生;6例术后创口有渗血;无严重并发症。结论改良式经皮气管切开术具有安全、简单、快速、创伤小、花费低廉的优点,可在ICU广泛应用。     

改良皮下隧道式腰大池引流术在脑肿瘤患者中的应用效果观察

［摘要］　目的　观察改良皮下隧道式腰大池引流术在脑肿瘤患者中的应用效果。方法　选择2014年8月至2021年7月广州医科大学附属肿瘤医院神经外科收治的需留置腰大池引流管的脑肿瘤患者80例,随机分为对照组和观察组,每组40例。对照组有2例因失访剔除,最终纳入38例;观察组无剔除。对照组采用常规腰大池引流术,观察组采用改良皮下隧道式腰大池引流术。比较两组穿刺点脑脊液漏、导管移位、非计划拔管及继发性颅内感染等不良事件发生率,并对比两组日均引流量。结果　观察组穿刺点脑脊液漏、导管移位、非计划拔管的发生率均低于对照组,差异有统计学意义（P<0.05）。两组继发性颅内感染发生率比较差异无统计学意义（P>0.05）。两组日均引流量比较差异无统计学意义［（159.07±30.20）ml vs （162.42±32.45）ml;t=0.472,P=0.638］。结论　改良皮下隧道式腰大池引流术的脑脊液引流效果满意,且能显著降低穿刺点脑脊液漏、导管移位及非计划拔管等不良事件的发生风险,操作简便易行,值得临床推广。     

改良式腹部横切口妇科手术370例分析

1999年 12月开始 ,我科应用改良式腹部横切口施行妇科手术 370例 ,现报告如下。临床资料 :本文改良组 370例 ,年龄 2 3～ 5 6岁 ;子宫全切除术 35 5例 ,子宫肌瘤挖除术 10例 ,宫外孕输卵管部分切除术 5例 ,均采用改良式腹部横切口。常规对照组 30 0例 ,年龄2 6～ 6 0岁 ;子宫全切除术 2 6 8例 ,子宫肌瘤挖除术 2 6例 ,宫外孕输卵管部分切除术 6例 ,均采用传统下腹部正中纵切口 ,常规切开腹壁各层 ,钳夹止血 ,直达腹腔手术。方法 :改良组 :切口选择耻骨联合上缘皱壁 ,长 5～ 7cm。弧形切开皮肤 (仅切透真皮 ) ,正中切开皮下脂肪 2～ 3cm深达…     

改良背带式缝合术在剖宫产术中大出血患者中的应用

目的探讨改良背带式缝合术用于剖宫产术中大出血的效果。方法对11例剖宫产术中大出血患者应用改良背带式缝合术,并随访产后恢复情况。结果9例手术成功,保留了子宫,产后42d复查子宫复旧好,产后6～12个月无后遗症及远期并发症。结论改良背带式缝合术是处理剖宫产术中出血,特别是宫缩乏力性出血的有效方法。     

改良封闭胃残端方法在贲门癌手术中的应用

1992～ 2 0 0 2年 ,我们于晚期贲门癌切除、胃食管吻合术中采用改良法封闭胃残端 ,效果满意。现报告如下。临床资料 :本组 94例晚期贲门癌患者 ,其中男 76例 ,女18例 ;年龄 44～ 76岁 ,平均 5 5岁。术前经食管造影检查、部分加纤维食管镜或 CT检查而确诊 ,均行贲门癌切除、胃食管吻合术。手术方法 :术中采用腔内胃食管吻合 5 6例 ,其中腔内弹力环扎吻合 10例 ;采用腔外胃食管置入吻合 3 8例。做左胸后外侧切口 ,经胸进腹探查 ,决定行肿瘤切除后游离下段食管 ,游离肿瘤及胃达幽门部 ,分别距肿瘤边缘 3～ 5 cm切断食管及胃 ,断胃时应尽量保留…     

改良悬雍垂手术在腭裂修复中的应用

悬雍垂是位于软腭后缘中央伸向下方的指状突起[1] ,是口腔通向咽腔的门户 ,具有独特的解剖外形和功能。腭裂患者只有悬雍垂痕迹 ,而无正常解剖形态的悬雍垂。手术时恢复正常形态的悬雍垂至关重要 ,以前对此重视不够。为此 ,1998年 10月 2 0 0 0年 10月 ,我们在腭裂手术中为患者     

改良Stark式剖宫产术的临床应用(附86例报告)

剖宫产是产科最常见的手术,由于剖宫产手术有逐渐增多趋势,故研究与完善剖宫产手术方法对降低母婴围产期发病率与死亡率有重要的意义。以色列Ｓｔａｒｋ教授通过１０多年的研究,于１９９４年在第１４届世界妇产科学术会议上介绍了Ｓｔａｒｋ式剖宫产术式,受到世界各国...     

改良腋下切口在胸腔手术中的应用

我科1992～2001年间将传统腋下切口进行改进，对67例胸腔内多种疾病剖胸行多种术式治疗，效果满意，报告如下。     

改良式透明帽在18例上消化道黏膜平坦隆起性病变中临床应用

目的评价改良式透明帽在内镜黏膜切除术中的应用效果,并对其适应症和操作方法等问题进行讨论。方法选择符合内镜黏膜切除术适应症的18例应用改良透明帽,切除了27处病变。对手术发生的并发症进行观察和处理。结果 18例患者中共切除病变27处,完全切除率100%。术后病理诊断起源于黏膜肌层的食管平滑肌瘤2处,食管乳头状瘤3处,黏膜慢性炎2处。胃:增生性息肉12处,炎性息肉7处,重度不典型增生1处。并发症主要是岀血,术中创面渗血2处,均行高频电凝止血。1例发生术后迟发性出血,应用钛夹止血成功。无便血及穿孔发生。结论改良式透明帽在EMR术中可以安全应用,操作简单,特别适合在基层推广应用。     

Advances in Insulin Pen Technologies: Practical Aspects of Insulin Pen Devices

Insulin pen devices have several advantages over the traditional vial-and-syringe method of insulin delivery, including improved patient satisfaction and adherence, greater ease of use, superior accuracy for delivering small doses of insulin, greater social acceptability, and less reported injection pain. In recent years, pens have become increasingly user-friendly, and some models are highly intuitive to use, requiring little or no instruction. Despite this progress, uptake of these devices in the United States has not matched that in many other areas of the world. There is a need for improved awareness of the current characteristics of insulin pen devices among United States health care professionals. Knowledge of the design improvements that have been incorporated into pens, both to address patient needs and as a result of the improved technology behind the device mechanics, is essential to promoting the use of insulin pen devices. This review highlights some of the practical aspects of pen use and discusses the factors to be considered when selecting among different insulin pens.     

Advances in Insulin Pen Technologies: Analysis of Symposium Articles on Insulin Pen Devices and Alternative Insulin Delivery Methods

Insulin therapy is a fundamental component of diabetes management, yet there is often resistance to insulin initiation by both prescribers and patients. A barrier to insulin use is the perceived shortcomings with the traditional vial-and-syringe administration method (inconvenience, difficulty of use, association with disease and addiction, etc.). This symposium in the journal discusses the advantages of alternative insulin delivery methods, primarily insulin pen devices. Although these administration methods, especially insulin pens, have some clear advantages over the vial/syringe, there are also limitations to their use and careful patient selection and education are still needed.     

基于行为转变理论的护理模式在胸外科糖尿病患者中的应用

目的 胸外科糖尿病患者应用行为转变理论护理模式,探讨其应用价值.方法 该次研究对象为80例该院2018年3月—2019年3月收治的胸外科糖尿病患者.其中40例患者接受常规护理方法,视为对照组,另外40例患者接受行为转变理论护理模式,视为观察组,比较观察两组患者的健康行为依从性、护理满意度以及血糖变化.结果 经过护理后,...     

他汀类调节血脂药在心血管外科中的应用

近来许多研究表明他汀类调节血脂药除降脂的作用外还具有良好的心血管保护作用 ,本文就其作用机理及其在心血管外科中的应用做一综述。     

Gamma Knife Radiosurgery in the Management of Patients with Acromegaly: A Review

Although acromegaly is a rare disease, the need for an effective treatment that is able to induce biochemical cure is an extremely important issue. Unsuccessfully treated acromegaly is associated with increased morbidity and an age-corrected mortality so that early and aggressive therapy to normalize hormonal levels should be instituted at diagnosis. Ideally, the growth hormone-secreting adenoma should be completely resected, with preservation or subsequent restoration of pituitary function. Patients with recurrence or failure after surgery are treated with a second surgery, medical, radiation treatment, or combined modality treatment. Steotactic radiosurgery with gamma knife allows the delivery of focused radiation in a single session to the pituitary tumor that delivers a more biologically effective dose to the tumor than fractionated radiotherapy. Its use as a primary or adjuvant treatment for acromegalics may be more cost effective than medical treatment in these patients. Although it seems to be very effective in controlling growth and secretion of the growth hormone-secreting pituitary adenomas, there is a chance that some major risks from gamma knife radiosurgery might occur. This article will review the role that gamma knife radiosurgery might have in patients with acromegaly.     

Pre-mixed Insulin Delivered by Disposable Pen in the Management of Children with Diabetes

Pre-mixed insulin preparations are being used increasingly in the management of children with IDDM. Recently this form of insulin has been produced in a disposable insulin pen device. An open randomized 3-month crossover study was conducted to compare glycaemic control on a self-titrating insulin regimen with a pre-mixed (30:70) preparation, both given twice daily. The pre-mixed preparation was delivered by disposable pen. Forty children (age range 7–16 yr) entered the study. Mean ± SEM glycosylated haemoglobin (HbA₁%) at the start of the study (13.1 ± 0.6) compared with values at the end of the self-titrating (11.8 ± 0.5) and pre-mixed periods (12.5 ± 0.5), as well as blood glucose profiles taken at 3-weekly intervals, showed no significant change. Fourteen of the children were on insulin ratios other than 30:70 (range 10:90 to 50:50) and were unaffected by the switch (HbA₁ at the start of the study 12.7 ± 1; at the end of the self-titrating 11.5 ± 0.8; and pre-mixed period 12.5 ± 0.8). Twenty-one children continued on the pen for a further 12 months with no deterioration in control (HbA₁ at the beginning and end of this period being 11.9 ± 0.7 and 11.0 ± 0.7, respectively). The children (95%) preferred the disposable pen and pre-mixed insulin regimen. Switching to pre-mixed insulin, while not improving, has no detrimental effect on glycaemic control.     

Advances in Insulin Pen Technologies: Evolution of Diabetes Insulin Delivery Devices

The first manufactured insulin pump was introduced in the 1970s and the first insulin pens in 1985; since then, many improvements have been made to both devices. The advantages of pens over syringes have been confirmed in numerous studies and include greater accuracy, ease of use, patient satisfaction, quality of life, and adherence. United States claims database analyses indicate that the improved adherence made possible by use of an insulin pen has the potential to reduce diabetes care costs when compared with using a vial and syringe. Features of certain advanced pump models include the ability to connect wirelessly to a blood glucose meter or to a subcutaneous interstitial glucose sensor for semicontinuous glucose-driven insulin rate adjustment. A new trend in the design of insulin pumps is the tubing-free patch pump that adheres directly to the skin. The low rate of insulin pen usage in the United States compared with European countries and the fact that many patients report that they are not offered the option of an insulin pen by their physician suggest that there is a need to increase patient and provider awareness of the currently available devices for insulin administration.