腹腔镜胆囊切除术对胆结石治疗效果分析

目的：分析胆结石采取腹腔镜胆囊切除术治疗的临床效果。方法将接诊的胆结石患者70例作为研究对象,皆签署知情同意书愿意配合研究,随机均分为研究组与对照组。对照组患者采取常规胆囊切除术治疗,而研究组患者采取腹腔镜胆囊切除术治疗,观察记录两组患者手术时间、术中出血量、术后排气时间、术后疼痛评分、术后下床活动时间、术后并发症、术后住院时间及临床疗效等情况,并对比分析。结果研究组手术时间、术中出血量、术后排气时间、术后疼痛评分、术后下床活动时间、术后住院时间、术后并发症发生率皆明显低于对照组,组间对比差异有统计学意义（ P＜0.05）;研究组总有效率为97.14％,对照组则为85.71％,研究组明显优于对照组（ P＜0.05）。结论胆结石患者采取腹腔镜胆囊切除术治疗可取得比较良好的效果,安全性高、操作简单方便、疼痛小、恢复快,同时出血量少、手术时间短、并发症少,可确保患者早日康复出院,值得借鉴。     

腹腔镜胆囊切除术应用有效方案治疗体会

目的：探讨腹腔镜胆囊切除术的临床效果。方法将80例急性胆囊炎患者按照抛硬币方法随机分为两组,标记为实验组、对照组。对照组40例患者使用开腹手术切除治疗,实验组40例患者使用腹腔镜胆囊切除术治疗,比较两组患者手术时间、术后引流量、术中出血及术后并发症等情况。结果实验组患者手术时间明显短于对照组,手术引流量明显多于对照组,术中出血量明显少于对照组,两组患者差异具有统计学意义（P＜0.05）。实验组患者术后并发症发生率为5.0％;对照组患者术后并发症发生率为20.0％,两组患者在并发症方面差异具有统计学意义（ P＜0.05）。结论腹腔镜胆囊切除术治疗急性胆囊炎疗效佳,切口小,并发症少,安全有效。     

外科手术联合药物治疗胆结石患者50例临床分析

目的：探讨分析外科手术联合药物治疗胆结石的临床效果。方法选取收治的胆结石患者50例作为研究对象,随机分为对照组和观察组,每组25例,对照组给予外科手术治疗,观察组给予外科手术联合药物治疗,比较两组患者的临床疗效以及不良反应的发生情况。结果经治疗后,观察组的临床总有效率为96.0％,对照组的临床总有效率为84.0％,观察组的临床总有效率明显高于对照组（ P＜0.05）,差异具有统计学意义;观察组的术后并发症发生情况明显低于对照组（ P＜0.05）。结论外科手术联合药物治疗胆结石的临床疗效显著,不良反应少,安全性高,具有良好的应用前景。     

腹腔镜胆囊切除在急性结石性胆囊炎临床治疗中的应用效果分析

目的探讨腹腔镜胆囊切除术治疗急性结石性胆囊炎的临床效果。方法选择收治的70例急性结石性胆囊炎患者为研究对象,随机分为对照组和观察组。对照组采用开腹胆囊切除术治疗,观察组采用腹腔镜胆囊切除术治疗。比较两组手术情况,术后并发症发生情况及取石成功率、结石清除率。结果观察组手术时间、术中出血量、住院时间均显著少于对照组,差异有统计学意义（P〈0.05）。观察组术后并发症发生率显著低于对照组,差异有统计学意义（P〈0.05）。两组取石成功率、结石清除率差异无统计学意义（P〉0.05）。结论腹腔镜胆囊切除术手术情况优于开腹手术,术后并发症发生率低,取石成功率、结石清除率高,操作方便。     

腹腔镜术中联合应用十二指肠镜对接技术(LER)治疗胆囊胆总管结石的临床评价

目的 研究并探讨腹腔镜术中联合应用十二指肠镜对接技术(Laparo-endoscopic rendenvous,LER)治疗胆囊胆总管结石的临床疗效.方法 于2012年1月～2015年12月,选取100例胆囊胆总管结石患者作为研究对象,采取数字随机抽取法将患者分为对照组、观察组,每组50例.对照组实施十二指肠镜、腹腔镜分期手术治疗,观察组实施腹腔镜联合十二指肠镜对接一期手术治疗.比较两组患者的手术成功率、手术时间、住院时间、术后并发症发生率、复发率.结果 两组患者经手术均取净结石,观察组、对照组的手术成功率均为98％,手术中各有1例患者因胆囊三角发生严重粘连而中转为开腹手术,差异无统计学意义(P＞0.05).观察组的手术时间、住院时间分别为(67.35±19.87) min、(7.85±2.13)d,与对照组的(124.69±28.56)min、(11.29±3.96)d相比,差异具有统计学意义(P＜0.05).两组患者手术后均未出现肠穿孔、消化道出血等十二指肠镜相关并发症,观察组的胰腺炎发生率为2％,较对照组的14％明显更低(P＜0.05).手术后随访发现,观察组、对照组分别有2例、1例患者出现复发,复发率分别为4％、2％,差异无统计学意义(P＞0.05).结论 在胆囊胆总管结石的临床治疗中,相对于腹腔镜、十二指肠镜分期手术治疗,采用腹腔镜联合十二指肠对接一期手术治疗可更加有效的缩短手术时间,促进术后恢复,减少术后胰腺炎的并发.     

急性坏疽性胆囊炎腹腔镜微创手术治疗的方法及其疗效

目的 探讨腹腔镜微创手术治疗急性坏疽性胆囊炎的临床效果.方法 将我院2015年1月—2015年11月期间收治的78例急性坏疽性胆囊炎患者随机分为对照组和观察组,观察组行腹腔镜微创胆囊切除术,对照组行开腹胆囊切除术.观察并记录两组患者各项手术指标,包括术中出血量以及手术、住院所用时间等,比较两组患者临床疗效.结果 观察组有效率(97.44%)高于对照组有效率(79.48%);观察组患者较对照组患者在手术、住院时间等一般手术指标比较有显著优势(P<0.05).结论 腹腔镜微创手术治疗急性坏疽性胆囊炎具有良好的治疗效果,安全可靠,在临床上值得应用和推广.     

腹腔镜胆囊切除术与传统胆囊切除术治疗急性胆囊炎患者临床对照研究

目的探讨腹腔镜胆囊切除术与传统胆囊切除术治疗急性胆囊炎患者的临床疗效。方法选取衡水市人民医院自2015年1月至2017年2月收治的104例急性胆囊炎患者为研究对象。采用随机数字表法将其分为A、B两组,每组各52例。A组采用传统胆囊切除术治疗,B组采用腹腔镜胆囊切除术治疗。比较两组患者临床疗效、手术相关指标及并发症发生情况。结果 B组患者治疗的总有效率为100. 0%(52/52),显著高于A组的90. 4%(47/52),两组间比较,差异有统计学意义(P <0. 05);两组患者手术时间、术中出血量、排气时间及住院时间比较,B组均显著优于A组,两组间比较,差异均有统计学意义(P <0. 05); B组的并发症发生率显著低于A组(P <0. 05)。结论腹腔镜胆囊切除术较传统胆囊切除术更具有优势,其疗效更佳,创伤更小,患者恢复快,并发症少。     

腹腔镜与开腹手术治疗子宫肌瘤的临床疗效分析

目的 探讨腹腔镜与开腹手术治疗子宫肌瘤的临床疗效.方法 将收治的72例子宫肌瘤患者分为两组,对照组36例,应用传统开腹手术治疗;观察组36例,应用腹腔镜下子宫肌瘤局部病灶切除术治疗,比较两组患者的治疗效果及各项临床指标.结果 观察组治疗有效率97.2％ (35/36),明显高于对照组80.5％(29/36)(P＜0.05).结论 在子宫肌瘤的临床治疗中,应用腹腔镜下病灶切除术治疗,比传统开腹手术的疗效更为显著,且创伤小,安全性高,给患者带去的痛苦较轻,有助于促进其尽快康复.     

腹腔镜输尿管切开取石术与开腹手术治疗输尿管上段结石的临床疗效观察

目的 探讨腹腔镜输尿管切开取石术治疗输尿管上段结石的临床应用优势.方法 将收治的98例输尿管上段结石患者依据手术方式差异分组,对比两组疗效、手术与并发症状况.结果 观察组与对照组治疗总有效率分别为96.00％与81.25％,组间差异显著(P＜0.05);两组手术时间、出血量、住院与下床活动时间、住院费用与并发症率均存在显著差异,且观察组各项明显更理想(P＜0.05).结论 腹腔镜输尿管切开取石术作为一种微创手术应用于临床对输尿管上段结石患者治疗,疗效确切且并发症率较低,该法深具临床推广价值.     

动脉栓塞治疗产后及异常妊娠子宫出血的临床应用效果

目的 探究动脉栓塞治疗产后及异常妊娠子宫出血的临床应用效果.方法 入选产后及异常妊娠子宫出血的患者94例,按照随机的分配原则分成对照组与观察组,各47例.对照组采用子宫切除术治疗,观察组应用动脉栓塞治疗.两组患者在治疗后对临床疗效,手术时间,术后流血量和住院时间进行比较与分析.结果观察组治疗总的有效率为68.1％,明显高于对照组治疗总的有效率95.7％,差异有统计学的意义(P＜0.05).观察组的手术时间和住院时间均较对照组短,观察组的术后流血量少于对照组,差异有统计学的意义(P＜0.05).结论 动脉栓塞治疗产后及异常妊娠子宫出血的临床应用效果较好,可减少患者的术后流血量.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.