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腹腔镜结直肠手术的现状与发展 总被引:6,自引:0,他引:6
腹腔镜胆囊切除术、抗反流手术及其他良性消化道肿瘤手术已被推荐为“金标准手术”。而腹腔镜手术在根治消化道恶性肿瘤中的应用仍然存在一定争议,1990年美国Jacobs进行了世界上首例腹腔镜右半结肠切除术,同年Folwer进行了腹腔镜乙状结肠切除术,从此腹腔镜技术逐渐运用于传统的结直 相似文献
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论腹腔镜结肠直肠手术 总被引:24,自引:1,他引:23
腹腔镜胆囊切除术、抗食管反流术及良性消化道肿瘤手术已被推荐为“金标准手术”。而腹腔镜手术在根治消化道恶性肿瘤中的应用则远未达成共识。1991年美国Jacob进行了世界上首例腹腔镜右半结肠切除术,同年Folwer进行了腹腔镜乙状结肠切除术.从此腹腔镜技术逐渐运用于传统的结肠直肠手术,但发展速度远不如其他腹腔镜手术。 相似文献
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传统开腹、腹腔镜与小切口胆囊切除术的对比研究 总被引:1,自引:0,他引:1
目的 分析传统开腹、腹腔镜及小切口胆囊切除术三者在治疗胆囊结石中手术疗效.方法 收集89例胆囊切除术患者资料,根据不同手术方法分为3组:传统开腹胆囊切除术(OC组,29例)、腹腔镜胆囊切除术(LC组,30例)及小切口胆囊切除术(MC组,29例),分析三类不同方法手术的优缺点.结果 LC组和MC组的出血量、消化功能恢复时... 相似文献
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<正>1987年Mouret首次报道腹腔镜胆囊切除术以来,近20年,腹腔镜技术获得巨大发展,已被广泛接受。我国腹腔镜技术经过19年的快速发展,手术数量和种类已发生了质的变化。就腹部外科而言,目前很多二级以上医院已能开展腹腔镜胆囊切除术、腹腔镜阑尾切除术、腹腔镜肝囊肿开窗引 相似文献
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黄武飙 《中国现代普通外科进展》2011,14(3):222+234-222,234
腹腔镜胆囊切除术(laparoscopic cholecystecto-my,LC)已成为胆囊良性疾病行胆囊切除术的"金标准"[1]。传统LC一般采用四孔或三孔法,并用钛夹夹闭胆囊管和胆囊动脉。随着生活水平的提高,患者对腹腔镜手术也提出了更高的要求。因此,寻求以最小创伤达到最佳治疗效果的术式已成为腔镜医 相似文献
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预防腹腔镜胆囊切除术并发症的体会 总被引:2,自引:0,他引:2
预防腹腔镜胆囊切除术并发症的体会杜国盛,萧荫祺,许红兵,邹一平,闫恒懦腹腔镜胆囊切除术(LC)可达到传统开腹切除胆囊的效果具有术后疼痛轻、住院时间短、恢复快等优点,已成为切除胆囊手术的重要方法.随着LC病例的增多,人们已认识到开膀胆囊切除术所发生的并... 相似文献
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Burd A 《Burns : journal of the International Society for Burn Injuries》2012,38(1):142; author reply 143
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Doxey G 《The Journal of orthopaedic and sports physical therapy》1984,5(6):336-347
The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347. 相似文献
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Subramaniam B Pomposelli F Talmor D Park KW 《Anesthesia and analgesia》2005,100(5):1241-7, table of contents
We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM. 相似文献
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Gómez-Arnau JI Aguilar JL Bovaira P Bustos F De Andrés J de la Pinta JC García-Fernández J López-Alvarez S López-Olaondo L Neira F Planas A Pueyo J Vila P Torres LM;Grupo de Trabajo de NVPO de la Sociedad Española de Anestesiología y Reanimación 《Revista espa?ola de anestesiología y reanimación》2010,57(8):508-524
Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol. 相似文献