Tip protectors for microsurgical instruments — an inexpensive alternative

Hypodermic needle shields may be used as tip protectors for several types of microsurgical instruments. These provide an inexpensive alternative to commercially available tip covers.     

微血管夹对血管损伤相关研究进展

在显微外科手术中微血管夹发挥着重要作用,因此,对微血管夹的研发及相关性血管损伤的研究一直是研究热点。本文从微血管夹引起的相关血管损伤的角度出发,从损伤评估方法、血管夹特性和血管损伤关系、血管损伤后修复以及微血管夹研究进展等四个方面进行总结,并根据目前研究现状而进行展望。     

104例听神经瘤分级及其显微外科手术治疗

目的：探讨听神经瘤分级与选择显微外科手术入路的关系。方法：根据１０４例听神经瘤的临床表现和影像学检查所见，将肿瘤分为四级，选择不同的入路行显微外科手术治疗。结果：应用显微外科技术将肿瘤全切除９１例，次全切除１３例。面神经保留率达９３．２７％，听力保存率达１６．３５％。无重残及死亡病例。结论：根据听神经瘤的大小、扩展方向及临床特征，可以将肿瘤分级，选择不同的显微外科手术入路，提高肿瘤全切除率，有效地保护颅神经的功能。     

Basic study of microsurgical orchidopexy for high undescended testis; assessment of clinical applicability.

An experimental microvascular surgical technique to bring an intraabdominal testis to the scrotum was used on rats and dogs. It appears that the method may be applicable to clinical cases in children.     

Chest wall thickness and decompression failure: A systematic review and meta-analysis comparing anatomic locations in needle thoracostomy

IntroductionCurrent Advanced Trauma Life Support guidelines recommend decompression for thoracic tension physiology using a 5-cm angiocatheter at the second intercostal space (ICS) on the midclavicular line (MCL). High failure rates occur. Through systematic review and meta-analysis, we aimed to determine the chest wall thickness (CWT) of the 2nd ICS-MCL, the 4th/5th ICS at the anterior axillary line (AAL), the 4th/5th ICS mid axillary line (MAL) and needle thoracostomy failure rates using the currently recommended 5-cm angiocatheter.MethodsA comprehensive search of several databases from their inception to July 24, 2014 was conducted. The search was limited to the English language, and all study populations were included. Studies were appraised by two independent reviewers according to a priori defined PRISMA inclusion and exclusion criteria. Continuous outcomes (CWT) were evaluated using weighted mean difference and binary outcomes (failure with 5-cm needle) were assessed using incidence rate. Outcomes were pooled using the random-effects model.ResultsThe search resulted in 34,652 studies of which 15 were included for CWT analysis, 13 for NT effectiveness. Mean CWT was 42.79 mm (95% CI, 38.78–46.81) at 2nd ICS-MCL, 39.85 mm (95% CI, 28.70–51.00) at MAL, and 34.33 mm (95% CI, 28.20–40.47) at AAL (P = .08). Mean failure rate was 38% (95% CI, 24–54) at 2nd ICS-MCL, 31% (95% CI, 10–64) at MAL, and 13% (95% CI, 8–22) at AAL (P = .01).ConclusionEvidence from observational studies suggests that the 4th/5th ICS-AAL has the lowest predicted failure rate of needle decompression in multiple populations.Level of evidenceLevel 3 SR/MA with up to two negative criteria.Study typeTherapeutic.     

应用显微外科技术预防尿道下裂术后尿瘘

目的：提高尿道下裂一期手术疗效，减少尿瘘等并发症发生。方法：应用显微外科技术，选择不同的术式一期修复尿道下裂17例，包括加盖带蒂包皮瓣尿道成形术(onlay island flap urthroplasty)4例，横形带蒂包皮瓣尿道成形术(Duckett术)8例，膀胱黏膜一期尿道成形术5例。结果：一期手术全部成功，无尿瘘、尿道狭窄、感染等严重并发症。结论：应用显微外科技术，能提高尿道下裂一期手术的成功率，减少尿瘘的发生。     

手术器械质量现状的调查分析

目的了解手术器械的质量现状,为保障手术顺利及患者安全提供参考。方法便利抽取706份手术器械,共计26 445件进行完整性和功能性检测。结果检测的26 445件手术器械中,其中完好器械占38.6%,表面损伤器械占6.7%,需要修理器械占13.2%,需要替换的器械占41.5%。结论手术器械总体质量较差,应进行定期检测,及时发现和解决存在的问题,对供应室人员进行专业培训,合理确定手术器械的份数及配置,促进手术顺利进行。     

难治性癫痫显微外科治疗的疗效分析

目的 报道应用显微外科治疗难治性癫痫的临床效果。方法应用三维痫灶定位诊疗计划对163例顽固性癫痫患者进行术前、术中致痫灶三维精确定位，然后在显微镜下采用几种术式结合的方法手术处理致痫灶、致痫网。术后随访1～2年，回顾性分析显微外科手术治疗的临床效果。结果结果发现术后癫痫发作完全消失52例（31．90％），发作显著改善83例（50．92％），改善较好10例（6．13％），改善较差15例（9．20％），发作无改善3例（1．84％），手术总有效率为88．96％，无效率为11.04％，术后88．96％以上的患者生活质量均有一定程度的提高。结论应用显微外科技术切除癫痫病灶可以明显减少术后并发症，提高临床疗效。     

输精管显微外科吻合术后复通效果临床研究

目的 报道应用显微外科手术技术施行输精管吻合复通的临床效果。方法 从１９７８年８月起,采用显微外科手术,选择无创伤缝针线,在手术显微镜下施行一层和二层方式的输精管显微外科吻合,术后得到随访２５２例,其中作一层吻合１３３例,二层吻合１１９例,术后不置腔内支架。结果 共作输精管吻合２７７例,随访率９１．２％,复通效果以射出精液中出现活精子作为依据者有２４８例,复通率达９８．４％,以配偶妊娠作为判断标准