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目的观察吻合器痔上黏膜环切术治疗Ⅲ度、Ⅳ度痔疮的术后并发症的情况,并探讨术后并发症的处理方法。方法回顾性分析68例行PPH术患者的术后并发症发生情况处理方法及效果。结果68例患者手术均获成功,切除的直肠黏膜环完整,完成随访6~12个月;术后发生肛门疼痛9例,术后一周内出血9例,术后一周后出血3例,肛门坠胀不适10例,痔核回缩不良6例,有2例随访12个月后复发;其中因术后早期出血再次手术患者3例,有3例患者随访12个月仍有肛门坠胀感,其余并发症患者经处理后临床症状消失;复发病例经痔核切除术治愈。结论吻合器痔上黏膜环切术是治疗Ⅲ度和Ⅳ度痔疮的有效方法。但其术后并发症需引起足够重视,细致、耐心和标准的手术操作是预防术后并发症的根本,及时正确的处理是治愈术后并发症的关键。 相似文献
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吻合器痔上直肠黏膜环形切除术(procedure forprolapse and hemorrhoids,PPH)是近年来开展的一种主要针对内痔或混合痔的新术式,并已成为一些地方治疗痔的主流术式。我院2000-03~2010-05共完成PPH手术244例,其中185例有完整的随访资料,报告如下。1资料与方法1.1一般资料:本组185例均为Ⅲ~Ⅳ期患者, 相似文献
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吻合器环形痔切除术的应用,被称做外科切除痔疮的一种显著突破,是一种创新性的手术治疗方法。1998年意大利学者Longo提出通过直肠下端粘膜及粘膜下层组织环形切除治疗Ⅲ、Ⅳ期脱垂内痔的新方法(procedure for prolapse and hemorrhoids,PPH),由于该手术避免损伤肛周皮肤,保留肛垫的完整性,术后疼痛轻,控便能力不受影响,减少术后 相似文献
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于祥林 《中国航天工业医药》2010,(3):82-83
目的探讨应用吻合器行痔切闭术治疗混合痔的临床应用价值。方法利用国产痔专用吻合器于齿线上方行痔切闭术,共130例。同时,随机各抽取60例分为切闭组与切扎组进行对比评估。结果手术时间平均为11.2(5~25)min。平均住院时间3d。随访2周至12月无复发、狭窄、失禁、排便障碍等并发症,术后1个月钛钉开始脱落。结论吻合器痔切闭术具有安全、有效、微创术后痛苦少、住院时间短和恢复快的优点,远期效果有待进一步观察。 相似文献
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<正>混合痔的传统手术方法,手术创面大,术后肛门疼痛重,肛门功能受损,术后恢复慢。近年来随着肛垫下移学说的广泛认可,吻合器痔上黏膜环切术(PPH)已成为手术 相似文献
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目的:采用吻合器行痔上粘膜及粘膜下层组织环切术(PPH),具有手术时间短、术后疼痛轻,恢复快等优点。方法:麻醉后采用PPH环切吻合器或国产吻合器,导入圆形肛管扩张器(CAD33)使痔脱垂或肛管粘膜脱出部分复位并可观察到齿状线,在会阴部3、6、9、12点位用疑线将CAD33固定。通过CAD33导入肛镜缝扎器在齿状线上2-5 cm处完成肛客四周荷包缝合脱垂粘膜,检查如无出血,可行跨越吻合口的“8”字缝合,对其合并症再另行处理。结果:单纯PPH手术时间为20-40 min,住院1-7 d;有合并症手术时间30-50 min,住院1-7 d,平均5.6 d。结论:严格把握PPH的适应症和筛选病例,术中注意荷包缝合的深度和高度,应根据直肠脱垂的程度选择单荷包或双荷包等方法。 相似文献
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Belenky A Aranovich D Greif F Bachar G Bartal G Atar E 《Cardiovascular and interventional radiology》2007,30(2):273-275
Purpose To report our experience with the Angioseal vascular closure device for hemostasis of distal brachial artery puncture.
Methods Between September 2003 and August 2005, 64 Angioseal vascular closure devices were inserted in 64 patients (40 men, 24 women;
mean age 65 years) immediately after diagnostic or therapeutic arterial angiographies performed through a 5 Fr to 7 Fr sheath
via the distal brachial artery. Ultrasound examination of the brachial artery preceded the angiography in all cases and only
arteries wider than 4 mm were closed by the Angioseal. In cases of a sonographically evident thin subcutaneous space of the
cubital fossa, tissue tumescence, using 1% Lidocaine, was performed prior to the arterial closure.
Results The deployment success rate was 100%. No major complications were encountered; only 2 patients developed puncture site hematoma,
and these were followed conservatively.
Conclusions Closure of low brachial artery punctures with the Angioseal is simple and safe. No additional manual compression is required.
We recommend its use after brachial artery access interventions, through appropriately wide arteries, to improve early patient
ambulation and potentially reduce possible puncture site complications. 相似文献
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Adjuvant Therapy in the Treatment of Complications Following Surgery for Hepatic Echinococcal Cysts 总被引:2,自引:0,他引:2
Haddad MC Huwaijah SH Mourad FH Sharara AI Al-Kutoubi AO 《Cardiovascular and interventional radiology》2000,23(5):406-409
Thirty-two patients had surgery for hepatic echinococcal cysts
(HEC). Serious complications were observed in 16 patients (50%):
cyst recurrence (n = 4), infected residual cyst cavity (n = 7),
infected residual cyst cavity with biliary and duodenal fistulae (n =
2), recurrent biliary obstruction following open surgery for a ruptured
HEC into the biliary tree (n = 2), delayed rupture of an HEC
into the biliary tree following laparoscopic surgery with secondary
biliary obstruction (n = 1). These major complications were
successfully managed by percutaneous methods in 8 of 16 patients
while antihelmintic therapy was sufficient in two patients with a
small recurrent cyst and ERCP was used in one patient to relieve
biliary obstruction. Surgery was required in two patients only. With
a success rate of 87.5%, the nonsurgical approach is the preferred
method for treating a post-surgical complication. 相似文献
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目的评价国产吻合器在低位直肠癌保肛术中的应用及术后靶向化疗预防直肠癌术后局部复发和远处转移的效果。方法研究对象为解放军总医院第二附属医院1990年1月-2004年12月收治的低位直肠癌患者284例,均应用国产吻合器施行保肛术,术中行髂内动脉置泵,术后局部靶向灌注化疗,随访2~8年,分析其保肛治疗效果、局部复发率、远处转移率及远期生存率等。结果284例患者均保肛成功,其中一次保肛成功282例(99.3%);保肛后控便效果良好247例(87.0%)。术后发生吻合口瘘2例(0.7%),吻合口狭窄1例(0.4%),吻合口出血1例(0.4%)。随访资料完整的患者共236例,随访率83.1%。术后1、3、5年有局部复发的分别为2例(0.8%)、6例(2.5%)、8例(3.2%);术后1、3、5年远处转移分别为11例(4.7%)、22例(9.3%)、10例(4.3%);术后1、3、5年生存率分别为229例(97.0%)、203例(86.0%)、154例(65.3%)。结论国产吻合器应用于低位直肠癌保肛手术安全、可靠,术后靶向化疗有益于降低局部复发率及远处转移率,提高远期生存率。 相似文献
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PACS图像显示器质量控制的初步研究 总被引:3,自引:0,他引:3
目的探讨放射科PACS系统中图像显示器的质量保证(QA)、质量控制(QC)问题。方法参考美国医学物理学会第18工作组(AAPMTG18)制定的测试图和质量评估标准,利用光度计、显示器校正软件,对3种型号的BARCOCRT灰阶显示器进行季度性定量检测。内容包括:DICOM灰阶标准显示函数校正、最高亮度和最低亮度检测、亮度均一性检测、显示器分辨率、几何失真校正。结果显示器的各项性能指标都符合AAPMTG18规范。放射科95%的医学图像依靠PACS显示器做出了诊断。结论PACS图像显示器的质量控制是确保数字化医疗环境优质性的重要措施。 相似文献
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Giansante Abud D Mounayer C Saint-Maurice JP Rezende MT Houdart E Moret J 《Cardiovascular and interventional radiology》2007,30(1):104-107
We report 2 cases of hemorrhagic complications related to use of the Angio-Seal hemostatic closure device that were successfully
managed with stent-grafts. Two patients with subarachnoid hemorrhage were referred to our departments for endovascular treatment
of ruptured intracranial aneurysms. The treatment was performed through a femoral access; the sheaths were removed immediately
after the procedures, and the punctures sites closed by Angio-Seals. Both patients presented clinical signs of hypovolemic
shock after treatment. The diagnosis of active bleeding through the puncture site was made by emergency digital subtraction
angiography. The lesions were managed with stent-grafts. The use of stent-grafts proved to be efficient in the management
of these life-threatening hemorrhagic complications following the use of the Angio-Seal hemostatic closure device. 相似文献
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目的 探讨结扎速血管闭合系统(LigaSure)在Ⅲ、Ⅳ度痔切除术中的应用价值.方法 65例Ⅲ、Ⅳ度痔患者,其中男41例、女24例,在局麻下实施LigaSure痔切除术.观察手术时间、术中及术后出血量、术后疼痛和并发症情况.结果 65例手术均获得成功.手术时间为5~25min(9.7±4.6min).术后疼痛评分:术后4h为1~7(3.7±1.7),术后24h为0~5(1.9±1.3).术后3天除4例评分在3~5以外,其他患者评分均在3以下.术后7天有5人评分为1~3,余患者均无疼痛主诉.术后2个月时所有患者均无疼痛主诉.9例(15.8%)患者术中出血量小于15ml,其余56例(86.2%)术中无明显出血.术后有1例因出血给予再处理,18例(27.7%)仅表现为少量血性渗出.术后6例出现短期排便轻度失禁,无严重并发症发生.结论 LigaSure用于痔切除术止血效果良好,手术时间短,患者术后疼痛轻. 相似文献
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肝——胃动脉在肝癌TACE中的意义:胃肠道合并症的原因探讨 总被引:1,自引:1,他引:1
目的 研究肝—胃动脉 (hepatogastricartery ,HGA)的解剖特征及其对肝癌患者动脉内化疗栓塞术 (transcatheterarterialchemoembolization ,TACE)后胃肠道并发症的影响。方法 回顾分析 10 0 0例肝动脉血管造影资料 ,将由肝固有动脉及其远端各级肝动脉发出的主要供应胃及十二指肠的变异血管命名为肝—胃动脉 ,研究其起源、走行、分支分布等解剖特征。分别统计分析 3 4例(共行 42次TACE)存在HGA(研究组 )及 3 2例 (共行 5 6次TACE)无HGA(对照组 )的肝癌患者TACE术后胃肠道合并症的发生率 ,比较两组间胃肠道合并症有无差异。研究组中 42次TACE ,其中 18次TACE在动脉注射栓塞剂前 ,行超选择性插管使导管尖端位于HGA开口的远端 (相对安全组 ) ;2 4次TACE导管尖端未避开HGA即行栓塞治疗 (危险组 ) ,比较两组间胃肠道合并症有无差异。结果 10 0 0例肝动脉造影中 ,744例存在HGA ,占 74%。研究组中TACE术后胃肠道合并症的发生率及其严重程度明显高于对照组(Ρ =0 .0 0 4) ;危险组中胃肠道合并症的发生率及其严重程度明显高于相对安全组 (Ρ =0 .0 0 0 )。结论 HGA是一种常见的血管变异 ,TACE时栓塞剂误栓HGA可引起术后不同程度胃肠道合并症的发生 ,行超选择插管避开HGA开口再行栓塞治疗 ,可有效地预防术后胃 相似文献