血管外科的进展

血管外科虽为一新兴学科，但近年来发展迅速。由于国人的生活水平的提高以及人口老龄化，血管疾病的发病率日见增加，国内各大医院也都相继设立了血管外科专业，特别是自１９９３年中华外科学会血管外科学组成立以来，更是有了迅猛发展。由于我国在诊治布加氏综合征等疾病中处于世界领先水平，使我国在世界血管外科领域中也具有重要地位。现就血管外科的诊治进展作一简介。１　临床领域的进展１－１　诊断技术的进展无创和微创检查方面，双相多普勒血流仪，二维超声成像（２Ｄ），超声双功仪（Ｄｕｐｌｅｘ），超声三功仪（Ｔｒｉｐｌｅｘ…     

血管外科进展和趋势

近二十年来,血管外科的诊治技术得到了迅速发展.随着腔内治疗材料和设备的不断更新,微创治疗适应证逐渐扩大,腔内血管外科技术的禁区逐渐缩小.例如杂交治疗以及带分支的腔内移植物出现,已经能够治疗累及主动脉弓的胸主动脉和升主动脉病变.从TASC Ⅱ分级和ACC/AHA指南的改变,可以明显看到这种趋势[1-2].     

我国血管外科的回顾、现状和展望

早在两千多年前的秦汉时代,古代中国人就已经有了关于血管系统和血管疾病的初步认识。著名的医学名著《黄帝内经·素问》(大约写于公元前305~240年)里有这样的描述:“天气通于肺,地气通于嗌,风气通于肝,雷气通于心,谷气通于脾,雨气通于肾……六经合川……诸血皆属于心……夫血脉营卫,周流不息”。这是当时的医生对人体血液的来源和血液循环所作的精辟见解。在《黄帝内经·灵枢经》里则有一段现在称之为血栓闭塞性脉管炎的描写:“发于足指,名脱疽,其状赤黑,死不治,不赤黑,不死,不衰,急斩之,不则死矣”。[1]一千八百年前汉代的名医华佗对脱疽…     

血管外科的现状及发展趋势--第四届国际血管外科学术会议述评

由中华医学会主办的第四届国际血管外科和腔内血管外科学术会议暨第四届国际布加综合征学术会议于2 0 0 2年 10月 17～ 2 0日在北京召开。来自 18个国家和国内 40 0余名代表出席会议。大会收到论文 3 5 2篇 ,大会报告 42篇 ,分会交流 14 4篇。通过卫星转播现场演示腹主动脉瘤腔内人工血管植入术 2例 ,还转播了激光治疗下肢静脉曲张多例和肺栓塞治疗的全程录像。1　布加综合征 (BCS)中华医学会外科学会血管学组组长、大会主席汪忠镐首先回顾了国际BCS学会诞生和历史。 1987年在北京国际血管学会上报告了BCS研究工作 ,引起了各国学者的兴…     

我国护理用具的发展现状及趋势

分析了我国临床护理用具的发展特点，阐述了现阶段护理用具存在的主要问题及对策，指出我国护理用具未来的发展重点和发展趋势。     

3D打印技术在血管外科领域应用现状及展望

正3D打印技术也被称为快速打印技术或增材法制造技术,它是一种通过断层扫描并通过计算机模拟出立体形态并最终完成立体形态的重建的新兴技术。目前3D打印技术主要包括选择性激光烧结(selected laser sintering)、熔融沉积制造(fused deposition modeling)、叠层实体制造(laminated object manufacturing)、光固化成型(stereolithography)、     

血管外科进展概述

我国血管外科事业在近五十年里取得了前所未有的发展 ,这是广大血管外科专业人员共同努力的结果。进入 2 1世纪后 ,血管外科将得到更加迅速的发展。本专题特邀国内在此领域有突出贡献的专家 ,就目前血管外科的现状与发展趋势作一讲座 ,希望这一方小小的论坛 ,能对血管外科新技术的推广起一点的推动作用 ,并能吸引更多的有志青年加入到血管外科专业医师的队伍中来     

血管镜在血管外科的应用

随着血管外科诊疗技术的发展,一种新型的诊疗设备——血管镜已开始应用于临床。通过血管镜可直接观察到心脏和血管腔内的三维图象,为准确地诊断血管系统的解剖异常和阻塞性疾病提供了直接证据。通过血管镜,在血管腔内可完成各种治疗操作,避免手术的盲目性。术毕可用来检查管腔内的情况,及时发现技术上的差错,并立即加以纠正。血管镜还可用来评价血管重建术的质量,观察静脉瓣膜的功能情况。与其它血管诊疗技术相比,具有操作简单、方便、安全、省时的优点。     

我国护理用具的发展现状及趋势

分析了我国临床护理用具的发展特点,阐述了现阶段护理用具存在的主要问题及对策,指出我国护理用具未来的发展重点和发展趋势.     

血管外科实验研究的现状和展望

近年来 ,血管外科作为一门新兴学科在世界范围内得到迅猛的发展。回顾血管外科的发展史 ,不难发现每一个成就的背后都有实验研究的突破和支撑。但血管外科在不断发展的同时也必将面临新的问题和挑战 ,而实验研究则为解决这些问题提供了支撑点和方法。现仅以血管外科研究的重点和热点从以下几个方面来评述血管外科实验研究的现状和展望。一、动脉粥样硬化和血管重建后再狭窄动脉粥样硬化性病变目前已成为工业化社会人群最主要的死亡原因 ,因此 ,对动脉粥样硬化性病变发病机制和防治的研究 ,是血管外科实验研究的重点基础工作之一。动脉粥样硬…     

Pheochromocytoma: current status and changing trends

From 1971 through 1980, 106 patients underwent operations for pheochromocytoma. Twelve patients had a pheochromocytoma as a manifestation of the multiple endocrine neoplasia type 2 syndrome. Twenty patients were found to have extra-adrenal paragangliomas. Fifteen patients (14%) had malignant tumors; eight of these tumors were encountered in the group with extra-adrenal lesions. The cumulative survival probability at 5 years was 53%. Determination of urinary metanephrines and vanillylmandelic acid were the most sensitive diagnostic aids, with accuracy rates of 95% and 89%, respectively. In recent years, the measurement of fractionated urinary and plasma catecholamine levels has greatly increased the diagnostic accuracy. Preoperative localization of pheochromocytoma has improved during the last decade. Nephrotomography, selective angiography, and venous sampling have essentially been abandoned in favor of computed tomography. With an accuracy of more than 90%, computed tomography represents the major step forward in the overall management of pheochromocytoma during the past decade.     

Digital surgery: current trends and techniques

Digital deformities continue to be a common ailment among many patients who present to foot and ankle specialists. When conservative treatment fails to eliminate patient complaints, surgical correction remains a viable treatment option. Proximal interphalangeal joint arthrodesis remains the standard procedure among most foot and ankle surgeons. With continued advances in fixation technology and techniques, surgeons continue to have better options for the achievement of excellent digital surgery outcomes. This article reviews current trends in fixation of digital deformities while highlighting pertinent aspects of the physical examination, radiographic examination, and surgical technique.     

PDE-5 inhibitors: current status and future trends

Phosphodiesterase-5 (PDE-5) inhibitors are a well-established, first-line therapy for erectile dysfunction (ED). Extensive clinical trials and clinical experience established the highly significant efficacy and the safety of this class of drugs in the treatment of ED.Furthermore, the efficacy of PDE-5 inhibitors has been established in men with ED with a broad range of etiologies and comorbidities. The future of PDE-5 inhibitors includes the expansion of indications such as the treatment of pulmonary hypertension and the potential of treatment of symptomatic BPH.     

Revascularization and aneurysm surgery: current status

Unclippable intracranial aneurysms are most effectively treated by hunterian ligation; however, the attendant risk of cerebral ischemia is significant. Many techniques have been used in an attempt to predict the safety of proximal vessel occlusion. Unfortunately, there is none that is risk-free and highly successful. A combination of stump pressure and cerebral blood flow measurements has been shown to be the most accurate in the acute assessment. In addition, recent studies have demonstrated that the long term risk of carotid ligation is significant. Extracranial-intracranial bypass grafting (EC-IC) has been shown to improve the safety of parent vessel ligation and is a low risk procedure. Whenever hunterian ligation is planned for the treatment of an intracranial aneurysm, EC-IC should be strongly considered.     

胸腔镜外科的现状与展望

一、历史回顾胸腔镜诞生于本世纪初。瑞典的一位内科教授Ｊａｃｏｂａｅｕｓ于１９１０年在局部麻醉下,使用膀胱镜来松解胸腔粘连,使肺萎陷以治疗肺结核［１,２］,这个方法迅速在欧美各地流行。到１９４０年,由于链霉素的问世,采用胸腔镜治疗肺结核的方法很快地被放弃了,胸腔镜只是偶尔地被用作诊断工具。１９７６年,Ｌｅｗｉｓ等［３］报道了在全身麻醉下,使用硬质支气管镜或光学纤维纵隔镜对４０例患者进行胸腔检查,病死率为０且并发症很少,所有患者都得到确诊。这项一度被忽略了的技术从此又受到重视。在８０年代,Ｈｏｐｋｉ…     

Vascular surgery in China

Guest lecture delivered during the Joint Annual Conference of the Cardiological Society of India and Association of Thoracic and Cardiovascular Surgeons of India held at Madras in December 1989.     

Endoscopic surgery in children: current status and problems

Endoscopic surgery has been established in various surgical conditions in children and infants for the past 10 years after pioneering work by experts specializing in pediatric endosurgery. These include pull-through for Hirschsprung's disease and anorectal malformations, pyloromyotomy, hernia repair, and endoscopic surgery for malignancies, malrotation, intussusception, etc. Laparoscopic pull-through is now accepted as a standard modality for the treatment of Hirschsprung's disease. Advanced endoscopic procedures such as esophageal atresia repair or fetal tracheal occlusion have also been performed. An efficient system for training is needed to compensate for the small number of patients and varieties of specific illness in children.     

Endoprosthesis of the knee joint: current status and trends

Knee joint endoprosthetics has proved to be at least as successful as hip joint endoprosthetics, although the total implantation rate has risen to only about 15%, which ignores its widespread unpopularity. There is a great variety of artificial knee joints, although according to ISO standards all models can be reduced to four basic ones. Deciding to use a stabilized, semi-constrained or unconstrained artificial knee prosthesis requires careful consideration especially if the possibility of its removal is taken into account. The main reason for unsatisfactory clinical results is still retropatellar pain. Intensive basic research is necessary in this area as well as in the development of new materials that might be used for new prosthetic designs. Designers as well as surgeons should aim at regaining the natural function level with no pain for the patient.