全腹腔镜下结直肠癌根治手术23例疗效分析

目的　评价总结在完全腹腔镜下结直肠癌根治术的优点、特点、技巧及方法。方法　对我院 2 0 0 3年 8月至2 0 0 4年 5月收住的 2 3例大肠癌患者 ,采用全腹腔镜下结直肠癌根治手术 ,对患者的临床资料、手术方式及随访结果进行总结。结果　本组 2 3例 ,11例行直肠癌全直肠系膜切除 (TME) ,结直肠 /或结肛对端吻合术 ;7例行乙状结肠切除、结直肠吻合术 ;5例行右半结肠切除 ,回结肠吻合术。术中平均出血量 86 .5ml,平均手术时间 15 0min。本组病人全部康复出院 ,最长随访 11个月 ,生活质量良好。结论　全腹腔镜下结直肠癌根治手术 ,安全可靠 ,出血量少 ,手术时间短、肠功能恢复快     

全腹腔镜结直肠癌根治术的临床护理

腹腔镜结直肠癌根治术是近年开展的微创外科新技术，具有术后出血少、疼痛轻、恢复快、切口小等优点，易被患者接受。尤其是超声刀的应用，使腹腔镜结直肠癌根治技术更安全、可靠、更精确。我院于2003年8月-2004年5月，使用美国Stryker公司生产的Sonoca190型超清晰度超声刀，为23例结直肠癌患者行全腹腔镜结直肠癌根治术。缩短了患者的住院时间，效果满意，现将护理体会介绍如下。     

腹腔镜下老年结直肠癌根治术（16例分析）

目的：探讨腹腔镜辅助下老年结直肠癌根治术安全性、可行性及短期疗效。方法：回顾性分析16例腹腔镜辅助下老年结直肠癌根治术患者的临床资料。结果：左半结肠癌6例,横结肠癌3例,右半结肠癌6例,行I期结肠癌切除吻合术11例,Hartmann手术3例,单纯近端结肠造瘘2例。无死亡病例,吻合口瘘0例。结论：腹腔镜辅助下老年结直肠癌根治术在正确掌握手术时机、合理选择手术方式、充分的术前评估、完善的围手术期处理下是安全可行的。     

腹腔镜辅助结直肠癌根治术在90例老年患者中的应用

目的探讨腹腔镜辅助结直肠癌根治术在老年患者中的应用价值。方法对2010—2013年我院收治的180例结直肠癌老年患者的临床资料进行研究。将90例行腹腔镜辅助结直肠癌根治术的结直肠癌患者作为观察组,将同期行开腹手术治疗的90例结直肠癌患者作为对照组。对两组患者手术情况及术后恢复情况进行对比分析。结果观察组患者的手术时间、术中出血量、淋巴结清扫数目与对照组患者比较,差异无统计学意义(P>0.05);观察组患者术后排气早、下床时间早、术后疼痛评分低,与对照组比较差异有统计学意义(P<0.05)。结论腹腔镜辅助结直肠癌根治术与传统的开腹手术比较,具有创伤小、术后恢复快等优点,且安全、有效,符合肿瘤根治原则。     

腹腔镜结直肠癌根治术的手术配合和护理体会

腹腔镜结直肠癌根治手术具有手术创伤小、出血少、术后疼痛轻、胃肠功能恢复快、住院时间短等优点[1-2]。在术后生存率、死亡率及并发症等方面与开腹手术效果相当[3]。我院自2006年2月～2008年9月对14例结直肠癌患者实施了腹腔镜下结直肠癌根治术,效果满意。现将手术护理配合总结报告如下。     

腹腔镜辅助下直肠癌手术51例分析

目的探讨腹腔镜辅助下直肠癌根治术的手术方法及疗效。方法回顾分析2007年3月—2010年10月我科51例直肠癌患者行腹腔镜辅助下直肠癌根治术的临床资料。结果 51例均顺利完成手术,平均手术时间(140±20)min,平均出血(80±10)ml,术后肠道功能平均恢复时间(40±11)h,平均住院(10±2)d;无围术期死亡及并发症发生;术后随访1～36个月,切口及Trocar处未见肿瘤种植转移。结论腹腔镜直肠癌根治术患者创伤小、出血少、痛苦轻、并发症少、康复快,是治疗直肠癌安全有效的方法。     

腹腔镜结直肠癌根治术的临床应用

目的 探讨腹腔镜下根治性结直肠癌切除术的可行性、方法和效果。方法 对2例结肠癌行腹腔镜根治性右半结肠切除,1例直肠癌行腹腔镜Miles根治术。结果 3例均成功完成腹腔镜手术。手术时间：第1例右半结肠切除240min,第2例右半结肠切除270min,Miles手术300min。术中出血量分别为120ml、200ml和150ml。淋巴结清扫数分别为16枚、8枚和5枚。术后胃肠功能恢复时间分别是3d、5d和4d。进流质时间分别是4d、6d和5d。下床活动时间分别为4d、5d和5d。术后近期效果良好,无1例手术并发症。结论 腹腔镜结直肠癌根治术是安全、可行的,具有创伤小、术后恢复快等微刨优势,能够达到与开腹手术相当的根治效果。     

腹腔镜直肠癌根治术体会

目的:探讨腹腔镜直肠癌根治术的手术方法及疗效。方法:回顾分析2007-03～2010-10我科51例直肠癌患者行腹腔镜直肠癌根治术的临床资料。结果:51例均顺利完成手术,平均手术时间150 min,平均出血80 ml,术后肠道功能平均恢复时间40 h,平均住院9 d;无围手术期死亡及并发症发生;术后随访1～36个月,切口及Trocar处未见肿瘤种植转移。结论:腹腔镜直肠癌根治术患者创伤小、出血少、痛苦轻、并发症少、康复快,是治疗直肠癌安全有效的方法。     

腹腔镜下结直肠癌根治术两例报告

电视腹腔镜下结、直肠癌根治术是目前在微创下新的手术方法。我院普外科成功完成电视腹腔镜辅助经腹腔会阴联合直肠癌根治术及右半结肠切除术各一例,现报告如下: 1 临床资料例1 患者男性,63岁,因“间断便血七月,下腹持续隐痛不适2月余入院。入院查体:截石点距肛缘5cm处可触及约3cm×2cm×2cm大小的菜花样肿块。电子结肠镜示直肠新生物,病理证实为直肠腺癌。于2003年12月16日行手术治疗:全麻插管下     

腹腔镜下结直肠癌根治术的临床应用研究

 目的 比较腹腔镜下结直肠癌根治术与同期开腹手术的临床疗效.方法 行腹腔镜下结直肠癌根治术43例,传统开腹根治术59例,观察两组的手术安全性、术后恢复情况、肿瘤根治性、医疗费用和随访.结果 与开腹根治术组比,腹腔镜组前 25 例手术时间较长(175.4 vs. 124.8 min,P=0.038),后18例与开腹手术时间相当(136.3 vs. 124.8 min,P=0.110),术中出血量较少(72.5 vs. 158 ml,P=0.030),术后肠功能恢复快(48.7 vs. 63.4 h,P=0.043)、术后住院时间短(9.1 vs. 11.2 d,P=0.030),手术并发症无明显差异(4/43 vs. 15/59,P=0.929),清扫淋巴结阳性数及总数相近(6.3 vs.7.0,P=0.090;13.9 vs.14.2,P=0.475).腹腔镜组43例随访平均(36.2±7.4) 个月,开腹组随访平均(39.1±5.8)个月,两组短期(≤5年)累计生存率差异无统计学意义(P>0.05).结论 腹腔镜下结直肠癌根治术创伤小、恢复快、根治效果好、生活质量高,值得临床推广应用.     

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.