腹腔镜下多脏器联合手术效果分析

目的：观察通过腹腔镜下进行多脏器联合手术效果。方法从本院抽取近五年来妇产科、肝胆外科及泌尿外科联合进行的腹腔镜下多脏器联合手术患者45例,其中行胆囊切除+肠粘连松解术的有18例、胆囊切除术+肝囊肿开窗引流术有15例、胆囊切除术+子宫附件有8例、胆囊切除术+子宫全切除+胆总管探查取石术4例,对他们的临床资料进行回顾性分析。结果45例患者手术均获得成功,没有出现中转开腹情况,平均手术时间为110min,平均住院天数为5.5d,没有发生大出血情况,也没有严重并发症发生。结论腹腔镜下多脏器联合手术,同时切除了多个病灶,减轻了患者的疼痛,缩短了住院时间,为患者节省了医疗费用,值得推广应用。     

腹腔镜联合手术的临床应用体会

目的探讨腹腔镜联合手术的临床应用价值和体会。方法回顾分析2005年1月～2008年12月间55例腹腔镜联合手术的临床资料。结果55例腹腔镜手术成功,无并发症发生,术后4～7 d痊愈出院。结论腹腔镜联合手术可以安全有效的处理多种腹部疾病,可在同一专科或多专科中联合应用,需严格掌握手术适应证。并且以各专科医师为主处理其专科疾病,不能擅自盲目独立跨科操作。     

肺心病多脏器功能衰竭死亡率分析

分析了30例肺心病并多脏器功能衰竭(MOF)的发病情况,平均年龄63.5岁,病程平均11年.死亡率2脏衰竭12.5％,3脏衰竭25.0％,4脏衰竭85.7％,≥5脏衰竭100％.衰竭脏器越多,病死率越高,提示要及早治疗肺心病,防止发生MOF.     

肺心病多脏器功能衰竭死亡率分析

分析了30例肺心病并多脏器功能衰竭(MOF)的发病情况，平均年龄63.5岁，病程平均11年.死亡率2脏衰竭12.5％，3脏衰竭25.0％，4脏衰竭85.7％，≥5脏衰竭100％.衰竭脏器越多，病死率越高，提示要及早治疗肺心病，防止发生MOF.     

妇科腹腔镜手术560例临床分析

目的探讨腹腔镜手术式在妇科的临床应用价值。方法对560例腹腔镜手术进行回顾性分析:异位妊娠术式为输卵管切除术及输卵管切开取胚术;卵巢肿瘤手术采用剔除术、卵巢切除术及患侧附件切除术;子宫手术采用子宫肌瘤剔除术、CISH术、LAVH及LTH术。结果腹腔镜手术占同期妇科手术的62.9%,手术成功率99.28%,发生并发症4例(7.12%)。结论适应证掌握得当,妇科大部分手术可在腹腔镜下完成。     

宫腹腔镜联合手术的围手术期护理

目的：探究宫腹腔镜联合手术围手术期护理方法。方法选择2013年1月~2014年3月在我院行宫腹腔镜联合手术的32例患者,并分析患者围手术期护理观察与并发症情况。结果32例患者手术全部成功,经围手术期综合护理均康复出院。结论宫腹腔镜联合手术的过程中,积极做好术前准备,术中配合,术后观察与护理,可有效提高患者预后效果,使得手术顺利完成。     

腹腔镜妇科手术1 630例临床分析

随着医学技术发展及医疗仪器的改进，腹腔镜已从诊断性进入手术性治疗阶段腹腔镜治疗效果确切，尤其对异位妊娠、不孕症、多囊卵巢综合征等患者，其治疗效果优于开腹手术。我院自2000年9月至2005年7月应用电视腹腔镜进行妇科手术1630例，现报道如下。     

妇科电视腹腔镜手术66例分析

目的 探讨腹腔镜手术在妇科的临床应用价值。方法 用腹腔镜行不孕症诊治手术,附件手术、子宫切除手术共66例,进行手术时间,术中出血,术后镇痛,用药率,术后输液日,住院日和术后发热率进行总结。结果 腹腔镜下绝大部分妇科良性疾病的手术获得成功,表明腹腔镜手术具有出血少,术后用药少,痛苦小,住院日短,术后发热率低。结论 腹腔镜手术创伤小恢复快,术后并发症少,可应用于大部分妇科良性疾病。     

多脏器发育畸形一例尸解报告

病例:女婴,足月.因其母腹部B超示:羊水过多.以"孕38 5周孕3产.头位临产,羊水过多"收入产科.其母曾人工流产2次(误服药),此孕期无服药史,无吸烟及饮酒史,无化学及毒性物品接触史.     

妇科腹腔镜手术临床应用162例分析

目的 探讨妇科电视腹腔镜手术在基层医院临床应用价值及其可行性。方法 应用腹腔镜分别行输卵管、卵巢肿物、子宫手术及盆腔松解术162例。结果 镜下手术获得成功率达96％,术中出血少,术后痛苦少,患者第二天下床活动,术后病率3.8％,平均住院2.8d。结论 腹腔镜手术创伤小、恢复快、效果好,随着操作技术的熟练,更多的妇科各类手术将可在镜下施行。     

急症产科子宫切除治疗产科出血23例分析

目的分析产科急症子宫切除的原因、价值、预防措施,降低急症产科子宫切除的可能性。方法对我院产科近11年间所做的急症产科子宫切除术作回顾性分析。结果急症产科子宫切除术发生率为0.27%,剖宫产子宫切除率为1.00%,阴道分娩子宫切除率为0.05%。首位原因为是胎盘因素(43.48%),其次为子宫收缩乏力(30.43%),子宫破裂居第三(13.04%)。结论胎盘因素及子宫收缩乏力是产科急症子宫切除的主要原因。产科急症子宫切除在挽救某些危重产科大出血患者的生命中起到关键作用。加强孕期保健和计划生育,提高产科质量,可以有效地降低急症产科子宫切除率。     

腹腔镜可调节胃束带术治疗肥胖症26例分析

目的评价腹腔镜可调节胃束带术（LAGB）治疗肥胖症的有效性、可行性。方法26例肥胖症患者，其中男性10例，女性16例，年龄18～36岁，平均年龄27．5岁。身高160～182cm，体质量88～240kg,体质量指数（BMI）为34．1～72．5kg/m^2平均40．6kg/m^2。对患者施行LAGB，观察分析手术前后患者肥胖相关指标变化。结果26例手术均获成功，围手术期无严重并发症。术后随访6个月以上的22例，减质量效果良好。结论LAGB术后近期疗效可靠，并发症低，是一种外科治疗肥胖症的有效方法。     

120例严重多发性损伤的救治体会

严重多发性损伤是指多个脏器和部位同时受伤并伴有休克和成人呼吸窘迫综合征(ARDS)。我院1993年至2003年收治120例严重多发性损伤病例，现将救治体会报告如下。     

Prognostic factors in ovarian carcinosarcoma: a clinicopathological and immunohistochemical analysis of 23 cases

Carcinosarcoma of the ovary is a rare, highly aggressive neoplasm comprising histologically of both epithelial and mesenchymal components. The aim of this study was to evaluate the clinicopathological prognostic factors in ovarian carcinosarcoma, including the immunohistochemical expression of p53 protein and Ki67. METHODS AND RESULTS: Twenty-three cases of carcinosarcoma of the ovary were studied retrospectively. The clinicopathological and immunohistochemical parameters including p53 and Ki67 staining were statistically analysed to investigate the prognostic significance of this tumour. The overall 5-year survival rate was 27.1%; 100% for stage I, 31.3% for stage II, 10.9% for stage III and 0% for stage IV. The low-stage group (stages I and II) was found to be a significant prognostic factor for patient survival (P = 0.0113). None of the other factors (tumour size, histological type of carcinomatous and sarcomatous components, mitotic count, vascular space invasion and immunoreactivity for p53 protein and Ki6 7) was found to be a statistically significant prognostic indicator. CONCLUSIONS: Ovarian carcinosarcoma is a rare malignancy with poor prognosis. In this study, advanced stage appears to be poor prognostic indicator of survival in patients with ovarian carcinosarcoma.     

Laparoscopic fimbrioplasty: an evaluation of 35 cases

The aim of this prospective study was to assess the value of laparoscopic treatment of severe fimbrial occlusions. During a period of 52 months infertile patients with fimbrial lesions were treated by operative laparoscopy. Only those patients requiring incision of the tubal serosa (salpingostomy) were included, representing the most severe lesions. The most frequent cases, those patients requiring simple adhesiolysis and deagglutination of the fringes, were excluded. All tubal lesions were documented carefully. Positive Chlamydia trachomatis (CT) serology was found in 65.7% of the patients. All the patients were followed up for at least 2 years. Three patients lost to follow-up were defined as failures. The global conception rate was 74.3%. The intrauterine pregnancy rate was 51.4%, and the 'take home baby rate' was 37.1% (only the first pregnancy being taken into account). The ectopic pregnancy rate was 22.9%. A positive CT serology was found to have a significant influence on the outcome. It can be concluded that the laparoscopic approach provides results similar to those obtained by microsurgery for the treatment of severe fimbrial occlusions, and represents an acceptable alternative to in-vitro fertilization (IVF) in selected cases.      

Mesenchymal chondrosarcoma: a series of 23 cases

A total of 23 cases of mesenchymal chondrosarcoma were studied from the histopathology records spanning 23 years. There were 16 men and 7 women afflicted with this tumor and their mean age was 28.1 years. The radiological features, histology and treatment outcomes have been studied. Osseous and extra-osseous mesenchymal chondrosarcomas are compared and the differential diagnosis discussed.     

12例矢状窦旁脑膜瘤手术治疗的回顾性分析

矢状窦旁脑膜瘤约占脑膜瘤总数的17％～20％，其基底位于矢状窦壁，瘤体突向大脑半球并侵及矢状窦壁、窦腔，切除时可能引起难以控制的大出血，手术根治颇为困难?从1996年至2004年，我院共收治矢状窦旁脑膜瘤患者共12例，其中11例行肿瘤全切术，疗效满意，现报告如下。     

Laparoscopic cholecystectomy: a hundred consecutive cases.

Laparoscopic cholecystectomy is a new, minimaly invasive technique for removing the gallbladder which has several advantages over the traditional laparotomy cholecystectomy. We reviewed our initial experience with 100 consecutive patients in whom laparoscopic cholecystectomy was attempted. The indications for operation were biliary colic, chronic cholecystitis, acute gallbladder and gallstone pancreatitis. Laparoscopic cholecystectomy was successfully performed in 87 patients. Anaesthesia time was 144 +/- 52 min. There was no mortality while overall morbidity was 14%. One patient had a retained common bile duct stone. Postoperative hospital stay was 4.1 +/- 2.2 days and the mean time to full activity in a random sample of 25 patients was 13.7 +/- 11.7 days. Laparoscopic cholecystectomy is a safe effective procedure which removes the gallbladder. We suggest that this technique be considered in all patients undergoing cholecystectomy.     

剖宫产术后腹壁血肿12例分析

目的:探讨剖宫产术后腹壁血肿的高危因素,病因及防治对策。方法:对我市8所医院2004年1月～2008年4月间12例剖宫产术后腹壁血肿病例的临床资料进行回顾性分析。结果:11例有发生出血的高危因素,12例均再次手术治疗,死亡3例,分别死于失血性休克、继发感染(败血症)、风心病。结论:剖宫产术后腹壁血肿是可以预防的,发生血肿后应早诊断早治疗。     

应用锁定钢板治疗肱骨近端骨折23例临床分析

肱骨近端骨折是临床上常见的骨折，临床治疗较困难，且治疗方法多样。我院自2004年12月至2006年10月对23例肱骨近端骨折采用肱骨近端锁定钢板（LPHP）治疗，取得了满意的效果，现报告如下。