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目的探讨工期非小细胞肺癌(NSCLC)患者的诊断与治疗。方法回顾性分析我院1991年至2004年226例Ⅰ期NSCLC的诊疗经过。全组肺叶切除206例,肺段或楔形切除15例,袖状切除5例。结果无围手术期死亡,Ⅰ期NSCLC患者的1、3、5年生存率分别为93.6%、80.3%和66.2%。鳞癌的1、3、5年生存率均比腺癌与腺鳞癌患者的1、3、5年生存率高(P〈0.05)。肺叶切除患者的1、3、5年生存率比肺段或楔形切除患者高(P〈0.05)。结论定期体检及综合检查对Ⅰ期肺癌的早期发现与诊断极为重要。外科治疗可以获得很好的疗效,肺叶切除加纵隔淋巴结清扫是早期肺癌的有较好预后的治疗方案。 相似文献
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目的 :总结心脏跳动中双腔右心室 (DCRV)的外科治疗经验。方法 :31例 DCRV患者接受了该手术 ,术中不阻断升主动脉 ,不灌注心脏停跳液 ,心脏缓慢空跳 40~ 5 0次 /min,鼻温控制在 31~ 35℃之间。结果 :2 2 (71% )例发生完全性右束支传导阻滞 (RBBB) ,全组无手术死亡 ,无低心排综合征 (L OS)、残余室间隔缺损、残余右室内狭窄、 度房室传导阻滞( °AVB)三尖瓣关闭不全 (TI)等并发症。结论 :心脏跳动中行 DCRV的外科治疗 ,心肌无缺血缺氧再灌注损伤 ,对减少和预防 L OS、残余室间隔缺损、残余右室内狭窄、 °AVB、 TI等并发症有积极临床意义。 相似文献
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Objective To estimate the value of aortic valves and combined mitral valve replacement wit h retrograde perfusion in beating hearts.Methods Continuous retrograde coronary sinus perfusion with beating hearts was used in 8 3 patients undergoing aortic valve or aortic valve combined with mitral valve re placement, without application of cardioplegia. After aortic valve replacement, the retrograde perfusion was changed to antegrade perfusion for mitral valve re placement or correction of the other deformities (group A). Cold blood cardiopl egia solution (15℃) was infused at intervals in 20 cases (group B). The follow ing parameters were tested: lactate, ET, CTn-T and MDA in blood; myocardial ult ra-structure; and cardiac rhythm and cardiac output (CO).Results All biochemical values increased after cardiopulmonary bypass (P<0.05-0.01 ). Empty and beating heart sinus rhythm was maintained in group A. Myocardial ultrastructure did not change significantly. The pump was stopped smoothly as t he surgical procedure finished. No postoperative low cardiac output syndrome or arrhythmia was observed. Eight-one patients recovered smoothly, two died from renal failure or infective shock. When the pump stopped, all patients in group B were supported by 5-10 μg·kg(-1)·min(-1) dopamine. Transie nt pacing was used in 9 patients. One patient died from low cardiac output synd rome. Conclusion This method is a good myocardial protection which simulates physiologic status. It is applicable to aortic valve and combined mitral valve replacement of patie nts with large heart or heart failure and long time aortic cross-clamping. Ide al clinical effect can be achieved. 相似文献
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目的 :评价在浅低温体外循环心脏跳动中巨大心脏病人二尖瓣置换术的远期疗效。方法 :对 131例巨大心脏患者在心脏跳动中施行二尖瓣置换术 ,早期死亡 5例。术后随访到 111例 ,失访 15例 ,随访率 88.1% ,随访时间 0 .5~ 9.0年。随访方法是对病人采用信访、电话随访和门诊复查相结合进行长期随访。结果 :远期死亡 9例 ,死亡原因为心衰 5例、心律失常 2例、瓣周漏 1例、原因不明 1例。 3、6、9年累积生存率为 92 .3%、84 .1%、79.5 %。随访结果与术前及术后早期结果进行统计学处理 ,左室收缩末直径、左室舒张末直径及心功能等指标差异均有统计学意义 (P <0 .0 5 )。左房型及右室型远期疗效较好 ,全心型及左室型效果较差。结论 :在心脏跳动中行巨大心脏的二尖瓣置换手术切实可行 ,安全有效 ,心肌保护效果良好 ,远期效果满意。随访期间加强心功能支持和室性心律失常防治 ,有助于提高巨大心脏二尖瓣置换术的远期疗效 相似文献