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21.
目的 探讨Ⅴ型斜视伴原发性下斜肌功能过强的治疗效果。方法根据手术方式将49例Ⅴ型斜视伴下斜肌功能过强惠者分为四组,分别采用水平肌加强减弱术不联合下斜肌切断减弱术(Ⅰ组)、联合单侧下斜肌切断减弱术(Ⅱ组)、联合双侧下斜肌对等切断减弱术(Ⅲ组)及联合双侧下斜肌不对等切断并部分切除减弱术(Ⅳ组)治疗Ⅴ型斜视。结果Ⅴ型斜视伴原发性下斜肌功能过强采用四种方式治疗后,眼位正位,下斜肌功能亢进改善+~++,双侧下斜肌功能对等,术前术后原在位度数和上下注视25。斜视角之差的差异有非常显著性(P〈0.001)。结论根据单侧或双侧下斜肌功能过强的具体情况来选择不同的手术方式治疗Ⅴ型斜视伴原发性下斜肌功能过强,眼位矫正满意,同时手术方式简单、安全有效。 相似文献
22.
Alcides José Branco Filho William Kondo Luis Sérgio Nassif Mariana Jorge Garcia Rafael de Almeida Tirapelle Carlos Marcelo Dotti 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2006,10(3):326-331
BACKGROUND: Gastrogastric fistula is a communication between the proximal gastric pouch and the distal gastric remnant, rarely described in the realm of bariatric procedures. The aim of this study was to review the existing literature about this topic and to demonstrate its laparoscopic treatment. METHODS: An extensive literature review found several articles reporting this complication. However, no citation was found describing the steps of the laparoscopic management of this situation. RESULTS: Gastrogastric fistula occurs in up to 6% of Roux-en-Y gastric bypasses. Two theories exist for fistula formation: (1) it is a technical complication derived from the incomplete division of the stomach during the creation of the pouch, and (2) it occurs after a staple-line failure, developing a leak with an abscess, which then drains into the distal stomach forming the fistula. Early symptoms include fever, tachycardia, and abdominal pain. Failure in weight loss is a late clinical sign observed in these patients. Diagnosis is based on radiologic study, upper endoscopy and computed tomography. When identified in the acute postoperative course, laparoscopic treatment is easy. Chronic fistulas are difficult to manage, and the laparoscopic approach is an alternative to open surgery. CONCLUSIONS: Gastrogastric fistula is a possible complication of Roux-en-Y gastric bypass and its laparoscopic treatment is feasible. 相似文献
23.
24.
目的 探讨内镜辅助肋骨-软骨移植重建髁突与同期正颌手术治疗严重颞下颌关节病变及牙颌面畸形的效果. 方法 于术前对患者进行临床检查和治疗设计,术中行Le Fort Ⅰ型截骨术、下颌支矢状骨劈开术、髁突等关节区病变的处理、内镜辅助下肋骨-软骨移植和颏成形术,术后进行随访. 结果 2003年9月至2005年12月,于临床应用15例,所有患者同期手术均顺利完成.术中、术后均无严重出血、神经损伤、受区感染等严重并发症发生.术后随访29~52个月,平均31.8个月,所有患者面容均显著改善,关节功能良好,且无关节区疼痛等主观症状,患者对手术疗效满意.术后张口度平均为33.6 mm,侧向运动度为0~6 mm. 结论 选择合适的适应证、设计合理的手术方案,内镜辅助髁突重建同期正颌手术效果较好. 相似文献
25.
Javairiah Fatima Scott G. Houghton Michael G. Sarr 《Journal of gastrointestinal surgery》2007,11(8):1052-1056
Small bowel transplantation (SBT) is associated with poorly understood enteric dysfunction. The study of SBT in mice is hindered
by the technical difficulty of orthotopic SBT in the mouse. Our aim was to develop an easy preparation of extrinsic denervation
of the entire jejunoileum in mice as a model of orthotopic SBT. All neurolymphatic tissues accompanying the superior mesenteric
artery (SMA) and vein (SMV) were ligated just distal to the middle colic vessels. The SMA and SMV were then stripped of investing
adventitia, and the mesentery to jejunum and colon were transected radially. Jejunum and colon were not transected and reanastomosed.
To confirm extrinsic denervation 1, 3, and 6 months later, segments of small bowel were stained for protein gene product 9.5
(PGP9.5) and tyrosine hydroxylase (TH). Tyrosine hydroxylase immunoreactive intensity was then quantified using a semiquantitative
analysis. Immunohistochemical fluorescence showed persistence of PGP9.5 immunoreactivity confirming enteric nerves in jejunoileum;
however, there was no TH immunoreactivity in jejunoileum in denervated mice despite the expected preservation of TH immunoreactivity
in the still-innervated duodenum at 1 month. At 3 months, sparse immunoreactivity for TH was present, and by 6 months, reinnervation
of TH-containing nerves appeared similar to controls. Quantification of intensity at each time-point further confirmed this
trend. This technique in the mouse accomplishes a complete extrinsic denervation of jejunoileum early postoperatively (1 and
3 months); reinnervation occurs by 6 months. This is an easily learned murine model of orthotopic SBT.
Presented at the American Gastroenterological Association during Digestive Disease Week in Los Angeles, CA, as a poster presentation
on May 23 2006. Abstract published in GastroenterologyE 2006; 130:A604. 相似文献
26.
Background The incidence rate of incisional hernias after open surgery has been reported to be higher than that of port site hernias
after laparoscopic surgery. No studies have compared the costs for the health care system in treating those two types of hernia.
Methods A systematic review was conducted to obtain the baseline data, and a decision analysis model was created to simulate the occurrence
and recurrence of incisional and port site hernias.
Results The overall risk of having incisional hernias was eight-times higher than that of having port site hernias (7.4% vs 0.9%).
A cost savings of £93 per patient can be generated for the health care system in the UK. Similar results were obtained for
Germany, Italy and France.
Conclusions The additional treatment costs for incisional hernia should be taken into account when the costs of a surgery performed by
open approach are compared with by laparoscopy. 相似文献
27.
A. Ravikumar S. Mohanty R. P. Vatsanath S. Raghunandhan 《Indian journal of otolaryngology and head and neck surgery》2004,56(4):317-320
The co-existence of fungal elements in allergic nasal Polyposis, has given rise to a distinct clinical entity known as ‘Allergic
fungal sinusitis ’ (AF’S). Many a time, these fungal elements may not be diagnosed pre-operatively by routine diagnostic nasal
endoscopy or CT scan of paranasal sinuses, due to the florid presentation of nasal polyps, which usually obscure the underlying
fungal pathology. The diagnosis is often made intra-operatively. The post-operative confirmation of AFS is by histopathology,
fungal smear, fungal culture, allergic murin study and fungal specific IgE titres. We report a series often such cases done
in our institution, which highlight that AFS should be considered as a differential diagnosis in Sinonasal Polyposis cases,
for their effective management. 相似文献
28.
糖尿病患者超声乳化白内障吸除手术的临床观察 总被引:4,自引:0,他引:4
目的:探讨糖尿病患者进行超声乳化白内障吸除联合人工晶状体植入手术的临床效果。方法:50例(61只眼)糖尿病患者(设为A组)和同期163例(174只眼)血糖正常患者(设为B组)接受超声乳化白内障吸除联合人工晶状体植入手术。糖尿病患者手术前通过饮食疗法、口服药物或肌注胰岛素治疗,使空腹血糖降到 10mmol/L以下。术后随访 1~28个月(平均 8.6个月),复查视力、裂隙灯及眼底检查。结果:术后矫正视力≥0.5者,A组为77.1%;B组为80.5%。两组经统计学处理差异无显著性(P>0.05)。两组术中出现后囊破裂及术后发生角膜水肿和前房渗出等并发症的差异无显著性(P>0.05 )。结论:糖尿病患者进行超声乳化白内障吸除手术前只要有效控制血糖,其手术效果与对照组患者相同。但术后血糖的控制仍然十分重要。眼科学报2003;19:98-100。 相似文献
29.
Gastroesophageal reflux disease (GERD) is a common disease and can be successfully treated by laparoscopic fundoplication.
This article describes the technique of laparoscopic surgery for GERD with a focus on operative pitfalls. 相似文献
30.
A. Bogaards PhD H.J.C.M. Sterenborg B.C. Wilson 《Photodiagnosis and Photodynamic Therapy》2007,4(3):170-178
With the advent of molecular-targeted fluorescent markers, there is a renewed interest in fluorescence quantification methods that are based on continuous wave excitation and multi-spectral image acquisition. However, little is known about their in vivo quantification performance. We reviewed the performance of five selected methods by analytically describing these and varying input parameters of irradiance, excitation geometry, collection efficiency, autofluorescence, melanin content, blood volume, blood oxygenation and tissue scattering using optical properties representing those for human skin. We identified one method that corrects for variations in all parameters. This requires image acquisition before and after marker administration, under identical geometry. Hence, it is suited for applications where the site of interest can be relocated (e.g. anaesthetized animals and dermatology). For applications where relocation is not possible, we identified a second method where the uncertainty in the fluorescence signal was ±20%. Hence, use of these methods can substantially aid in vivo fluorescence quantification compared to use of the raw fluorescence signal, as this changed by more than 3 orders of magnitude. Since these methods can be computed in real-time, they are of particular interest for applications where direct feedback is critical, as diagnostic screening or image-guided surgery. 相似文献