右侧肾上腺肿瘤的辅助显露方法

目的：探讨右侧肾上腺肿瘤的手术技巧。方法：术中切断8例患者的部分肝脏韧带，向左旋转肝脏，充分显露肿瘤及肝后腔静脉。结果：8例均获完整切除，效果较好。结论：切断部分肝脏韧带，有助于显露肿瘤，可免除胸腔联合切口，提高切除率，降低手术风险。     

高龄冠状动脉硬化性心脏病的外科治疗

目的：探讨高龄冠状动脉硬化性心脏病(冠心病)患者外科治疗的特点。方法：对35例70岁以上冠心病患者外科治疗方法的选择、术前和术中的注意事项以及术后处理的特点进行回顾性分析。结果：本组病人无手术中死亡，1例术后3d死于严重的低心排综合征，其余患者术后恢复顺利。结论：合理的手术方法、做好术前准备、完善的手术技术及正确的术后管理，高龄冠心病患者的冠脉旁路移植术与一般患者相比死亡率无明显增加，且可明显改善患者症状，减轻心绞痛，提高生活质量。     

移动式护理机器人的控制系统

介绍自行研制的移动式护理机器人控制系统的功能和结构、开发过程中所面临的主要问题以及安全保护措施。所研制的机器人的控制系统具有高水平命令编译、机器人运动规划及环境设备控制功能。用户发出的任务指令由机器人的高水平集成控制系统分解为一系列低层的机器人部件控制命令或电器设备操作指令，然后由相应的控制器予以执行。     

Comparison of Tympanic, Esophageal and Blood Temperatures during Mild Hypothermic Cardiopulmonary Bypass: A Study using an Infrared Emission Detection Tympanic Thermometer

Objective. Tympanic temperature can be obtained instantaneously using an infrared emission detection (IRED) thermometer. Its accuracy has been documented in a variety of clinical settings, but its performance at low body temperatures is still unknown. In this study we evaluated its performance during coronary artery revascularization surgery in which mild hypothermic cardiopulmonary bypass (CPB) was used. Methods. Thirty adult patients undergoing coronary artery bypass graft surgery were enrolled in the study. Tympanic temperature obtained using IRED thermometry (Tt1) was compared with core temperatures from the esophagus (Te), and venous blood of CPB (Tv) before, during, and after CPB. We also measured tympanic temperature using a thermocouple probe (Tt2) in 16 of the 30 patients in order to study the agreement between the two methods. Values for correlation coefficients and limits of agreement were computed to assess the degree of agreement among the temperatures obtained. Results. The highest agreement with Tv during CPB was obtained from Tt1 (r = 0.94, 0.41 ± 1.73, limits of agreement) and from Te (0.91, 0.36 ± 2.46). Tt1 also showed good agreement with Tt2 during surgery. Conclusions. Infrared tympanic thermometry is a reliable, alternative method to measure tympanic temperature and may be useful to assess core temperature in both normothermic and mild hypothermic conditions.     

High frequency jet ventilation for microlaryngeal laser surgery

The use of a triple lumen central venous catheter, which can be shielded from laser irradiation by metal tape, as a conduit for high frequency jet ventilation in six children, is described. The problems of anaesthesia for laryngeal laser surgery and the advantages of the technique described in this paper are discussed.     

Peri-operative liver graft function: monitoring using the relationship between blood glucose and oxygen consumption during anaesthesia

The purpose of our study was to test the hypothesis that the quotient between plasma glucose and whole body oxygen consumption (VO2) as a 'metabolic index' is a sensitive indicator of early graft function. Arterial levels of glucose and oxygen consumption were determined in 100 consecutive patients during orthotopic liver transplantation performed without anhepatic veno-venous bypass. Patients were divided into survivors with no obvious problems related to graft function and those with primary nonfunction of the graft. The neohepatic increase in VO2 was significantly higher in survivors (112 +/- 4 vs 88 +/- 11 ml.min-1.m-2; p < 0.05), whereas blood glucose levels after reperfusion were higher (352 +/- 18 vs. 287 +/- 36 mg dl-1) in those with primary non-function of the graft. The calculated metabolic index was also higher (4.02 +/- 0.93 vs 2.67 +/- 0.45, p < 0.05) in patients with primary nonfunction of the graft. Our principal conclusion was that 92% of normal functioning liver grafts could be classified correctly by the metabolic index immediately after reperfusion, whereas glucose levels and VO2 alone classified only 67% and 70% of normal functioning liver grafts correctly.     

Dental mirror for difficult nasotracheal intubation

A patient with a previous surgical history of a cleft lip and palate repair and a pharyngeal flap pharyngoplasty was admitted for repair of mandibular prognathism. Following induction of anaesthesia, it was impossible to advance the nasotracheal tube into the oropharynx. Using a dental mirror and retrograde tracheal intubation equipment, under direct vision, the nasotracheal tube was finally advanced into the oropharynx.