全文获取类型
收费全文 | 33539篇 |
免费 | 1206篇 |
国内免费 | 504篇 |
专业分类
耳鼻咽喉 | 395篇 |
儿科学 | 794篇 |
妇产科学 | 556篇 |
基础医学 | 1564篇 |
口腔科学 | 473篇 |
临床医学 | 2965篇 |
内科学 | 3621篇 |
皮肤病学 | 303篇 |
神经病学 | 980篇 |
特种医学 | 727篇 |
外科学 | 5975篇 |
综合类 | 5960篇 |
一般理论 | 2篇 |
预防医学 | 2859篇 |
眼科学 | 316篇 |
药学 | 2619篇 |
55篇 | |
中国医学 | 4249篇 |
肿瘤学 | 836篇 |
出版年
2023年 | 333篇 |
2022年 | 780篇 |
2021年 | 951篇 |
2020年 | 1100篇 |
2019年 | 1251篇 |
2018年 | 1189篇 |
2017年 | 873篇 |
2016年 | 914篇 |
2015年 | 1038篇 |
2014年 | 2664篇 |
2013年 | 2013篇 |
2012年 | 2054篇 |
2011年 | 2414篇 |
2010年 | 2687篇 |
2009年 | 1356篇 |
2008年 | 1263篇 |
2007年 | 1386篇 |
2006年 | 1200篇 |
2005年 | 825篇 |
2004年 | 622篇 |
2003年 | 644篇 |
2002年 | 408篇 |
2001年 | 422篇 |
2000年 | 319篇 |
1999年 | 327篇 |
1998年 | 238篇 |
1997年 | 195篇 |
1996年 | 215篇 |
1995年 | 210篇 |
1994年 | 185篇 |
1993年 | 132篇 |
1992年 | 143篇 |
1991年 | 133篇 |
1990年 | 120篇 |
1989年 | 85篇 |
1988年 | 116篇 |
1987年 | 92篇 |
1985年 | 438篇 |
1984年 | 512篇 |
1983年 | 363篇 |
1982年 | 388篇 |
1981年 | 420篇 |
1980年 | 367篇 |
1979年 | 357篇 |
1978年 | 317篇 |
1977年 | 195篇 |
1976年 | 261篇 |
1975年 | 231篇 |
1974年 | 181篇 |
1973年 | 200篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
51.
Early laparoscopic cholecystectomy for acute cholecystitis 总被引:4,自引:0,他引:4
Background: The timing of laparoscopic cholecystectomy for acute cholecystitis remains controversial.
Methods: One hundred ninety-four patients with acute cholecystitis were reviewed. The conversion rates for the various number of days
of symptoms before surgery were analyzed. The conversion rate dramatically increased from 3.6% for those patients with 4 days
of symptoms to 26% for those patients with 5 days of symptoms. The mean number of days of symptoms prior to surgery in those
patients who underwent successful laparoscopic cholecystectomy was 4.1 as compared to 8.0 in those patients who required open
cholecystectomy (p < 0.0001). Based on this data the patients were divided into two groups. Group 1 consisted of 109 patients who underwent
laparoscopic cholecystectomy within 4 days of onset of symptoms and group 2 consisted of 85 patients who underwent laparoscopic
cholecystectomy after more than 4 days following onset of symptoms.
Results: The conversion rate from laparoscopic to open cholecystectomy was 15%. The conversion rate for group 1 was 1.8% as compared
to 31.7% for group 2 (p < 0.0001). Indications for conversion were inability to identify the anatomy secondary to inflammatory adhesions (68%), cholecystoduodenal
fistula (18%), and bleeding (14%). The major complication rate for group 1 was 2.7% as compared to 13% for group 2 (p= 0.007). The mortality rate for all patients with attempted laparoscopic cholecystectomy for acute cholecystitis was 1.5%.
The average procedure time for group 1 was 100 ± 37 min vs 120 ± 55 min in group 2. The average number of postoperative hospital
days in group 1 was 5.5 ± 2.7 days as compared to 10.8 ± 2.7 days in group 2.
Conclusions: We advocate early laparoscopic cholecystectomy within 4 days of onset of symptoms to decrease major complications and conversion
rates. This decreased conversion rate results in decreased length of procedure and hospital stay.
Received: 28 March 1996/Accepted: 12 September 1996 相似文献
52.
Thyroid storm as a cause of loss of consciousness following anaesthesia for emergency Caesarean section 总被引:1,自引:0,他引:1
A previously undiagnosed thyrotoxic patient was anaesthetised for an emergency Caesarean section. The recovery period was complicated by an acute thyroid crisis resulting in loss of consciousness following an apparently normal recovery from general anaesthesia. 相似文献
53.
Cardiovascular responses to insertion of the laryngeal mask 总被引:6,自引:0,他引:6
We have compared, in 40 healthy patients, the cardiovascular responses induced by laryngoscopy and intubation with those produced by insertion of a laryngeal mask. Anaesthesia was induced with thiopentone and maintained with enflurane and nitrous oxide in oxygen; vecuronium was used for muscle relaxation. Arterial pressure was measured with a Finapres monitor. The mean maximum increase in systolic arterial pressure after laryngoscopy and tracheal intubation was 51.3% compared with 22.9% for laryngeal mask insertion (p less than 0.01). Increases in maximum heart rate were similar, (26.6% v 25.7%) although heart rate remained elevated for longer after tracheal intubation. We conclude that insertion of the laryngeal mask airway is accompanied by smaller cardiovascular responses than those after laryngoscopy and intubation and that its use may be indicated in those patients in whom a marked pressor response would be deleterious. 相似文献
54.
A stratified intraoperative surgical strategy is mandatory during laparoscopic common bile duct exploration for common bile duct stones 总被引:3,自引:0,他引:3
J. F. Gigot B. Navez J. Etienne E. Cambier P. Jadoul P. Guiot P. J. Kestens 《Surgical endoscopy》1997,11(7):722-728
Background: Open exploration and endoscopic sphincterotomy (ES) remain the preferred treatment of common bile duct stones (CBDS). The
recent spread of laparoscopy has worsened the dilemna of choosing between surgical and endoscopic treatment of CBDS. The aim
of this study was to critically evaluate the results of our preliminary experience with laparoscopic common bile duct exploration
(CBDE) for CBDS.
Methods: Ninety-two consecutive patients were prospectively submitted to laparoscopic CBDE. Surgical strategy included an initial
transcystic approach or laparoscopic choledochotomy. Failure of stone clearance was managed by conversion to open CBDE or
by postoperative ES. Electrohydraulic lithotripsy and papillary balloon dilatation were selectively used. Stone clearance
was assessed by choledochoscopy and control cholangiography.
Results: The overall laparoscopic stone clearance in this series was 84% (transcystic route 63% and choledochotomy 93%). Conversion
to laparotomy was mandatory in 12% of the patients because of incomplete stone clearance and in 5% because of intraoperative
complications. Postoperative ES was required in 4% of the patients, giving an overall surgical success rate of 96%. When indicated
(small and limited number of stones located below the cysticocholedochal junction, with a dilated and patent cystic duct)
the transcystic route had the lower success rate, the higher complication rate, and the shorter operative time and postoperative
hospital stay. When indicated (accessible and dilated common bile duct over 7 mm), laparoscopic choledochotomy had the higher
success rate, the lower complication rate, the longer operative time, and the longer postoperative hospital stay, which is
related to associated external biliary drainage. The hospital mortality included two high-risk patients (2%) and the complications
rate was 15%.
Conclusions: Laparoscopic CBDE is safe in selected patients. A stratified intraoperative surgical strategy is mandatory in deciding between
a transcystic route and choledochotomy with specific indications for each approach. When feasible, laparoscopic choledochotomy
is more efficient and safe than the transcystic route, but it is associated with a longer postoperative hospital stay, which
is due to external biliary drainage.
Received: 7 May 1996/Accepted: 19 November 1996 相似文献
55.
The extrusion of a pacemaker, due to infectious or mechanical problems, is a condition that usually requires the removal of the device and implantation of a new pacemaker. A case is presented in which an extruded pacemaker was successfully salvaged using the greater omentum as a wrap-around pedicled flap. The current protocol for salvaging exposed pacemakers at the authors' center is described. 相似文献
56.
The aim of this investigation was to study the role of the nasal airway in mediating upper airway reflexes during induction of anaesthesia when the commonly used irritant inhalational anaesthetic agent enflurane is used. In a prospective randomised study, 40 ASA 1 & 2 day-case patients undergoing body surface surgery were recruited. Following intravenous induction using propofol, 20 patients received enflurane administered via a laryngeal mask airway (LMA), the anaesthetic vapour therefore bypassing the nasal airway. In the other group, 20 patients received enflurane anaesthesia administered using a face mask, the nasal airway therefore being exposed to inhalation anaesthetic. We were unable to demonstrate any significant (p < 0.05) differences between the two groups in relation to upper airway complications (cough, breath holding, laryngeal spasm, bronchospasm and excitement). Previous work has identified the nose as a possible important reflexogenic site for upper airway reflexes in humans during anaesthesia. We have been unable to demonstrate any difference in upper airway complications when the nasal airway was included or excluded from exposure to irritant anaesthetic vapours, when administered in a clinical setting. 相似文献
57.
室间隔缺损的介入封堵治疗 总被引:2,自引:0,他引:2
对介入封堵治疗室间隔缺损的应用情况以及适应症、并发症等作一综述. 相似文献
58.
对AF系统整复压缩爆裂骨折椎体高度及椎管横截面的观测 总被引:4,自引:3,他引:1
目的 :量化评价AF系统恢复胸腰段压缩爆裂椎体高度椎管截面积的效果。方法 :测量AF系统治疗的 72例胸腰段压缩爆裂骨折术前后影像。统计椎体前后缘高度、Cobb角、椎管截面积资料。结果 :术后伤椎前缘高度恢复至 ( 96.5± 2 .3 ) %后缘高度恢复至 ( 98.2± 0 .9) % ,Cobb角恢复至 ( 5 .4± 1.5 )° ,椎管截面积恢复至 ( 97.2± 2 .1% ) ,各项指标与术前比较有非常显著性差异 (P <0 .0 0 1)。术后随访 0 .5~ 3 .5年 ,神经功能按Frankel评定 :60例提高 1~ 3级。结论 :AF系统能恢复或基本恢复胸腰段压缩爆裂骨折椎体的前后缘高度、Cobb角、椎管容积 ,为脊髓神经功能的恢复提供一个良好的环境。是治疗脊柱胸腰段压缩爆裂骨折较好的内固定器。 相似文献
59.
Complications associated with maxillary nerve block anaesthesia via the greater palatine canal 总被引:2,自引:0,他引:2
Anthony M. Sved John D. Wong Head Peter Donkor James Horan Leesa Rix Justin Curtin and Russell Vickers 《Australian dental journal》1992,37(5):340-345
This paper documents the type, frequency and duration of complications associated with regional anaesthesia of the maxillary nerve via the greater palatine canal in a series of 101 patients treated in the Oral Surgery Department, United Dental Hospital of Sydney. 相似文献
60.