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81.
潘福军 《眼外伤职业眼病杂志》1996,18(1):30-31
报告20例(21眼)青光眼白内障并存患者采用显微囊外摘除联合小梁切除术.术后眼压控制满意,滤过泡形成,视力不同程度提高,无明显并发症.并对有关机制,手术优点及不易控制的眼压问题进行了讨论. 相似文献
82.
A. J. Pope P. J. R. Shaw M. J. Coptcoat P. H. L. Worth 《Neurourology and urodynamics》1990,9(5):503-508
The changes in bladder function occurring after a surgical alteration in bladder outflow resistance were studied in 20 males undergoing transurethral prostatectomy (TURP) and in 20 females undergoing an endoscopic bladder neck suspension (EBNS). Serial cystometrograms (CMG) were performed before operation, and on alternate days after spontaneous micturition was re-established, for 5 days in the males and for 21 days in the females. CMGs were repeated at 3 months and 1 year after operation. After TURP voiding pressures (Pdet) fell rapidly from a mean of 118 cm H2O before operation to 57 cm H2O at 5 days, with an increase in flow rate during this time from 10.5 ml/s to 24 ml/s. Detrusor instability that had been present in 14 patients resolved within 2 days in 12. There was no further significant urodynamic change over the 1-year study period. After EBNS, there was an early rise in voiding pressure (Pdet rose from 26 cm H2O before operation to 42 cm H2O at 3 days). This continued to increase up to 21 days particularly in those patients with initial large residuals. Three patients developed detrusor instability. Flow rates were greatly reduced at first (27 ml/s before operation and 13 ml/s at 3 days), and gradually increased in line with voiding pressures, yet were still diminished 1 year after operation. The urodynamic changes following a reduction in bladder outflow resistance by TURP are immediate and sustained and unlikely to be the result of structural changes within the bladder wall. EBNS produces an increase in outflow resistance and it can be several weeks before balanced voiding is achieved, with significantly increased detrusor pressures needed to achieve complete bladder emptying at a reduced flow rate. 相似文献
83.
Laparoscopic hysterectomy 总被引:1,自引:0,他引:1
Michel Canis Gerard Mage Charles Chapron Arnaud Wattiez Jean Luc Pouly Maurice Antoine Bruhat 《Surgical endoscopy》1993,7(1):42-45
Summary Thirty-three patients were selected for laparoscopic hysterectomy and operated on in the Department of Obstetrics, Gynecology and Reproductive Medicine of Clermont-Ferrand University Hospital. Surgical techniques included blunt dissection with scissors and bipolar coagulation to achieve hemostasis. A case was considered successful when all the uterine vessels were treated by laparoscopy. Twenty-four cases were completed laparoscopically (72.7%). None of these patients had postoperative bleeding; 22 had an uneventful postoperative recovery. Nine procedures were converted to laparotomy (27.3%), five because of a difficult or unsatisfactory hemostasis. We conclude that in selected cases, a total hysterectomy can be performed safely by experienced laparoscopists. Further technological progress is necessary to make this procedure more acceptable. Its value as compared to the others will have to be demonstrated. 相似文献
84.
耳脑医用粘合剂是α-氰基丙烯酸正辛酯和α-氰基丙烯酸正丁酯及少量添加剂配伍而成的复合性医用粘合剂。应用此粘合剂粘合修补脑脊液漏27例,其中外伤性脑脊液鼻漏5例,经鼻蝶入路垂体瘤切除术脑脊液漏6例,开颅手术后手术切口脑脊液漏11例,脊膜膨出修补术后脑脊液漏5例。成功25例,成功率93%。应用此粘合剂修补脑脊液漏具有简便、迅速、有效的特点。 相似文献
85.
86.
Experimental studies demonstrated a severe cardiac load of the CO2 pneumoperitoneum caused by an accelerated after- and a decreased preload. Patients displaying cardiovascular risks are therefore
often rejected from laparoscopic surgery. Hence, the pathophysiological changes and the intraoperative risk of the CO2 pneumoperitoneum in high-risk cardiopulmonary patients (NYHA II–III, n= 15) undergoing laparoscopic cholecystectomy are described. The changes in cardiac after- and preload seem to be due to the
elevated intraabdominal pressure rather than transperitoneally resorbed CO2 and are reversible by desufflation. In one patient conversion to open operation had to be performed because of a severe drop
in cardiac output and right ventricle ejection fraction. Mixed oxygen saturation was predicting intraoperative worsening in
this case. The described pathophysiological changes may seem to be well tolerated even in high-risk cardiac patients. Monitoring
of hemodynamics should include an arterial catheter line and blood gas analyses. Pharmacologic interventions or pressureless
laparoscopic procedures might not be necessary as long as laparoscopic cholecystectomy is performed.
Received: 13 December 1996/Accepted: 8 January 1997 相似文献
87.
Background: The gastric bypass operation has evolved since 1966 when it was first introduced. The purpose of this study was
to determine the present state of gastric bypass by consensus among the members of the American Society for Bariatric Surgery
(ASBS). Method: A questionnaire was sent to all members of the ASBS. Forty-three percent responded reporting over 41,200 cases.
Results: Results were analyzed by using χ2 tests with a null hypothesis. Surgeons agreed on several technical aspects, preferring a vertical to a horizontal stapleline;
estimating, rather than measuring, the pouch volume at an average of 22 cc. Few surgeons divide the short gastric vessels,
and only 25% of surgeons polled use a restrictive ring or band proximal to the gastroenterostomy. Most surgeons calibrate
the gastroenterostomy, reporting a preferred average diameter of 12.3 cm. There was no consensus regarding forming the gastroenterostomy,
58% preferring hand-sewn and 42% stapled anastomoses. There was no consensus regarding dividing the gastric pouch from the
bypassed stomach: Conclusion: The preferred gastric bypass is vertical, with the pouch estimated at 20-25 cc, and the gastroenterostomy
calibrated at 12 mm diameter. The short gastric vessels need not be divided, and restrictive bands or rings are not preferred.
This technique of gastric bypass should be used as the control procedure when modifications are tested in future trials. Randomized
prospective studies are suggested to probe the benefits of division of the stomach pouch from the bypassed stomach. 相似文献
88.
一种便携式野战多功能骨科手术器械。重量仅1.1kg,体积为215mm×105mm×15mm,如铅笔盒,而功能多达33种,具有结构紧凑、操作简便、一械多用、轻巧便携。价廉实用、效价比高的特点。是基层巡诊、抢险救灾救治中适用的骨科器械。 相似文献
89.
Nephron Sparing Surgery for De Novo Renal Cell Carcinoma in an Allograft Kidney: A Case Report 总被引:1,自引:0,他引:1
Kyun II Park Hitoshi Inoue Choi Jan Kim Tadao Tomoyoshi 《International journal of urology》1997,4(6):611-614
De novo renal cell carcinoma in a renal allograft is rare and has special implications in renal transplant recipients. We describe a patient with a renal allograft who developed a de novo renal cell carcinoma in the functioning renal allograft 258 months after transplantation. The patient underwent enucleation of the tumor because preoperative MRI showed it was well-encapsulated. A DNA banding study showed that the tumor originated from the donor. Indications for conservative renal surgery in renal cell carcinoma have been increasing. Accordingly, 1 option in the treatment of de novo renal cell carcinoma in a functioning renal allograft is enucleation as a method of nephron sparing surgery. 相似文献
90.
Background: Laparoscopic surgery has been successfully applied to several gastrointestinal procedures. Although the totally laparoscopic
gastrectomy is feasible, tactile sensation and manipulation of the organ as well as the lesion are decreased when compared
to open surgery. The Dexterity Pneumo Sleeve is a new device which allows the surgeon to insert a hand into the abdominal
cavity while preserving the pneumoperitoneum. This device was used for patients who underwent laparoscopic gastric surgery.
Methods: The first patient presented with a non-Hodgkin's lymphoma of the stomach. A laparoscopically assisted distal gastrectomy
was performed with Roux-en-Y reconstruction. The second patient had a 5-cm leiomyoma involving the greater curve of the stomach,
and this device was used for manipulation of the tumor. The last patient suffered from morbid obesity with its associated
medical complications and a ventral hernia. The Sleeve was applied at the hernia site and a laparoscopically assisted gastric
bypass was performed.
Results: The Pneumo Sleeve was useful in these cases for tactile localization of the tumor and for retraction and manipulation of
the stomach and surrounding upper abdominal organs.
Conclusions: The utilization of this device resulted in a more easily performed dissection, resection, and anastomosis and was felt to
decrease operation time.
Received: 18 September 1996/Accepted: 26 December 1996 相似文献