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61.
Temporary closure of the abdominal wall (laparostomy) 总被引:2,自引:0,他引:2
A. Schachtrupp V. Fackeldey U. Klinge J. Hoer A. Tittel C. Toens V. Schumpelick 《Hernia》2002,6(4):155-162
The definitive closure of the abdominal wall, i.e., a closure of the fascial layer and skin may not be favorable in the treatment
of numerous surgical conditions, e.g., peritonitis, trauma, or mesenteric ischemia. In these cases, the abdominal wall is
temporarily closed, and a laparostomy is created to facilitate re-exploration or to prevent abdominal compartment syndrome.
Regarding the technique and material used for the temporary closure, no prospective randomized data exists, but mesh materials
are commonly used. They provide drainage of infectious material, permit visual control of the underlying viscera, facilitate
access to the abdominal wall, preserve the fascial margin, enable healing by secondary intention, and allow mobilization of
the patient. In the case of decreasing intra-abdominal pressure, meshes can be trimmed to centralize the rectus muscle and
to facilitate definitive closure. Non-absorbable meshes have been frequently reported to cause enteric fistulae and persistent
infection necessitating mesh explantation. While these infectious complications appear to occur less frequently with the use
of absorbable materials, these meshes will finally lead to an incisional hernia, requiring repair with non-absorbable mesh
after a period of 6–12 months. Nevertheless, in the complex situation requiring a temporary abdominal wall closure, use of
absorbable mesh material is common and represents the state of the art.
Electronic Publication 相似文献
62.
Annette Anderton 《Journal of human nutrition and dietetics》1994,7(1):53-60
The HACCP (hazard analysis critical control point) concept is now widely applied in the food industry and provides a structured and critical approach to the identification and control of hazards that may affect food safety. It has shifted the emphasis for control from retrospective end-product testing to the effective control of raw materials and key processing operations.
This paper discusses how the HACCP approach can be applied to enteral feeding. This involves each unit assembling a multidisciplinary team of personnel involved in enteral feeding. This team will then carry out a detailed analysis of the process from selection of ingredients and feeding systems through to consumption of the feed by the patient by constructing a flow chart that relates specifically to each unit. They can then identify and assess the hazards associated with the handling of the product at each stage in the process. This will enable them to identify the points where control over an identified hazard can be achieved (critical control points, CCP) such as quality of ingredients, design of administration systems, preparation and distribution of the feeds and the procedures involved in the assembly and manipulation of the systems. Control and monitoring procedures can then be specified and implemented at relevant stages in the process. The major strengths of the HACCP procedure are that it entails a team effort from key personnel involved in the full range of activities associated with the product and each detailed analysis is specific to each unit's practices and resources and can be continually reviewed and modified in response to changing circumstances. 相似文献
This paper discusses how the HACCP approach can be applied to enteral feeding. This involves each unit assembling a multidisciplinary team of personnel involved in enteral feeding. This team will then carry out a detailed analysis of the process from selection of ingredients and feeding systems through to consumption of the feed by the patient by constructing a flow chart that relates specifically to each unit. They can then identify and assess the hazards associated with the handling of the product at each stage in the process. This will enable them to identify the points where control over an identified hazard can be achieved (critical control points, CCP) such as quality of ingredients, design of administration systems, preparation and distribution of the feeds and the procedures involved in the assembly and manipulation of the systems. Control and monitoring procedures can then be specified and implemented at relevant stages in the process. The major strengths of the HACCP procedure are that it entails a team effort from key personnel involved in the full range of activities associated with the product and each detailed analysis is specific to each unit's practices and resources and can be continually reviewed and modified in response to changing circumstances. 相似文献
63.
温州地区近6年907例精神病司法鉴定案例分析 总被引:2,自引:0,他引:2
石华孟 《神经疾病与精神卫生》2004,4(5):343-345
目的 探讨近 6年精神病司法鉴定案例的特征。方法 对浙江温州鹿城精神病医院1998~ 1999年 (A组 ) 2 0 2例 ,2 0 0 0~ 2 0 0 1年 (B组 ) 36 8例 ,2 0 0 2~ 2 0 0 3年 (C组 ) 337例进行对照研究。结果 近 6年 ,女性和无业构成比上升 (P <0 .0 1)。责任能力评定下降 ,服刑能力、民事行为能力评定上升 (P <0 .0 1)。精神损伤评定构成比上升 (P <0 .0 5 )。诊断为精神分裂症、情感性精神病逐年上升(P <0 .0 1)。无责任能力评定上升 (P <0 .0 1) ,完全责任能力评定下降 (P <0 .0 1)。法院委托鉴定上升 (P <0 .0 5 )。结论 近 6年中精神病司法学呈现不同的特点 ,并逐步向规范化、法规化迈进 ,服务范围和对象将会扩大 相似文献
64.
本文应用电力载波技术,实现远端时钟的中央控制。系统通过电力载波芯片从电力线上收发控制信号,中央控制端发送的时钟校准信号到电力线网络,接人网络的远端时钟接收到校准信号后,由微处理器解析数据调整受控端时钟显示,从而实现时钟的中央控制。 相似文献
65.
A direct solution is proposed to an optimal control problem of linear econometric systems with a quadratic welfare loss function when there are linear equality constraints on the control variables. The direct solution proposed here eliminates the problem of non-uniqueness of the optimal solution, which is present when this optimal control problem is solved using the recursive algorithm proposed by Chow,1 Pindyck2 and Tan.3 If a unique solution to the optimal control problem exists, then the direct solution and the recursive solution coincide. 相似文献
66.
67.
颅面部的 CT扫描检查主要包括颅脑面部上、下颌骨、中耳、内耳、鼻窦、眼眍、眼球及颞骨茎突等部位的扫描检查 ,上述部位的扫描检查的位置的摆法 ,层面的厚度、间距 ,扫描时间及螺距等参数的选择及扫描后图像的后处理工作对检查结果的诊断至关重要。上述参数任意一个选择不当及 相似文献
68.
霍秀月 《菏泽医学专科学校学报》2002,14(1):22-23
目的 观察一次性小剂量米非司酮用于紧急避孕的效果。方法征集无保护性交或避孕失败后72小时内就诊并符合条件的健康妇女100例,单次口服米非司酮10mg。结果失败1例,按照Dixon方法计算,避孕有效率为89.55%;受试的月经周期无明显改变且未出现明显副作用。结论小剂量米非司酮单次口服用于紧急避孕简单、有效、安全。 相似文献
69.
【目的】研究拉米夫定对HBsAg阳性孕妇的乙肝病毒 (HBV)宫内阻断作用。【方法】拉米夫定组 43例 ,孕 2 8周起口服拉米夫定 ,每天 10 0mg至产后 30d。对照组 5 2例 ,未予用药。两组孕妇均于孕 2 8周、分娩前 ,其新生儿于生后 2 4h内免疫接种前抽静脉血检测HBsAg、HBeAg及HBV的定量。【结果】拉米夫定组孕妇HBV的DNA水平显著下降 (P <0 0 5 ) ,其新生儿宫内感染率 (16 3% )明显低于对照组 (32 7% ) ,P <0 0 5。两组孕妇及其新生儿未发现有不良反应。【结论】携带HBV孕妇产前服用拉米夫定可有效减少HBV宫内感染发生率。 相似文献
70.