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排序方式: 共有186条查询结果,搜索用时 15 毫秒
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目的探讨快速康复外科理念在食管癌患者围手术期的应用及对患者的临床结局的影响。方法收集2011年1-6月间南京医科大学附属淮安第一医院胸外科接受食管癌根治术的食管鳞癌患者117例,其中4-6月63例(研究组),围手术期采用快速康复外科理念进行处理:1~3月接受手术54例(对照组),围手术期按常规处理。结果研究组术后排气时间、术后拔除胸腔引流管时间、术后住院时间及住院总费用均显著低于对照组(P〈O.05):手术时间两组差异无统计学意义(P〉0.05)。研究组和对照组总并发症的发生率分别为7.9%(5/63)和24.1%(13/54),差异有统计学意义(P〈0.05)。结论食管癌患者围手术期应用快速康复外科理念,可促进术后肠功能恢复.减少术后并发症发生率.从而改善患者的临床结局. 相似文献
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Alison Lyon Christopher J Payne Graham J MacKay 《World journal of gastroenterology : WJG》2012,18(40):5661-5663
Enhanced recovery after surgery (ERAS) employs a multimodal perioperative care pathway with the aim of attenuating the stress response to surgery and accelerating recovery. It has been difficult to determine the relative importance of some of the individual components of these pathways such as epidural analgesia and laparoscopic colorectal surgery. Some argue that only a rigid adherence to the published ERAS protocol can achieve the proposed benefits of fast-track surgery. In this article, we explore some of the areas where the evidence base may be changing and ask whether a more flexible and individualised approach should be considered. 相似文献
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目的:探讨快速康复外科(FTS)应用于胃肠手术的安全性及个体化原则。方法:将采用FTS方法进行围手术期处置的180例择期胃肠手术患者(FTS组)与采用标准方法处理的110例患者(传统组)进行非随机对照研究,比较其一般并发症、严重并发症、消化道瘘和总体并发症发生率的差异。结果:FTS组的总体并发症及一般并发症发生率均显著低于传统组(P<0.05);两组的严重并发症发生率虽差异无显著性(P>0.05),但FTS组的消化道瘘发生率较传统组有增高趋势(2.2%vs0.9%,P>0.05)。结论:FTS可显著降低胃肠手术后的并发症发生率,但如应用不当可能增加消化道瘘的发生率,因此,FTS的临床应用应遵循个体化原则。 相似文献
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目的:比较快速康复外科(FTS)理念下结直肠癌手术中腹腔镜与开腹手术的差异,探讨FTS联合腹腔镜的必要性.方法:将2010年3月至2011年10月间广州军区广州总医院普外科收治的80例结直肠癌,随机分为两组,每组各40例,A组采用FTS联合腹腔镜手术(FTS+腹腔镜组),B组采用FTS开腹手术(FTS组),两组行随机对照研究.比较两组术后首次排气时间、排便时间、术后住院时间、住院费用等临床指标,C-反应蛋白(CRP)、白细胞介素-6(IL-6)和皮质醇等应激反应指标及术后并发症情况.结果:A组同B相比,术后首次排气时间(2.3 d vs 2.6 d)、排便时间(3.1 d vs 3.5 d)、术后住院时间(4.1 d vs 4.5 d)略有缩短,但差异均无统计学意义(P > 0.05);住院费用显著增加(3.6万元 vs 2.3万元),且差异有显著统计学意义(P < 0.05).两组术后第1、3天 CRP、IL-6、皮质醇等应激反应指标均明显高于术前,但两组比较差异无统计学意义(P > 0.05).单个并发症及总体并发症两组比较差异无显著性(P > 0.05).两组均无死亡病例.A组再入院率(1/40,2.5%)稍低于B组(2/40,5.0%),但差异无统计学意义(P > 0.05).结论:腹腔镜的联合应用并不能进一步改善FTS指导下的结直肠癌术后康复进程. 相似文献
6.
Han LO Zhou LH Cheng SJ Song C Song CF 《World journal of gastroenterology : WJG》2011,17(45):5021-5027
AIM: To investigate which surgical techniques and perioperative regimens yielded the best survival rates for diabetic rats undergoing gastric bypass. METHODS: We performed Roux-en-Y gastric bypass with reserved gastric volume, a procedure in which gastrointestinal continuity was reestablished while excluding the entire duodenum and proximal jejunal loop. We observed the procedural success rate, long-term survival, and histopathological sequelae associated with a number of technical modifications. These incl... 相似文献
7.
Liu-Hua Wang Fang Fang Chun-Ming Lu Dao-Rong Wang Ping Li Ping Fu 《World journal of gastroenterology : WJG》2014,20(41):15423-15439
AIM: To compare the safety of fast-track rehabilitation protocols (FT) and conventional care strategies (CC), or FT and laparoscopic surgery (LFT) and FT and open surgery (OFT) after gastrointestinal surgery.METHODS: We searched MEDLINE, WHO International Trial Register, Embase and The Cochrane Central Register of Controlled Trials up to 2014 for randomized controlled trials (RCTs) comparing FT and CC or comparing LFT and OFT, with 10 or more randomized participants and about 30 d follow-up. Two reviewers independently extracted data on complications, anastomotic leak, obstruction, wound infection, re-admission between FT and CC or LFT and OFT after gastrointestinal surgery.RESULTS: Twenty-four RCTs of FT vs CC or LFT vs OFT were included. Compared with CC, FT reduced overall complications and wound infection. However, anastomotic leak, obstruction and re-admission were not significantly reduced. The pooled risk ratio (RR) of 0.69 (95%CI: 0.60-0.78; P < 0.001), pooled RR of 0.71 (95%CI: 0.57-0.88; P < 0.001), pooled RR of 0.93 (95%CI: 0.68-1.25; P > 0.05), a pooled RR of 0.87 (95%CI: 0.67-1.15; P > 0.05) and pooled RR of 0.94 (95%CI: 0.73-1.22; P > 0.05) respectively. Compared with OFT, LFT reduced complications, with a pooled RR of 0.66 (95%CI: 0.54-0.81; P < 0.001).CONCLUSION: FTs are safe after gastrointestinal surgery. Additional large, prospective RCTs should be conducted to establish further the safety of this approach. 相似文献
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Objective The use of laparoscopic surgery coupled with an enhanced recovery programme (ERP) has resulted in hospital stays of 4 or less days for colonic and 6 days following rectal resection, in previously reported small selected groups of patients. This report analyses an unselected cohort to determine if such benefits are reproducible.
Method Consecutive patients undergoing elective colonic or rectal surgery at a single centre between January 2002 and January 2006 were followed. All were included in the ERP and underwent either laparoscopic or open surgery.
Results The study group comprised 241 patients (mean age of 67 ± standard deviation 14 years and 49% male sex distribution) who underwent elective colorectal resection within the context of an ERP. One hundred and fifty-one (62.7%) patients had malignant disease. Overall, 191 (79.3%) patients underwent a laparoscopic procedure and the remaining underwent an open operation. Postoperative stay was shorter in patients undergoing laparoscopic vs open, colonic surgery (4 days vs 6 days, P = 0.002). A nonsignificant trend towards reduced postoperative stay was observed for patients undergoing laparoscopic vs open, rectal surgery (6 days vs 9 days, P = 0.088). Patients undergoing laparoscopic colectomy demonstrated significantly lower 30-day mortality rates than those undergoing traditional colectomy (3/131 vs 3/39, P = 0.049).
Conclusion Laparoscopic colonic surgery in the context of an ERP offers reduced hospital stay and may confer a survival advantage over traditional techniques. These results confirm that previously reported benefits of laparoscopic surgery are reproducible within an unselected population. 相似文献
Method Consecutive patients undergoing elective colonic or rectal surgery at a single centre between January 2002 and January 2006 were followed. All were included in the ERP and underwent either laparoscopic or open surgery.
Results The study group comprised 241 patients (mean age of 67 ± standard deviation 14 years and 49% male sex distribution) who underwent elective colorectal resection within the context of an ERP. One hundred and fifty-one (62.7%) patients had malignant disease. Overall, 191 (79.3%) patients underwent a laparoscopic procedure and the remaining underwent an open operation. Postoperative stay was shorter in patients undergoing laparoscopic vs open, colonic surgery (4 days vs 6 days, P = 0.002). A nonsignificant trend towards reduced postoperative stay was observed for patients undergoing laparoscopic vs open, rectal surgery (6 days vs 9 days, P = 0.088). Patients undergoing laparoscopic colectomy demonstrated significantly lower 30-day mortality rates than those undergoing traditional colectomy (3/131 vs 3/39, P = 0.049).
Conclusion Laparoscopic colonic surgery in the context of an ERP offers reduced hospital stay and may confer a survival advantage over traditional techniques. These results confirm that previously reported benefits of laparoscopic surgery are reproducible within an unselected population. 相似文献
10.
Alfonso Sevillano-Jiménez Manuel Romero-Saldaña Guillermo Molina-Recio 《Enfermería clínica》2018,28(4):266-273
Rapid recovery (RR) or fast-track programmes are aimed at reducing surgical stress, leading to a reduction in nurse workload, costs and hospital stay, greater patient empowerment, early post-surgical recovery and reduced morbidity and mortality. These new protocols require the coordinated participation of a multidisciplinary team.Based on an integrative review of the literature, this paper aims to define the concept of a RR or fast track programme and show the existing evidence on the implementation of these programmes in nursing.The benefits and low incidence of damage of RR programmes in nursing justify their implementation. The programmes require greater support and diffusion in order to develop, as well as more research to increase the evidence on the effectiveness and efficiency of the protocols. 相似文献