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胆道手术中十二指肠损伤是一种严重的医源性损伤,是胆道手术的严重并发症[1].如不及时妥善处理,术后可发生十二指肠瘘、严重感染、出血,甚至死亡[2].现就胆道手术中十二指肠损伤的诊治及防范进行探讨.…… 相似文献
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医用胶补贴法在腹内脏器切口和创面的应用 总被引:2,自引:0,他引:2
目的探讨补片喷涂医用生物胶在腹内脏器手术中的粘贴效果。方法用可溶性止血纱布或明胶海绵喷涂医用胶粘贴于实质脏器的创面止血,用腹膜或胆囊浆肌层薄片借助医用胶粘贴于胆总管缝合切口。结果本文32例均明显有效,随访6~12个月,无后遗症及并发症。结论腹内实质脏器破裂和淋巴清扫创面,可用止血纱布喷涂医用胶粘贴创面,对胆总管切口,经一期缝合后,加用自身腹膜或胆囊浆肌层薄片喷涂生物胶粘贴,效果更佳,达到密闭、不透水、减张作用,可预防胆漏发生。避免了胆管内留置T形管的弊端。 相似文献
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1994年1月-2004年12月,本院急诊救治骨盆骨折伴后尿道损伤患者26例,疗效满意,现报道如下。
1 临床资料
1.1一般资料本组均为男性,年龄23~64岁,平均41岁。损伤原因:交通事故伤17例,重物挤压伤7例,高处坠落伤2例。后尿道完全断裂19例,部分断裂7例。均伴有骨盆骨折,其中多处骨折使骨盆完整性受到破坏11例,耻骨联合分离5例,骶髂关节错位2例。所有患者在伤后1~10h就诊。 相似文献
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胆道手术中十二指肠损伤的诊治及防范 总被引:1,自引:0,他引:1
胆道手术中十二指肠损伤是一种严重的医源性损伤,是胆道手术的严重并发症。如不及时妥善处理,术后可发生十二指肠瘘、严重感染、出血,甚至死亡。现就胆道手术中十二指肠损伤的诊治及防范进行探讨。 相似文献
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155例耻骨上前列腺摘除术后并发前列腺窝大出血10例、排尿困难3例、尿失禁3例、急性附睾炎1例,对其发生的原因,预防和处理方法进行讨论。 相似文献
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8例前列腺增生症射频热疗后并发持续尿潴留而手术治疗,并对其发生的原因和射频适应的掌握进行讨论。 相似文献
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改良Sigma直肠膀胱术中输尿管单腔、并腔肠吻合的疗效分析 总被引:1,自引:0,他引:1
目的 评价改良Sigma直肠膀胱术中输尿管单并腔肠吻合的疗效.方法 对14例膀胱多发移行细胞癌、1例膀胱腺癌根治性膀胱全切术后患者行改良Sigma直肠膀胱术.折叠25 cm直肠乙状结肠缝合成U形储尿囊,其中输尿管分别单腔与储尿囊吻合5例、双输尿管末端1.5~2.0cm并腔缝合后与储尿囊吻合10例.结果 15例患者控尿良好,无明显水电解质酸碱紊乱,术后15~22 d痊愈出院.13例随访8~24个月,其中输尿管单腔肠吻合4例出现吻合口狭窄、轻~重度肾积水,并腔肠吻合9例未出现肾积水.结论 改良Sigma直肠膀胱术创伤小、并发症少,患者可通过肛门括约肌自控排尿,无需配带尿袋或间断导尿,符合生理要求,提高了患者的生活质量;输尿管并腔后吻合口径大,不易发生狭窄等严重并发症.Abstract: Objective To make a comparison of curative effect of 1 and 2 ureters anastomosis in modified sigma operation. Methods Modified sigma operation was used after radical cystectomy in 14 cases of bladder transitional cell carcinoma and 1 case of adenocarcinoma of the bladder.We used a folded suture of 25 cm from the sigmoid colon to make the U-shaped urinary reservoirs to anastomose with the ureters in study group.Among study group,1 ureter was anastomosed with urinary reservoir in 5 cases.In the other 10 cases,1.5-2 cm of the terminal parts of 2 ureters were sutured tI am not sure what the authors mean by "big diamogether and then anastomosed with the urinary reservoir.Results 15 cases obtained good voiding control and no obvious water-electrolyte disturbance occurred.All the patients were cured and discharged within 15 to 22 days.Thirteen cases were followed-up in 8 to 24 month time period.Anastonmtic stenosis and moderate-severe hydronephrosis occurred in 4 cases with 1 ureter anastomosis.No hydronephrosis occurred in the 9 cases with 2 ureters anastomosis.Conclusions Modified sigma operation has the advantages of less injury and fewer complications.The patients can obtain self-control urination by anal sphincter without urine bags or intermittent catheterization,so the life quality of the patients is improved.Modified sigma operation with 2 ureters anastomosis has big diameter and there was a lower incidence of serious complications such as anastomotic stenosis. 相似文献
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