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目的探讨重症胆石性胰腺炎(SGP)手术治疗的若干问题.方法回顾性分析35例SGP的临床资料,讨论胰腺包膜和后腹膜的作用、坏死组织清除程度、胰床引流方式等问题.结果胆囊切除35例,胆总管探查16 例;行有限的和彻底的坏死组织清除分别为24例和5例.死亡5例,出院时有胰瘘2例,其余痊愈出院.结论胰腺包膜和后腹膜具有局限化和限制性的双重作用,坏死组织清除的程度和胰床引流的方式取决于病变有无局限化和病程的阶段. 相似文献
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腹腔镜胆总管探查取石术62例临床分析 总被引:1,自引:0,他引:1
目的探讨腹腔镜胆总管探查取石术的手术方式、适应证。方法回顾性分析2002年2月至2004年8月62例腹腔镜胆总管探查取石术的临床资料。结果62例均在胆道镜的配合下完成腹腔镜胆总管探查取石术。其中胆总管切开取石后置T管引流20例,胆总管切开取石后一期缝合42例。2例发生术后胆漏。结论对腹腔镜下胆总管探查取石术,不管是采取T管引流还是一期缝合,只要掌握手术方式及适应证,腹腔镜下治疗胆总管结石是可行的,是一种创伤小、恢复快、安全可靠的微创手术。 相似文献
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目的探讨腔镜下甲状腺切除术的临床应用前景和手术关键。方法分析腔镜下30例甲状腺疾病患者进行的经胸乳入路甲状腺切除术患者的临床资料。结果30例手术均获成功,其中3例甲状腺乳头状癌,转行传统甲状腺癌根治术。手术时间平均120min。术中出血约50m1。术后平均48-72h拔除引流管,术后5d出院。术后1例出现短暂声音嘶哑,3个月后恢复,可能与超声刀切割时过分靠近喉返神经导致热损伤所致。结论腔镜甲状腺切除术具有创伤小、手术美观的优点。 相似文献
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1915年Stewart采用梭形横切口行乳房切除术以来,虽适于多数乳房切除乳癌根治及乳房重建病例,但由于乳房形状和肿块部位不同,切口两边皮瓣不等,常在切口外侧形成“狗耳”状畸形,尤其是肥胖和皮肤松驰患者,同时,这种切口常难以充分暴露腋窝和达到美观整形的要求。作者介绍一种新的“鱼形”切口,即在原梭形横切 相似文献
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腹腔镜胆总管探查一期缝合术的临床观察 总被引:3,自引:0,他引:3
目的观察腹腔镜下胆总管探查一期缝合术的临床效果。方法观察自2003年6月后行腹腔镜下胆总管切开取石一期缝合术28例,随机观察传统开腹胆总管切开取石T管引流术30例,对比两组手术效果,统计学进行分析。结果术后患者下床活动时间、肛门排气时间、进食时间、术后住院时间、补液量、留置导尿、胆漏、疼痛,两组比较P<0.05,差别有显者性意义;术后胆漏、腹腔引流时间,两组比较P>0.05,差别无显著意义。结论腹腔镜胆总管切开取石一期缝合术具有并发症低,住院时间短,痛苦少,恢复快等优点,是一种安全、有效的好方法,值得推广应用。 相似文献
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目的探讨胸乳入路行内镜甲状腺手术的可行性和技术要点以及术后的美容效果。方法采用胸乳入路,在胸前间隙及颈前间隙形成操作空间。内镜下以超声刀切除甲状腺良性肿瘤12例。结果12例手术均获得成功。术后1例出现声音嘶哑,2个月后恢复。无饮水呛咳、皮下气肿、术后出血等并发症出现。结论胸乳入路内镜甲状腺手术具有明显的美容效果,手术的关键在于建立适当的操作空间、良好的术野显露、避免术中出血。 相似文献
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Objective To explore the feasibility of imaging and treatment of cervical cancer xenograft model using 131I mediated by hNIS gene transfection. Methods The cervical cancer xenograft models were established with Hela-NIS( +) cells and Hela cells, respectively. Five Hela-NIS( +) xenograft models and five Hela xenograft models were dynamically imaged at 0.5, 1, 2, 4, 8, 16 and 20 h postinjection of 131I(7.4 MBq). Five Hela-NIS( +) xenograft models were imaged at 0. 5,1,2,4,8,16, 20 and 25 h postinjection of 99TcmO4-(11.1 MBq). Twenty Hela-NIS( +) cervical cancer xenograft models were randomly divided into four groups: Three 131I treating groups and one control group. The therapeutic effects of 131I at threelevels (74,111,148 MBq) were investigated following intraperitoneal injection. Results Hela-NIS( +)human cervical cancer xenografts were established successfully in nude mice. The Hela-NIS( +) xenografts significantly accumulated radioactivity after intraperitoneal injection of 131I, and the radioactivity was persistently present until 20 h postinjection, but Hela xenografts had no radioactive accumulation. The T/B value of the Hela-NIS( +) xenografts reached 17.34 at 8 h postinjection. The imaging with 99TcmO4- showed that the radioactivity was persistently present in Hela-NIS( +) xenografts for almost 25 h. The Hela-NIS( +)xenografts shrinked after 131I treatment. The inhibition ratios of tumor growth in 111 MBq and 148 MBq groups were both significantly higher than that of 74 MBq group (t: 2.74-5.75, P <0.05). Conclusions Hela-NIS( +) cervical cancer xenografts in nude mice could persistently accumulate 131I and 99TcmO4- and could be treated successfully with 131 I. 131 I treatment mediated by hNIS gene transfection could be a promising cancer treatment method. 相似文献
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内镜下逆行胰胆管造影(endoscopic retrograde cholangiopancretography,ERCP)适用于十二指肠乳头、壶腹、肝内外胆管、胆囊及胰腺疾病的诊断与治疗。现就近年来的应用进展概述如下: 相似文献
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腹腔镜肠粘连松解术吴浩荣王浩炜吴斌陈伟苏州医学院附属第二医院普外科(215004我们于1996年10月~1997年12月采用腹腔镜行肠粘连松解术10例,现报告如下。1临床资料11一般资料本组10例中,男1例,女9例。年龄39~67岁,平均50岁。胆... 相似文献