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        west china medical publishers
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        find Keyword "外科" 1935 results
        • Vitreous surgery for severe ocular trauma

          Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)

          Release date:2016-09-02 06:08 Export PDF Favorites Scan
        • 胸內巨淋巴結增生癥的診斷及外科治療

          目的 為了提高對胸內巨淋巴結增生癥的認識,探討其診斷方法、外科治療特點. 方法 回顧11例胸內巨淋巴結增生癥的病例,對其臨床癥狀、影象學特點、手術方式、病理分類等進行分析. 結果 胸內巨淋巴結增生癥的臨床癥狀無特異性,影象學表現為縱隔、肺部或肺門陰影和胸腔積液.9例瘤體完整切除,2例有少量殘留;術后效果良好,隨訪至今無復發. 結論 胸內巨淋巴結增生癥可以發生在胸腔的任何部位,術前確診率低,但手術效果好.病理屬良性腫瘤,故術中應盡量保留正常肺組織,并避免損傷周圍臟器.

          Release date:2016-08-30 06:30 Export PDF Favorites Scan
        • 玻璃體切除手術治療永存性原始玻璃體增殖癥一例

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        • 肺曲菌病的診斷與外科治療

          目的 總結肺曲菌病的診斷和外科治療經驗。 方法 57例肺曲菌病患者中17例(29.8%)術前已明確診斷,21例(36.8%)于術前誤診為肺結核、肺部占位病變、肺囊腫和肺膿腫等,19例(33.3%)術前漏診。行肺葉切除術27例,肺段或肺楔形切除術18例;在電視胸腔鏡輔助下行肺段或局部病變切除術5例,電視胸腔鏡輔助下小切口肺楔形切除或局部病變切除術7例。 結果 無住院死亡。術后出現包裹性液氣胸4例,胸腔積液、積氣2例,切口感染1例,肺部感染3例,均經3~7d的相應處理治愈。術后積極治療肺部基礎疾病,同時均給予氟康唑400mg/d,治療4~8周。所有患者均得到隨訪,隨訪時間6個月~12年,肺曲菌病未復發,患者生活質量良好。 結論 肺曲菌病誤診、漏診率高,術前應加強對肺曲菌病的認識,認真檢查診斷;手術切除病變是治療肺曲菌病的有效方法。

          Release date:2016-08-30 06:15 Export PDF Favorites Scan
        • ABSTRACTXEXPERIMENTAL STUDY ON CARBON DIOXIDE LASER FOR SMALL ARTERYANASTOMOSIS WTH DEGRADABLE INTRALUMINAL BIOMATERIAL SUPPORT

          In search of a rapid method for vascular anastomosis with high quality,a compatative study was carried out to observe the results of laser welding of the saphenous artery of rabbit(0.45-0.85 indiameter)with the use of a degradable intraluninal bionterial support and the traditional method of suture anastomosis. The results showed that there was no significant difference observed between the two groups in the immediate and long patency rated and the occurrence of stenosis,However,the time ...

          Release date:2016-09-01 11:18 Export PDF Favorites Scan
        • The surgical treatment strategy and perioperative management of patients with heart valve disease complicated with severe chronic heart failure

          ObjectiveTo summarize the individualized selection of surgical treatment strategies and the key points of perioperative management for patients with heart valve disease complicated with severe chronic heart failure.MethodsThe clinical characteristics of 5 male patients with valvular heart disease complicated with severe chronic heart failure (CHF) were analyzed retrospectively from June 2017 to October 2018 in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, with an average age of 60.21 years.ResultsFive patients were given angiotensin receptor and neprilysin inhibitor (ARNI)-based anti-heart failure treatment after admission. The operation mode of these patients was decided to be valve replacement under cardiopulmonary bypass after individualized evaluation of patients’ improving symptoms. Three patients were treated with intra-aortic balloon pump (IABP) and continuous renal replacement therapy (CRRT) early after operation to assist patients in improving cardiac function. Five patients recovered oral anti-heart failure after awakening. All patients were discharged smoothly 2 weeks after operation.ConclusionIndividualized evaluation is needed for the choice of operation timing and mode, standardized preoperative treatment for heart failure, shortening the aortic blocking time during cardiopulmonary bypass, and early application of left ventricular adjuvant drugs or instruments are all important measures to help patients recover smoothly.

          Release date:2019-09-18 03:45 Export PDF Favorites Scan
        • Over- and under-treatment of lung cancer

          With the development and improved availability of low-dose computed tomography (LDCT), an increasing number of patients are clinically diagnosed with lung cancer manifesting as ground-glass nodules. Although radical surgery is currently the mainstay of treatment for patients with early-stage lung cancer, traditional anatomic lobectomy and mediastinal lymph node dissection (MLND) are not ideal for every patient. Clinically, it is critical to adopt an appropriate approach to pulmonary lobectomy, determine whether it is necessary to perform MLND, establish standard criteria to define the scope of lymph node dissection, and optimize the decision-making process. Thereby avoiding over- and under-treatment of lung cancer with surgical intervention and achieving optimal results from clinical diagnosis and treatment are important issues before us.

          Release date:2021-07-28 10:02 Export PDF Favorites Scan
        • MICROSURGICAL REPAIR OF DEFECTS OF SOFT TISSUE AND INFECTED WOUNDS OF EXTREMITIES

          A study was carried out to observe the application of microsurgical technique in the repair defects of soft tissue and infected wounds of extremities. Eighty-three patients with soft tissue defects and infected wounds of extremities were treated by either transferring of vascularized cutaneous flap or transplantation of myocutaneous flap with vascular anastomosis. The result showed that eighty-three patients had gained success after a follow-up of 6 months to 4 years. It was concluded that soft tissue defects and infected wounds of extremities should be repaired as early as possible. Selecting the donor flap near the recipient site was of first choice. The method used for repair should be simple and easily applicable rather these very complicated one. The success depended on the correct treatment of local conditions, resonable design of donor flap and close monitoring after operation.

          Release date:2016-09-01 11:07 Export PDF Favorites Scan
        • Clinical Research of Small Caliber Stapler Applying in Anterior Resection of Ultra-Low Rectal Cancer with Anal Sphincter Preservation

          Objective To evaluate the safety and ascendancy of small caliber stapler application for anterior resection in ultra-low rectal cancer with anal sphincter preservation. Methods A retrospective analysis of the data of 60 cases of ultra-low rectal cancer treated by anterior resection with anal sphincter preservation by double stapling technique according to TME principle between June 2006 and June 2009 were undertaken. The 60 patients were divided into two groups, each group included 30 cases. One group adopted 33 mm stapler and another group adopted 29 mm stapler, and then the profiles of medi-operation, post-operation, and prognosis were assessed. Results Time of simple anastomose in operation was (9.0±3.3) min in 33 mm stapler group and (6.0±2.6) min in 29 mm stapler group, and there was significant difference between them (P=0.022 5). There were 6 cases needed to be restored because of lesion during operation or dys-anastomosis in 33 mm stapler group, while 2 cases in 29 mm stapler group, there was significant difference between them (P=0.030 1). No significant differences were observed between the two groups in terms of the time for operation, leakage, bleeding, stenosis, anastomotic recurrence, and fecal incontinence after operation or length of stay. Conclusion The application of 29 mm stapler not only can shorten time for anastomose and step down the degree of difficulty, but also dosen’t increase stenostomia and other complications.

          Release date:2016-09-08 10:50 Export PDF Favorites Scan
        • Analysis of Laparoscope-Ureteroscope Combination for Lithotripsy in 36 Patients with Hepatolithus

            Objective To evaluate the clinical value of ureteroscope in cholelithiasis treated by laparoscopic surgery.   Methods The clinical data of 36 patients admitted because of hepatolithus with ureteroscope combination in laparoscopic surgery from February 2007 to September 2009 in Guidong People’s Hospital of Guangxi were analyzed retrospectively.   Results In 33 cases, stones were removed once by ureteroscope in laparoscopic surgery with residual stones (in 3 cases residual stone were removed secondarily through T tube) and the other 3 cases were transferred to laparotomy forcedly due to bleeding of biliary duct and vessels of porta hepatis and tearing of bile duct. During operation, blood loss was 30-280 (94.51±54.70) ml; operation time was 110-260 (147.22±48.45) min; recovery time of bowel movement was 1-3 (2.03±0.76) d; postoperative hospitalization time was 6-13 (7.12±1.65) d (some discharged with T tube); the time of patients of T tubes pulled out was 28-45 (38.92±6.52) d. Bile leakage happened in 1 case and infection of biliary tract in 1 case, no complications such as biliary stricture or bile duct bleeding were found after operation.   Conclusions Treatment of intrahepatic bile duct or a single extra-hepatic sand-like stones with ureteroscopy usage in laparoscopic surgery is feasible and less invasive. It is a minimally invasive treatment for intra- or extra-hepatic stones due to rapidly postoperative rehabilitation.

          Release date:2016-09-08 10:52 Export PDF Favorites Scan
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