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find Keyword "外科治疗" 340 results
  • SURGICAL TREATMENT OF CHOLELITHIASIS WITH PORTAL HYPERTENSION

    Release date:2016-09-08 01:59 Export PDF Favorites Scan
  • 肺曲菌病的诊断与外科治疗

    目的 总结肺曲菌病的诊断和外科治疗经验。 方法 57例肺曲菌病患者中17例(29.8%)术前已明确诊断,21例(36.8%)于术前误诊为肺结核、肺部占位病变、肺囊肿和肺脓肿等,19例(33.3%)术前漏诊。行肺叶切除术27例,肺段或肺楔形切除术18例;在电视胸腔镜辅助下行肺段或局部病变切除术5例,电视胸腔镜辅助下小切口肺楔形切除或局部病变切除术7例。 结果 无住院死亡。术后出现包裹性液气胸4例,胸腔积液、积气2例,切口感染1例,肺部感染3例,均经3~7d的相应处理治愈。术后积极治疗肺部基础疾病,同时均给予氟康唑400mg/d,治疗4~8周。所有患者均得到随访,随访时间6个月~12年,肺曲菌病未复发,患者生活质量良好。 结论 肺曲菌病误诊、漏诊率高,术前应加强对肺曲菌病的认识,认真检查诊断;手术切除病变是治疗肺曲菌病的有效方法。

    Release date:2016-08-30 06:15 Export PDF Favorites Scan
  • 先天性主动脉瓣上狭窄的外科治疗

    目的 为了提高先天性主动脉瓣上狭窄(SVAS)的外科治疗水平,总结其治疗经验.方法 对我院1986年5月~1996年11月收治的9例先天性SVAS患者施行手术治疗.手术均在体外循环下进行,局限型SVAS均采用"泪滴"状补片行升主动脉扩大成形术;弥漫型SVAS采用主动脉延长加宽补片成形术.结果 无围术期死亡.随访25~130个月,平均随访45.4个月,局限型SVAS狭窄解除满意,压差降至0~2.66kPa(0~20mmHg),平均1.49±1.33kPa(11.2±10mmHg);弥漫型效果不佳,术后仍有轻到中度狭窄.远期死亡2例.结论 局限型SVAS使用"泪滴"状补片行升主动脉扩大成形术可有效地解除狭窄;而弥漫型SVAS应慎重选择其手术方式.合并畸形的处理是否恰当是影响手术远期效果的重要原因.

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • 175例低位直肠癌的外科治疗体会

    Release date:2016-08-29 09:16 Export PDF Favorites Scan
  • Surgical Treatment for Congenital Heart Diseases Through Right Axillary Mini-thoracotomy in 224 Patients

    Objective To summarize the experience of surgical treatment of congenital heart diseases through right axillary mini-thoracotomy and analyse related problems. Methods Two hundred and twenty-four patients of congenital heart diseases underwent open heart surgery under cardiopulmonary bypass (CPB) through a right axillary mini-thoracotomy(3rd or 4th intercostal). Among them repair of ventricular septal defect (VSD) in 168, repair of atrial septal defect (ASD) in 48, total correction of tetralogy of Fallot (TOF) in 6, double-outlet right ventricular in 1 and Ebstein syndrome in 1. Results There was 1 postoperative death (0.45%), the cause of death was acute pulmonary edema. Postoperative complication occurred in thirteen cases (5.8%). There were no significant changes in CPB time, aortic cross clamping time, ventilating time and hospital stay days between right axillary minithoracotomy and median sternotomy at the same period (Pgt;0. 05), but the bleeding volume both intraoperative and postoperative in the patients of right axillary mini-thoracotomy were significantly less than those in the patients of median sternotomy (Plt;0. 01). Two hundred and fourteen patients were followed up (follow-up time from 2 months to 7 years), 3 of them had early mild cardiac function insufficiency(ejection fractionlt;0. 50), small residual shunt were found in 2 patients after VSD operation and the others recovered satisfactorily. Conclusion There were merits in right axillary mini-thoracotomy approach for treatment of properly selected congenital heart diseases; safe and reliable, low operative bleeding volume, and good results of aesthetics. But the use of this incision for repair of TOF and more complex congenital heart diseases should be careful.

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • Surgical Treatment of 25 Cases with Duodenal Gastrointestinal Stromal Tumors

    摘要:目的:总结十二指肠间质瘤的诊断及外科手术体会。方法:回顾分析1999年~2008年收治的25例十二指肠间质瘤患者的临床资料。结果:临床表现最多见为黑便(14/25),其次为右上腹不适(11/25),腹块被(2/25),无明显症状者(2/25)。术前诊断采用上消化道钡餐造影、CT、B超、胃镜或十二指肠镜、超声内镜检查。25例均手术治疗,其中胰十二指肠切除6例,局部切除18例,组织活检术+胃肠吻合1例。术后随访5~96个月,1、3、5年生存率为95.4%、85.5%和67.3%。结论:综合CT、胃肠道钡餐造影、消化内镜可使大部分十二指肠间质瘤术前得到确诊。手术方式依据肿瘤部位、大小而定,局部切除应选择正确重建方式。Abstract: Objective: To investigate the diagnosis and surgery treatment of duodenal gastrointestinal stromal tumors(GIST).Methods: The clinical data of 25 patients with GIST from 1999 to 2008 were analyzed retrospectively.Results: The most common symptoms of duodenal GIST were melena(14/25), as well as abdominal pain(11/25),abdominal mass, absence of symptoms(2/25). We performed the diagnosis by upper gastrointestinal radiography, gastroscopy, endoscopic ultrasonography and CT scan. All the 25 patients underwent surgical resection, of which 6 with pancreaticoduodenectomy, 18 with local resection, 1 with tissue biopsy and stomach intestinal anastomosis. With 5 to 96 months followup after operation, 1, 3 and 5year survival rates were 95.4%, 85.5% and 67.3%. Conclusion: Preoperative diagnosis of most of GIST was dependent on CT scan, upper gastrointestinal radiography and gastroscopy. The choices of surgical procedures are mainly determined by the location and size of the tumors, local excision should choose the correct way to rebulid alimentary tract.

    Release date:2016-09-08 10:12 Export PDF Favorites Scan
  • Analysis of Surgical Treatment of 72 Colorectal Cancer Patients with Intestinal Obstruction

    【摘要】 目的 探讨结直肠癌致肠梗阻的诊断和治疗。方法 回顾性分析2003年1月—2008年12月间72例结直肠癌致肠梗阻的外科诊治资料。结果 72例患者中肿瘤位于右半结肠23例,左半结肠29例,直肠16例,回盲部4例。其中63例手术治疗,一期切除吻合46例,Hartmann术7例,单纯造口10例。有9例因肿瘤全身广泛转移等因素自动放弃手术治疗。结论 重视对结直肠癌致肠梗阻的认识、合理选择手术方式、做好围手术期处理是减少并发症、提高疗效的重要措施。

    Release date:2016-09-08 09:37 Export PDF Favorites Scan
  • Preliminary Experience with Indications for Liver Transplantation for Hepatolithiasis

    Objective To explore the indications for liver transplantation among patients with hepatolithiasis. Methods Data from 1431 consecutive patients with hepatolithiasis who underwent surgical treatment from January 2000 to December 2006 were retrospectively collected for analysis. Surgical procedures included T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones, hepatectomy, cholangiojejunostomy, and liver transplantation. Results Nine hundred and sixty-one patients who had a stone located in the left or right intrahepatic duct underwent hepatectomy or T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones. The rate of residual stones was 7.5% (72/961). Four hundred and seventy patients who had a stone located in the bilateral intrahepatic ducts underwent surgical procedures other than liver transplantation; the rate of residual stones was 21.7% (102/470). Only 15 patients with hepatolithiasis underwent liver transplantation; they all survived. According to the degree of biliary cirrhosis, recipients were divided into 2 groups: a group with biliary decompensated cirrhosis (n=7), or group with biliary compensated cirrhosis or noncirrhosis group (n=8). There were significant differences in operative times, transfusion volumes and blood losses between 2 groups (P<0.05). In the first group, 6 of 7 patients experienced surgical complications, and in the second, 8 recipients recovered smoothly with no complications. Health status, disability and psychological wellness of all recipients (n=15) were significantly improved in 1 year after transplantation as compared with pretransplantation (P<0.05). Conclusion Liver transplantation is a possible method to address hepatolithiasis and secondary decompensated biliary cirrhosis or difficult to remove, diffusely distributed intrahepatic duct stones unavailable by hepatectomy, cholangiojejunostomy, and choledochoscopy.

    Release date:2016-09-08 10:56 Export PDF Favorites Scan
  • 糖尿病足伤的外科治疗

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  • Analysis of Diagnosis and Treatment of 50 Cases of Primary Presacral Tumor

    目的 探讨原发性骶前肿瘤的诊断及外科治疗。方法 回顾性分析徐州医学院附属医院普外科1980年1月至2012年7月期间收治的50例原发性骶前肿瘤患者的临床资料,并结合文献复习进行讨论。结果 原发性骶前肿瘤的术前诊断主要依靠直肠指检、B超、CT、MRI等相关检查。手术采用经骶尾部入路22例,经下腹部正中入路22例,经腹、骶尾部联合入路6例。肿瘤被完整切除33例,行部分切除10例,未切除7例。并发症有术中出血、直肠损伤,术后切口感染、脓肿形成等。结论 骶前肿瘤如无禁忌证均应行手术治疗。充分的术前评估、合理选择手术入路、多学科协作以及对术中和术后并发症的充分认识是手术成功的关键。

    Release date:2016-09-08 10:25 Export PDF Favorites Scan
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