目的 探讨吻合器痔上黏膜环形切除钉合术(ＰＰＨ)手术操作规范。 方法 对《PPH暂行规范》（修订）“术中操作” 中的两个关键性步骤进行分析、讨论。结果 《PPH暂行规范》（修订）中的手术操作指导存在不便操作、相互矛盾、难以取得理想效果等问题。在PPH操作中，适度牵拉后置入肛管扩张器以充分显露痔上黏膜，原位6～8针均匀而恰到好处的黏膜下层双荷包缝合，以痔核上缘作为荷包缝合的主要定位依据，荷包缝好松开牵拉钳后用食指或无创伤钳裹纱布将痔核及脱出的肛管组织尽量往直肠内推送复位，以及收紧吻合器时持续用力牵引荷包线，旋紧吻合器直至最紧状态时才予以击发是保证PPH手术顺利进行和增加切割组织宽度的重要操作技巧。结论 对《PPH暂行规范》（修订）的探讨得出的操作技巧宜在规范中予以推荐和强调。
Primary bronchopulmonary carcinoma occurs in the bronchial mucosa epithelium, also called lung cancer (LC), and has currently become the first cause of death of malignant tumors in China. With constant efforts of Chinese physicians, the diagnosis and management of LC has made certain progress, but standardized surgery for LC still varies to a great extent due to difference regions, nature of medical centers, and technical levels. Complete and standardized surgical resection can provide good long-term survival for patients with stageⅠ, Ⅱand partly ⅢA LC, and cannot be a substitute for other treatment, which shows the importance of standardized surgery. As the most solid member, surgery plays a decisive role in comprehensive multidisciplinary treatment of LC. Today's medical development requires thoracic surgeons to provide most standardized and individualized treatment with principles of evidence-based medicine. This review focuses on progress of standardized surgery for stage Ⅰto ⅢA LC.
手术是治疗分化型甲状腺癌的重要手段和有效方法，已在我国各级医院广泛开展。但由于对疾病认识的不足和技术条件的限制，分化型甲状腺癌的外科治疗在不同地区、不同医疗机构和不同医生之间存在着很大的差异，其治疗结果也迥然不同。尽管目前对分化型甲状腺癌的外科治疗还存在一些不同的观点和尚需进一步研究和探讨的问题，但在很多方面已逐渐达成共识，治疗方案也逐渐趋于规范化，现就以下几个方面浅谈加强分化型甲状腺癌的规范化治疗，旨在提高分化型甲状腺癌的诊治水平……