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1.
目的探求一种微创手术有效治疗上颌窦粘膜囊肿,解除传统的上颌窦根治术所带来的创伤和可能带来的后遗症。方法对CT检查发现上颌窦粘膜囊肿并有相应症状的28例患者行鼻内镜手术资料进行回顾性分析,并对比上颌窦根治术治疗30例上颌窦粘膜囊肿患者的病例资料。结果鼻内镜手术治疗上颌窦粘膜囊肿优于传统的上颌窦根治术。结论上颌窦粘膜囊肿应首选鼻内镜手术治疗。  相似文献   

2.
目的:对鼻内镜手术操作过程进行规范化处理,量化手术操作的步骤要求。方法:回顾性分析50例鼻内镜手术资料,操作过程中均一侧采用了鼻腔塑形法、两步法钩突切除术、探查性鼻窦开放法三种操作方法综合应用,另一侧采用一般操作方法(不使用切割吸引器)。比较两种操作方法的出血量和手术时间,以及鼻内镜手术和传统鼻窦手术的治疗效果。结果:新方法鼻内镜手术能有效减少出血量,缩短手术时间(P〈0.05),鼻内镜手术的治愈率明显高于传统的上颌窦根治术(P〈0.01)。结论:鼻内镜手术比传统鼻窦手术方法具有明显的优势,而在鼻内镜手术操作时,鼻腔塑形法、两步法钩突切除术、探查性鼻窦开放法三种操作方法的综合应用能明显提高手术的质量、缩短手术操作时间、减少手术并发症。这对手术经验较少的医生尤为重要。  相似文献   

3.
改良B-Lynch缝合术在剖宫产产后出血中的应用   总被引:1,自引:0,他引:1  
目的探讨改良B-Lynch缝合术在治疗剖宫产产后出血中的应用价值。方法研究组87例剖宫产术中宫缩乏力性出血病例采用改良B-Lynch缝合术治疗。随机选择45例剖宫产术中宫缩乏力性出血病例作为对照组采用传统方法治疗,在手术时间、产后出血量、住院天数、治疗效果方面对比两组术式的临床治疗效果。结果研究组病例治疗后临床效果显著,其在手术时间、产后出血、住院天数及有效率与对照组比较差异有统计学意义(P〈0.05),无一例子宫切除,无并发症发生,子宫复旧,月经复潮时间无差异。结论改良B-Lynch缝合术具有操作简单,止血迅速和安全有效等优点,值得在临床上进一步推广普及。  相似文献   

4.
目的:通过对鼻内镜手术治疗鼻腔粘膜接触性头痛的临床观察,探讨鼻腔粘膜接触区与头痛的相关性及鼻内镜手术治疗鼻腔粘膜接触性头痛的可行性。方法:统计52例鼻内镜手术治疗的鼻腔粘膜接触性头痛患者术前及术后头痛情况并进行分析。结果:鼻内镜手术治疗鼻腔粘膜接触性头痛术后3~6月有效率为96.2%,12~24月总有效率为82.7%。结论:鼻腔粘膜接触是难治性头痛的原因之一,鼻内镜手术矫正解剖结构异常可缓解头痛,但鼻腔粘膜接触不是难治性头痛的唯一病因,术后应长期随访以观察远期疗效。  相似文献   

5.
目的::探讨鼻内镜下低温等离子治疗非特异性鼻出血的临床疗效以及注意事项.方法:选取我院门诊自2012年10月~2014年11月期间收诊的150例非特异性鼻出血的患者作为研究对象,采用随机数字表法分为治疗组(n=75)和对照组(n=75),治疗组患者给予鼻内镜下低温等离子治疗,对照组患者给予传统鼻腔填塞治疗,选择一次性成功率、总出血量、鼻腔恢复通气时间、术后鼻粘膜恢复时间、不良反应发生率、3个月复发率作为指标对比两组患者的治疗效果.结果:治疗组的一次性成功率明显高于对照组,总出血量、鼻腔恢复通气时间、术后鼻粘膜恢复时间、不良反应发生率以及3个月复发率均明显少于对照组,所有差异均具有统计学意义(p<0.05).结论:鼻内镜下低温等离子治疗非特异性鼻出血的临床疗效的临床疗效明确,可以提高一次性治愈率,减少术中总出血量,缩短鼻腔恢复通气时间和术后鼻粘膜恢复时间,降低不良反应发生率以及3个月复发率,建议在临床上大力推广使用.  相似文献   

6.
目的:探讨鼻内镜手术失败的原因及修正性鼻内镜手术的方法,避免并发症,提高治疗效果.方法:回顾性分析我科39例复发性鼻窦炎、鼻息肉患者的病例资料.结果:通过术后一年以上的随访,治愈29例(74.35%),有效8例(20.51%),无效2例(5.1%).术中并发症大出血3例,眶周损伤2例,术后鼻腔粘连4例.结论:病变去除不彻底,鼻腔粘连、息肉复发及鼻窦口阻塞是鼻内镜手术失败的常见原因;修正术中辨认残存解剖标志,熟练的技术操作,适当的术式、术后处理以及长期随访是提高疗效防止并发症的关键.  相似文献   

7.
《莆田学院学报》2016,(5):31-33
探讨不可触及乳腺肿物微创治疗中麦默通旋切系统的应用效果。选取2016年1—6月在莆田学院附属医院住院时采取麦默通旋切微创术治疗的76例不可触及乳腺肿物患者作为观察组,同时选取采用传统开放手术治疗的56例不可触及乳腺肿物患者作为对照组,并比较两组患者手术时间、术中出血量、住院时间以及术后并发症发生率。结果,观察组患者手术时间、术中出血量、住院时间以及术后并发症发生率等均显著优于对照组,两组比较差异具有统计学意义(P<0.05)。结果表明,对不可触及乳腺肿物患者采取麦默通旋切微创术治疗有助于缩短手术和住院时间、减少术中出血量和术后并发症。  相似文献   

8.
目的观察外痔剥离内痔切除并结扎加注射术的手术方法对Ⅲ、Ⅳ期环状混合痔的治疗效果.方法将358例Ⅲ、Ⅳ期环状混合痔患者随机分为治疗组182例、对照组176例.治疗组采取外痔剥离切除内痔结扎加注射术,对照组采取传统的治疗术式.结果两组治愈时间、水肿、肛门不适比较差异有统计学意义(P〈0.01),术后残留皮赘差异比较亦有统计学意义(P〈0.05),术后疼痛和排尿障碍比较则无统计学意义(P〉0.05).结论外痔剥离切除内痔结扎加注射术可以明显缩短治愈时间、改善水肿和肛门不适,减少术后残留皮赘.  相似文献   

9.
目的:观察经三角肌微创入路结合3D打印技术治疗肱骨近端骨折的临床疗效.方法:选取病例为2016年05月至2017年06月肱骨近端骨折60例本院患者,随机分为两组.30例患者选择并接受经三角肌微创入路结合3D打印技术治疗肱骨近端骨折(A组),30例患者选择并接受经三角肌胸大肌间隙入路治疗肱骨近端骨折(B组).比较两组手术时间,术中出血量,手术切口长度.随访12-15个月,随访内容包含骨折愈合时间、并发症发生率、肩关节功能评分等,进行比较分析.结果:A组与B组对比:A组在手术室时间、术中出血量、手术切口长度、并发症发生率、术后1月肩关节功能评分均优于B组,具有统计学差异(P0.05),而术后6月两组肩关节功能评分无统计学差异(P0.05).结论:经三角肌微创入路结合3D打印技术治疗肱骨近端骨折手术时间短,创伤小,并发症发生率低,其治疗效果优于经三角肌胸大肌间隙入路治疗肱骨近端骨折,值得临床推广.  相似文献   

10.
目的探讨腹腔镜手术治疗异位妊娠的临床效果。方法将60例异位妊娠患者按照自愿原则分为实验组和对照组,每组30例。其中实验组采取腹腔镜手术治疗,对照组应用传统开腹手术治疗,比较2组手术时间、术中出血量、术后下床活动时间、术后并发症及随访期间再次正常妊娠情况。结果实验组手术时间、术中出血量、术后下床活动时间、术后感染发生率均低于对照组,2组比较,差异有统计学意义(P<0.05)。2组均获3 a随访,实验组正常妊娠例数明显多于对照组,2组差异有统计学意义(P<0.05)。结论腹腔镜手术治疗异位妊娠创伤小、恢复快,再次正常妊娠率高,效果肯定。  相似文献   

11.
Objective: The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography (CT) and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography (EUS) with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. Methods: Patients with duodenal protruding lesions who were indicated for EUS were examined by EUS with 12-15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of EUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of EUS. Those patients without endoscopic resection or surgical excision were periodically followed up with EUS. Results: A total of 169 patients with duodenal protruding lesions were examined by EUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner's gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After EUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of EUS, with 93.33% diagnostic accuracy. The results of follow-up with EUS indicated that duodenal cyst, Brunner's gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1-3 years. No related complications occurred among all patients that received EUS examinations. Conclusion: EUS is an effective and reliable diagnostic method for duodenal protruding lesions.  相似文献   

12.
While traditional open vein harvest was related to postoperative wound complications, endoscopic vein harvest was developed to minimize the morbidity in the greater saphenous vein harvest procedure. In this study, these two procedures were compared for postoperative wound healing and long-term graft patency. We reviewed all consecutive patients undergoing elective off-pump coronary artery bypass grafting from January 2004 to December 2005 and collected data regarding wound complications and coronary events. Wound complications included dehiscence, excessive discharge, edema, altered sensation, cellulitis, hema-toma, pain scale, and superlicial and deep wound infection. Coronary events were defined as diagnosis of myocardial infarction during the first year's follow-up. A total of 392 patients were included in our series, among whom 44 were excluded from the study due to emergent operation, preoperative intra-aortic balloon pump support, or the greater saphenous vein varicose characteristic, 78 belonged to open vein harvest group, and 270 to endoscopic vein harvest group. Wound complications were significantly less in the endoscopic group (5.2%) compared to the open group (19.2%) (P=0.0002). There was no significant difference on preopera-tive risk factors, total operative time, or hospitalization days. During one-year follow-up, both the early and late graft patency rates were similar between the two groups. Endoscopic vein harvest is safe and effective, which carries less risk for wound complica-tions and is associated with better satisfaction and cosmetic result than the traditional greater saphenous vein harvest procedure. The endoscopic vein harvest also demonstrates a great long-term patency.  相似文献   

13.
Objective: To evaluate the benefit of intraoperative ERCP and endoscopic sphincterotomy (EST) combined with laparoscopic cholecystectomy (LC) in the treatment of cholelithiasis with choledocholithiasis. Methods: Fifty-two patients with cholelithiasis and choledocholithiasis (as determined by intraoperative cholangiography) were randomly divided into 2 groups during LC. In group A (27 patients), common bile duct stones were extracted by intraoperative EST during LC. In group B(25 patients), common bile duct (CBD) stones were extracted by conversion to open CBD exploration and cholecyctectomy. Results: The success rate was 26/27 (96.3%) in group A and 25/25 (100%) in group B (0.25<P<0.5); The mean postoperative hospitalization was 3.32±0.56 days in group A and 17.5±4.61 days in group B (P<0.001). In group A, two cases were complicated transient hyperamylasemia after the combined procedure. In group B, one case of bile leakage and one case of duodenal ulcer occurred after conversion to open cholecystectomy with CBD exploration. There were no retained stones in group A but 2 cases in group B. Conclusion: Intraoperative ERCP and endoscopic sphincterotomy combined with LC for treatment of cholelithiasis and chiledochlithiasis is safe, effective and results in shorter hospitalization and fewer complications than traditional open cholecystectomy with CBD exploration.  相似文献   

14.
40例慢性鼻窦炎功能性鼻内窥镜手术治疗临床观察   总被引:2,自引:0,他引:2  
目的观察应用功能性鼻内窥镜手术治疗慢性鼻窦炎的临床疗效。方法 2006年6月至2008年8月利用鼻内窥镜手术治疗慢性鼻窦炎40例。结果 40例患者中治愈28例,好转12例,效果满意。结论功能性鼻内窥镜手术微创,可视,手术边界清,减少损伤,彻底清除病变,疗效确切。今后应在功能性鼻内镜手术过程中向微创、无创精细程度上发展。  相似文献   

15.
目的:探讨个体化护理对经尿道前列腺电切术患者临床疗效的影响.方法:122例前列腺电切患者随机分为对照组和观察组,每组61例,对照组给予常规护理,观察组给予个体化护理.观察比较两组患者的并发症、舒适度和护理满意度和住院时间.结果:观察组患者的术后并发症较对照组减少,患者的治疗舒适度和护理满意度明显高于对照组(P<0.05),住院时间缩短(7.2±0.8 d VS9.9 ±1.2 d,P<0.05).结论:个体化护理应用于前列腺电切患者能提高护理满意度,减少术后并发症和促进术后康复,该模式值得推广.  相似文献   

16.
目的:探讨老年人大肠癌的外科治疗方法。方法:回顾分析116例老年大肠癌的临床资料。结果:误诊率35%,共存病62%,肿瘤切除率75.9%,术后并发症发生率28%,围手术期死亡率5.7%。结论:手术切除是老年大肠癌病人的最好治疗方法,围手术期的正确处理是提高疗效的关键。  相似文献   

17.
Objective: To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle. Methods: Among the general physical check-up population, subjects with shallow anterior chambers, as judged by van Herick technique, were recruited for further investigation. Ultrasound biomicroscope (UBM) was used to detect and measure the cysts located in the iris and/or ciliary body, the anterior chamber depth (ACD), the angle opening distance at 500 μm (AOD500), and the trabecular-iris angle (TIA). A-scan ultrasonography was used to measure the ocular biometry, including lens thickness, axial length, lens/axial length factor (LAF), and relative lens position (RLP). The effect of the cyst on narrowing the corresponding anterior chamber angle and the entire angle was evaluated by the UBM images, ocular biometry, and gonioscopic grading. The eye with unilateral cyst was compared with the eye without the cyst for further analysis. Results: Among the 727 subjects with shallow anterior chamber, primary iris and ciliary body cysts were detected in 250 (34.4%) patients; among them 96 (38.4%) patients showed unilateral single cyst, 21 (8.4%) patients had unilateral double cysts, and 42 (16.8%) patients manifested unilateral multiple and multi-quadrants cysts. Plateau iris configuration was found in 140 of 361 (38.8%) eyes with cysts. The mean size of total cysts was (0.6547±0.2319) mm. In evaluation of the effect of the cyst size and location on narrowing the corresponding angle to their position, the proportion of the cysts causing corresponding angle narrowing or closure among the cysts larger than 0.8 mm (113/121, 93.4%) was found to be significantly higher than that of the cysts smaller than 0.8 mm (373/801, 46.6%), and a significant higher proportion was also found in the cysts located at iridociliary sulcus (354/437, 81.0%) than in that at the pars plicata (131/484, 27.1%). In evaluating the effect of the cyst on the entire anterior chamber angle, the eyes with multiple and multi-quadrants cysts manifested significant narrowing of the entire anterior chamber angle as compared with the eyes without cysts, based on the data analysis in comparison of TIA, AOD500, and gonioscopic grading evaluation. The unilateral single or double cysts in the eyes had no significant effect on narrowing of anterior chamber angle as compared with eyes without cysts. The iris and/or ciliary body cysts did not seem to affect the axial length, ACD, lens thickness, RLP, LAF. Conclusions: The prevalence of primary iris and ciliary body cyst was 34.4% in the subjects with shallow anterior chamber. The cysts larger than 0.8 mm, locating at iridociliary sulcus, or multiple and extensive cysts were inclined to cause the angle narrowing or closure.  相似文献   

18.
Objectives: The use of gasless laparoscopy with an abdominal wall-lifting device for benign gynecological diseases was compared to conventional laparoscopy with CO_2 pneumoperitoneum. Methods: From February 2007 to July 2007, 76 women with uterine and/or adnexal benign diseases and candidates for laparoscopic surgery were recruited in this study. Thirty-two women underwent gasless laparoscopic surgery and 44 women underwent pneumoperitoneum laparoscopic surgery. Results: Diverse pathologies, including adnexal cyst, uterine myoma and ectopic pregnancy, were treated successfully with gasless laparoscopic surgery. Compared with the patients in the pneumoperitoneum group, the similar hospital stay (P=0.353) and in-traoperative blood loss (P=0.157) were observed. However, the mean operative time in the gasless group was significantly longer than that in the pneumoperitoneum group (P=0.003). No severe intraoperative or postoperative complications were found in either group, except for one case of laparotomic conversion in the pneumoperitoneum group due to dense pelvic adhesions. The total hospital charges were significantly less in the gasless group than in the pneumoperitoneum group (P=0.001). In 38 cases of ovarian cyst resection, the mean operative time in the gasless group remained longer than that in the pneumoperitoneum group (P=0.017). The total hospital charges were also significantly less in the gasless group than in the pneumoperitoneum group (P<0.001). Con-clusion: Our preliminary results demonstrated that the laparoscopic procedure using the gasless technique was a safe, effective method to treat benign gynecological diseases. Moreover, it was easy to master. As a minimally invasive treatment, gasless laparoscopic surgery provides a good choice to patients in the undeveloped regions in China without increasing the patients' and the government's burden significantly.  相似文献   

19.
目的探讨ERAS在单孔法小儿疝囊高位结扎术围手术期护理中的临床应用价值。方法选择2017年3月至2018年3月行择期单孔法小儿疝囊高位结扎的120例患儿随机分为ERAS组(60例)和对照组(60例)进行分析对比。对照组患者采用传统的围手术期护理方法进行护理,ERAS组采用快速康复外科理念的护理方法进行干预。比较两组患儿术后麻醉苏醒的时间、切口疼痛程度、肛门排气的时间、术后并发症、住院时间、出院后满意度等,通过对比两组之间的差异来评价ERAS护理的价值。结果ERAS组患儿术后麻醉苏醒时间平均值、切口疼痛评分平均值、术后排气时间平均值均低于对照组,术后并发症发生率降低,住院时间均减少,且患儿家属对护理服务的满意度也优于对照组,差异均具有统计学意义(P<0.05)。结论在单孔法小儿疝囊高位结扎术围手术期中采用ERAS理念可以加速患儿康复,缩短住院时间,减轻患儿疼痛,减少并发症,提高患儿家属满意度及患儿的舒适度。  相似文献   

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