治疗男性乳房发育症两种不同术式比较

目的比较局部肿胀麻醉下施行乳晕小切口腺体切除术与吸脂联合小切口乳腺切除术治疗男性乳腺发育症的手术效果.方法将31例脂肪腺体型男性乳腺发育症患者按手术方式的不同分为两组,观察组13例共21侧乳房行吸脂联合小切口腺体切除术,对照组18例共32侧乳房行乳晕小切口腺体切除术,比较两组患者切口长度、手术时间、带管时间、并发症例数、手术疤痕隐蔽程度等指标.结果观察组患者切口明显小于对照组(P<0.05),两组患者手术时间、带管时间、并发症例数、手术疤痕隐蔽程度等指标比较差异均无统计学意义(P>0.05),随访0.5～2 a,两组均无复发.结论肿胀吸脂联合小切口乳腺切除术治疗脂肪腺体型男性乳房发育症创伤小、胸部塑形满意、无复发,是治疗脂肪腺体型男性乳房发育症的理想术式。     

腹腔镜肾部分切除术治疗局限性肾细胞癌27例

目的:探讨经腹腔镜肾部分切除术治疗局限性肾细胞癌的手术技巧和近期疗效.方法:选择T1期、单发肿瘤,平均肿瘤直径4.0 cm(3.0～7.0 cm)的局限性肾细胞癌27例, 术中用内镜bulldog钳阻断肾动脉;用剪刀或超声刀在距离肿瘤边缘0. 5～1.0 cm处进行局部切除;肾切除床内置Surgicel薄片卷垫后,间断缝合肾实质,创面边缘喷涂FloSeal明胶基质以防延迟出血.术中冰冻确定切缘阴性.结果:27例手术均获成功,无术中、术后并发症.手术时间平均110 min;热缺血时间20～55 min,平均32 min;术中出血量平均150 mL.术后随访平均6个月,未见肿瘤局部复发,未见转移.结论:腹腔镜肾部分切除术治疗局限性肾细胞癌安全可靠,短期随访效果肯定.     

复合式小梁切除术治疗难治性青光眼的临床疗效分析

目的探讨复合式小梁切除术治疗难治性青光眼的临床效果。方法对36例40只眼的难治性青光眼施行复合式小梁除术,术后观察视力、眼压、前房深度及滤过泡形态,随访6～24月。结果11只眼术后视力提高,术后早期（1～5d）Ⅱ度浅前房发生率7.5%,3～5d后前房逐渐恢复。出院时40只眼眼压为6～14mmHg,平均（9±2）mmHg;术后6月,40只眼平均眼压（13±2）mmHg,36只眼压处于12～17mmHg之间。随访1年,功能性滤过泡占95%（38/40）。结论复合式小梁切除术能有效提高难治性青光眼的手术成功率。     

腹腔镜下胆囊切除术前后病人的护理

腹腔镜胆囊切除术作为一门新兴的医疗技术,已经被广大患者所青睐,作为医护工作者,如何护理好该手术的病人,非常值得我们去探讨研究。本文就该手术术前及术后的护理工作以及注意事项做了细致的分析总结,旨在为我们今后的护理工作做出正确的向导。     

腹腔镜阑尾切除术治疗急性阑尾炎肥胖患者的临床观察

观察分析急性阑尾炎肥胖患者应用腹腔镜阑尾切除术治疗的临床效果.选择2019年1月—2020年7月接受治疗的急性阑尾炎肥胖患者80例,根据不同方案分组,设2组对比,各为40例.参照组应用开腹阑尾切除术治疗,试验组应用腹腔镜阑尾切除术治疗.比较参照组和试验组总有效率、手术情况、并发症率及生存质量.参照组和试验组的总有效率比...     

腹腔镜子宫次全切除术23例临床分析

目的探讨腹腔镜子宫次全切除术的效果、手术要点及临床应用价值.方法回顾性分析腹腔镜下子宫次全切除术23例的临床资料.结果22例顺利完成手术,1例因粘连严重而中转开腹,手术成功率95.65%,平均手术时间(90.0±30.0)min,平均术中出血(50.0±20.0)ml,平均术后住院2～4d,无严重并发症.结论腹腔镜子宫次全切除术具有安全、创伤小、出血少、恢复快、出院早、术后生活质量高等优点.     

腹腔镜胆囊大部分切除术的临床应用

目的探讨腹腔镜胆囊切除术中某些特殊情况的处理办法.方法分析总结本院54例胆囊大部切除的原因、方法、经验和体会.结果 54例手术顺利完成,无术后出血、胆瘘及肝外胆管损伤,平均手术时间65min(42～110min),术后恢复顺利,无症状复发.结论在化脓性胆囊炎或胆囊三角严重粘连、解剖关系不清,肝内型胆囊,不能够常规行胆囊切除的病人行腹腔镜胆囊大部分切除术简便、安全可行.     

Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

Objective: to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods: The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF). The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast:saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60 degrees C. The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132+/-68 min for our patients. The average fluoroscopy time was 33+/-17 min. With a mean follow-up of 16+/-8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion: Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.     

耻骨上前列腺切除术的改进(附51例报告)

51例耻骨上前列切除术中采用缩缝前列腺窝口、不作膀胱造瘘,经尿道留置三腔气囊导尿管及使用新型膀胱(?)、双弯形镶片持针钳,提高了手术效果,缩短了住院时间。