浅谈全凭静脉复合麻醉在动物实验中的应用

近年来,复合静脉全麻在大型哺乳动物的实验外科手术中越来越多地受到了实验者的重视和应用,但随意混杂应用麻醉药物的情况仍屡见不鲜。文中就动物手术中常用的几类复合静脉麻醉药物的适用范围、使用方法、优缺点及注意事项等进行了讨论。     

Recent advances of variational model in medical imaging and applications to computer aided surgery

In this paper, we review some mathematical models in medical image processing. Due to the superiority in modeling and computation, variational methods have been proven to be powerful techniques, which have been extremely popular and dramatically improved in the past two decades. On one hand, many models have been proposed for nearly all kinds of applications. On the other hand, a lot of models can be globally optimized and also many computation tools have been introduced. Under the variational framework, we focus on two basic problems in medical imaging: image restoration and segmentation, which are core components for kinds of specific tasks. For image restoration, we discuss some models on both additive and multiplicative noises. For image segmentation, we review some models on both whole image segmentation and specific target delineation, with the later being a key step in computer aided surgery. Additionally, we present some models on liver delineation and give their applications to living donor liver transplantation.     

新辅助化疗在软组织肉瘤治疗中的应用分析

目的研究并探讨新辅助化疗在软组织肉瘤治疗中的应用效果。方法选取2013年1月—2016年6月期间甘肃中医药大学临床医学院收治的软组织肉瘤共80例作为研究对象,采取单盲随机分组法随机分为对照组和观察组各40例,对照组实施手术治疗,观察组在手术前实施新辅助化疗,比较两组患者的保肢率、治疗效果、术后半年复发情况。结果观察组患者的保肢手术率为77.50%,对照组患者为55.00%,差异具有统计学意义(P0.05);观察组患者的治疗总有效率明显高于对照组(P0.05);术后半年随访发现,观察组的复发率明显低于对照组(P0.05);观察组患者在新辅助化疗期间未出现严重的不良反应。结论在软组织肉瘤患者行手术治疗前实施新辅助化疗,可提高患者的保肢率,提高治疗效果,减少复发,有利于改善预后。     

超声刀在甲状腺手术中保护喉返神经及入喉处甲状腺组织的应用效果观察

目的探讨超声刀在甲状腺手术中对于喉返神经及入喉处甲状腺组织的保护作用。方法选取2016年1月至12月间广东省遂溪县人民医院收治的120例甲状腺疾病的患者,随机分为对照组和观察组,每组60例,对照组采用传统电刀手术,观察组采用超声刀进行手术,比较两种手术方式的效果以及对喉返神经及入喉处甲状腺组织的影响。结果相较于传统电刀手术,采用超声刀可明显缩短腺体切除时间和手术总时间,减少术中出血量,差异具有统计学意义(P0.05);两种手术方式在术后引流量和住院时间方面比较,差异无统计学意义(P0.05);观察组患者喉返神经损伤以及甲状旁腺功能低下的发生率低于对照组,但是两组间差异无统计学意义(P0.05),所有观察组患者的声音嘶哑现象均于术后3个月内恢复,而对照组有3例于3~6个月恢复,2例1年以上未好转。结论在甲状腺手术最终采用超声刀可明显缩短手术时间,减少术中出血量,利于术中对喉返神经和入喉处甲状腺组织的辨认和保护,是一种安全可行的手术方法。     

Mechanical and dynamic aspects of voice production as related to voice therapy and phonosurgery

Laryngeal framework surgery can change the position and tensionof the vocal folds safely without direct surgical intervention in the vocal fold proper. Some 23 years of experience with phonosurgery have proved its usefulness in treating dysphonia related to unilateral vocal fold paralysis, vocal fold atrophy, and pitch-related dysphonias. Meanwhile, much information about the mechanism of voice production has been obtained through intraoperative findings of voice and fiberscopic examination of the larynx . Based on such knowledge together with information obtained through model experiments, the human vocal organ was reconsidered mainly from the mechanical view point, and the roles of voice therapy and singing pedagogy were discussed in relation to phonosurgery. The vocal organ may not be an ideal musical organ and is rather vulnerable, but its potential is enormous.     

全麻高频通气下显微支撑喉镜手术400例分析

目的:总结分析全麻高频通气麻醉的优点及显微喉镜手术的疗效。方法:对2000年1月至2010年12月间我院采用全麻高频通气麻醉下显微支撑喉镜下声带息肉切除手术400例病例进行临床观察。结果:400例手术麻醉效果良好,手术时间短,声带损伤小,术后嗓音恢复快。随访半年无复发。结论:全麻高频通气安全性好,显微支撑喉镜手术操作简便,疗效高,值得基层医院推广应用。     

腹部外科手术对家兔血浆中分子物质含量的影响

用改进的紫外吸收法测定家兔腹部外科手术后血浆中分子物质含量的动态变化。结果表明，腹部外科手术组家兔血浆中分子物质含量呈进行性显著性降低；而对照组家兔血浆中分子物质含量无明显变化。结果提示，腹部外科手术可导致血浆中分子物质含量显著性降低。其降低机制可能与应激反应有关。     

脑室型脑囊虫病17例临床分析

目的:探讨脑室型脑囊虫病的诊断及外科手术治疗。方法:对我院2005年9月至2010年6月收治的17例脑室型脑囊虫病患者进行回顾性分析,其中4例行侧脑室脑囊虫摘除术,9例行第四脑室脑囊虫摘除术,2例行侧脑室脑室镜脑囊虫取出术,2例第三脑室囊虫行药物驱虫保守治疗,术后进行脱水和抗囊虫治疗。结果:15例患者手术治疗均获成功,所有患者术后颅内高压症状均缓解,随访3个月～24个月未发现新的神经损害症状。2例无颅内高压患者行药物驱囊虫保守治疗,症状得到改善。结论:MRI对脑室型脑囊虫病的诊断和治疗均具有重要的指导意义,外科手术治疗是脑室型脑囊虫病治疗的重要手段。