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Among them, 20 patients were candidates of valve replacement and 18 PDA and pericarditis had their blood samples taken before operation,and 1,2,24 and 48 hours after closure of thorax for measurement of concentrations of CK、CK-MB and TnT,together with ECG recording. Results Of the 60 patients, concentrations of cTnT before operation were normal; 2 hours after aortic unclamping, the correlation coefficient between cTnT and aortic clamping was r = 0.873( P<0.01), the regression analysis showed Y = 0. 019X-0. 026. Of the 20 patients, ECG showed the myocardium was ischemic; CK、CK-MB and cTnT all rose significantly, reaching the peak after closure of thorax. Of the 18 patients, the ECG and cTnT before operation and after closure of thorax were normal; except 2 patients with pericarditis.
结果 60例瓣膜手术患者术前cTnT均在正常值范围内,主动脉开放后2 h时,阻断时间和cTnT的相关系数为r=0.875(P<0.01),回归方程为Y=0.019X-0.026;其中20例瓣膜手术患者心脏经过阻断后,心电图有缺血性改变,周围血液中的CK、CK-MB和cTnT均有明显升高,分别在关胸后2 h达到高峰,数值分别为术前的12.6、9.2和257倍;18例行动脉导管结扎和心包剥脱术的患者术前和关胸后的心电图和血液中的cTnT均正常,CK和CK-MB除2例心包炎患者关胸后出现明显变化外,余均未见改变。
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Methods Detailed preoperative evaluation was performed electrocorticogram monitoring was used during the microsurgery. The operations included the resection of the epileptogenic foci, anterior temporal lobectomg, anterior temporal lobectomg and hippocampectomy, corpus callosotomy.
全部病例术前进行详细评估,术中采用皮质脑电监测,手术方式采用显微手术方法,包括致痫灶切除术,前颞叶切除术,前颞叶及海马切除术和胼胝体切开术。
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Result:Among total of 80 cases with non-visualized kidney in IVP,renal parenchyma of 37 cases were non-visualized under ~(99m)Tc-DTPA renography,GFR was 0 ml/min,32 cases carried out nephrectomy;Renal parenchyma of the rest 43 cases were visualized under ~(99m)Tc-DTPA renography,GFR were(20.03±9.64) ml/L,among them 9 cases were carried out nephrectomy, 34 cases received kidney-sparing operation;The 34 cases(divided into 4 groups according to range of GFR) recheck ~(99m)Tc-DTPA renography 2 months later after the operation,Preoperative GFR within(1~10) ml/min,GFR were(4.25±2.99) ml/min,postoperative GFR were(4.00±2.94) ml/min,t=0.522,P>0.05,indicated no significant change of GFR after the operation; Preoperative GFR within(11~20) ml/min、(21~30) ml/min、(31~40) ml/min groups, preoperative GFR were(15.38±2.63) ml/min、(24.83±2.92) ml/min、(34.25±2.75) ml/min, postoperative GFR were(17.77±3.79) ml/min、(29.42±3.90) ml/min、(40.25±3.50) ml/min respectively,paired t-test,P<0.05,indicated that 2 months\' postoperative GFR increased significantly,the function of kidneys recovered in some degree.
结果:在80例IVP不显影患肾中,37例患肾在~(99m)Tc-DTPAI肾动态显像上肾实质不显影,GFR为0 ml/min,其中32例行患肾切除;43例患肾在~(99m)Tc-DTPA肾动态显像上肾实质显影,GFR为(20.03±9.64)ml/L,其中9例行患肾切除,34例行保留肾手术;34例保留患肾手术者(根据术前GFR在不同值范围分为4组)在术后2个月返院复查~(9m)Tc-DTPA肾动态显像,GFR值在(1~10)ml/min组(5例),术前GFR为(4.25±2.99)ml/min,术后2月GFR为(4.00±2.94)ml/min,t=0.522,P>0.05,表明术后GFR无明显变化;术前GFR在(11~20)ml/min(13例)、(21~30)ml/min(12例)、(31~40)ml/min组(4例),术前GFR分别为(15.38±2.63)ml/min、(24.83±2.92)ml/min、(34.25±2.75)ml/min,术后2月复查GFR分别为(17.77±3.79)ml/min、(29.42±3.90)ml/min、(40.25±3.50)ml/min,经配对t检验,P<0.05,有统计学意义,术后2月GFR较术前增高,肾功能有不同程度的恢复。
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And There was no serious complication;②In the course ofinterventional therapy, Direct portal vein angiography demonstrated vena coronaria ventriculi(100%)andgastricveins(65.26%)andvenagastricaposterior38.43%, Angiography demonstrated venacoronariaventriculi communicate esophagus varicose veins, gastric veins and vena gastrica posterior communicategastric varicose veins. vena coronaria ventriculi had only a small percentage of double vein, about30.57%. The sites of vena coronaria ventriculi arising from the portal vein, splenic vein, portosplenic junction, were found in 52.06%、27.39%、20.55% respectively.③12 extrahepaticprotosystemic shunts were found in these patients. Include gastro-nephrosshuntof 3 cases, 7 caseswere splenetic- nephros shunt and 2 cases shown recanalization of umbilical vein .④The averageportal pressure before and after the procedure were 3.87±1.82kPa and 3.64±1.14kPa in 73patients, but to the time of rebleeding, it was 3.96±0.23kPa in the 11 cases.⑤There werethree kinds of variceal outcome: disappearance (54,low degree (19).⑥Spearman logisticanalyse and ANOVAtest shown liver function class, variceal degree of the splenic necrosis area,the blood direction in portal vein before operation and remain small collateral routes were thesignificant factors concerning outcome of varices.⑦The bleeding volume and portalhypertensive gastropathy are main risk factors of rebleeding.⑧The course of livercirrhosis is the risk factor of survival and extrahepatic portosystemic shunt , fine varices are thebeneficial factors to survival.⑨During all cases'followed-up data, the 1, 2, 3, 4, 5 yearcumulative survival rates and rebleeding rates were 17.81%, 28.77%, 38.36%, 43.84%, 47.95%and93.15%,91.78%,86.30%,83.56%,80.82%respectively. Conclusion The interventional disconnection treatment for liver cirrhosis and portalhypertension was designed suitability. It rapidlycontrol bleeding,butpressure of portal vein was notobvious high, perfusion was not low .it was compared with surgery therapeutic that interventionaldisconnection treatment was safe and had a significant clinical effect to hemorrhage and preventfrom rebleeding.
结果:①术后一过性发热62例(84.9%),腹痛腹胀48例(65.8%)是介入断流术常见的并发症,未发生严重并发症;②门静脉造影显示胃冠状静脉、胃短静脉和胃后静脉的曲张分流的出现率是100%、65.26%和38.34%;显示食管静脉曲张主要由胃冠状静脉供血,胃静脉曲张主要由胃短静脉和胃后静脉供血;胃冠状静脉大多数为单支,少数为双支,其双支的出现率分别为30.57%;胃冠状静脉开口于门静脉主干的为52.06%,开口于脾静脉主干的为27.39%和开口于门脾静脉交汇处的为20.55%;③发现胃肾分流3例,脾肾分流7例、腹膜后门腔静脉分流2例,以及CTA检查发现脐静脉开放者2例;④73例患者介入断流术前和术后平均自由门静脉压力分别为3.87±1.82kpa和3.64±1.14kpa,前后比较存在显著性差异;11例再次介入手术患者的术前、术后和复发后的自由门静脉压力分别为4.02±0.24kpa、3.82±0.25kpa和3.93±0.23kpa ,前后比较发现首次术前与术后存在显著性差异,首次术前和复发出血术前门静脉压力比较无显著性差异;⑤介入术后复查曲张静脉转归基本消失54例,轻度19例;⑥Spearman相关分析和Logistic多因素回归分析,肝功能分级、静脉曲张程度、门脉血流方向和残存小侧支四个因素对曲张静脉转归有影响;Spearman相关分析和Logistic多因素回归分析门脉高压性胃病和出血量等因素对复发出血时间有影响;⑦COX回归分析,门体分流和曲张静脉转归两个因素对术后生存有影响;⑧术后随访6-70月,1、2、3、4、5年的累计复发出血率和累计生存率分别为17.81%、28.77%、38.36%、43.84%、47.95%和93.15%、91.78%、86.30%、83.56%、80.82%;结论:介入断流术治疗门脉高压食管胃底静脉曲张有独特的优点,可以快速直接控制曲张静脉出血而门静脉压力无显著增高,保证了肝脏灌注;与外科分流术相比适应证广、损伤轻、术后恢复快,不易遗漏曲张静脉;肝功能分级、曲张静脉程度、门脉血流方向和残存侧支血管对食管胃曲张静脉转归有影响;门脉高压性胃病对复发出血时间有影响;门体分流和曲张静脉转归对生存时间有影响。
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Results (1)In the group (109 eyes) with preoperative intraocular pressure≤21mmHg,sixty-four eyes were treated with trabeculectomy,and 31 eyes with slerectoiridectomy of which there were 9(14.1%) and 7(20.6%) eyes had undergone PAC respectively.There was no PAC in 11 eyes treated with iridencleisis;(2)In the group(175 eyes)with PIOP from 22 to 35 mmHg,there were 26 eyes(25.2%) and 15 eyes(32.6%) developing PAC of 103 eyes treated with trabeculectomy,and 46 eyes with slerectoiridectomy respectively,of 26 eyes with iridencleisis,there were 5 eyes(19.2%) developing PAC;(3)In the group(106 eyes)with PIOP>35mmHg,there were 13 eyes(31%) developing PAC of 23 eyes with trabeculectomy,5 eyes(21.7%) developing PAC of 23 eyes with slerectoiridectomy.
结果 (1)术前眼压≤21mmHg(1mmHg=0.133kPa)者109只眼,小梁切除术64只眼,术后浅前房9只眼,占14.1%,巩膜咬切术31只眼,术后浅前房7只眼,占20.6%,虹膜嵌顿术11只眼,术后无浅前房发生;(2)术前眼压22-35mmHg者175只眼,小梁切除术103只眼,术后浅前房26只眼,占25.2%,巩膜咬切术46只眼,术后浅前房15只眼,占32.6%,虹膜嵌顿术26只眼,术后浅前房5只眼,占19.2%;(3)术前眼压>35mmHg者106只眼,小梁切除术42只眼,术后浅前房13只眼,占31%,巩膜咬切术23只眼,术后浅前房5只眼,占21.7%,虹膜嵌顿术41只眼,术后浅前房5只眼,占12.2%。
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Method]from january 2003 to may 2006,32 patients were corrected with qin si-he's orthotics devices on the ilizarov principle of tension-stress,which involved 15 males and 17 females,the age ranged from 10 to 25 years.among these patients,2 were caused by peroneal nerve injury,l by tumor in the vertebral canal,5 by meningocele,11 were caused by poliomyelitis,13 by congenital talipes equino-varus.in accordance with deformities,external fixator and limitied operative methods were dertermined.the limited release of soft tissue were performed in 7 patients,limited osteotomy in 25 patients.the dynamic muscle balance operation were performed in 9 patients with imbalance of muscle strength.according to the ilizarov technique,the fixative rods were installed.the telescopic rods on the apparatus were rotated one week after the operation,the divices had corrective function in three-dimensional directions.the deformity of talipes equinovarus,internal rotation and drooping of the forefoot were gradually corrected,and the patients could bear weight and walked on the deformed foot.the mean duration of traction were 42 days,then removed the external fixator maintained with plaster for a site time.
方法]2003年1月~2006年5月,根据ilizarov张力应力法则,应用秦泗河改良的外固定矫形器,遵循ilizarov穿针固定的基本原则,共手术治疗马蹄内翻足32例,男15例,女17例;年龄10~25岁,平均17岁。病因:腓总神经损伤2例,腰椎管内肿瘤1例,硬脊膜膨出5例,小儿麻痹后遗症11例,先天性马蹄内翻足13例。术前用足掌的前外缘负重行走者11例,用足的外缘或足背外侧负重者21例。根据马蹄内翻足畸形程度、性质和患者年龄,确定实施有限矫形手术的方法和外固定矫形器治疗。本组7例同期实施有限的软组织松解术,25例同期实施了有限的截骨术和跗骨间关节融合术,9例合并踝关节内外翻肌力明显失衡者,同期行足部肌腱转移的肌力平衡术。然后安装外固定矫形器。术后按作者制定的管理程序,7 d开始旋转相应的螺纹牵拉杆,对器械进行三维空间的缓慢调整,先矫正前足内收和后足内翻,后矫正足下垂畸形,直至达到矫形要求的标准。在矫形的过程中定期进行x线检测,以防止发生踝关节前后移位,治疗期间允许患足负重行走。术后平均牵伸42 d,拆外固定器后患足再上石膏固定适当时间。
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[Objective] To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion [Method] From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score [Result] All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found [Conclusion] Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory
分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。[方法]2005年12月至2007年6月间,对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间(12~16 d,平均135 d)后采用枕骨大孔后缘扩大,寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术,手术后采用日本骨科学会神经功能评分分析临床疗效。[结果]8例患者随访6个月~2年,平均为15个月。8例患者无一例出现术后并发症,术前寰齿前间隙为5~9 mm,经颅骨牵引后为5~7 mm,寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复,影像学检查示枕颈区减压充分植骨区获得骨性融合,无一例出现内固定松动或断裂。[结论]合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变,采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的,且临床效果满意。
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Results Recurrence and metastasis in surgery, full-dose preoperative intracavitary irradiation, non full-dose preoperative intracavitary and radiotherapy alone groups were 19.8%, 8.1%, 22.2% and 34.6%, respectively. The recurrent rates of vaginal stump were 6.2%, 1.6%, 11.1% and 11.5%, respectively. The rates of proctitis and cystitis in full dose preoperative intracavitary irradiation group were 3.2% and 3.2%, 2.8 and 0.0% in non-full dose preoperative intracavitay irradiation group, and 0.0% and 3.8% in radiotherapy alone group.
结果手术组、术前腔内全量放疗组、术前腔内非全量放疗组及单纯放疗组的总复发转移率分别为19.8%、8.1%、22.2%、34.6%,其中阴道残断复发率分别为6.2%、1.6%、11.1%、11.5%;放疗并发症中,放射性直肠炎、膀胱炎的发生率,术前腔内全量放疗组均为3.2%,术前腔内非全量放疗组分别为2.8%、0.0%,单纯放疗组分别为0.0%、3.8%。
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The study sample was composed of 40 female patients with maxillary excess or bimaxillary protrusion. The mean age of patient was 25.9. All patients had undergone the modified Wunderer technique for anterior subapical osteotomy. The postoperative follow-ups were all over 6 months. We studied the relationship between movement of anterior maxillary segment and soft tissue changes over nose and lip areas by the statistics in the hard tissue displacement and soft tissue changes 3 and 6 months postoperatively.
本研究收集以改良式Wunderer's前上颚根尖下截骨术矫治双颚前突或上颚生长过度的病例共40位,皆为女性,平均年龄25.9岁,术后追踪半年以上;分别研究术前与立即术后,立即术后与术后三个月,以及术前与术后六个月的硬组织方位改变,鼻唇区域软组织的方位改变,以及硬组织与软组织间方位改变的对应关系。
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It was found that the peak urine flow rate increased from 7.6 ml/s to 20.1 ml/s, the residual urine volume decreased from 126.5 ml to 16.3 ml, and the ipss decreased from 24.1 to 5.6 points in 6 months.conclusion tups as a good treatment for bph is effective, highly safe and causing few complications.
最大尿流率由术前7.6 ml/s升到术后20.1 ml/s(术后6个月),剩余尿量由术前126.5 ml减至术后16.3 ml,国际前列腺症状评分由术前24.1分降至术后5.6分。结论经尿道前列腺裂开术治疗前列腺增生,具有安全性高、并发症少、疗效好的优点。
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ls:腹腔镜脾切除术
目的:探讨超声刀在腹腔镜脾切除术(LS)中的应用.方法:对15例有脾切除指征的特发性血小板减少性紫癜(ITP)病人使用超声刀施行LS,术前使血小板计数提高达30×109/L以上,术中使用高流量的人工气腹,气腹压力维持在12~15 mmHg之间,
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We checked his eyes before the surgery. No papilledema:术前检查过他眼睛 没有视神经乳头水肿
Pseudotumor cerebri?|假脑瘤? | We checked his eyes before the surgery. No papilledema.|术前检查过他眼睛 没有视神经乳头水肿 | Candy?|糖果?
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pneumonectomy:肺切除术
Events Graham成功的做肺癌之全肺切除术 (pneumonectomy) 后,全肺切除几乎是肺癌之标准手术. 但近三十年来由於临床经验之累积、手术方式及技术之改善、麻醉之进步、术前之正确评估及计划,使得其他型手术增加. 基於肿瘤外科之原则,
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pneumonectomy:全肺切除术
Events Graham成功的做肺癌之全肺切除术 (pneumonectomy) 后,全肺切除几乎是肺癌之标准手术. 但近三十年来由於临床经验之累积、手术方式及技术之改善、麻醉之进步、术前之正确评估及计划,使得其他型手术增加. 基於肿瘤外科之原则,
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premedication:<医>术前用药法
tub-thumper 敲击讲桌滔滔不绝演讲的传教士, 叫嚣者 | premedication 术前用药法 | running load 运行负载 工作负载
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subtotal hysterectomy:子宫次全切除术
(1)子宫次全切除术(subtotal hysterectomy):将子宫体切除,保留子宫颈. 其益处是保留了盆底正常解剖,对性生活无影响. 缺点是由于保留了子宫颈,有发生子宫颈残端癌(carcinoma of cervical stump)的可能,因此要求拟行子宫次全切除术前,
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preoperation:术前
术后 postoperation | 术前 preoperation | 术中 intraoperation
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preoperative care:术前护理
preoperotive preparation 术前准备 | preoperative care 术前护理 | preparation 制剂,标本
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Preoperative preparation:术前准备
手术前准备(preoperative preparation)包括对病人的评估和术前必需的准备. 术前评估包括准确的诊断,和对病人心理状态、生理状态充分了解了解,综合评价手术的安全性,从而选择手术时机. 术前尽可能调整失衡器官的功能,提高病人耐受手术和麻醉的能力.
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Preoperative Assessment:术前评估
Shoulder: Rotator Cuff Tear 轴转肌撕裂 | Preoperative Assessment术前评估 | Assessment and Implementation评估实施