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前切口

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Methods: 1. Experimental laparoscopic liver resection: We selected pigs as experimental models aiming to approach human beings physiological and anatomical condition. After CO2 pneumoperitoneum was established, the ligaments around liver were dissociated. Livers were cut off by the methods such as clamp dissection, microwave tissue coagulator, ultrasound dissector, Ligsure dissection, hand-assisted, short abdominal incision laparoscopy-assisted, and Endo-GIA switcher. The operation time and bleeding volume were compared between different methods of laparoscopic liver resection. The advantages and limitations of different methods were summarized. 2. Clinical laparoscopic liver resection: 15 cases with tumors in segment V of anterior right lobe or segments II, III of left lateral lobe or segment IV of left internal lobe were selected in this study. The liver diseases included hepatocellular cancer, hepatic cavernous hemangioma and hepatic focal nodular hyperplasia. The ligaments around liver were dissociated after CO2 pneumoperitoneum established. Laparoscopic liver resection were carried out by some of the methods combined such as clamp dissection, microwave tissue coagulator, hand-assisted, short abdominal incision laparoscopy-assisted, ultrasound dissector, rotation and suction dissector.

1、实验性腹腔镜肝切除:以猪为实验动物,旨在接近人体的生理、解剖环境下进行实验,建立操作空间后游离肝脏周围韧带,采用钳夹分离切肝法、微波刀切肝法、超声刀切肝法、Ligsure切肝法、手辅助腹腔镜肝切除法、小切口腹腔镜辅助切肝法、Endo-GIA切肝法等方法实施腹腔镜下肝切除,比较不同切肝方法的手术时间、出血量,总结各种方法的优越性及其局限性。2、临床腹腔镜肝切除:选择肿瘤位于肝右前叶第Ⅴ段、肝左外叶第Ⅱ、Ⅲ段及左内叶第Ⅳ段的15例患者,病种包括原发性肝癌、肝海绵状血管瘤、肝脏局灶性增生,建立气腹后游离肝脏周围韧带,采用钳夹分离断肝、微波刀固化后断肝、手辅助腹腔镜肝切除、小切口腹腔镜辅助肝切除、超声刀断肝、旋吸断肝等多种方法分离切线肝组织,暴露管道结构,再采用高频电凝、钛夹夹闭、缝扎止血、止血纱布覆盖、氩气刀止血、生物胶止血、Endo-GIA处理等多种方法相结合处理肝断面,统计手术完成情况、手术时间、手术出血量、术后并发症及术后住院时间等,评价腹腔镜肝切除的可行性及安全性。

Results The eyeball distorted, intraocular structure disordered and vision lost severely in 3 eyes. Epithelial plugs were found in superficial layer of stroma and Bowman's layer broke and displaced in three cases. Healing and gap of incision presented 29 days after RK in 1 case. There were incision scar, collagen disarrangement and epithelial island in deep incision more than 2 years following RK in two cases, descent's layer broke in 1 case.

结果3例眼球严重变形,眼内结构紊乱,视力丧失。3例角膜浅层切口有上皮栓形成,前弹力层断裂错位;1例术后29d的切口部分愈合部分缝隙存在;2例术后2a以上的切口瘢痕化,胶原纤维排列紊乱,深层切口有上皮岛;1例后弹力层断裂。

These patients were told that there were three operation methods for them to select.We also told patients the operation-relative informaˉtion such as the site,length and number of operative incision,the degree of damage to body,the complication,the cosˉmetic effect,and the operation cost for each operation ways.

术前将甲状腺手术的三种手术方式详细告知患者,其内容包括手术切口的部位、切口的长短、切口的数目,对机体组织的损伤程度,容易产生的并发症、美容效果,三种手术所产生费用的比较,请患者慎重考虑后自己选择,并以签字为证。

Objective To explore curative effect of corresponding dual incisions in serious hyphema after ocular contusion.

目的 探讨颞侧角膜隧道切口及对侧辅助切口的&对应双切口法&,治疗严重挫伤性前房积血的临床效果。

Methods Superior partial median sternotomy,inferior partial median sternotomy,right parasternal approach,left parasternal approach,right anterolaterial minor thoracotomy,left anterolaterial minor thoracotomy,and minor median thoracotomy was imitated on twelve adult cadavers.

在12具成人尸体上模拟上半部分胸骨劈开切口、下半部分胸骨劈开切口、右侧胸骨旁切口、左侧胸骨旁切口、右前外侧小切口、左前外侧小切口以及正中小切口。

Objective:To determine whether shaving the incision site before spinal surgery causes postsurgical infection.

目的:确定脊柱手术术前切口部位备皮是否会导致术后感染。

Amputation organizations were drawed by homemade iris hook, drawing to limbal incision,suturing through cornea incision anterior lip to 0.5mm away from iris root with 100 nylon line,and then the root of the iris suture about 0.5mm, and then were ligatured and sutured through the corneal incision posterior lip.

使用自制的虹膜钩勾取离断的虹膜组织,拉至角膜缘切口处,用100尼龙线经角膜切口前唇、缝合虹膜根部约0.5mm,然后再穿过角膜切口后唇出针,结扎缝线。

Anterior, and quite out of the round-bellied become down grilled; c.

前切口不齐,并挺出大肚子变成倒扒圆;c。

Results:The anterior bundle of the UCL starts from anterior inferior part of the medial condyle,and ends on the sublimis tubercle in front of the coronoid process of ulna,locating in the deep layer of the flexor carpal ulnar muscle.The distance between ulnar nerve and UCL is (0.9±0.1)cm in the center of cubital tunnel,and (0.6±0.3)cm in the distal foramen of cubital tunnel.The distance from the point of ulnar nerve entering the flexor carpi ulnar muscle to the medial epicondyle is (3.7±0.8)cm.The distance between the closest branch innervated flexor muscle of the median nerve and the approach is (1.6±0.5)cm at the level of medial epicondyle,and (0.9±0.4)cm at the level of ulnar tubercle.

结果:UCL前束起于肱骨内侧髁的前下方,止于尺骨冠突内侧的小结节,UCL前束位于尺侧腕屈肌肱头、尺头之间的深层;尺神经在肘管中部与尺侧副韧带前束的平均距离为(0.9±0.1)cm,在肘管的远侧出口,距尺侧副韧带的尺骨止点(0.6±0.3)cm;尺神经至尺侧腕屈肌尺头肌支的入肌点距肱骨内侧髁的距离为(3.7±0.8)cm;正中神经最靠近切口的分支距切口的距离,在肱骨内侧髁和尺骨结节水平分别为(1.6±0.5)cm和(0.9±0.4)cm。

Lateral brow incisions, inferior eyelid incisions, coronal incisions and intraoral incisions applied in 45 patients, through which fracture lines of suborbital edge, outside and inferior walls of orbital cavity, zygomatic arch were exposed.

通过眉弓外侧切口、下睑切口、前庭沟切口和冠状切口联合入路,在建立良好咬合关系的基础上,恢复和加强眶颧复合体正常解剖结构,微型钛板坚强内固定,Medpor充填修复眶壁骨折矫正眼球内陷。45例患者术后随访12~30mo。

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