手术前的

It not only can relieve the traction of retinal inner limiting membrane to retina and clivus of fovea but also can get rid of the virose substance adhered firmly to the surface of macular, improve the macular's metabolize, accelerate the furbish of the function of macular.

视网膜内界膜剥离在玻璃体视网膜手术中的应用越来越广泛，其不但可以解除内界膜对黄斑中心凹处视网膜的牵引，还可以清除紧密附着在黄斑前视网膜表面的毒性物质，改善黄斑区局部的代谢，有利于黄斑功能的恢复。

objective to discuss perioperative complication and management of patient with high risk copd following esophagectomy.methods 45 patients with high risk copd underwent esophagectomy with epidural block combined with general anesthesia.perioperative treatment included smoking cessation,chest physiotherapy,prevention and control of infection of air way and appropriate bronchodilators of air way,breathing exercises,nutrition support and oxygen therapy.painkiller was instilled after surgery,early exercises,ensuring unobstruction of the air way,mechanical ventilation was applied when needed.results 3 had hypoxaemia in operation.after surgery,all patients had spo2 somewhat declined.6 had lung infection.6 were removed of bronchial secretion by bronchoscope.2 were supported by ventilator by using intubation.2 underwent tracheotomy.1 had disturbances of acid base balance and treated by using hydrochloric acid muriatic acid.all patients recovered rather smoothly and discharged from hospital.conclusion high risk copd is not the absolute contraindication of esophagectomy.active management before and after surgery ensures the safety and recovery of patients.

目的 探讨重度慢性阻塞性肺疾病简称慢阻肺病人食管切除术围手术期常见并发症及其处理。方法 45例重度慢阻肺的病人在全麻联合硬膜外阻滞下进行开胸食管切除手术，围手术期处理包括术前戒烟、胸部理疗、预防和控制呼吸道感染、解痉化痰、呼吸功能锻炼、营养支持和氧疗；术后硬膜外镇痛、早期锻炼、保持呼吸道通畅，部分病人予以呼吸支持。结果术中3例出现低氧血症。术后所有病人pao2均有不同程度的下降，6例出现肺部感染，6例行纤维支气管镜吸痰，2例通过气管插管给予呼吸机支持，2例行气管切开术，1例酸碱平衡紊乱使用盐酸精氨酸治疗。所有病人均痊愈出院。结论重度慢阻肺病人并非开胸食管切除手术的绝对禁忌证，积极的术前准备和严格的术后管理可减少和控制术后急性发作，有助于确保此类病人的围手术期安全和康复。

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。

The post-operational patient on liquid or semiliquid diet injected insulin subcutaneously before three meals,applied inˉsulin according to blood sugar level until end of perioperative period.

目的 探讨糖尿病对耳鼻咽喉—头颈外科患者手术后并发症的影响以及糖尿病患者的围手术期治疗方法对51例接受耳鼻咽喉及头颈部不同类型手术的糖尿病患者，观察其围手术期并发症，并于术 3天改三餐前0.5h皮下注射速效胰岛素治疗，根据血糖的测定结果，开始剂量约为4～8U；对术后禁食需要补液的患者，按葡萄糖3～4g/胰岛素1U的比例给药，并每日监测血糖指标；术后进流质或半流质饮食的患者，于三餐前皮下注射胰岛素，按血糖测定情况给药，直至围手术期结束。

Methods: Between November 2003 and December 2005, 67 patients with renal cell carcinoma underwent retroperitoneal laparoscopic radical nephrectomy (34 patients, group A) and open radical nephrectomy (33 patients, group B). Operating time, blond loss, amount of postoperative drainage, time to ambulation, recovery of intestinal function after operation, the postoperative hospital stay, use of antalgesic and transfusion blood and plasma were compared between group A and group B, retrospectively. Results: In group A, the operations of 31 patients were successful and 3 cases failed, then conversed to open surgery. Firstly, one case were not decented the prerenal fascia and the other two cases occurred complications, one case was due to injurying genital gland vein, with blood loss of 500m1, another fatty renal capsula was too thick to explose the renal pedicle. The operations of group B were all successful, only one case was died of intracerebral hemorrhage after two monthes.

回顾性分析和比较后腹腔镜肾癌根治性切除术(Retroperitoneal laparoscopic radical nephrectomy， RLRN)34例与开放性肾癌根治性切除术(Open radical nephrectomy， ORN)33例，比较两种方法的手术时间、术中出血、术后引流、术后最早下床活动时间、肠功能恢复情况、术后住院时间、术后镇痛剂使用量、术中术后输血、血浆量、术后随访时间及手术效果结果：A组中1例因最初对解剖结构难于辨认，无法分离肾前筋膜至肾门而改行开放手术，1例因损伤精索静脉出血难以控制而改行开放手术，1例因肾周脂肪过多，无法将肾脏掀起显露肾蒂而行开放手术，31例手术成功。B组手术均获成功，1例术后2个月因大面积脑出血死亡，余均无瘤生存。

Tissue were taken from intestine before and at 2h, 4h, 6h after operation, placed in 10% formalin, reviewed by a histopathologist.: Intestinal ischemia was noted with worsening grades of injury observed with greater ligation times.

结果：随着缺血时间的延长，肠壁的缺血损害程度逐渐加剧。D-乳酸的活性在术后2小时就随着缺血时间的延长，肠壁组织缺血程度的增加而逐渐升高，与手术前相比，P.05。

There are different viewpoints about the live of costal cartilage autograt, the repair of offer region and the recovery style of the cartilage, especially about the selection of surgical time in congenital microtia, the use of chondrium in the growth of cartilage autograft and the growth ability of the reconstructed ear in preschool children.

对于自体肋软骨移植后能否成活，肋软骨膜在移植软骨中的作用，供区的修复以及软骨间的愈合方式等均存在不同的看法；特别是对先天性小耳畸形患儿的手术时机的选择，肋软骨膜在移植软骨生长中的作用以及学龄前儿童再造耳能否随年龄增长而与正常耳同步按比例生长等均存在不同的观点。

From preoperative to six-month visits, the percentage of time with good mobility and without dyskinesias increased from 27% to 74% with subthalamic stimulation, and from 28% to 64% with pallidal stimulation.

在手术前到半年前的就诊中，接受丘脑下刺激的病患生活中活动机能良好没有行动不良的时间由原来的百分之二十七增加到百分之七十四，而接受苍白球治疗的患者则由百分之二十八提升至百分之六十四。

Since it was established, it has been working hard to innovate hospital care and surgical equipment. The company has a high-quality design team, can be designed according to customers' requirement of scientific and practical, beautiful, medical equipment products. And it continuously increased investment in production equipment and improved production technology such as CNC cutting machine, CNC bending machine, CNC punch and other high-end equipment. At the same period, Company established industry investment in the largest spraying plastic line and preliminary treatment equipment in Shandong Province, coating using world-leading akzo Nobel powder coatings.

公司自成立以来，一直致力于医院护理、手术设备的研制与更新，拥有一支高素质的设计开发团队，能够按照客户要求设计出实用、美观、科学的医疗设备产品；不断加大生产设备的投资力度，不断改进生产工艺：新上了数控剪板机、数控折弯机、数控冲床等高端设备；投资新建了省内同行业规模最大的喷塑流水线和前处理设备，涂层采用世界领先水平的阿克苏诺贝尔粉末涂料。

In general, the mild to the chicken heart, lung did not affect too much, and at present the effects of breast surgery and are not satisfied with the other boys in the growth and development of a view to strengthening the pectoralis major exercise to full-bodied, you can chicken breast to improve the appearance of sudden deformity, and girls after puberty, breast development is also made up the appearance of the deformed sternum.

一般来说，轻度的鸡胸对心、肺影响并不太大，并且目前鸡胸手术治疗的效果并不满意，另外，男孩子在生长发育期加强胸大肌锻炼，使其丰满健壮，可以改善鸡胸前突畸形的外观，女孩子青春期后，乳腺的发育也在外观上弥补了胸骨的畸形。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。