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find Keyword "外科治疗" 340 results
  • THE HISTORY,PRESENT AND PROSPECT OF THE SURGICAL TREATMENT OF PRIMARY LIVER CANCER IN CHINA

    Release date:2016-09-08 02:00 Export PDF Favorites Scan
  • Surgical treatment of pregnancy complicated with aortic dissection

    Objective To summarize the characteristics and management of pregnancy complicated with aortic dissection, and to explore the reasonable diagnosis and treatment plan. Methods The clinical data of 10 patients of pregnancy complicated with aortic dissection in Wuhan Tongji Hospital from January 2011 to June 2017 were collected. Their age was 25.2 (21-29) years. Results In the 10 patients, the majority (8 patients) were primipara, and most of them were in the late stages of pregnancy (5 patients) and puerperal (4 patients). Among them, 1 patient had gestational hypertension, and the blood pressure of the left and right upper extremities was significantly abnormal (initial blood pressure: left upper limb blood pressure: 90/60 mm Hg, right upper limb blood pressure: 150/90 mm Hg). The major clinical manifestations were severe chest and back pain which happened suddenly, with D-dimmer and C-creative protein increased which may be associated with inflammatory reaction. All patients were diagnosed by thoracoabdominal aortic CTA, including 5 patients of Stanford type A dissection and 5 patients of Stanford type B dissection. In the 10 patients, 1 patient refused surgery and eventually died of aortic rupture with the death of fetus before birth. And the remaining 9 patients underwent surgical treatment, 3 patients of endovascular graft exclusion for thoracic aortic stent graft, 2 patients underwent Bentall operation, 1 patient with Bentall + total aortic arch replacement + vascular thoracic aortic stent graft, 1 patient with Bentall operation combined with endovascular graft exclusion for thoracic aortic stent graft, 1 patient with Bentall + coronary artery bypass grafting, 1 patient of thoracoabdominal aortic vascular replacement. Among them, 1 patient underwent endovascular graft exclusion for thoracic aortic stent graft died of severe postoperative infection, and the remaining 8 patients were discharged from hospital. Nine patients were single birth, among them 5 newborn patients had severe asphyxia, 4 patients had mild asphyxia. Finally, 3 neonates died of severe complications, and the remaining 6 survived. Conclusion The ratio of pregnancy with Stanford type A aortic dissection is far higher than in the general population, the possibility of fetal intrauterine asphyxia is larger, but through active and effective surgical and perioperative treatment, we can effectively save the life of mother and fetus.

    Release date:2018-11-02 03:32 Export PDF Favorites Scan
  • Surgical treatment for hypertrophic obstructive cardiomyopathy associated with aortic stenosis

    Objective To evaluate the clinical and follow-up results of the surgical treatment for hypertrophic obstructive cardiomyopathy associated with aortic stenosis. Methods We retrospectively analyzed the clinical data of the patients with hypertrophic obstructive cardiomyopathy plus aortic stenosis in our hospital from February 2008 to October 2015. There were 4 males and 3 females aged 55.6 ± 7.5 years. All the patients were received concomitant aortic valvulopasty at the time of modified extended Morrow procedure. Echocardiographic data and major complications were recorded through the outpatient clinic and telephone. Results The postoperative ventricular septal thickness, left ventricular outflow tract gradient and aortic gradient were significantly lower than those in preoperation with statistical differences (P<0.05). During the mean follow-up 25.6 ± 28.2 months period, 1 patient died of cerebral hemorrhage, 1 patient was implanted a permanent pacemaker, and 1 patient had a postoperative new-onset atrial fibrillation. All patients had a satisfied prosthetic valve function and the left ventricular outflow tract gradient. The patient's symptoms and heart function significantly improved postoperatively. Conclusion For patients with hypertrophic obstructive cardiomyopathy associated with moderate to severe aortic stenosis, concomitant aortic valvulopasty at the time of modified extended Morrow procedure is an appropriate and effective treatment, which can significantly alleviate the clinical symptoms, and improve quality of life with a satisfied prognosis.

    Release date:2019-12-13 03:50 Export PDF Favorites Scan
  • Surgical treatment for 30 patients with tracheal and main bronchial tumors

    Objective To study the surgical treatment of tracheal and main bronchial tumors. Methods We retrospectively analyzed the clinical data of 30 patients with tracheal and main bronchial tumors treated in Shengjing Hospital of China Medical University from January 2000 to December 2015. There were 12 males and 18 females with the age ranging from 22 to 80 years. Results Ten patients were treated with enucleation, 12 patients tracheal tumor resection and end-to-end anastomosis, 1 patient window resection, 1 patient wedge resection, 5 patients tumor resection and tracheal reconstruction by using pulmonary tissue flap with alloy stent and 1 patient left pneumonectomy. One patient died of sudden massive hemoptysis 26 d after operation. Intraoperative complications were found in 2 patients. Others had a good recovery after operation. Patients were followed up for 11 months to 14 years. Eight patients were followed up less than 5 years postoperatively, one patient died of sudden massive hemoptysis 14 months after operation, while others survived; 21 patients were followed up more than 5 years and 5 patients were lost to follow-up. Conclusion Surgical resection is recommended for tracheal and main bronchial tumors. Patients with small benign tumor may choose local tracheal resection; tracheal segmental resection and end-to-end anastomosis is the most common surgical treatment. Patients with more than half of the whole length of tracheal defects or in the risk of anastomotic ischemic necrosis may be suggested to receive tracheal reconstruction.

    Release date:2017-08-01 09:37 Export PDF Favorites Scan
  • Experience of Improved Surgical Techniques for Thyroid Disease

    目的 探讨利用特殊手术器械和相应的手术操作技巧对提高甲状腺外科手术的安全性及质量的作用。方法 借助MPBS系列器械和超声刀的推剥、分离、切割、止血等技术完成甲状腺手术。结果 完成甲状腺部分切除、次全切除或侧叶切除术共468例,手术时间(40±20)min,术中出血量(30±25)ml,住院时间(4±1)d;切口细小,瘢痕平整;术后出现短暂声嘶3例,饮水呛咳2例,局部皮下积液2例。随诊1~3年,平均1.8年,3例复发,1例甲状腺功能低下。无甲状旁腺功能低下和永久性神经损伤病例。结论 利用MPBS器材和超声刀技术在甲状腺疾病外科治疗中的应用安全可靠,具有手术安全、简捷、出血少、时间短、切口小、副损伤少、恢复快的临床效果,值得进一步推广和探讨。

    Release date:2016-09-08 10:37 Export PDF Favorites Scan
  • Diagnosis and Surgical Treatment for Solitary Fibrous Tumor in the Thorax

    Abstract: Objective To investigate the clinical features of solitary fibrous tumor (SFT) in the thorax and its optimal surgical approaches. Methods We retrospectively reviewed the clinical records of 16 patients with SFT in the thorax in our hospital between January 2004 and June 2010. There were 8 males and 8 females, with a median age of 49 years (1973 years). Laboratory examination showed normal results. Chest Xray and computed tomographic scan revealed lung tumor in 8 cases, mediastinal mass in 3 cases, fibrous tumor in 2 cases, pleural mass in 2 cases, and retroperitoneal mass in 1 case. Five patients underwent CT guided biopsy or thoracoscopy, and 3 of them were diagnosed to have SFT. There was no clear diagnosis for the remaining 13 cases before operation. None of them had been exposed to asbestos. Symptoms were present in 5 patients. All patients underwent surgical treatment with resection performed through routine thoracotomy in 10 cases and by means of videoassisted thoracoscopy in 6 cases. The tumors originated from the visceral pleura in 12 patients, from parietal pleura in 3 patients (from diaphragmatic pleura in 1, and costal pleura in 2), and from the lung in 1 patient. Results All tumors were totally excised. Immunohistochemical staining showed CD34 was positive in all tumors. There was no postoperative mortality and no major complications. All patients were regularly rechecked and followed up. The followup was ranged from 1 to 72 months, with a median time of 21 months. During the followup, all patients survived and no recurrence was observed by means of chest X radiography or CT. Conclusion SFT tumors in the thorax are rare neoplasms and can have giant diameters. Wide local excision is recommended as the best therapeutic option. The SFT has the possibility of recurrence, and careful longterm clinical followup is required.

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • 21例肠系膜上动脉压迫综合征诊治体会

    目的总结21例肠系膜上动脉压迫综合征(SMAS)的诊治体会。 方法回顾性分析笔者所在医院2011年4月至2014年3月期间收治的21例SMAS患者的临床资料。 结果21例患者中10例行保守治疗后症状明显缓解,另外11例经多次保守治疗无效而行手术治疗:8例行十二指肠-空肠吻合术,2例行胃大部切除、胃空吻合术(BillrothⅡ),1例行单纯胃空吻合术;均痊愈出院并获随访,随访时间10~36个月,平均16个月,症状均缓解,无复发。 结论上消化道造影、CT及CT血管成像可作为SMAS的首选检查手段;对确诊为SAMS的患者首先采取保守治疗,病情可逐渐痊愈;若经多次保守治疗失败者可采取手术治疗,其中以十二指肠-空肠吻合术是有效、易行的手术方式。

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  • Over- and under-treatment of lung cancer

    With the development and improved availability of low-dose computed tomography (LDCT), an increasing number of patients are clinically diagnosed with lung cancer manifesting as ground-glass nodules. Although radical surgery is currently the mainstay of treatment for patients with early-stage lung cancer, traditional anatomic lobectomy and mediastinal lymph node dissection (MLND) are not ideal for every patient. Clinically, it is critical to adopt an appropriate approach to pulmonary lobectomy, determine whether it is necessary to perform MLND, establish standard criteria to define the scope of lymph node dissection, and optimize the decision-making process. Thereby avoiding over- and under-treatment of lung cancer with surgical intervention and achieving optimal results from clinical diagnosis and treatment are important issues before us.

    Release date:2021-07-28 10:02 Export PDF Favorites Scan
  • 先天性右位心合并心血管畸形的诊断与外科治疗

    目的总结先天性右位心合并心血管畸形的诊断和外科治疗经验。方法23例先天性右位心患者,其中镜面右位心17例,右旋心6例;所有患者均合并右心室双出口、室间隔缺损、房间隔缺损等心血管畸形。对所有患者的心脏病变施行手术治疗,包括全腔静脉一肺动脉连接术、Glenn手术、Fontan手术、Rastelli手术、法洛四联症纠治术等。结果围术期死亡2例,死亡原因主要为低心排血量综合征;术后3个月死亡1例,死亡原因为左肺上叶不张、乳糜胸和充血性心力衰竭。随访16例,随访时间8个月~18年,心功能I~Ⅱ级14例,Ⅲ级2例。结论超声心动图和胸腹部X线片检查是诊断先天性右位心的主要方法;先天性右位心合并心血管畸形的患者需施行手术治疗;肺动脉高压、肺血管发育不良及Kartagener综合征是影响外科治疗效果的主要危险因素。

    Release date:2016-08-30 06:18 Export PDF Favorites Scan
  • Surgical Treatment for Medullary Thyroid Carcinoma

    Release date:2016-09-08 11:52 Export PDF Favorites Scan
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