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find Keyword "微创" 576 results
  • 快速康复外科理念与胸外科

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  • CONTINUOUS TRACTION TREATMENT FOR CORRECTION OF INVERTED NIPPLE WITH SELF-MADE ADJUSTABLE TRACTOR

    ObjectiveTo explore the effectiveness of self-made adjustable tractor for correction of inverted ni pple. MethodsBetween March 2005 and March 2011, 37 female patients with inverted ni pples (69 ni pples) underwent continuous traction with self-made adjustable tractor for 2 to 4 months. The age ranged from 18 to 46 years (mean, 23 years). Of 37 cases, 5 had unilateral inverted ni pple, and 32 had bilateral inverted ni pples, including 8 cases (15 ni pples) of mild inversion, 16 cases (30 ni pples) of moderate inversion, and 13 cases (24 ni pples) of severe inversion. The 2 cases (4 ni pples) recurred after traditional surgical method, and 1 case (2 ni pples) had infection because of severe inversion before traction. ResultsNo infection or hemodynamic disorder occurred during traction. All cases were followed up 6-12 months (mean, 8.2 months). Wound healed after traction in 1 patient (2 ni pples) with infection because of severe inversion; 2 recurrent cases (2 ni pples) were cured after re-traction; wire dislocation occurred in 1 case (1 ni pple), and was cured after changing traction position. The shape, sensation, and erectile function were normal after treatment with no scar. ConclusionContinuous traction with selfmade adjustable tractor is a good method for all the types of inverted ni pple. It is a simple, safe, effective, and minimally invasive method without scar.

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  • ESTABLISHMENT OF INTERVERTEBRAL DISC DEGENERATION OF RABBITS BY USING MINIMALLY INVASIVE ACUPUNCTURE AND ROTARY-CUTTING

    ObjectiveTo investigate the feasibility of establishing intervertebral disc degeneration (IDD) model by using minimally invasive acupuncture and rotary-cutting. MethodsForty New Zealand white rabbits [male or female, (2.9±0.3) kg in weight] were randomly divided into control group (n=20) and experimental group (n=20). No treatment was done in the control group; percutaneous puncture was performed on L4, 5 and L5, 6 intervertebral disc by using 18G needle under C-arm X-ray monitoring for rotary-cutting of nucleus pulposus to promote degeneration of the disc in the experimental group. At 4, 8, 12, and 16 weeks after operation, general observation and MRI observation were done, and intervertebral disc degeneration was accessed based on Pfirrmann grade; the specimens were harvested for Masson staining and Safranine O staining. ResultsThe nucleus pulposus showed dark colors and reduced elasticity in the experimental group when compared with the control group. T2-weighted MRI images indicated that the disc signal intensity of control group had no obvious change at early stage, and weakened slightly at late stage; disc signal intensity of the experimental group decreased with time. According to Pfirrmann grade for disc degeneration, disc degeneration degree was significantly aggravated with time in 2 groups (P < 0.05); degeneration was significantly more severe in the experimental group than the control group at the other time points (P < 0.05) except 4 weeks (P > 0.05). Masson staining results showed that irregular arrangement of annulus with integrate structure was observed in the control group with time; the annulus of the experimental group arranged in disorder, or even disc fibrous circle rupture appeared with time. Safranin O staining showed that the nucleus pulposus cells reduced significantly in the experimental group, but did not in the control group. ConclusionMinimally invasive acupuncture and rotary-cutting could successfully establish the IDD model in rabbits.

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  • 经胸微创膜部室间隔缺损封堵术围术期炎症因子的变化

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  • Application of Minimal Extracorporeal Circulation in the Aortic Valve Replacement

    目的观察微创体外循环(minimal extracorporeal circulation,MECC)对主动脉瓣置换术临床效果的影响。 方法回顾性分析我院2010年3月至2012年10月共25例应用MECC方法行单纯主动脉瓣置换术(AVR)的临床资料,其中男15例、女10例,年龄40(19~58)岁。 结果总体外循环时间67(51~89)min、主动脉阻断时间42(33~63)min、转流中最低血红蛋白(Hb)9.6(8.3~12.6)g/dl、流转后Hb 9.5(7.7~12.6)g/dl,体外循环中无1例患者因Hb低而输入红细胞。所有患者均顺利拔除胸腔引流管,顺利出院,无院内死亡。 结论MECC系统应用于主动脉瓣置换安全可行,比传统心肺旁路系统具有更好的生物相容性和良好的临床结果,值得推广。

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  • Mitral Valvuloplasty for the Treatment of Mitral Regurgitation

    Abstract: Compared with mitral valve replacement, there areseveral advantages in mitral valvuloplasty, so recently more and more sights are caught on mitral valve repair. According to different etiology, the surgeon can apply annuloplasty, triangular resection, quadrangular resection, replacement or transposition of chordae tendineae and so on to treat mitral regurgitation(MR). With the development of minimally invasive surgical technology, robotic mitral valve reconstruction evolve rapidly and percutaneous interventional therapy also commence from lab to bedside.We believe surgeons can repair MR safely and successfully in the majority of patients with proficiency in the basic techniques.

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • 非体外循环下冠状动脉旁路移植术

    目的 探讨和评价微创非体外循环冠状动脉旁路移植术(OPCAB)的临床效果. 方法 38例OPCAB患者中左冠状动脉主干病变 4例, 1支血管病变10例,2支14例,3支10例,均经胸骨正中切口行 OPCAB,每例移植血管1~5支,平均移植血管2.42支.应用左乳内动脉38支,大隐静脉54支. 结果 全组无手术死亡,36例顺利完成手术,2例转为心肺转流术下冠状动脉旁路移植术.38例均在手术后2~12小时,平均4.9±2.6小时顺利拔除气管内插管.全组均顺利康复,15例手术后1个月内恢复了原工作. 结论对有适应证的患者,OPCAB是一项安全有效的术式.

    Release date:2016-08-30 06:31 Export PDF Favorites Scan
  • 骨骼创伤修复和重建的发展

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • Two-staged hybrid ablation versus thoracoscopic epicardial ablation for long-standing persistent atrial fibrillation: Mid-long term result of a randomized controlled trial

    ObjectiveTo evaluate the efficacy of hybrid ablation through compared with thoracoscopic epicardial ablation.MethodsIn this study, 108 patients with all long-standing persistent atrial fibrillation (LSPAF) received thoracoscopic epicardial ablation (TEA) after enrollment. There were 82 males and 26 females at age of 56.5±9.4 years. After blanking-period, patients off antiarrhythmic therapy with sinus rhythm were divided into a hybrid ablation (HA) group (50 patients) and a TEA group (58 patients). Only patients in the HA group received catheter ablation after randomization subsequently. In at least two-year observation period, cardiovascular risk factors were observed in all groups’ patients.ResultsThe mean follow-up duration was 17.3-41.8 (26.9±6.1) months and there was no significant difference between two groups [8.2-40.6 (27.5±5.7) months in the HA group and 17.3-41.8 (26.4±6.7) months in the TEA group]. The off antiarrhythmic agents (AADs) sinus rhythm rate was significantly higher in the HA group than that in the TEA group at the time of postoperative 6, 12, 24 and 36 months [96.0%, 90.0%, 83.7%, 83.7% versus 79.3%, 75.9%, 67.3%, 63.1%, HR=0.415 (95%CI 0.206-0.923)].ConclusionWe can conclude that the efficacy of two-staged hybrid ablation for LSPAF is superior to thoracoscopic epicardial ablation alone. Patients can obtain benefit from a supplemental radiofrequency catheter ablation after blanking-period of surgical ablation, instead of those without a supplemental ablation.

    Release date:2021-03-05 06:30 Export PDF Favorites Scan
  • 经皮微创钢板内固定治疗胫骨骨折

    目的 总结经皮微创钢板内固定技术(minimally invasive percutaneous plate osteosynthesis,MIPPO)治疗胫骨骨折的方法和临床疗效。 方法 2005 年5 月- 2008 年5 月,采用MIPPO 治疗胫骨闭合骨折208 例。男156例,女52 例;年龄18 ~ 52 岁,平均35 岁。摔伤126 例,交通伤52 例,高处坠落伤21 例,砸伤9 例。胫骨中1/3 骨折56 例,下1/3 骨折152 例。骨折按AO分型:A型142 例,B型53 例,C型13 例。伤后至手术时间7 h ~ 10 d,平均8.5 d。 结果 术后2 周2 例内踝上切口拆线后钢板外露,经换药或局部皮瓣移位修复后切口愈合;其余切口均Ⅰ期愈合。术后208 例均获随访,随访时间12 ~ 24 个月,平均16 个月。骨折均于术后8 ~ 22 周达临床愈合,平均15 周。无内固定失败及松动等并发症发生。膝踝关节功能以Johner-Wruhs 方法评价,获优150 例,良42 例,可16 例,优良率92.3%。 结论 MIPPO治疗胫骨骨折软组织损伤轻、创伤小、并发症少、符合生物学要求。

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
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