简介:腹外疝主要分两大类,包括腹壁疝和腹股沟疝.目前,对于腹壁疝,首选的外科治疗方法是腹腔镜疝修补术.创伤小,手术后恢复快,并发症发生率及复发率均低于开放性切口疝修补术.对于腹股沟疝的外科治疗方法主要以Bassini和Shouldice为典型的传统张力性疝修补术,以及Lichtenstein无张力疝修补术.随着材料学的发展,无张力腹股沟疝修补术主要包括开放前路,开放后路(腹膜前)疝修补术,腹腔镜腹股沟疝修补术(LIHR).LIHR包括完全腹膜外疝修补(TEP)、经腹腹膜前疝修补(TAPP)、腹腔内补片修补(IPOM).对于腹腔镜腹股沟疝修补方法,尤其是IPOM存在较大争议.本文对其作一综述.
简介:目的:总结危重先天性心脏病(先心病)患儿新生儿期心内直视术的体外循环(CPB)管理经验。方法:对我院2009年度90例危重先心病患儿新生儿期行心内直视术的CPB情况进行回顾性总结分析。其中深低温停循环(DHCA)1例,深低温低流量(DHLF)结合下半身DHCA2例,DHLF43例,中度低温中低流量CPB33例,浅低温中高流量CPB5例,常温不停跳CPB6例。2例术中给予平衡超滤(ZBUF)结合常规超滤(CUF)和改良超滤(MUF),其余均给予CUF联合MUF。结果:CPB转流时间37~380(118.9±66.5)min,主动脉阻断时间14~195(74.4±40.9)min。所有病例在开放主动脉后心脏均能自动复跳。86例成功脱离CPB。1例左心发育不良(HLHS)术后转为体外膜肺氧合支持160h后死亡。本组死亡共13例,病死率14.4%。结论:接近生理的CPB预充,良好的心肌保护,选用适宜的灌注方式,合理的血气管理,联合运用各种超滤方法是确保危重先心病患儿新生儿期心内直视术成功的重要环节。
简介:[摘要 ]目的:研究分析眶隔脂肪重新分布去眼袋的术后疗效。方法:此次研究的对象是选择 2018年 1月至 2020年 1月来我院就诊的 67例去下睑眼袋的患者,将其临床资料进行回顾性分析,取下睑缘切口,于眼轮匝肌下剥离,至过眶骨缘 1~ 2mm,剪开眶隔,将疝出脂肪展开平铺于下睑,颧面沟明显者将脂肪固定于鼻侧眶骨膜下,少数脂肪过多者去除部分脂肪,剪去一条眼轮匝肌,缝合眼轮匝肌,去除多余下睑皮肤,缝合皮肤,加压包扎。结果:本组 67例眼袋改善明显,颧面沟亦改善明显,术后无明显并发症。结论:该方法是去除眼袋、改善颧面沟过深的理想术式。 [关键词 ]眼袋;眶隔脂肪 [Abstract] Objective: To study and analyze the effect of orbital septal fat redistribution and pouch removal. Methods: 67 patients who went to the lower eyelid pouch from January 2018 to January 2020 were selected for this study. The clinical data were analyzed retrospectively. The incision of the lower eyelid margin was removed, and the incision of the lower eyelid margin was dissected under the orbicularis oculi muscle. The incision of the lower eyelid margin was cut to 1-2mm across the orbital margin. The herniated fat was spread and spread on the lower eyelid. The fat was fixed under the nasal orbital periosteum in those with obvious zygomatic groove, and a small amount of fat was fixed Remove part of fat, cut off a orbicularis oculi muscle, sew up orbicularis oculi muscle, remove redundant lower eyelid skin, sew up skin, compress and bandage. Results: in this group, the pouch and zygomatic groove of 67 cases were improved obviously, and there was no obvious complication after operation. Conclusion: this method is an ideal way to remove the pouch and improve the depth of zygomatic groove.
简介:【摘要】目的:探究STABLE项目在危重新生儿转运应用的效果。方法:选择我院自2020年1月至2020年12月收治的