目的 總結腹部閉合性損傷的診治體會。方法 回顧性分析我院78例腹部閉合性損傷患者的臨床資料。結果 78例中67例手術治療，4例行腎動脈栓塞術，7例保守治療； 除1例死亡外，余均治愈。結論 及時診斷和治療是救治腹部閉合性損傷患者的關鍵，腹腔穿刺、B超、CT及X線檢查的合理應用對診斷有重要價值。
目的:分析經后腹腔鏡腎上腺囊腫去頂減壓術的療效,安全性和臨床價值。方法:我院2004年12月至2007年12月6例經后腹腔鏡腎上腺囊腫去頂減壓臨床資料進行回顧分析。結果:經后腹腔鏡5例腎上腺囊腫患者順利切除去頂,其中左側腎上腺囊腫3例,右側腎上腺囊腫3例。1例轉開放,為雙側腎上腺囊腫。平均手術時間(45.73±1.32)min,平均術中出血量(7.35±0.45)mL。平均住院天數(7.67±0.24)天,平均術后住院天數(5.0±0.11)天。結論:經后腹腔鏡腎上腺囊腫去頂減壓是一種安全,有效且可行的治療方式,必要時應及時轉開放。
Objective To explore the diameter change of the extrahepatic bile duct before and after laparoscopic cholecystectomy (LC). Methods From Jan. 2006 to Dec. 2007， 113 patients including chronic gallstone cholecystitis （n=55）, inactive cholecystolithiasis （n=46） and gallbladder polyps （n=12） were collected and treated by LC. The diameters of their extrahepatic bile ducts were measured by B ultrasonography before operation， 3 months and 6 months after operation. These data were collected and analyzed retrospectively. Results The diameters of the extrahepatic bile ducts of all patients before LC， 3 months and 6 months after LC were (5±2) mm, (8±2) mm and (6±2) mm respectively. And in chronic gallstone cholecystitis patients they were (5±2) mm, (9±2) mm and (6±2) mm respectively， in inactive gallstone cholelithiasis patients they were (5±2) mm, (8±2) mm and (6±2) mm respectively， and in gallbladder polyps ones they were (5±2) mm, (7±2) mm and (5±2) mm respectively. Conclusion The change of the extrahepatic bile duct diameter after LC is a dynamic process. It is enlarged on the third month after operation than before operation. In the sixth month after operation marked retraction occurs, and compared with before operation, it shows no obvious statistic significance.
目的 總結基層醫院初期開展腹腔鏡直腸癌根治術的臨床經驗。 方法 回顧分析2008年10月-2009年10月收治的20例腹腔鏡直腸癌手術的臨床資料。 結果 16例順利完成手術，4例中轉開腹，1例發生吻合口瘺。隨訪2~10個月，均無操作孔種植及腫瘤復發。 結論 采用手術者已習慣的手術路徑，電刀、超聲刀相結合游離直腸腸管，直視下裸化和用凱途閉合腸管，縮短了手術學習曲線,降低了手術成本，有助于在基層醫院推廣。
【摘要】目的 探討腹腔鏡技術在急腹癥探查術中應用的臨床意義。方法 回顧性總結我院行急診腹腔鏡探查及治療的22例急腹癥患者的臨床資料。結果 22例經腹腔鏡檢查全部明確診斷,除1例腸系膜上動脈栓塞的患者中轉開腹外，所有手術均在腹腔鏡下或輔助下完成，均恢復順利,無術后并發癥及死亡。結論 急診腹腔鏡探查術不僅能對急腹癥的病因作出明確診斷,而且可在腹腔鏡下完成大部分患者的治療。
ObjectiveTo investigate the value of different minimally invasive surgical techniques, stent placement, laparoscopic surgery, and sustained-releasing 5-fluorouracil, in solving intestinal obstruction due to colorectal cancer. MethodsFrom May 2000 to May 2010, total 68 patients with obstructed colorectal cancers in three centers were treated in two ways in terms of the stage: The first, patients with resectable tumors underwent colorectal stent placement as a ‘bridge to surgery’ guided by enteroscope under X-ray. After clinical decompression and bowel preparation, laparoscopic radical resection was performed. The second, patients with unresectable tumors underwent rectal stent placement just for palliation. Sustained-releasing 5-fluorouracil was implanted into the local cancerous intestinal tract through stent walls. ResultsFifty-one of 52 patients underwent laparoscopic radical resection successfully following stent placement, while one failed and died during follow-up 93 d postoperatively. Forty patients with successful laparoscopic surgery were followed up in 3 to 36 months (with an average of 15 months) without tumor planting in the incision, postoperative local recurrence or anastomotic stricture. Fifteen unresectable patients and one high-risk, intolerable patient underwent rectal stent placement and implantation of sustained-releasing 5fluorouracil. During follow-up 3 to 24 months (with an average of 14 months), 11 died, who survived for (350±222) d (range 101-720 d), and 5 were still alive for 3 to 13 months (with an average of 9 months) without intestinal obstruction. ConclusionsLaparoscopic surgery combined with stent placement is an effective and safe procedure for resectable obstructed colorectal cancer. For unresectal obstructed rectal cancer, rectal stent placement combined with sustained-releasing 5-fluorouracil can prolong survival time avoiding colostomy.
目的探討腹腔鏡聯合手術的優越性和臨床應用價值。方法回顧性分析2005年6月至2010年6月期間在我院行腹腔鏡聯合手術的98例患者臨床資料。結果98例均順利完成聯合手術，無中轉開腹。一期膽總管縫合病例中有2例患者術后第2天出現漏膽，3 d后停止，超聲檢查無異常、拔管出院。所有患者平均下床活動時間13 h，隨訪3~48個月（平均35個月），無嚴重并發癥發生。結論腹腔鏡聯合手術能安全、有效地處理腹腔內多個病灶，擴大了腹腔鏡的手術領域，值得推廣。