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    find Author "郭欣" 6 results
    • 腹腔鏡與開腹手術治療 Mirizzi 綜合征的臨床療效比較

      目的 比較腹腔鏡和開腹手術治療 Mirizzi 綜合征的臨床療效。 方法 回顧性收集解放軍第 451 醫院全軍腹腔鏡中心于 2010 年 1 月至 2014 年 12 月期間收治的 69 例 Mirizzi 綜合征患者的臨床資料,根據接受的手術類型分為腹腔鏡組(n=36)和開腹組(n=33),比較腹腔鏡組和開腹組患者的手術療效。 結果 腹腔鏡組患者的手術時間〔(56.2±19.4)min比(86.2±22.1)min〕、術中出血量〔(47.5±25.4)mL比(104.9±41.6)mL〕、術后進食時間〔(12.4±5.6)h比(29.2±10.4)h〕、術后排氣時間〔(11.4±5.7)h比(25.4±6.6)h〕和住院時間〔(5.4±2.4)d比(8.9±3.1)d〕均短于開腹組,差異均有統計學意義(P<0.05)。術后腹腔鏡組發生膽瘺 2 例,并發癥發生率為 5.56%;開腹組發生膽瘺 1 例,肺部感染 1 例,并發癥發生率為 6.06%,2 組患者的近期并發癥發生率比較差異無統計學意義(P>0.05)。術后所有患者均獲訪,隨訪時間為 10~35 個月,中位數為 19 個月。隨訪期間,腹腔鏡組和開腹組各有 1 例患者新發膽瘺,遠期并發癥發生率分別為 2.78% 和 3.03%,2 組患者的遠期并發癥發生率比較差異也無統計學意義(P>0.05)。所有患者隨訪期間均無膽管狹窄和結石殘留發生。 結論 腹腔鏡治療Ⅰ型和Ⅱ型 Mirizzi 綜合征安全有效,可減輕對患者的創傷并加快恢復,對于術前明確診斷的患者可首選腹腔鏡治療。

      Release date:2017-07-12 02:01 Export PDF Favorites Scan
    • 上腹部手術史患者行三孔腹腔鏡膽囊切除術的臨床研究

      目的 總結對有上腹部手術史患者行三孔腹腔鏡膽囊切除(LC)術的安全性及經驗。 方法 對解放軍第 451 醫院 2011 年 6 月至 2015 年 6 月期間收治的有上腹部手術史且行三孔 LC 術的 98 例患者的臨床病理資料進行回顧性分析。 結果 98 例患者均成功建立氣腹,其中 96 例成功完成三孔 LC 術,成功率為 97.96%;1 例患者因嚴重肥胖、腹腔內視野顯露不足,于右側腋前線處建立第 4 個 Trocar 后完成手術;1 例患者因肝血管瘤切除術后膽囊三角區粘連嚴重而中轉開腹手術。手術時間 29~136 min,平均 53 min,中位時間 49 min。有 29 例患者術后放置引流管并于術后 48 h 拔除。術后無一例患者死亡、腹腔出血、膽汁漏等并發癥發生,患者均于術后 4 d 痊愈出院。術后病理結果證實慢性膽囊炎 51 例,慢性膽囊炎急性發作 38 例,膽囊息肉 9 例,無膽囊癌患者。 結論 有上腹部手術史患者行三孔 LC 術是安全、有效的,術前應利用 B 超評估粘連并選擇穿刺部位,術中直視下建立氣腹,術中具體的解剖需要術者嫻熟的操作技能。

      Release date:2017-05-04 02:26 Export PDF Favorites Scan
    • 腹腔鏡膽囊切除術意外膽囊癌22例報道

      目的探討腹腔鏡膽囊切除術(laparoscopic cholecystectomy,LC)中發現意外膽囊癌(unexpected gallbladder cancer,UGC)的臨床診治流程及其療效評價。 方法收集解放軍第451醫院腔鏡外科2013年1月至2015年8月期間因膽囊良性疾病行LC術患者的臨床資料,共計發現UGC 22例,評價其診治流程及治療效果。 結果22例患者手術均獲成功,無手術死亡病例。術后無感染、腹腔內出血等嚴重并發癥發生;有2例患者術后出現少量膽汁滲漏,2例患者術后出現腹腔內少量滲血,均經引流2~5 d后好轉。術中有6例行冰凍病理學檢查確診,其中重度不典型增生伴局部癌變5例,行單純膽囊切除術;高分化腺癌1例,中轉開腹行膽囊癌根治術。其余16例為術后病理學檢查提示膽囊癌,其中13例二次手術行膽囊癌根治術,另3例患者家屬放棄二次手術治療。22例患者中Nevin分期為Ⅰ期17例,Ⅱ期3例,Ⅲ期2例。Ⅰ期、Ⅱ期和Ⅲ期患者術后1年存活者分別為14/17、2/3和0/2例。 結論膽囊癌早期診斷困難,術前應對存在危險因素的膽囊良性病變患者提高警惕,早期行手術治療可提高其臨床療效。

      Release date:2016-10-25 06:10 Export PDF Favorites Scan
    • Study on the Control of Dynamic Artificial Limb Ankle Based on Central Pattern Generator

      In order to obtain the normal gait for the prosthesis-carrier with the change of external environment and gait, we designed a model of dynamic ankle prosthesis and control system and introduced the strategy of centralpatterngenerator (CPG) about the moving trail of dynamic ankle prosthesis. The dynamic parts, which are incorporated in the model of dynamic ankle prosthesis, provide power in order to have anthropic function and character. The tool of Matlab/simulink was used to simulate the strategy. The simulation results showed that the strategy of CPG learning control in this study was effective and could track the reference trail rapidly and fit the moving trail of a person's normal limb. It can make the prosthetic timely regulation and action, enhance the prosthetic intelligence. It has important practical value for intelligent prosthesis development based on this analysis of technology.

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    • Efficacy of acellular dermal matrix and subepithelial connective tissue flap on gingival recession: a systematic review

      ObjectiveTo systematically review the efficacy of acellular dermal matrix (ADM) and subepithelial connective tissue flap (sCTG) on patients with gingival recession (GR).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) about the efficacy of ADM and sCTG on patients with GR from inception to August 11st, 2019. Two reviewers indepeudently screened literature, extracted data and assessed the risk of bias of included studies, and then meta-analysis was performed by using RevMan 5.3 software and Stata 12.1 software.ResultsA total of 9 RCTs were included. The results of meta-analysis showed that: there were no significant differences in probing depth (PD) (MD3m=?0.04, 95%CI ?0.18 to 0.11, P=0.63; MD6m=?0.01, 95%CI ?0.13 to 0.12, P=0.90) and GR degree (MD3m=?0.10, 95%CI ?0.37 to 0.18, P=0.48; MD6m=?0.02, 95%CI ?0.33 to 0.29, P=0.89) in 3 and 6 months after operative between two groups. But the clinical attachment loss (CAL) in 3 months after operation (MD=0.33, 95%CI 0.00 to 0.66, P=0.05) and width of keratinized tissue (KTW) in 6 months after operation (MD=?0.48, 95%CI ?0.76 to ?0.20, P=0.000 7) of sCTG group were superior to ADM group, the differences were statistically significant.ConclusionCurrent evidence shows that there are no differences in PD and GR degree in 3 months and 6 months after operation between ADM and sCTG group. But the CAL in 3 months after operation and KTW in 6 months after operation of sCTG group is superior to ADM group. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.

      Release date:2020-03-13 01:50 Export PDF Favorites Scan
    • 三種自身抗體和補體C3水平檢測對狼瘡性腎炎患者的診斷意義

      目的探討抗心磷脂抗體(ACA)、抗核小體抗體、抗核糖體p蛋白抗體3種自身抗體與補體C3水平檢測對狼瘡性腎炎(LN)患者的診斷意義。 方法2005年7月-2010年12月對406例系統性紅斑狼瘡(SLE)患者(其中LN 122例)和120例健康體檢者采用酶聯免疫吸附測定法測定ACA,應用歐蒙印跡法測定抗核小體抗體和抗核糖體p蛋白抗體,應用散射比濁法測定補體C3水平。 結果ACA和抗核糖體p蛋白抗體陽性率在LN組均為21.31%,在非LN組分別為17.61%、14.08%,差異無統計學意義(P>0.05);抗核小體抗體在LN組為56.56%,在非LN組為39.08%,差異有統計學意義(P<0.05);LN組和非LN組3種抗體陽性率與對照組比較差異有統計學意義(P<0.01);LN組、非LN組和對照組補體C3水平分別為(0.52±0.22)、(0.67±0.29)、(1.28±0.32)g/L,3組比較差異均有統計學意義(P<0.01);LN組ACA、抗核小體抗體和抗核糖體p蛋白抗體同時陽性率(10.66%)高于非LN組(3.17%),差異有統計學意義(P<0.05)。 結論ACA、抗核小體抗體、抗核糖體p蛋白抗體及補體C3的聯合檢測對狼瘡性腎炎的診斷及鑒別診斷、預后判斷等方面具有一定意義。

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