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股股转流下胸腹主动脉瘤的外科治疗
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作者 胡海瓯 朱俊明 +7 位作者 郑铁 乔志钰 里程楠 葛翼鹏 唐兵 方卫纲 刘永民 孙立忠 《中国心血管病研究》 CAS 2023年第5期385-389,共5页
目的总结股股转流下胸腹主动脉瘤的外科治疗经验。方法回顾性分析首都医科大学附属北京安贞医院2013年2月至2020年10月期间,在股股转流体外氧合下行胸腹主动脉替换患者资料,并对这组患者的术前、术中及术后的临床资料进行总结分析。结... 目的总结股股转流下胸腹主动脉瘤的外科治疗经验。方法回顾性分析首都医科大学附属北京安贞医院2013年2月至2020年10月期间,在股股转流体外氧合下行胸腹主动脉替换患者资料,并对这组患者的术前、术中及术后的临床资料进行总结分析。结果股股转流下胸腹主动脉替换术患者共137例,病理类型包括CrawfordⅠ型19例(13.9%),CrawfordⅡ型66例(48.2%),CrawfordⅢ型36例(26.3%),CrawfordⅣ型16例(11.7%)。手术死亡2例(1.5%),术后30天死亡10例(7.3%)。术后急性肾功能衰竭需要连续肾脏替代疗法(CRRT)治疗患者20例(14.6%),呼吸功能衰竭二次插管11例(8.0%);截瘫10例(7.3%),其中迟发性截瘫6例(4.4%)。137例患者中深低温停循环下手术31例,术后无截瘫发生。结论股股转流下行胸腹主动脉替换术,术中能够对阻断远端各脏器提供有效保护,同时,在股股转流情况下能够降低近端主动脉游离的难度,保障手术顺利进行,尤其适合在刚开始开展胸腹主动脉替换手术的单位和近端主动脉游离困难的患者中推广应用。 展开更多
关键词 胸腹主动脉瘤 股股转流 胸腹主动脉替换术 连续肾脏替代疗法 截瘫
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车门结构多目标轻量化研究 被引量:4
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作者 侯振方 胡海欧 +2 位作者 张爱兵 李洪亮 霍俊焱 《机电工程》 CAS 北大核心 2020年第4期359-364,共6页
针对现有结构多目标轻量化设计采用单一变量(如板件厚度为优化变量)的不足,将网格变形技术创建的形状变量引入到了车门结构多目标轻量化设计中,建立了以板件厚度与车门结构形状同时作为设计变量的参数化有限元模型。对该车门进行了动态... 针对现有结构多目标轻量化设计采用单一变量(如板件厚度为优化变量)的不足,将网格变形技术创建的形状变量引入到了车门结构多目标轻量化设计中,建立了以板件厚度与车门结构形状同时作为设计变量的参数化有限元模型。对该车门进行了动态试验测试,验证了有限元模型及计算结果的可靠性;考虑到该车门一阶频率过低的问题,将一阶频率最大、车门质量最小作为优化目标,垂向刚度、窗框刚度为约束,进行了试验设计(DOE),通过Kriging函数模型拟合了要优化的目标及约束,经过精度校验,验证了该近似函数模型符合精度要求;最后利用多目标遗传算法进行了寻优计算。研究结果表明:在垂向刚度、窗框刚度满足约束值的情况下,车门质量最终降低2.84 kg(减重达13%),一阶频率提高了25.8 Hz。 展开更多
关键词 车门刚度 轻量化 形状变量 网格变形 多目标优化
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Eighty-six cases of laparoscopic vaginoplasty using an ileal segment 被引量:5
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作者 WU Ji-xiang LI Bin +6 位作者 LIU Tao LI Wen-zhi JIANG Yong-guang LIANG Jie-xiong WEI Chang-sheng hu hai-ou ZHONG Chen-xi 《Chinese Medical Journal》 SCIE CAS CSCD 2009年第16期1862-1866,共5页
Background The surgical management of the absence of the vagina is a complex problem and constitutes a significant technical challenge. As the laparoscopy has been an important tool for the treatment of uterovaginal a... Background The surgical management of the absence of the vagina is a complex problem and constitutes a significant technical challenge. As the laparoscopy has been an important tool for the treatment of uterovaginal anomalies, we evaluated the feasibility of laparoscopic vaginoplasty using an ileal segment retrospectively. Methods Totally 86 patients who underwent laparoscopic vaginoplasty using an ileal segment in Beijing Anzhen Hospital during February 2004 to July 2007 were enrolled in this study. Of the 86 patients, 70 (81.4%) underwent primary operations and 16 (18.6%) secondary operations. Nineteen (22.1%) patients underwent total laparoscopic vaginoplasty and 67 (77.9%) patients underwent laparoscope-assisted vaginoplasty. The operation time, cost of hospitalization, and hospital duration were compared between the two laparoscopic groups. The Student's t test and the Mann-Whitney test were used to examine the differences. Results All the surgeries were successfully completed with no any intraoperative complication. There were three major surgical complications in the postoperative period: one case of intra-abdominal hemorrhage, one case of meatal stenosis and one case of intestinal obstruction. The mean follow-up period of this series was 18 months. Seventy-eight patients were satisfied with their sexual lives after the surgeries except 5 women complaining of vaginal stenosis and 3 with no sexual partner during the follow-up. Significant differences were obtained between total laparoscopic and laparoscope-assisted vaginoplasty groups, such as the operation time, cost of hospitalization, and hospital duration (P 〈0.01). There were no significant differences in sexual function between the two groups. Conclusions The laparoscopic vaginoplasty using an ileal segment is satisfactory for cosmetic, functional, and anatomic results. Vaginoplasty with an ileal segment, performed by either total laparoscopic or laparoscope-assisted techniques, has a high success rate for a functional vagina. 展开更多
关键词 ILEUM LAPAROSCOPY VAGINOPLASTY
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