目的探讨肠道支架联合腹腔镜治疗左半结直肠癌伴急性肠梗阻的临床疗效。方法 可根治性切除左半结肠癌伴急性肠梗阻的患者48例,根据手术方式的不同分为急诊开腹组18例和支架联合腹腔镜组30例。急诊开腹组全身麻醉下急诊行一期切除造瘘术...目的探讨肠道支架联合腹腔镜治疗左半结直肠癌伴急性肠梗阻的临床疗效。方法 可根治性切除左半结肠癌伴急性肠梗阻的患者48例,根据手术方式的不同分为急诊开腹组18例和支架联合腹腔镜组30例。急诊开腹组全身麻醉下急诊行一期切除造瘘术,术后3~6个月行二期瘘口还纳手术;支架联合腹腔镜组急诊内镜下行肠道支架置入术,先缓解肠梗阻症状,3~10 d后行腹腔镜一期左半结肠根治术。比较2组近期临床疗效,包括手术时间、术中出血量、术后通气时间、术后并发症、术后转ICU率、术后住院时间及总住院费用(其中急诊开腹组总住院费用包括二期造瘘还纳手术费用)。结果 2组患者术中出血量、术后并发症、术后住院时间比较差异无统计学意义(均 P >0.05)。急诊开腹组手术时间为(210.0±58.5)min,比支架腹腔镜组的(247.9±55.6)min短( P < 0.05 );急诊开腹组肛门排气时间为(104.8±27.1)h,比支架腹腔镜组的(83.1±15.0)h长( P <0.05);急诊开腹组术后转ICU率和总住院费用明显高于支架腹腔镜组( P <0.05, P <0.001)。结论 肠道支架在左半结直肠癌伴急性肠梗阻中的应用安全可靠,联合腹腔镜使得手术达到一期切除吻合,避免了肠造瘘,实现了微创及快速康复的临床疗效。展开更多
A quantitative model was applied to analyze the energy demand and CO2 emissions in China following the Energy Production and Consumption Revolution Strategy(2016e2030)and long-term economic and social development targ...A quantitative model was applied to analyze the energy demand and CO2 emissions in China following the Energy Production and Consumption Revolution Strategy(2016e2030)and long-term economic and social development target China Dream.Results showed that 1)toward the 2050 China Dream target,total final energy consumption is expected to peak at 3.9 Gtce in 2030 and remain stable until 2050,whereas total primary energy consumption is expected to reach an upper platform by 2040 and around 5.8 Gtce by 2050;2)the proportion of non-fossil fuels is expected to reach approximately 50%and that of natural gas to reach more than 16%by 2050;3)CO2 emissions from energy use are expected to peak at 9.6 Gt by no later than 2030 and then gradually decline to 6.7 Gt by 2050.展开更多
文摘目的探讨肠道支架联合腹腔镜治疗左半结直肠癌伴急性肠梗阻的临床疗效。方法 可根治性切除左半结肠癌伴急性肠梗阻的患者48例,根据手术方式的不同分为急诊开腹组18例和支架联合腹腔镜组30例。急诊开腹组全身麻醉下急诊行一期切除造瘘术,术后3~6个月行二期瘘口还纳手术;支架联合腹腔镜组急诊内镜下行肠道支架置入术,先缓解肠梗阻症状,3~10 d后行腹腔镜一期左半结肠根治术。比较2组近期临床疗效,包括手术时间、术中出血量、术后通气时间、术后并发症、术后转ICU率、术后住院时间及总住院费用(其中急诊开腹组总住院费用包括二期造瘘还纳手术费用)。结果 2组患者术中出血量、术后并发症、术后住院时间比较差异无统计学意义(均 P >0.05)。急诊开腹组手术时间为(210.0±58.5)min,比支架腹腔镜组的(247.9±55.6)min短( P < 0.05 );急诊开腹组肛门排气时间为(104.8±27.1)h,比支架腹腔镜组的(83.1±15.0)h长( P <0.05);急诊开腹组术后转ICU率和总住院费用明显高于支架腹腔镜组( P <0.05, P <0.001)。结论 肠道支架在左半结直肠癌伴急性肠梗阻中的应用安全可靠,联合腹腔镜使得手术达到一期切除吻合,避免了肠造瘘,实现了微创及快速康复的临床疗效。
基金We thank National Key R&D Program of China(2016YFA0602601),National Natural Science Foundation of China(71573062),China Energy Modeling Forum(CEMF),for support of the study.
文摘A quantitative model was applied to analyze the energy demand and CO2 emissions in China following the Energy Production and Consumption Revolution Strategy(2016e2030)and long-term economic and social development target China Dream.Results showed that 1)toward the 2050 China Dream target,total final energy consumption is expected to peak at 3.9 Gtce in 2030 and remain stable until 2050,whereas total primary energy consumption is expected to reach an upper platform by 2040 and around 5.8 Gtce by 2050;2)the proportion of non-fossil fuels is expected to reach approximately 50%and that of natural gas to reach more than 16%by 2050;3)CO2 emissions from energy use are expected to peak at 9.6 Gt by no later than 2030 and then gradually decline to 6.7 Gt by 2050.