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腹腔镜诊治腹股沟区脂肪疝的临床体会(附26例报告) 被引量:10
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作者 元海成 张楠 +3 位作者 钟岗 杨强 单涛 常旭 《腹腔镜外科杂志》 2018年第10期738-740,共3页
目的:探讨腹腔镜经腹腹膜前疝修补术(TAPP)诊治腹股沟区脂肪疝的临床经验。方法:回顾分析2015年3月至2017年12月320例TAPP患者的临床资料,术中诊断与治疗腹股沟区脂肪疝26例。结果:TAPP视角下脂肪疝发病率为8.1%(26/320),26例患者中男24... 目的:探讨腹腔镜经腹腹膜前疝修补术(TAPP)诊治腹股沟区脂肪疝的临床经验。方法:回顾分析2015年3月至2017年12月320例TAPP患者的临床资料,术中诊断与治疗腹股沟区脂肪疝26例。结果:TAPP视角下脂肪疝发病率为8.1%(26/320),26例患者中男24例,女2例,中位年龄55(46~72)岁,中位BMI 23.4 (17.7~27.2) kg/m^2;斜疝区脂肪疝24例,直疝区脂肪疝2例,其中单纯直疝区脂肪疝1例。患者均成功完成TAPP,无中转病例,脂肪疝直径3(2~5) cm,12例行病理检查均为脂肪组织,随访18(3~24)个月,无复发病例。结论:脂肪疝需外科处理,TAPP视角下诊治腹股沟区脂肪疝优势明显。脂肪疝是术后局部复发的独立影响因素,可能是一种保护机制,需引起疝外科医生的关注。 展开更多
关键词 脂肪疝 腹股沟 腹腔镜检查
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腹腔镜诊治老年嵌顿性腹股沟疝62例临床分析 被引量:19
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作者 董国强 元海成 +1 位作者 张楠 张兴洲 《腹腔镜外科杂志》 2020年第2期141-144,共4页
目的:探讨腹腔镜技术诊治老年嵌顿性腹股沟疝的应用价值。方法:回顾分析2017年1月至2019年2月收治的62例老年嵌顿性腹股沟疝患者的临床资料,包括一般资料、手术成功率、并发症发生率、死亡率、复发率。结果:62例患者中斜疝59例,直疝1例... 目的:探讨腹腔镜技术诊治老年嵌顿性腹股沟疝的应用价值。方法:回顾分析2017年1月至2019年2月收治的62例老年嵌顿性腹股沟疝患者的临床资料,包括一般资料、手术成功率、并发症发生率、死亡率、复发率。结果:62例患者中斜疝59例,直疝1例,股疝2例,患者均完成腹腔镜探查及疝内容物还纳,其中5例行肠切除加内环口成形术,55例行腹腔镜经腹膜前疝修补术,2例中转李金斯坦术。手术时间平均(76.4±18.9)min;平均住院(5.9±1.8)d;术后发生血清肿发生率2例(3.2%),无切口感染、慢性疼痛发生;死亡率1.6%(1/62)。术后随访4~24个月,随访率78.7%(48/61),无复发病例。结论:腹腔镜技术具有探查优势,诊治老年嵌顿性腹股沟疝安全、有效。 展开更多
关键词 嵌顿性腹股沟疝 疝修补术 腹腔镜检查 老年人
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Acupuncture Combined with Early Enteral Nutrition on Patients with Postoperative Laparoscopic Common Bile Duct Exploration:A Prospective Randomized Trial 被引量:7
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作者 yuan hai-cheng XIANG Qi +2 位作者 ZHANG Nan QIN Wei-jing CAI Wang 《Chinese Journal of Integrative Medicine》 SCIE CAS CSCD 2020年第10期769-775,共7页
Objective To assess the efficiency of acupuncture combined with early enteral nutrition(EEN)in patients with postoperative laparoscopic common bile duct exploration.Methods A total of 200 patients with postoperative l... Objective To assess the efficiency of acupuncture combined with early enteral nutrition(EEN)in patients with postoperative laparoscopic common bile duct exploration.Methods A total of 200 patients with postoperative laparoscopic bile duct exploration was randomized using sealed envelopes and assigned to the convenitional,EEN,acupuncture plus convenitional and acupuncture plus EEN groups,50 cases in each group.Twelve hours after operation,the patients in EEN groups began to receive oral enteral nutrition,and the acupuncture approach was performed by acupuncturist in acupuncture plus conventional and acupuncture plus EEN groups.Acupuncture was given at Zusanli(ST 36),Shangjuxu(ST 37)and Xiajuxu(ST 39)with a depth of 15–20 mm,using the lifting-thrusting and twisting method to obtain Deqi sensation.The needles were maintained for 30 min.Treatment was given once daily,3 times per section.After the intervention,the patients’characteristics,operation time,bleeding volume,postoperative time to first anal exhaust,postoperative complications including abdominal distension,diarrhea,gastric dilatation,intestinal obstruction,pharyngodynia,incision,abdominal and pulmonary infection and postoperative hospitalization days were assessed and compared in patients among 4 groups.Results Postoperative time to first anal exhaust in the convenitional group was longer compared with the other 3 groups(P<0.05),and was shorter in the acupuncture plus EEN group than those of the convenitional,acupuncture plus convenitional and EEN groups(P<0.01).The acupuncture plus EEN group showed significant decrease in the incidence of complications and less postoperative hospitalization days compared with the other groups(P<0.05 or P<0.01).There was no readmission.Conclusion After laparoscopic bile duct exploration,acupuncture combined with EEN treatment significantly improves the patients’gastrointestinal function,reduces complications,and shortens postoperative hospitalization days. 展开更多
关键词 laparoscopic bile duct exploration ACUPUNCTURE enteral nutrition gastrointestinal function enhanced recovery after surgery
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