简介:目的:探讨分层缝合在腹腔镜胆总管切开取石一期缝合术中的应用价值。方法回顾性分析我院2007年3月~2013年3月216例腹腔镜胆总管切开取石一期缝合术,按胆总管缝合方法分为2组:单层缝合组127例和分层缝合组89例,比较2组患者术后胆漏发生率、术后住院时间。结果2组手术均顺利,无中转开腹。2组患者手术时间无显著差异(t=-0.931,P=0.353),分层缝合组术后住院时间(5.9±1.7)d,明显短于单层缝合组(7.7±1.8)d(t=7.400,P=0.000)。分层缝合组术后胆漏发生率3.4%(3/89),显著低于单层缝合组20.5%(26/127)(χ2=13.167,P=0.000)。单层缝合组合并急性胆管炎患者术后胆漏发生率明显高于非急性胆管炎患者[45.4%(10/22)vs.15.2%(16/105),χ2=8.429,P=0.004];分层缝合组合并急性胆管炎患者术后胆漏发生率与非急性胆管炎患者无显著差异[7.1%(1/14)vs.2.7%(2/75),χ2=0.002,P=0.964]。结论分层缝合可明显减少腹腔镜胆总管切开取石一期缝合术后胆漏,避免术后胆漏可能引起的并发症,缩短住院时间,扩大腹腔镜胆总管切开取石一期缝合术的适应证。
简介:摘要目的探索肛瘘切除I期缝合术应用于低位单纯性肛瘘治疗的临床效果.方法采用平行对比和随机原则对我院2013年5月到2015年5月收治的低位单纯性肛瘘患者70例进行了研究,将其平均分为对照组和实验组.对照组接受常规的肛瘘切除开放治疗术,实验组则接受肛瘘切除I期缝合术进行治疗.结果实验组患者的术后甲级、乙级愈占比显著高于对照组;甲级治愈率实验组的为(48.5%)显著高于对照组的(28.5%)(P<0.05);观察组的术后感染、复发率显著低于对照组(P<0.05).结论在低位单纯性肛瘘中应用肛瘘切除I期缝合术进行治疗,临床治疗效果显著,且术后感染和术后复发率较小,值得临床应用与推广.关键词肛瘘切除I期缝合术;低位单纯性肛瘘;临床疗效SimplelowanalfistulasurgicaltreatmentofstageIEffectAbstractobjectiveToexploretheanalfistulasutureremovalIappliedtotheclinicaleffectsoflowanalfistulatreatment.MethodsArandomizedparallelcomparisonandprinciplestoourhospitalinMay2013toMay2015ofsimplelowanalfistulatreated70patientswerestudied,whichweredividedintocontrolandexperimentalgroups.Thecontrolgroupreceivedconventionalopenresectionoffistulatherapy,theexperimentalgroupreceivedfistulaIsutureremovaltreatment.ResultsTheexperimentalgrouppostoperativeClassA,Bmoresignificantlyhigherproportion;is(48.5%)GradecurerateintheexperimentalgroupwassignifiGcantlyhigherthan(28.5%)(P<0.05);postoperativeinfectionoftheobservationgroup,therecurrenceratewassignificantlylowerthanthecontrolgroup(P<0.05).ConclusionApplicationofsimplelowanalfistulaanalfistulaIsutureremovaltreatment,clinicaltreatmenteffectisremarkable,andpostoperativeinfectionandrecKueryrewnocredsrateissmall,itisworthyofclinicalapplicationandpromotion.fistulaexcisionIsuture;simplelowanalfistula;clinicalefficacy中图分类号R657.1文献标识码B文章编号1008-6315(2015)12-0536-02
简介: 摘要:目的:研究分析在产妇剖宫产产后出血的治疗中实施子宫背带式缝合术的围手术期护理观察。方法:对近期在剖宫产产后出现出血症状的产妇资料进行整理,其中有 14例的治疗中实施了子宫背带式缝合术,并加强对其围手术期的护理,着重预防贫血(继发性)等症状,对资料中的护理措施进行总结。结果:所有产妇的术后愈合均满足甲级标准,产妇的平均治疗用时为( 8.7±12)天。 30日的跟踪随访中未有贫血(继发性)、产后出血等症状的记录,所有产妇的子宫复旧情况均符合要求, 5个月左右的跟踪随访中未有远期并发症的记录。结论:加强对在剖宫产产后出现出血症状的产妇进行子宫背带式缝合术的围手术期护理可以缩短治疗用时,促进愈合,降低并发症状的出现机率。 关键词:剖宫产 ;产后出血 ; 子宫背带式缝合术 ; 围手术期护理 Abstract: Objective: To study and analyze the perioperative nursing observation of the implementation of the womb belt suture in the treatment of postpartum hemorrhage of the parturient after cesarean section. Methods: the recent data of postpartum hemorrhage in cesarean section were sorted out. Among them, 14 cases were treated with suture of uterine back belt, and the perioperative nursing was strengthened, with emphasis on prevention of anemia (secondary) and other symptoms, and the nursing measures in the data were summarized. Results: the postoperative healing of all the parturients met the grade a standard. The average treatment time of the parturients was (8.7 ± 12) days. During the follow-up of 30 days, there was no record of anemia (secondary), postpartum hemorrhage and other symptoms. The uterine involution of all the parturients met the requirements. There was no record of long-term complications in the follow-up of about 5 months. Conclusion: it can shorten the time of treatment, promote the healing and reduce the incidence of complications to strengthen the perioperative nursing care of the pregnant women with bleeding symptoms after cesarean section.
简介: 摘要:目的:研究分析在产妇剖宫产产后出血的治疗中实施子宫背带式缝合术的围手术期护理观察。方法:对近期在剖宫产产后出现出血症状的产妇资料进行整理,其中有 14例的治疗中实施了子宫背带式缝合术,并加强对其围手术期的护理,着重预防贫血(继发性)等症状,对资料中的护理措施进行总结。结果:所有产妇的术后愈合均满足甲级标准,产妇的平均治疗用时为( 8.7±12)天。 30日的跟踪随访中未有贫血(继发性)、产后出血等症状的记录,所有产妇的子宫复旧情况均符合要求, 5个月左右的跟踪随访中未有远期并发症的记录。结论:加强对在剖宫产产后出现出血症状的产妇进行子宫背带式缝合术的围手术期护理可以缩短治疗用时,促进愈合,降低并发症状的出现机率。 关键词:剖宫产 ;产后出血 ; 子宫背带式缝合术 ; 围手术期护理 Abstract: Objective: To study and analyze the perioperative nursing observation of the implementation of the womb belt suture in the treatment of postpartum hemorrhage of the parturient after cesarean section. Methods: the recent data of postpartum hemorrhage in cesarean section were sorted out. Among them, 14 cases were treated with suture of uterine back belt, and the perioperative nursing was strengthened, with emphasis on prevention of anemia (secondary) and other symptoms, and the nursing measures in the data were summarized. Results: the postoperative healing of all the parturients met the grade a standard. The average treatment time of the parturients was (8.7 ± 12) days. During the follow-up of 30 days, there was no record of anemia (secondary), postpartum hemorrhage and other symptoms. The uterine involution of all the parturients met the requirements. There was no record of long-term complications in the follow-up of about 5 months. Conclusion: it can shorten the time of treatment, promote the healing and reduce the incidence of complications to strengthen the perioperative nursing care of the pregnant women with bleeding symptoms after cesarean section.
简介: 摘要:目的:研究分析在产妇剖宫产产后出血的治疗中实施子宫背带式缝合术的围手术期护理观察。方法:对近期在剖宫产产后出现出血症状的产妇资料进行整理,其中有 14例的治疗中实施了子宫背带式缝合术,并加强对其围手术期的护理,着重预防贫血(继发性)等症状,对资料中的护理措施进行总结。结果:所有产妇的术后愈合均满足甲级标准,产妇的平均治疗用时为( 8.7±12)天。 30日的跟踪随访中未有贫血(继发性)、产后出血等症状的记录,所有产妇的子宫复旧情况均符合要求, 5个月左右的跟踪随访中未有远期并发症的记录。结论:加强对在剖宫产产后出现出血症状的产妇进行子宫背带式缝合术的围手术期护理可以缩短治疗用时,促进愈合,降低并发症状的出现机率。 关键词:剖宫产 ;产后出血 ; 子宫背带式缝合术 ; 围手术期护理 Abstract: Objective: To study and analyze the perioperative nursing observation of uterine strap suture in the treatment of postpartum hemorrhage after cesarean section. Methods: the recent data of postpartum hemorrhage in cesarean section were sorted out. Among them, 14 cases were treated with suture of uterine back belt, and the perioperative nursing was strengthened, with emphasis on prevention of anemia (secondary) and other symptoms, and the nursing measures in the data were summarized. Results: the postoperative healing of all parturients met the class a standard, and the average treatment time was (8.7 ± 12) days. During the follow-up of 30 days, there was no record of anemia (secondary), postpartum hemorrhage and other symptoms. The uterine involution of all the parturients met the requirements. There was no record of long-term complications in the follow-up of about 5 months. Conclusion: to strengthen the perioperative nursing care of the pregnant women with bleeding symptoms after cesarean section can shorten the treatment time, promote the healing and reduce the incidence of complications.
简介:目的探究术中鼻胆管引流术在胆总管结石合并胆囊结石一期缝合术中的应用。方法回顾分析2014年1月至2017年12月经确诊的胆总管结石合并胆囊结石患者76例资料,根据治疗方式的不同,分为研究组(LC+LCBDE+术中ENBD+CBD一期缝合)和对照组(术前ERCP+LC),每组各38例,采用统计学软件SPSS24.0进行统计学分析,术中术后情况比较采用(均数±标准差)表示,采用独立t检验;术后并发症、ASA分级组间比较采用卡方检验,P〈0.05表示差异有统计学意义。结果研究组手术时间、住院时间显著少于对照组,P〈0.001;研究组手术成功率为100%,显著高于对照组89.5%,P=0.040;研究组患者平均手术费用显著少于对照组[(1.3±0.1)万元vs.(1.6±0.1)万元,P〈0.001)]。两组并发症的发病率差异无统计学意义。结论LC+LCBDE+术中ENBD+CBD一期缝合术较术前ERCP+LC治疗胆总管结石合并胆囊结石,其治疗效果更优。
简介: 摘要:目的:研究分析在产妇剖宫产产后出血的治疗中实施子宫背带式缝合术的围手术期护理观察。方法:对近期在剖宫产产后出现出血症状的产妇资料进行整理,其中有 14例的治疗中实施了子宫背带式缝合术,并加强对其围手术期的护理,着重预防贫血(继发性)等症状,对资料中的护理措施进行总结。结果:所有产妇的术后愈合均满足甲级标准,产妇的平均治疗用时为( 8.7±12)天。 30日的跟踪随访中未有贫血(继发性)、产后出血等症状的记录,所有产妇的子宫复旧情况均符合要求, 5个月左右的跟踪随访中未有远期并发症的记录。结论:加强对在剖宫产产后出现出血症状的产妇进行子宫背带式缝合术的围手术期护理可以缩短治疗用时,促进愈合,降低并发症状的出现机率。 关键词:剖宫产 ;产后出血 ; 子宫背带式缝合术 ; 围手术期护理 Abstract: Objective: To study and analyze the perioperative nursing observation of uterine strap suture in the treatment of postpartum hemorrhage after cesarean section. Methods: the data of recent postpartum hemorrhage after cesarean section were sorted out. Among them, 14 cases were treated with uterine sling suture, and the perioperative nursing was strengthened, and the prevention of anemia (secondary) and other symptoms was emphasized. The nursing measures in the data were summarized. Results: the postoperative healing of all parturients met the class a standard, and the average treatment time was (8.7 ± 12) days. No anemia (secondary), postpartum hemorrhage and other symptoms were recorded during the 30 day follow-up. The uterine involution of all the pregnant women met the requirements. No long-term complications were recorded during the follow-up of about 5 months. Conclusion: to strengthen the perioperative nursing care of the pregnant women with bleeding symptoms after cesarean section can shorten the treatment time, promote the healing and reduce the incidence of complications.
简介:摘要:目的:探讨腹腔镜胆管切开取石(LCBDE)Ⅰ期缝合术治疗胆总管结石的临床疗效。方法:选取2020年1月~2022年4月我院收治的70例胆总管结石患者作为研究对象,采用随机数字表法分为试验组与对照组,各35例。两组患者均行LCBDE手术治疗,对照组术后予以T管引流术治疗,试验组术后予以Ⅰ期缝合术治疗,比较两组患者的围术期相关指标及血清胆红素水平。结果:试验组患者的手术时间、术后首次排气时间、住院时间均短于对照组(P
简介:比较菱形切除Limberg皮瓣转移术与切除一期缝合术治疗骶尾部藏毛窦的疗效。回顾性分析中国医科大学附属第四医院肛肠科2007年1月—2013年6月收治的122例接受两种不同术式治疗的骶尾部藏毛窦患者,其中藏毛窦菱形切除Limberg皮瓣转移术58例(皮瓣组),藏毛窦切除一期缝合术64例(缝合组)。随访12~89个月(平均43.6个月),比较两组的术后疼痛评分、手术时间、住院时间、切口愈合时间、复发及并发症的发生率。皮瓣组的术后疼痛评分、切口愈合时间、复发及并发症发生率均少于缝合组(P〈0.05);皮瓣组手术时间大于缝合组(P〈0.05);两组住院时间差异无统计学意义(P〉0.05)。菱形切除Limberg皮瓣转移术除了手术时间相对较长以外,操作并不复杂,术后疼痛轻、切口愈合时间短、并发症少、复发率低,值得临床推广。
简介:【摘要】目的:研究急诊美容缝合术与普通急诊清创缝合术治疗面部外伤患者的临床疗效。方法:选取我院2020年1月-2023年1月期间收治的面部外伤患者,共76例,按照随机数字表法分为2组,分别38例患者。对照组患者采用普通急诊清创缝合术,实验组患者采用急诊美容缝合术,将两组临床数据进行统计,分析对比差异。结果:实验组水肿持续时间、创口愈合时间均短于对照组,实验组治疗费用显著高于对照组;实验组临床治疗效果为97.37%,相较于对照组84.21%,实验组临床治疗效果更高(P<0.05)。结论:急诊美容缝合术与普通急诊清创缝合术均能对面部外伤患者起到较好的临床治疗效果,但是,急诊美容缝合术治疗效果更佳,不过急诊清创缝合术治疗费用更低,具体选择何种治疗方式需结合患者实际情况自行抉择。
简介:目的探讨腹腔镜胆总管探查Ⅰ期缝合术治疗胆总管结石的中长期效果。方法2005年1月~2010年12月对89例胆总管结石常规四孔法行腹腔镜胆囊切除及胆总管探查,钬激光碎石联合胆道镜取石,5-0或4-0可吸收带针线8字或连续扣锁缝合胆总管。结果手术时间80~210min,平均110min;术中出血量20~220ml,平均50ml。术后胆漏6例(60~150ml/d),经保守治疗后腹腔引流管拔除时间4~8d,平均5.1d;余83例均在术后3~4d拔除腹腔引流管;无大出血及胆管损伤。85例随访1~6年,平均3.2年,其中随访1~3年32例,〉3~5年40例,〉5年13例:9例有上腹部疼痛史1~2次,未经治疗自行缓解;12例因腹痛就诊1次,其中7例诊断为胆系感染,经抗炎治疗后好转,另外5例术后8~38个月(平均15个月)胆总管结石复发,其中2例胆总管结石〈1.0cm行EST,3例因结石较大或多枚开腹手术治疗,预后均良好;术后肝功能正常76例,轻度肝功能损害7例,重度度肝功能损害2例;超声检查示63例胆总管直径〈1.5cm,22例胆总管直径≥1.5cm,其中2例胆总管直径≥2.0cm经手术证实为胆总管多枚结石复发。结论腹腔镜胆总管探查Ⅰ期缝合术是一种安全可靠的治疗方法,应严格把握适应证,术中取净结石。