Background During the past decade, graft materials have been widespread used in the vagina in order to correct pelvic organ prolapse. The aim of this study was to describe and compare the exact anatomical position of ...Background During the past decade, graft materials have been widespread used in the vagina in order to correct pelvic organ prolapse. The aim of this study was to describe and compare the exact anatomical position of the puncture devices and their relations to the relevant anatomical structures in the ProliftTM and a modified pelvic reconstructive surgery with mesh. Methods Twelve fresh cadavers were allocated randomly to either the ProliftTM or the modified pelvic reconstructive surgery group. Each group had six fresh cadavers. Relevant distances between the puncture devices and anatomical structures were recorded in both minimally invasive puncture surgeries. Results The mean distances from the posterior puncture points of the obturator membrane to the posterior branch of obturator arteries were shorter （（0.60＋0.36） cm and （0.78＋0.10） cm） when compared with the distances to the anterior branch of obturator arteries （（1.53＋0.46） cm and （1.86＋0.51） cm） for the reconstruction of the anterior compartment in both surgeries （all P 〈0.05）. The distance from the puncture points of the pelvic floor through the ischiorectal fossa to the coccygeal and inferior gluteal arteries in the ProliftTM technique （（0.88＋0.10） cm） and （（1.59＋0.36） cm））were much shorter than that in the modified pelvic reconstructive surgery （（2.95＋0.09） cm） and （（3.40＋0,36） cm）） for the reconstruction of the middle and posterior compartments （all P 〈0.05）. Conclusions Compared with the ProliftTM technique, the modified pelvic reconstructive surgery with mesh would be safer not to cause great damage to the inferior gluteal arteries and the coccygeal arteries, The posterior branch of obturator arteries would be easier to be injured than the anterior branch of obturator arteries during anterior compartment reconstruction in both surgeries.展开更多
背景与目的肺癌是世界范围内发病率和死亡率最高的恶性肿瘤之一,手术仍然是早期非小细胞肺癌的首选治疗方法。本研究的目的是探讨术后极早期肺功能的恢复情况,并比较肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响...背景与目的肺癌是世界范围内发病率和死亡率最高的恶性肿瘤之一,手术仍然是早期非小细胞肺癌的首选治疗方法。本研究的目的是探讨术后极早期肺功能的恢复情况,并比较肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响。方法选取中国医学科学院肿瘤医院胸外科2015年9月-2016年2月间手术的肺癌患者,按术式不同分为胸腔镜肺段切除术组、胸腔镜肺叶切除术组、开胸肺叶切除术组,分别于术前、术后第3天和术后3个月检查测试肺功能。统计分析采用SPSS 20.0版本,应用单因素方差分析,比较组间差异。结果 1在术后第3天,对比胸腔镜肺叶切除术、胸腔镜肺段切除术、开胸肺叶切除术,三组患者的肺功能,用力肺活量(forced vital capacity,FVC)、FVC占预计值的百分比(FVC%)、一秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1占预计值的百分比(FEV1%)、最大呼气流速峰值(peak expiratory flow,PEF)、每分钟最大通气量(maximal voluntary ventilation,MVV)、肺一氧化碳弥散因子(transfer factor for carbon monoxide of lung,TLCO)、TLCO占预计值的百分比(TLCO%),组间差异具有统计学意义(P值分别为0.033、0.042、0.029、0.045、0.039、0.021、0.018、0.024)。2在术后3个月,对比胸腔镜肺叶切除术、胸腔镜肺段切除术、开胸肺叶切除术,三组患者的肺功能,组间比较发现FVC、FVC%、FEV1、FEV1%、PEF、MVV、TLCO、TLCO%差异显著(P值分别为0.019、0.024、0.044、0.021、0.037、0.029、0.045、0.017)。结论肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后在术后极早期(术后第3天)与术后3个月,肺功能的恢复情况均为胸腔镜肺段切除优于胸腔镜肺叶切除,胸腔镜肺叶切除优于开胸肺叶切除。展开更多
目的比较不同手术方法以探讨微创治疗脑室出血的新方法。方法应用神经内镜微创治疗脑室出血22例,以传统的单纯脑室体外引流术治疗同类疾病20例为对照组,并相互比较。结果在内镜组,术后24h复查头颅CT,脑内或(和)脑室内血肿绝大部分清除者...目的比较不同手术方法以探讨微创治疗脑室出血的新方法。方法应用神经内镜微创治疗脑室出血22例,以传统的单纯脑室体外引流术治疗同类疾病20例为对照组,并相互比较。结果在内镜组,术后24h复查头颅CT,脑内或(和)脑室内血肿绝大部分清除者(90%以上)者15例;未发现继发出血;术后无颅内感染;术后2个月对患者进行GOS(G lasgow outcom e scale)评分,5分5例,4分9例,3分4例,2分2例,1分2例。在脑室引流组,术后24h复查颅脑CT,仅有3例脑室内血肿大部分清除(60%以下);未发现继发出血;术后颅内感染2例;术后2个月对患者进行GOS评分,5分1例,4分5例,3分7例,2分5例,1分2例。与内镜组比较,术后好转优良率低(P<0.05),差异有统计学意义;死亡率差异无统计学意义(P>0.05)。结论应用神经内镜清除脑室内血肿,具有直视下操作、术后疗效好等优点,是脑室出血较佳的外科治疗方法。展开更多
基金This study was supported by grants from the National Natural Science foundation of China （No. 30973180 and No. 81100412） and from Higher Education Outstanding Young Talent Fund Project of Anhui Province, China （No. 2011SQRL088）.We thank Wang Naili, lab assistant from the Department of Anatomy, Peking Union Medical College for his constructive comments and suggestions during the anatomical process.
文摘Background During the past decade, graft materials have been widespread used in the vagina in order to correct pelvic organ prolapse. The aim of this study was to describe and compare the exact anatomical position of the puncture devices and their relations to the relevant anatomical structures in the ProliftTM and a modified pelvic reconstructive surgery with mesh. Methods Twelve fresh cadavers were allocated randomly to either the ProliftTM or the modified pelvic reconstructive surgery group. Each group had six fresh cadavers. Relevant distances between the puncture devices and anatomical structures were recorded in both minimally invasive puncture surgeries. Results The mean distances from the posterior puncture points of the obturator membrane to the posterior branch of obturator arteries were shorter （（0.60＋0.36） cm and （0.78＋0.10） cm） when compared with the distances to the anterior branch of obturator arteries （（1.53＋0.46） cm and （1.86＋0.51） cm） for the reconstruction of the anterior compartment in both surgeries （all P 〈0.05）. The distance from the puncture points of the pelvic floor through the ischiorectal fossa to the coccygeal and inferior gluteal arteries in the ProliftTM technique （（0.88＋0.10） cm） and （（1.59＋0.36） cm））were much shorter than that in the modified pelvic reconstructive surgery （（2.95＋0.09） cm） and （（3.40＋0,36） cm）） for the reconstruction of the middle and posterior compartments （all P 〈0.05）. Conclusions Compared with the ProliftTM technique, the modified pelvic reconstructive surgery with mesh would be safer not to cause great damage to the inferior gluteal arteries and the coccygeal arteries, The posterior branch of obturator arteries would be easier to be injured than the anterior branch of obturator arteries during anterior compartment reconstruction in both surgeries.
文摘背景与目的肺癌是世界范围内发病率和死亡率最高的恶性肿瘤之一,手术仍然是早期非小细胞肺癌的首选治疗方法。本研究的目的是探讨术后极早期肺功能的恢复情况,并比较肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响。方法选取中国医学科学院肿瘤医院胸外科2015年9月-2016年2月间手术的肺癌患者,按术式不同分为胸腔镜肺段切除术组、胸腔镜肺叶切除术组、开胸肺叶切除术组,分别于术前、术后第3天和术后3个月检查测试肺功能。统计分析采用SPSS 20.0版本,应用单因素方差分析,比较组间差异。结果 1在术后第3天,对比胸腔镜肺叶切除术、胸腔镜肺段切除术、开胸肺叶切除术,三组患者的肺功能,用力肺活量(forced vital capacity,FVC)、FVC占预计值的百分比(FVC%)、一秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1占预计值的百分比(FEV1%)、最大呼气流速峰值(peak expiratory flow,PEF)、每分钟最大通气量(maximal voluntary ventilation,MVV)、肺一氧化碳弥散因子(transfer factor for carbon monoxide of lung,TLCO)、TLCO占预计值的百分比(TLCO%),组间差异具有统计学意义(P值分别为0.033、0.042、0.029、0.045、0.039、0.021、0.018、0.024)。2在术后3个月,对比胸腔镜肺叶切除术、胸腔镜肺段切除术、开胸肺叶切除术,三组患者的肺功能,组间比较发现FVC、FVC%、FEV1、FEV1%、PEF、MVV、TLCO、TLCO%差异显著(P值分别为0.019、0.024、0.044、0.021、0.037、0.029、0.045、0.017)。结论肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后在术后极早期(术后第3天)与术后3个月,肺功能的恢复情况均为胸腔镜肺段切除优于胸腔镜肺叶切除,胸腔镜肺叶切除优于开胸肺叶切除。
文摘目的比较不同手术方法以探讨微创治疗脑室出血的新方法。方法应用神经内镜微创治疗脑室出血22例,以传统的单纯脑室体外引流术治疗同类疾病20例为对照组,并相互比较。结果在内镜组,术后24h复查头颅CT,脑内或(和)脑室内血肿绝大部分清除者(90%以上)者15例;未发现继发出血;术后无颅内感染;术后2个月对患者进行GOS(G lasgow outcom e scale)评分,5分5例,4分9例,3分4例,2分2例,1分2例。在脑室引流组,术后24h复查颅脑CT,仅有3例脑室内血肿大部分清除(60%以下);未发现继发出血;术后颅内感染2例;术后2个月对患者进行GOS评分,5分1例,4分5例,3分7例,2分5例,1分2例。与内镜组比较,术后好转优良率低(P<0.05),差异有统计学意义;死亡率差异无统计学意义(P>0.05)。结论应用神经内镜清除脑室内血肿,具有直视下操作、术后疗效好等优点,是脑室出血较佳的外科治疗方法。
