(承2007年第6期) 6.2 盆腹膜重建的种类和方法 6.2.1 盆底隔离法如前所述,因超低位直肠/肛管癌浸润会阴直肠隔、盆侧壁及肛周扩约肌群而实施了新腹会阴局部扩大切除术,因T4期直肠癌浸润子宫阴道或膀胱前列腺部分组织而实施了盆腔脏器局部扩大切除术,因局部复发性直肠癌而实施了腹会阴联合再切除术,因各种原因对中晚期直肠癌实施了Hartmann手术,以及因技术不确定性而实施了传统腹会阴联合切除术,无论手术切除范围或术者的操作技巧如何,由于病变性质决定了这类手术只能定位于根治性(R0)与姑息性(R2)之间的程度.因此,初次切除只是获得治愈或延长生存期的第一步,接下来是盆腔放疗或局部内放射治疗,最后,尚存在局部复发的高风险,若发生,可经会阴骶尾部再次甚至多次对复发癌行局部姑息性切除.因而预先有效的盆底隔离就可避免再手术时的小肠损伤,这就是盆底重建术的主要功能和适应证之一.……
ObjectiveTo evaluate the effectiveness of mitral valve repair for mitral regurgitation. MethodsWe retrospectively analyzed the clinical data of 47 patients underwent mitral repair in General Hospital of Ningxia Medical University between January 2010 and June 2014 year. There were 36 males and 11 females with age of 10 months to 65 years, mean age of 42.38±15.27 years. ResultsThere was no operative death within follow-up time of 18±7 months (ranged 14 to 1 586 days). Mitral valve function was normal or traces regurgitation in 33 patients (70.21%). Mild mitral regurgitation occurred in 11 patients (23.40%). Postoperative transesophageal echocardiography showed that 2 patients (4.26%) had moderate regurgitation. They underwent mitral valve repair again and cured. One patient (2.13%) underwent mitral valve replacement because of moderate to severe regurgitation. The dimensions of left atrium and left ventricle obviously decreased and heart function improved significantly compared with preoperative ones. ConclusionStrict control of surgical indications for different valve disease, the use of mitral valve repair technique, mitral surgery can get a good clinical efficacy. Preoperative diagnosis by transesophageal echocardiography, intraoperative monitoring, and immediate postoperative assessment for mitral valve repair results provide good technical support.