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肝癌肝移植的适应证及应用前景

人工晶体眼玻璃体切除手术18例报告

食管金属支架治疗食管良、恶性狭窄

目的 通过对124例食管良、恶性狭窄患者的治疗,探讨食管金属支架治疗的临床效果、适应证、并发症以及治疗过程中存在的问题.方法 食管狭窄患者在内窥镜和食管X线透视下进行食管金属支架治疗.分别置入镍钛记忆合金支架83例次,带膜不锈钢支架47例次.结果 金属支架操作均一次性完成,位置良好,支架扩张内径1.2～1.6cm,吞咽困难程度由术前的3.35%下降至1.05%,患者恢复正常饮食.并发症为下胸痛、反流性食管炎、上消化道出血等,无食管穿孔和手术死亡.结论 食管金属支架治疗食管狭窄操作简单、效果确切,能提高晚期食管癌、贲门癌患者的生存质量,但对贲门失弛缓症等良性疾患的金属支架治疗需慎重,要掌握适应证.

APPLICATION STRATEGY OF ANKLE AND HINDFOOT ARTHRODESIS

ObjectiveTo summarize the progress in the application of ankle and hindfoot arthrodesis. MethodThe domestic and foreign related literature about the application of ankle and hindfoot arthrodesis was reviewed, summarized, and analyzed. ResultsAnkle and hindfoot arthrodesis include the multi-joint fusion and the single joint fusion, and they involve tibiotalar joint, subtalar joint, talonavicular joint, and calcaneocuboid joint. The methods of fixation include screw, plate, intramedullary nail, and external fixation. ConclusionsDifferent terminal illnesses of ankle and hindfoot have different choices in both the fusion location and the method of fixation, appropriate program for therapeutic purposes can also alleviate complication simultaneously.

Clinical Analysis of Laparoscopic Procedure in Treatment of 1356Cases of the Adnexal Masses

目的：探讨腹腔镜诊治附件包块的有效性与安全性。方法:回顾性分析四川大学华西第二医院2004年1月至2005年12月妇科收治的1356例附件包块行腹腔镜治疗的病例。结果:手术适应证主要为异位妊娠、卵巢宫内膜囊肿及卵巢良性畸胎瘤，手术方式主要为输卵管造口取胚术、输卵管切除术、卵巢囊肿剥除术及患侧附件切除术，手术成功率98.45%,无严重并发症发生。术中发现可疑病例78例（5.8％），病理检查提示交界性及低度恶性包块共9例（0.66％），其中4例在腹腔镜下完成手术。既往有腹部手术史85例，77例在腹腔镜下完成手术。结论：腹腔镜技术在诊治妇科良性附件占位方面是安全有效的。

聚左旋乳酸可吸收肋骨钉治疗重症肋骨骨折患者的适应证探讨

摘要： 目的 探讨聚左旋乳酸可吸收肋骨钉治疗重症肋骨骨折患者的适应证，总结其应用经验。 方法 2005年6月至2008年8月，我科对46例（男31例，女15例；年龄15～61岁，平均年龄38岁）合并多根多段肋骨骨折、连枷胸、大出血和胸内外复合伤患者行开胸手术治疗，根据骨折特点分类，用聚左旋乳酸可吸收肋骨钉固定骨折肋骨,同时处理相应的胸内外复合伤。 结果 围术期死亡1例，术后第3 d死于突发腹腔大出血。44例患者术后胸壁稳定，自主呼吸，排痰良好。随访45例，随访时间6个月~3年，随访期间有39例胸壁稳定，胸部X线片示：固定处无透明带，对位愈合良好；有4例患者出现可耐受的胸痛；7例患者有13处固定后肋骨移位，分别出现在gt;3 cm劈裂或斜形骨折、老年皮质较薄、多发性肋软骨骨折和双侧肋骨骨折患者中。 结论 断面相对较整齐有移位的横形骨折、3cm以内较短的劈裂或斜形骨折、合并线性胸骨骨折是采用可吸收肋骨钉固定骨折肋骨首选的适应证；对粉碎性骨折和gt;3 cm较长的劈裂斜形骨折，不宜采用；软骨部、老年骨皮质较薄骨折应慎重选用。

Further Discussion of Indications for Laparoscopic Hepatectomy

Liver Transplantation for Hepatocellular Carcinoma

Advances in indications of anatomical pulmonary segmentectomy for early-stage lung cancer

Whether anatomical segmentectomy can replace lobectomy in the treatment of early-stage lung cancer remains controversial. A large number of studies have been conducted for decades to explore whether pulmonary segmentectomy can treat early-stage lung cancer, which is actually to explore the indications of intentional segmentectomy. With the development of scientific researches, it is found that many characteristics affect the malignancy of lung cancer, and the different grades of each characteristic affect the prognosis of patients. It is worth exploring whether different surgical approaches can be used for early-stage lung cancer with different characteristics and different grades. This article reviews the literature and studies to discuss the advances in indications of segmentectomy for early-stage lung in terms of tumor size, consolidation-to-tumor ratio, pathological classification and tumor location, respectively. The objective of this review is to help thoracic surgeons to objectively and scientifically select the surgical method according to the clinical characteristics of early-stage lung cancer.

Surgical Indications of Thyroid Nodule and The Selection of Surgical Procedures