简介:目的探讨电视胸腔镜胸交感神经干夹闭术治疗头面部多汗的可行性.方法双腔气管插管全麻,先左侧卧位,左侧单肺通气,腋中线第2~3肋间、腋后线4~5肋间置入7mm与4.5mmtrocar,放置手术器械与胸腔镜光学视管,找到交感神经链,小号钛夹夹闭第2肋骨下缘处交感神经干.膨肺,缝合切口.将体位改为右侧卧位,改变体位行对侧手术.结果手术时间55~130min,平均110min.术后头面部出汗全部消失,术后胸部、腹部、背部或腿脚部轻度代偿性多汗7例,10例对手术效果感到满意,术后第2~3天出院.术后无霍纳综合征等严重并发症发生.术后7~10d后均能恢复正常学习工作和体育锻炼.10例术后随访1~9个月,平均6.3月,均无复发.结论电视胸腔镜钛夹夹闭第2肋下缘胸交感神经干可以安全有效地治疗头面部多汗.
简介:摘要目的探讨金属钛夹夹闭对结直肠粗蒂大息肉内镜电切术中及术后出血的预防作用.方法选择我科85例患者共92枚粗蒂大息肉内镜下高频电切除的患者资料,将其分为二组,一组为钛夹组,先予金属钛夹夹闭息肉基底后再行高频电切除.另一组为对照组,直接予以高频电切除,若术中或术后出血,再予金属钛夹治疗.比较两组术中及术后的出血率.结果钛夹组出血率(4.26%,2/47例)低于对照组出血率(17.78%,8/45例)(p<0.05).两组出血病例均无需外科手术治疗.结论金属钛夹夹闭可以有效预防结直肠粗蒂大息肉内镜电切术中及术后迟发性出血,减少再次手术需求.关键词内镜;金属钛夹;结直肠息肉TheclinicalresearchoftitaniumclipsonpreventingbleedinginpolypectomyofcolorectalthickpedunculatedpolypsZhen-ShiYe,Jian-MinChen,Li-JuanSi,LinWang,Yi-QunHu,Bao-YingCai,MiaoLv,Jian-LinRenDivisionofGastroenterology,ZhongshanHospitalXiamenUniversity;GastroenterologyInstituteofXiamenUniversity;GastroenterologyCenterofXiamen,Xiamen361004,FujianProvince,ChinaAbstractObjectiveToinvestigatethepreventiveeffectofmetaltitaniumclipontheendoscopicresectionofcolorectalpolypsandthepostoperativebleedig.Methodsthedataof92patientswith85casesofhighfrequencyelectricresectionweredividedintotwogroups.Onegroupwastitaniumclipgroup,andthefirstmetaltitaniumclipwasthentreatedwithhigh-frequencyelectricresection.Anothergroupservedasthecontrolgroup,whichwasdirectlytreatedwithhighfreGquencyelectricresection,andthentreatedwithmetaltitaniumclip.Thebleedingrateofthetwogroupswerecompared.Resultsthebleedingrateinthetitaniumclipgroup(4.26%,2/47)waslowerthanthatofthecontrolgroup(17.78%,8/45)(<0.05P).Nosurgicaltreatmentwasneededforthetwogroupsofbleeding.ConclusionmetaltitaniumclipcanbeeffectiveinpreventingpostoperativedelayedbleedingincolorectalpolypsandlargepolypsEndoscopicresetion,andreducetheneeKdeyfowrorredsoperation.endoscopy;metaltitaniumclip;colorectalpolyps中图分类号R546.3文献标识码B文章编号1008-6315(2015)12-0030-01