COMPLICATIONS IN LAPAROSCOPIC GYNECOLOGIC SURGERY

Objective. To investigate retrospectively the complications and associated factors of gynecological laparescopies.Methods. 1769 laparoscopic surgeries were carried out from January 1994 to October 1999 at our department. The procedures included 1421 surgeries of ovary and tube, 52 myomectomies and 296 cases of laproscopic-assisted vaginal hysterectomy (LAVH). A total of 312 patients had a history of prior laparotomy (17.6%). Results. Complications occured in 34 cases, the overall complication rate was 1.92%. Unintended laparotomies occured in 6 cases(0.34% ). 12 complications were associated with insertion of Veress needle or trocar and creation of pneumoperitoneum, including 5 severe emphysema and 7 vascular injuries, this figure represents 35.3% of all complications of this series. Five intraopemtive complications (14.7 % ) occured during the laparescopic surgery (3 severe bleedings, one bladder injury and one skin bum of leg caused by damaged electrode plate), laparotomy was re-quired in four of these cases. Seventeen complications occured during postoperative stage: 2 intraperitoneal hemor-rhages needing laparotomy, 2 bowel injuries, 4 nerve paresis and 9 febrile morbidities. Cordusions. Operative gynecologic laparoscopy is associated with acceptable morbidity rate, but can not be over-looked. Complication rate seems to be higher in advanced procedures such as LAVH.     

无虹膜缝合固定法人工晶状体植入术一例

患者男,23岁,左眼被方木碰伤1小时于1994年4月7日急诊入院.眼部检查:视力:右:1.0 ,左:眼前数指.右眼正常.左眼结膜混合充血,12.00～1.00点角膜缘穿孔伤约3.0mm,少许虹膜嵌顿,少量玻璃体脱出,前房积满新鲜血液,后部情况不清,眼压T_2o入院后立即行角膜缝合术,手术完成时发现前房内积血     

坐骨棘筋膜固定术的临床解剖学研究

Objective The study was to explore the safety, firmness and convenience of the fascia around the ischial spine as a new fixation site for the vaginal fornix. Methods Between June 2007 and January 2008, detailed dissections and related measurements of the regions around the ischial spine were performed on 10 Chinese female cadavers (3 unembalmed and 7 embalmed cadavers). At the same time, the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were exposed and the pull-out strength sequentially tested using a digital push-pull force gauge. Results The fascia on the ischial spine was firm and strong, with a thickness of 3 about mm. No major vessels or nerves were observed on the ischial spine. The greatest pullout strengths of the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were (102±26),(64±15),(33±8)and(32±6)N, respectively. Conclusion The fascia at 1 cm from anterior lateral ischial spine, free of major vessels and nerves, is safe and strong and could be used as a new site for suspension in vaginal prolapse.     

双外阴合并双阴道、双宫颈、双子宫畸形一例

患者20岁,因发现肛门处肿物,于1984年12月于我院妇科门诊就诊.患者14岁初潮,月经正常.妇科检查:双外阴、双阴道,每侧阴道口外有两片小阴唇,共4片小阴唇,见图1A;肛门开口于左侧阴道口下方,其上方为尿道口,正常肛门处为一隆起的皮赘,见图1B.     

第31届美国腹腔镜医师协会会议纪要

第31届美国腹腔镜医师协会(AAGL)国际会议于2002年11月20日至24日在美国佛罗里达州迈阿密召开。与会者逾1000人，4位中国大陆妇产科医师参加了会议，5篇论文被选入会议发言。此次会议内容丰富，交流形式多样，主要特点：(1)交流形式除发言、壁报，还有录相与手术演示；(2)除介绍腹腔镜、宫腔镜的手术进展外，特别重视对手术     

中医药抗消化性溃疡复发的临证探讨

根据临证体会 ,结合祖国医学与现代医学研究进展 ,探讨了消化性溃疡复发的病理机制 ,将其归纳为胃气壅滞、肝胃积热、邪毒未尽、瘀血阻络、脾胃虚寒五个方面 ,相应提出了通降胃气、清肝泻胃、清解邪毒、化瘀通络、温中健脾五种治法 ,并强调临证时应详细辨证 ,精当选药 ,才能取得较好的疗效。认为中医药抗溃疡复发有其优势和前景。     

阿霉素脂质体淋巴管灌注的靶向效果

目的：探讨阿霉素脂质体经淋巴管灌注后的体内动力学过程以及靶向效果。方法：将６０只家兔随机分为阿霉素脂质体和阿霉素水溶液两组，从家兔足背淋巴管给药，采用高效液相色谱（ＨＰＬＣ）法检测给药后各时点外周血及腹膜后淋巴结中阿霉素药物浓度，并将摘取的淋巴结作病理检查。结果：水溶液组腹膜后淋巴结阿霉素峰浓度（Ｃｍａｘ）为４６．８１μｇ／ｇ，药时曲线下面积（ＡＵＣ）为３１．８６μｇ／ｄａｙｇ－１；而脂质体组阿霉素峰浓度为９１．２３μｇ／ｇ，ＡＵＣ为１３８．３４μｇ／ｄａｙｇ－１。在外周血中脂质体组的峰浓度只有水溶液组的１／５。淋巴结病理检查结果表明，脂质体组的水肿、坏死、纤维化较水溶液组明显，而心肌病理反应较轻或不存在。结论：脂质体对淋巴结具有高度靶向性，阿霉素脂质体淋巴管灌注有可能成为治疗淋巴结转移的有效且副作用少的新方法。     

新生儿自发性全身运动对脑损害和脑性瘫痪预测的评估

目的探讨新生儿自发性全身运动（ＧＭｓ）对脑损害及其神经系统后遗症，特别是脑性瘫痪（简称脑瘫）的评估作用。方法对１８例新生儿ＧＭｓ进行了定性及半定量研究。结果（１）正常组ＧＭｓ评分为１２．３±１．１，异常组为８．４±１．０，两者差异有非常显著意义（Ｐ＜０．０１）。（２）ＧＭｓ评分与５分钟Ａｐｇａｒ评分具有正相关性。（３）ＧＭｓ评分对脑瘫的预测价值与颅脑超声检查相似，而优于常规神经系统检查。结论ＧＭｓ评分对脑损害和脑瘫的预测具有一定的实用意义     

春季结膜炎的中药疗效观察

春季结膜炎的中药疗效观察安铭辉徐深郎卫华许湘萍董杰本组３０例患者中男２１例，女９例；年龄９～２５岁，平均１５．５岁；病程３～１０年；为双眼发病；均为常规治疗效果不佳而改中药治疗。拟方清热凉血散风加减：防风、荆芥、苍术、蒲公英、菊花、羌活、柴胡、女贞子...