Abdomen, Pelvic cavity operation
1 Ordinary data
Altogethers 41 cases
Gall bladder calculus will be 9 liver inside and outside bile duct calculus 4
Acute appendicitis will be 6 gastric ulcer 3
Will close intestinal cancer 4 rectal Cancer 3
Cirrhosis of the liver, Portal vein a pulse high pressure accompany on alimentary tract bleed 1
Uterus muscular tumor will be 6 ovary cyst 3
Abdomen knife wound accompanies colon wear go to wound 2
2 State of an illness analysis
9 gall bladder calculuses average line peritoneoscope exscind gall bladder, The rest case average open abdomen operation. Owns jointly 15 emergency treatments operations, Among them acute festers sex appendicitis 6, Liver inside and outside bile duct calculus accompany acute block sex fester sex cholangitis one, Cirrhosis of the liver portal vein high pressure accompany on alimentary tract blood greatly one, Rectal Cancer accompanies ileus 3, Closes intestinal cancer accompany ileus 3, Abdomen knife wound accompanies colon wear go to wound 2. This 8 large intestine operation average antecedently one issue colon build fistula ( Tumour totallies cure art 23, Appease sex exscind 3, Colon renovates art 2) , Behind two parts line build fistula has closed for 4 week, Another has one close intestinal cancer exscind art behind travel I edition anastomosis.
3 Clinics check target
① will diagnose relevant project: Peritoneum stimulates enlist, Gurgling sound, B exceed, CT/ MRI and corresponding hormone, Tumour sign thing check.
② will operate relevant project: Whole blood picture, PT, APTT ( Or cruor picture) , Liver, Kidney achievements, Blood sugar, Electrolyte, ECG, Chest piece.
Will be with curative effect relevant project: Ordinary situation, Life body enlists, Whethers appear tetter, Intestines function recovers time, Cut cicatrizes situation, Whole blood picture, Liver, Kidney function, Electrolyte, In case of necessity abdomen X piece, CT wait for.
4 , Contrasts group's enactment
This issue design for foresightedness at random contrast experiment, Experiments object 's bring into standard for: ( 1) Part skin have not infect and canker; ( 2) Acute appendicitis not bores, Colon damage injured abdominal cavity pollution slightness, Has not obvious peritoneum infection; ( 3) Has not serious hypersusceptibility or immune defection medical history; ( 4) Malignancy patient life expectance be more than 8 month; ( 5) Patient frees will join this experiment research, And can cooperate with with doctor treatment. Accords with above bring into normative case and then be OK as research object, Again will case point at random proceed number divide into experiment, Contrast two groups of, Patient ins turn by turns come into two groups of. Contrasts 's emergency treatment operation person in group, Because all sorts of reason in 4 week internal needs again operation person, Then points half at random principles, Ins turn by turns come into experience, Contrast two groups of.
5 Clinics effect standard
Recovery ( Excellence) :
A. Cut has not wheal, Has not secretion, Has not repulsion reaction;
B. Has not ileus symptom, Body enlists and X line behave;
C. Has arted behind in recover intestines function for three day
D. Obviates other complication, Animal heat< Will be 39 ℃;
E. Arts behind liver kidney function normally;
F. Again operation will discover original overlay region ≤ I grade adhesion.
Display effect ( Good) : A. Cut has not wheal, Has not secretion, Has not repulsion reaction;
B. Has not ileus symptom, Body enlists and X line behave;
C. Has arted behind in recover intestines function for three day, But intestines sound slightly active, Minutely> 10 time;
D. Obviates other complication, Animal heat will be 39-39.5 ℃;
E. Arts behind liver kidney function normally;
F. Again operation will discover original overlay region Ⅰ- Ⅱ will adhesion.
Affection ( In) : A. Cut has not wheal or light wheal but have not repulsion reaction, Has not secretion;
B. There is light abdominal distension, Gripes but have not tenderness and anti- jump ache, Abdomen X line shows intestines antrum of light enlarge but have not liquid calm down;
C. Has arted behind 3 to recover intestines function or I hear of sharp intestines chirp but have not gas water sound for 5 day;
D. Obviates other complication, Animal heat will be 39.5-40 ℃;
E. Arts behind liver kidney function normally;
F. Again operation will discover original overlay region Ⅱ- Ⅲ will adhesion.
Invalid ( Difference) :
A. Cut wheals have secretion or have membrane arrange come out;
B. Arts behind or make a follow-up visit in appear ileus' symptom and body enlist, Abdomen piece of shows intestines antrum of enlarge and liquid calm down;
C. Has not other reason appear art behind liver kidney function abnormal;
D. Again operation will discover original overlay region Ⅳ grade adhesion.
Note: Again operation time, Adhesions organization grade assess standard: ( Refers Nair report 's five grades taxonomies enact)
6.Clinic usage record
3, Again operation observation record
Again operation observes record situation come to 8 again operation. Among them big intestinal cancer 6, Colon wears go to wound 2, Average by turns come into a, b group. First time operation style: Colon bores renovation, Transverse colon builds fistula art 2 ( a, b group each one) , Half colon resections art, Colon Shan kou build fistula art 2 ( a group one, b group one) , Transverse colon 袢 style build fistula art 4 ( a, b group each 2) . 8 average has arted behind by intestinal tract prepare behind again operation for 4 week, Among them fistula close art 4, Mile' s art 2, Left, Right half colons exscind art each one. Art in discover: Membrane has not displacement, Has already degraded become big flinders. Injured area and fistula surrounding adhesion situation detailed see watch 3 two groups of cuts under.
7、 Clinics effect statistics
8、 Clinics give a trial conclusion
1. Curative effect sureness: This clinics research team by 41 at random contrast experiments ( Includes 8 again operation) Patient 's observes and data statistics, Uses experiment group's curative effect obvious superior to contrast group. From again in operative case, Can observe go use absorb medical membranous part, It prevents organization adhesion 's effect exact.
2 . Uses convenience: Absorbs medical membrane pliable and tough and resist tension force very good, Pulls stretch behind with organization paste add sex much good, Not need needle fixation under ordinary situation, Compares good field overcome some same kind product 's brittleness big, Uses inconvenient shortcoming.
3 . Organize consist with sex good, At applies to have no discover allergic reaction and exclude react wait for bad reaction in process.
Orthopedics operation
A, Clinics ordinary data
Case: ( Altogether 23)
Lumbar 4, 5 between, Lumbar 5 sacrums one between intervertebral disc protrude disease 5
Lumbar 3, 4 between, Lumbar 4, 5 between intervertebral disc protrudes disease 4 .
Lumbar 4, 5 between intervertebral disc will protrude disease meanwhile tube narrow 6
Lumbar 5 will be sacrum one between intervertebral disc protrude disease meanwhile tube narrow 3
Cervical vertebra administers narrow disease 5
State of an illness analysis:
23 in 5 cervical vertebras administer narrow disease patient, Chief behaves for wimble body bunch incur press 's symptom, At basis+ A numbness next line back route Shan open the door zhui tube enlargement become shape art, Zhui board crevice will reach about 1.0cm. Another will have 9 a pair of section section intervertebral disc protruding and 9 intervertebral disc protruding combination zhui administer narrow case, Average has lumbago, Roots sex symptom, Intermittence limp and different extent's lower limbs muscle strength slow down wait for symptom, Will hold hard next line back route half zhui board or all zhui board resection and intervertebral disc excise art.
2 Clinics check target
① will diagnose relevant project: Arms and legs feel sport function, Physiology reflection, Pathology enlists, Straights leg lift experiment, Spinal plus, Lean piece, CT/ MRI wait for;
② will operate relevant project: Whole blood picture, PT, APTT ( Or cruor picture) , Liver, Kidney achievements, Blood sugar, Electrolyte, ECG, Chest piece;
Will be with curative effect relevant project: Ordinary situation, Life body enlists, Whethers appear tetter, Cut cicatrizes situation, Straights leg lift experiment, Whole blood picture, Liver, Kidney function, CT/ MRI wait for.
3 Clinics check target
① will diagnose relevant project: Arms and legs feel sport function, Physiology reflection, Pathology enlists, Straights leg lift experiment, Spinal plus, Lean piece, CT/ MRI wait for;
② will operate relevant project: Whole blood picture, PT, APTT ( Or cruor picture) , Liver, Kidney achievements, Blood sugar, Electrolyte, ECG, Chest piece;
Will be with curative effect relevant project: Ordinary situation, Life body enlists, Whethers appear tetter, Cut cicatrizes situation, Straights leg lift experiment, Whole blood picture, Liver, Kidney function, CT/ MRI wait for.
4、 Clinics effect grade standard
Recovery ( Excellence) : Patient wound me/ First concrescence, Symptom completely disappearance, Straights leg lift experiment feminine, Has not leave over lumbago, Liver kidney function normally, Countercheck CT it is obvious that hard raphe 's clearance exist between membrane and cicatrice organization, And will be 2mm.
Display effect ( Good) : Wound me/ First concrescence, Pain limp symptom basically disappearance, Straights leg lift experiment feminine, Has not or light lumbago, Liver kidney function normally, Countercheck CT hard raphe 's clearance clearly discernible between membrane and cicatrice organization.
Affection ( In) : Wound appears light scorching sex reaction, Art behind pain limp symptom lysis compare obviously, Straights leg lift experiment can for masculine, Liver kidney function basically normally, Countercheck CT it is obvious that hard raphe 's clearance die away between membrane and cicatrice organization, But not constraint putamen bursa.
Invalid ( Difference) : Part appears red, Tumours even violent repulsion reaction, Arts small of the back ache obviously, Even can aggravate, Liver kidney function abnormal, Countercheck CT can see hard raphe 's clearance die away between membrane and cicatrice organization, And putamen obvious incurs press.
5 , Clinic probationership practice record:
6、 Clinics effect statistics ( Includes contrast group)
7、 Clinics give a trial conclusion
1. Curative effect sureness: This clinics research team by 23 at random contrast experiment patient 's observe and data statistics, Uses experiment group's curative effect obvious superior to contrast group, Can observe go use absorb medical membranous part, It prevents organization adhesion 's effect exact.
2 . Uses convenience: Absorbs medical membrane pliable and tough and resist tension force very good, Pulls stretch behind with organization paste add sex much good, Not need needle fixation under ordinary situation.
3 . Organize consist with sex good, At applies to have no discover allergic reaction and exclude react wait for bad reaction in process.
