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find Author "徐志飞" 16 results
  • 高龄低肺功能食管、贲门癌患者的外科治疗

    目的探讨高龄低肺功能食管、贲门癌患者的外科手术治疗、手术方式的选择及围手术期的合理处理。方法回顾性分析1990年1月~2003年12月44例70岁以上低肺功能食管、贲门癌患者的手术切除方式、围手术期处理及术后呼吸机的应用。结果术后19例行呼吸机辅助呼吸,围手术期死亡3例,其中2例死于呼吸衰竭,1例吻合口瘘患者死于胸腔感染,全身衰竭。结论由于手术技术的改进、术后呼吸机的应用及围手术期的正确处理,高龄低肺功能食管、贲门癌患者的手术适应证可相对扩大。

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • 同时性食管、肺重复癌的临床诊治

    Release date:2016-08-30 06:13 Export PDF Favorites Scan
  • 肺动脉、支气管成形肺叶切除术治疗中央型肺癌

    目的 总结肺动脉、支气管成形肺叶切除术治疗中央型肺癌的临床经验,探讨手术的应用指征及方法,以提高手术疗效和患者的生存率。 方法 自1995年1月至2005年12月,对64例中央型肺癌患者施行肺动脉、支气管成形肺叶切除术,包括袖式肺叶切除术21例,支气管楔形肺叶切除术11例,支气管、动脉双袖式肺叶切除术2例,肺动脉成形(楔形+线形)肺叶切除术30例。 结果 全组无手术死亡。术后发生并发症12例(18.75%),其中肺不张7例次,心律失常7例次,有肺不张、心律失常和肺部感染2例。术后随访64例,随访时间1~5年,随访期间死亡9例,死亡原因为肿瘤远处转移,包括脑、纵隔、颈部淋巴结和全身骨转移。术后1、3、5年的生存率分别为88%、58%和42%,中位生存时间为45.76个月。N0患者(21例) 1、3、5年生存率分别为93%、82%和56%;N1患者(28例)为75%、56%和39%;N2患者(15例)为55%、21%和12% (Plt;0.01)。 结论 肺动脉、支气管成形肺叶切除术扩大了肺癌患者的手术指征,减少了因肺动脉受侵犯而行全肺切除术,提高了患者术后的生存质量。对该类手术,淋巴结转移分期仍然是影响术后生存率的主要因素。

    Release date:2016-08-30 06:10 Export PDF Favorites Scan
  • The Preparation of Two Scaffolds for Tissue Engineering Rib and Comparison of Their Degradability

    Objective Choose polylactide-co-glycolide/hydroxyapatite (PLGA/HA) and porous phosphate calcium (PPC) as the object that we will study, compare their degradabality and choose one as a suitable scaffold for rib reconstruction. Methods All the experiments were divided into PLGA/HA group and CPC group. Degradabality experiment in exvivo: put the two scaffold which have the same size into 0.9% NaCl, keep sterile, then put the container into warm cage,get out and weigh them in 2, 4, 8, 12 and 24 weeks, compare the different speed of the two scaffold. Degradability experiment in vivo: put the two scaffold which have the same size under the skin of the rabbit, and weigh them in 2, 4, 8, 12 and 24 weeks, the tissue around the scaffold was examinzed by HE and the scaffold was examined by electron scanning microscope. Results Micro-CT and Scanning electron microscopy shows that CPC group had better structure (1101.2228±0.6184 mg/ccm vs. 1072.5523±0.7442 mg/ccm)and porosity(70.26%±0.45% vs.72.82%±0.51%)than PLGA/HA group; The result of degradabality experiment in vitro shows that the speed of the two scaffolds was slow. It is at 24 weeks that the degradability is obvious,and the PLGA/HA group degraded a lot which was 60%. The result of degradabality experiment in vivo shows that the speed of degradabality of PLGA/HA group was faster than that is in the 0.9% Nacl, also was faster than that of CPC group which was 96%.The reponse of tissue around the PLGA/HA was more sever than that of CPC group which is in favour of the growth of cells. Conclusion As for the reconstruction of large defect of rib, CPC is more suitable than PLGA/HA.

    Release date:2016-08-30 06:06 Export PDF Favorites Scan
  • 腋下垂直小切口行肺切除术

    目的 探讨腋下垂直小切口行肺切除术的方法特点。 方法 采用腋下垂直小切口行肺切除术 15 1例 ,切口长 8~ 12 cm。肺楔形切除术 2 3例 ,肺叶切除术 95例 ,支气管袖式肺叶切除术 2例 ,全肺切除术 31例。 结果 全组无手术死亡。开胸过程中出血量均少于 2 0 ml;术后胸腔引流量 16 0~ 72 0 ml,平均 30 0 ml;共清扫胸内淋巴结 12 4 5个 ,其中转移阳性淋巴结 2 4 3个 ,占 19.5 %。术后伤口疼痛均较轻 ,止痛时间 2~ 3天。术后住院天数平均 12天。结论 腋下垂直小切口行肺切除术是可行的 ,能完成对胸内淋巴结的清扫 ,减小肺部肿瘤手术切口的创伤。

    Release date:2016-08-30 06:27 Export PDF Favorites Scan
  • 经气管置管冲洗治疗肺切除后支气管胸膜瘘

    目的 探讨经气管置管冲洗治疗肺切除术后支气管胸膜瘘的疗效。 方法 对发生支气管胸膜瘘患者先行胸腔闭式引流 ,然后在纤维支气管镜下将一直径 2 mm导管通过鼻腔经支气管残端瘘口置入胸腔 ,导管超过瘘口1~ 1.5 cm ,经导管向胸腔滴注生理盐水 ,并从患侧胸腔引流管充分引流。冲洗至引流液清亮 ,细菌培养阴性 ,引流管无明显气泡溢出时 ,停止冲洗。 结果  5例患者均获得治愈 ,治愈时间为 4 2~ 6 0天。 结论 经气管置管冲洗治疗肺切除术后支气管胸膜瘘可以取得满意的疗效 ,与单纯胸腔冲洗的保守治疗方法比较 ,治愈率明显提高。

    Release date:2016-08-30 06:28 Export PDF Favorites Scan
  • 吲哚菁绿荧光胸腔镜技术在单孔胸腔镜下肺段切除术段间平面的识别

    Release date:2019-05-28 09:28 Export PDF Favorites Scan
  • Clinical comparative study of 3D and 2D single-portal inflatable mediastinoscopic and laparoscopic esophagectomy for esophageal cancer

    ObjectiveTo investigate the safety and efficacy of 3D single-portal inflatable mediastinoscopic and laparoscopic esophagectomy for esophageal cancer.MethodsClinical data of 28 patients, including 25 males and 3 females, aged 51-76 years, with esophageal squamous cell carcinoma undergoing single-portal inflatable mediastinoscopic and laparoscopic esophagectomy from June 2018 to June 2019 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods including a 3D mediastinoscopic group (3D group, 10 patients) and a 2D mediastinoscopic group (2D group, 18 patients). The perioperative outcome of the two groups were compared.ResultsCompared with the 2D group, the 3D group had shorter operation time (P=0.017), more lymph nodes resected (P=0.005) and less estimated blood loss (P=0.015). There was no significant difference between the two groups in the main surgeon's vertigo and visual ghosting (P>0.05). The other aspects including the indwelling time, postoperative hospital stay, pulmonary infection, arrhythmia, anastomotic fistula, recurrent laryngeal nerve injury were not statistically significant between the two groups (P>0.05).ConclusionThe 3D inflatable mediastinoscopic and laparoscopic esophagectomy for esophageal cancer, which optimizes the surgical procedures of 2D, is safe and feasible, and is worthy of clinical promotion in the future.

    Release date:2021-03-05 06:30 Export PDF Favorites Scan
  • Clinical study of 3D versus 2D thoracoscopic surgeries in uniportal lobectomy

    ObjectiveTo investigate the safety and efficacy of 3D thoracoscopic surgery in uniportal lobectomy.MethodsClinical data of 248 patients with lung cancer who underwent uniportal thoracoscopic lobectomy in our hospital from September 2018 to May 2019 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods, a 3D thoracoscopic group (76 patients, including 52 males and 24 females with an average age of 58.59±7.62 years) and a 2D thoracoscopic group (172 patients, including 102 males and 70 females with an average age of 57.75±8.59 years). Statistical analysis of clinical and pathological data, lymph node dissection, surgical complications, postoperative hospital stay, etc was performed.ResultsCompared with the 2D thoracoscopic group, the 3D thoracoscopic group had shorter operation time, more lymph nodes dissected and pleural effusion on the first day after operation (P<0.05). There was no significant difference in the postoperative chest tube duration, postoperative hospital stay, incidence of pulmonary infection, arrhythmia, bronchopleural fistula, or recurrent laryngeal nerve injury between the two groups.ConclusionCompared with the traditional 2D thoracoscopic minimally invasive surgery, uniportal lobectomy with 3D thoracoscopic surgery is safer and more efficient during operation, and lymph node dissection is more thorough, which is worth promoting.

    Release date:2020-07-30 02:16 Export PDF Favorites Scan
  • Clinical comparative study of naked eye 3D versus 2D thoracoscope in minimally invasive esophagectomy

    ObjectiveTo investigate the safety and efficacy of naked eye 3D thoracoscopic surgery in minimally invasive esophagectomy.MethodsClinical data of 65 patients, including 50 males and 15 females aged 47-72 years, with esophageal cancer who underwent minimally invasive thoracoscopic esophagectomy from October 2018 to April 2019 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods including a naked eye 3D thoracoscopic group (group A: 30 patients) and a traditional 2D thoracoscopic group (group B: 35 patients). The effects of the two groups were compared.ResultsThe operation time in the group A was significantly shorter than that in the group B (P<0.05). The number of dissected lymph nodes in the group A was more than that in the group B (P<0.05). The thoracic drainage volumes on the 1th-3th days after operation in the group A were significantly larger than those in the group B (P<0.05), but there was no significant difference between the two groups on the 4th-5th days after operation (P>0.05). The indwelling time in the group A was longer than that in the group B (P<0.05). Postoperative hospital stay, pulmonary infection, arrhythmia, anastomotic leakage, and recurrent laryngeal nerve injury were not significantly different between the two groups (P>0.05).ConclusionNaked eye 3D thoracoscopic surgery for minimally invasive esophagectomy is a safe and effective surgical procedure. Compared with traditional 2D minimally invasive thoracoscopic surgery, it is safer in operation and more thorough in clearing lymph nodes. The operation is more efficient and can be promoted.

    Release date:2020-04-26 03:44 Export PDF Favorites Scan
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