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The relationship between community noise and arterial hypertension in the population of the city of Niš 尼日什市人群中社区噪声与动脉高血压的关系
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.5937/afmnai39-34187
L. Stošić, D. Stojanovic, K. Lazarević
Aim: The aim of the study was to examine the relationship between noise exposure and the incidence of arterial hypertension as well as the relationship of noise annoyance and noise sensitivity with hypertension. Methods: A cross-sectional questionnaire survey was performed on 911 adult residents of Niš, Serbia, of whom 388 were men (42.6%) and 523 women (57.4%). The criterium for the diagnosis of arterial hypertension was that it was diagnosed by a physician. Based on measurement results of noise, residents, streets were marked as noisy [daily equivalent noise level (Leq) ≥ 55 dB (A) and night Leq ≥ 45 dB (A)] and as quiet [daily equivalent noise level (Leq) ≤ 55 dB (A) and night Leq ≤ 45 dB (A)]. The numerical and verbal noise annoyance scales were used to assess the degree of noise annoyance, while noise sensitivity was measured with the Weinstein's Noise Sensitivity Scale. Results: Arterial hypertension was statistically significantly more frequent in residents in the noisy area compared to residents in the quiet area. After the inclusion of independent variable factors in the logistic regression models, no significant diference was found (p = 0.66, OR = 1.11; 95% CI: 0.69-1.78). A correlation analysis between noise annoyance wich was measured by verbal and numeric scales and arterial hypertension showed a highly significant positive relation. The same case was between the relationship between subjective sensitivity and arterial hipertension. Conclusion: The introduction of the limit for the community noise level that corresponds to the requirements of highly sensitive persons is a significant measure in preventing the harmful effects of noise on the exposed population.
目的:探讨噪声暴露与动脉高血压的关系,以及噪声烦扰和噪声敏感与高血压的关系。方法:采用横断面问卷调查方法对塞尔维亚尼乌斯市911名成年居民进行调查,其中男性388人(42.6%),女性523人(57.4%)。动脉高血压的诊断标准是由医生诊断。根据噪声测量结果,将居民、街道标记为嘈杂[日等效噪声级(Leq)≥55 dB (A),夜间Leq≥45 dB (A)]和安静[日等效噪声级(Leq)≤55 dB (A),夜间Leq≤45 dB (A)]。使用数字和语言噪声烦恼量表来评估噪声烦恼的程度,而使用温斯坦噪声敏感性量表来测量噪声敏感性。结果:与安静区居民相比,嘈杂区居民动脉高血压发病率有统计学意义。在logistic回归模型中纳入自变量因素后,差异无统计学意义(p = 0.66, OR = 1.11;95% ci: 0.69-1.78)。用语言和数字量表测量的噪声烦恼与动脉高血压呈极显著正相关。主观敏感性与动脉高血压之间的关系也同样如此。结论:引入符合高敏感人群要求的社区噪声限值是预防噪声对暴露人群有害影响的重要措施。
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引用次数: 0
A complex rare presentation of rice tablet poisoning: A case report 一复杂罕见的米片中毒病例报告
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.5937/afmnai38-29018
F. Sabzi, Aghigh Heydari, R. Moghaddam, M. Rouzbahani, Atefeh Asadmobini
Aluminum phosphide, known as "rice tablet" (RT), is a common cause of suicide in adult women in Iran, with a high rate of lethal outcome. We report a patient with RT toxicity, with a complex syndrome of hepatic failure, renal failure, Brugada electrocardiography (ECG) patterns, and pleuropericardial effusion. The patient received conventional management with fluid therapy, gastric washing, activated charcoal followed by intra-aortic balloon pump insertion, inotropic drugs support, and mechanical ventilation. The unique features of our case are related to a combination of multiorgan failure with Brugada atypical ECG patterns and pleuropericardial effusion. Among the aforementioned complications, pleuropericardial effusion, ascites, and Brugada syndrome are exceedingly rare events. The patient was treated with high-dose inotropic drugs and intra-aortic balloon pump insertion. Despite tremendous management of metabolic acidosis, all efforts failed, and the patient died with sudden cardiac arrest.
磷化铝,被称为“米片”(RT),是伊朗成年妇女自杀的常见原因,死亡率很高。我们报告了一位RT毒性患者,伴有肝功能衰竭,肾功能衰竭,Brugada心电图(ECG)模式和胸膜心包积液的复杂综合征。患者接受常规治疗,包括液体治疗、洗胃、活性炭、主动脉内球囊泵插入、肌力药物支持和机械通气。本病例的独特特征与多器官功能衰竭合并Brugada非典型心电图模式和胸膜心包积液有关。在上述并发症中,胸膜心包积液、腹水和Brugada综合征是极为罕见的事件。患者给予大剂量肌力药物和主动脉内球囊泵插入治疗。尽管对代谢性酸中毒进行了大量的治疗,但所有的努力都失败了,病人死于心脏骤停。
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引用次数: 1
Postural disorders and muscle power in primary school children 小学生体位障碍与肌肉力量的关系
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.5937/afmnai38-29283
S. Bubanj, Stevan Đorđević, S. Milenkovic, R. Stanković, Mikica Vidojević, Milan Đokić
The aim of the research was to contribute to better understanding of the correlation between postural disorders and muscle power in primary school children. The sample of respondents consisted of 1,120 children, aged 7 to 12 years (549 boys and 571 girls) from the territory of the municipality of Knjaževac. In the assessment of the spinal column status, the device "Spinal Mouse" (Switzerland) was used, while in the analysis of the status of the feet, the podoscope "Pedic" (Hungary) was used. A handheld dynamometer "Lafayette" (USA) and tensiometric force platform "Vernier Force Plate" (USA) were used in the analysis of muscle power. Spinal column and feet status were measured in the static condition, with children being in the upright standing position. Muscle power status was measured in both static (a clinician was applying muscle force to the dominant upper extremity of a child trying to overcome or "break" the child's muscle resistance) and dynamic conditions (Counter Movement Jump). Descriptive statistics and correlation analysis were used in data processing by the means of the SPSS software version 24. Results revealed poor postural and muscle power status, and correlations suggesting to possible kinetic chain reaction causing the disruption of the normal postural status in primary school children. Determined postural disorders are characterized by the early functional stage that can be reduced by appropriate corrective exercise programme application and augmented level of proper physical activity. Those programmes and activities are being guided and implemented by physicians and PE teachers in the municipality of Knjaževac.
这项研究的目的是为了更好地了解小学生体位障碍和肌肉力量之间的关系。调查对象包括来自Knjaževac市境内的1 120名7至12岁的儿童(549名男孩和571名女孩)。在评估脊柱状态时,使用了“spinal Mouse”(瑞士)装置,而在分析足部状态时,使用了“Pedic”(匈牙利)足镜。使用手持式测功仪“Lafayette”(美国)和张力测量平台“游标力板”(美国)分析肌肉力量。脊柱和足部状态在静态条件下测量,儿童处于直立站立位置。肌肉力量状态在静态(临床医生对儿童的主要上肢施加肌肉力量,试图克服或“打破”儿童的肌肉阻力)和动态条件(反运动跳跃)下进行测量。数据处理采用描述性统计和相关分析,采用SPSS软件24版。结果显示,小学生体位状态和肌力状态较差,并提示可能存在动力学链式反应导致正常体位状态的破坏。确定的姿势障碍的特点是早期功能阶段,可以通过适当的纠正性运动计划的应用和适当的身体活动水平的增加来减少。这些方案和活动由Knjaževac市的医生和体育教师指导和执行。
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引用次数: 0
Shocked to happy: Experiences of Iranian diabetics in reaction to the bad news of the diagnosis 从震惊到快乐:伊朗糖尿病患者对诊断的坏消息的反应
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.5937/afmnai38-28720
Areshtanab Namdar, Moonaghi Karimi, M. Vahidi, L. Jouybari, Zeydi Emami, H. Ranjbar
Diagnosis of a chronic disease like type 2 diabetes mellitus (T2DM) is frequently shocking for patients, which influences their lives. Getting aware of bad news such as obtaining a chronic illness diagnosis is a sensitive issue in patients' lives. Conversely, reactions to the reception of a diagnosis of diabetes are often varied for a few reasons. To manage the diseases through care planning, the identification and modification of the causes of various reactions are necessary. The aim of the present survey was to investigate the reaction of diabetics to the reception of diabetes diagnosis and its possible reasons. In this qualitative study, in-depth interviews were used. Furthermore, traditional content analysis of semi-structured interviews was conducted using a qualitative strategy with 20 individuals with type 2 diabetes. The purposeful sampling approach was employed for recruiting the participants. Eleven male and nine female participants having type 2 diabetes had been transferred to the diabetes association of Iran for receiving consulting assistance in the areas of nutrition, psychology, and health care. Four categories of reactions have arisen from the investigation including behavioral, emotional, contextual, and cognitive reactions. Reactions to the prognosis of diabetes may be different for some reasons. The findings of the present investigation may be employed by health care providers to obtain a more comprehensive understanding of unusual and usual reactions, their causes, and the context in the early years after the diagnosis and planning care programs for disease management.
慢性疾病如2型糖尿病(T2DM)的诊断常常让患者感到震惊,这影响了他们的生活。了解坏消息,如获得慢性病诊断,是患者生活中的一个敏感问题。相反,由于一些原因,接受糖尿病诊断的反应往往是不同的。为了通过护理规划来管理这些疾病,必须确定和改变各种反应的原因。本调查的目的是了解糖尿病患者对接受糖尿病诊断的反应及其可能的原因。本质性研究采用深度访谈法。此外,对20例2型糖尿病患者采用定性策略进行了半结构化访谈的传统内容分析。采用有目的的抽样方法招募参与者。患有2型糖尿病的11名男性和9名女性参与者被转到伊朗糖尿病协会接受营养、心理学和保健方面的咨询援助。调查产生了四类反应,包括行为反应、情绪反应、环境反应和认知反应。由于某些原因,对糖尿病预后的反应可能不同。本调查的结果可用于卫生保健提供者,以获得更全面的了解异常和正常的反应,其原因,以及在诊断和疾病管理计划护理方案后的早期背景。
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引用次数: 0
The burden of tuberculosis as a permanent medical and legal challenge for mankind through centuries 结核病的负担是几个世纪以来人类面临的一项永久的医疗和法律挑战
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.5937/afmnai38-30478
M. Radović, A. Đorđević, B. Božanić
Tuberculosis (TB) is a contagious disease, and throughout human history, it has been permanently opening numerous medical and legal questions, for which the answers are implied by the current social circumstances. In ancient times, insufficient knowledge of the etiopathogenesis of TB resulted in discrimination and isolation of patients. In the Middle Ages, kings used TB as a disease to secure their political power over the citizens, while TB culturally took a romanticized form during the 19th and 20th centuries, together with a great social phobia of contagion, disease, and dying on the other hand. Stereotypes were formed around all TB victims, while society tried to understand the nature of the disease and establish a civilizational relationship with it as a health problem having numerous social implications. Modern public health measures for the control of the TB pandemic were established after the discovery of the Koch bacillus in the 19th century. The invention and mass use of the BCG vaccine, the discovery of streptomycin and isoniazid, and the new era of TB treatment, with the consequent emergence of drug resistance, coepidemic with AIDS, neglect of public health facilities and the current COVID-19 pandemics threaten many legal rights of the infected and the sick and pose new challenges in its global elimination. Numerous attempts by society over the centuries to devise preventive and therapeutic measures for TB, through different levels of social obligations and activities, have had and continue to have a profound impact on the human race, shaping its further response to the victims of this deadly disease.
结核病是一种传染性疾病,在整个人类历史上,它一直在永久地提出许多医学和法律问题,其答案隐含在当前的社会环境中。在古代,由于对结核病发病机制的认识不足,导致对结核病患者的歧视和隔离。在中世纪,国王利用结核病作为一种疾病来确保他们对公民的政治权力,而结核病在19世纪和20世纪的文化上以浪漫主义的形式出现,另一方面,对传染病,疾病和死亡的巨大社会恐惧。人们对所有结核病患者都形成了刻板印象,而社会则试图了解这种疾病的性质,并将其作为具有许多社会影响的健康问题与之建立文明关系。控制结核病流行的现代公共卫生措施是在19世纪发现科赫杆菌之后建立的。卡介苗的发明和大规模使用,链霉素和异烟肼的发现,以及结核病治疗的新时代,随之而来的耐药性、与艾滋病的共流行、对公共卫生设施的忽视以及当前的COVID-19大流行威胁着感染者和患者的许多合法权利,并对全球消除结核病提出了新的挑战。几个世纪以来,社会通过不同层次的社会义务和活动,为制定结核病预防和治疗措施作出了许多努力,这些努力已经并将继续对人类产生深远影响,形成了人类对这一致命疾病受害者的进一步对策。
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引用次数: 0
Ultrastructural analysis of the surface changes on the nickel-titanium endodontic instruments after multiple use 镍钛根管器械多次使用后表面变化的超微结构分析
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.5937/afmnai38-29386
Nenad Stošić, J. Popović, Marija Anđelković-Apostolović, A. Mitić, Marija Nikolić, Radomir Barac
One of the primary goals in endodontics is efficient cleaning and shaping of the root canal while maintaining its original configuration. Numerous studies highlight the advantage of using nickel-titanium instruments and the most important is their high flexibility and the ability to penetrate the curved canals. The aim of this study was to analyze the ultrastructure of the surface of nickel-titanium endodontic files before and after use. Eighty-four instruments were included in this study. The instruments were used one, three and six times for root canal preparation on extracted upper premolars. The analysis was performed based on the number of uses and the size of the instruments. Changes on flat surfaces in the grooves of the instruments, defects of the cutting edges and fractures were evaluated. The surface ultrastructure was analyzed on a scanning electron microscope (SEM). SEM analysis showed irregularities on the surfaces of the new instruments. Surface defects and damage of the cutting edges were present after the first use. After three uses, the damage was more evident in instruments of all sizes. After six uses, all instruments showed damage of the cutting edges, and a significant number of fractures were observed. Irregularities on the working parts are already noticed on the new endodontic instruments and originate from the production process. The first signs of damage appear after the first use. In order to prevent errors in clinical work during root canal preparation, it is recommended that the number of instruments uses should be limited.
牙髓学的主要目标之一是在保持根管原始结构的同时有效地清洁和塑造根管。大量的研究强调了使用镍钛器械的优势,最重要的是它们的高灵活性和穿透弯曲管的能力。本研究的目的是分析镍钛根管锉使用前后表面的超微结构。本研究共纳入84种仪器。分别使用器械1次、3次和6次对拔除的上前磨牙进行根管预备。分析是根据使用次数和仪器的大小进行的。对仪器凹槽平面的变化、切削刃缺陷和断口进行了评价。用扫描电镜对其表面超微结构进行了分析。扫描电镜分析表明,在新仪器的表面不规则。首次使用后出现表面缺陷和切削刃损伤。经过三次使用,各种尺寸的仪器都受到了更明显的损坏。6次使用后,所有器械均出现切削刃损伤,并观察到大量骨折。在新的根管器械上已经注意到工作部件的不规则性,这些不规则性源于生产过程。第一次使用后就会出现损坏的迹象。为了防止临床工作中出现根管预备时的错误,建议限制器械的使用数量。
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引用次数: 2
A comprehensive review of COVID-19 treatment COVID-19治疗的全面回顾
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.5937/afmnai38-26326
Z. Afshar, A. Babazadeh, M. Javanian, M. Barary, Vasigala Rekha, S. Ebrahimpour
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus strain that caused coronavirus disease 2019 (COVID-19). This novel coronavirus is an emerging global health threat. It caused approximately 140 million confirmed cases, with about 3 million deaths worldwide until April 18, 2021. Although there are two approved medications for this disease, remdesivir and dexamethasone, numerous studies are underway to investigate more therapeutic options. However, so far, most treatments have been supportive, and the clinical efficacy of the suggested drugs is still under consideration. The purpose of this review is to summarize the ongoing treatments, such as several antivirals, convalescent plasma transfusion, and adjunctive medications, with the intent of serving as a clinical guide for the physician and a resource for further evaluations in various clinical trials.
严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)是导致2019冠状病毒病(COVID-19)的病毒株。这种新型冠状病毒是一种新兴的全球健康威胁。截至2021年4月18日,它在全球造成约1.4亿确诊病例,约300万人死亡。尽管目前有两种已获批准的治疗此病的药物,瑞德西韦和地塞米松,但仍有许多研究正在进行中,以探索更多的治疗选择。然而,到目前为止,大多数治疗都是支持性的,推荐药物的临床疗效仍在考虑中。本综述的目的是总结正在进行的治疗,如几种抗病毒药物,恢复期血浆输注和辅助药物,旨在为医生提供临床指导,并为各种临床试验的进一步评估提供资源。
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引用次数: 3
The 2019 novel coronavirus disease (COVID-19) and neonates 2019年新型冠状病毒病(COVID-19)和新生儿
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.5937/AFMNAI38-26743
Zhilla Heydarpoor Damanabad, L. Valizadeh, Sadollah Yeghanedoost, Fariborz Roshangar
In late December 2019, Wuhan, China, became the center of an unknown outbreak of pneumonia that spread rapidly throughout China and around the world, including Iran, and the World Health Organization (WHO) declared the novel disease a public health emergency with global concern. Since the COVID-19 outbreak, many studies have been performed on epidemiological data and clinical signs in adults. However, coherent studies in this field are very rare in infants, and support and attention to infants in the pandemic situation should be doubled due to the weakness and underdevelopment of the neonatal immune system. Therefore, the present study aimed to review COVID-19 infection in infants in which there are discussions on topics such as diagnostic tests, clinical manifestations, recommendations on breastfeeding, the criteria for discharge, and family education in pandemic conditions. The literature review shows no existing evidence of COVID-19 placental transmission from mother to infant, and that all samples prepared from amniotic fluid, umbilical cord blood and breast milk in mothers with COVID -19 was negative for COVID-19 infection, and the clinical manifestations of COVID-19 were non-specific in infants, especially premature infants. Given that there is a limited number of births from a mother with COVID-19, and because the epidemiological and clinical pattern of COVID-19 in infants is unclear, this review study describes diagnostic tests, clinical manifestations, breastfeeding considerations, discharge criteria, and family education in the current understanding of COVID-19 infection in newborns and provides information for better management of SARS-CoV-2 infection in newborns.
2019年12月下旬,中国武汉成为一场未知的肺炎疫情的中心,这场疫情在中国和包括伊朗在内的世界各地迅速蔓延,世界卫生组织(世卫组织)宣布这种新型疾病为全球关注的突发公共卫生事件。自2019冠状病毒病暴发以来,对成人的流行病学数据和临床症状进行了许多研究。然而,这一领域在婴儿中的一致研究非常罕见,由于新生儿免疫系统的薄弱和发育不全,在大流行情况下对婴儿的支持和关注应该加倍。因此,本研究旨在回顾COVID-19婴儿感染情况,并就大流行条件下的诊断检测、临床表现、母乳喂养建议、出院标准和家庭教育等主题进行讨论。文献复习未发现COVID-19母婴经胎盘传播的证据,从感染COVID-19的母亲的羊水、脐带血和母乳中提取的样本均为阴性,并且COVID-19的临床表现在婴儿特别是早产儿中无特异性。鉴于感染COVID-19母亲的新生儿数量有限,且婴儿中COVID-19的流行病学和临床模式尚不清楚,本综述研究描述了目前对新生儿COVID-19感染的认识中的诊断检查、临床表现、母乳喂养注意事项、出院标准和家庭教育,为更好地管理新生儿SARS-CoV-2感染提供信息。
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引用次数: 0
Treatment satisfaction in patients with diabetes mellitus type 1 treated with intensified insulin therapy with insulin analogues 胰岛素类似物强化胰岛素治疗1型糖尿病患者的治疗满意度
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.5937/afmnai38-32875
S. Radenković, M. Velojić-Golubović, D. Radojković, V. Ćirić, R. Kocić
The outcome of diabetes treatments can and should be evaluated through the patients' treatment satisfaction. The aim of this study was to examine the patients' satisfaction with the therapy with human insulin analogues compared with previous treatment with human insulin. We evaluated patient satisfaction in patients with T1DM in our institution who were currently on IIT with human insulins. We performed testing with standard World Health Organization Diabetes Treatment Satisfaction Questionnaire (WHO DTSQ) before and after the therapy with insulin analogs. The overall DTSQ score in forty-nine patients after the third month of therapy and after the sixth month of therapy is higher than before the initiation of therapy (p < 0.001). The results of the responses on the perception of hyperglycaemia were lower after three months of therapy (p < 0.05) and after the six months of treatment than before the onset of therapy (p < 0.01). There were no differences in the perception of hypoglycaemia after three months; however, perception of hypoglycaemia after the sixth month of treatment was lower than before the onset of therapy (p < 0.001) and compared to the score after the third month of therapy (p < 0.01). Therapy of T1DM patients with insulin analogue aspart over three months led to an increase in satisfaction with therapy and a reduction of the perception of hyperglycaemia. Therapy of T1DM patients with insulin analogues (aspart and glargine) over three months led to an increase in satisfaction with therapy and a reduction of the perception of both hyperglycaemia and hypoglycamia.
糖尿病治疗的效果可以而且应该通过患者的治疗满意度来评价。本研究的目的是比较患者对人胰岛素类似物治疗的满意度与先前使用人胰岛素治疗的满意度。我们对我院目前正在接受胰岛素治疗的T1DM患者的满意度进行了评估。我们在胰岛素类似物治疗前后使用标准的世界卫生组织糖尿病治疗满意度问卷(WHO DTSQ)进行测试。49例患者在治疗后第3个月和第6个月的总DTSQ评分高于治疗前(p < 0.001)。治疗后3个月和6个月的高血糖感知反应均低于治疗前(p < 0.05)。三个月后对低血糖的感知没有差异;然而,治疗第6个月后的低血糖感知低于治疗开始前(p < 0.001),与治疗第3个月后的评分相比(p < 0.01)。胰岛素类似物aspart治疗T1DM患者超过3个月,导致治疗满意度的增加和高血糖的感觉减少。用胰岛素类似物(天冬氨酸和甘精氨酸)治疗T1DM患者超过3个月,导致治疗满意度增加,高血糖和低血糖的感觉减少。
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引用次数: 0
Laparoscopic cholecystectomy in situs inversus totalis: A case report 全反位腹腔镜胆囊切除术1例
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.5937/afmnai38-30172
R. Gelevski, G. Jota, L. Todorović, Gjorgji Trajkovski, V. Joksimović, Bojan Trenčić
Situs inversus totalis represents a rare autosomal recessive morphological anomaly of the internal viscera, equally affecting both genders. The genetic defect occurs in the 2nd week of embryonic life, when a 270-degree clockwise rotation of the primitive digestive tube occurs. The incidence of calculosis of gallbladder in patients with situs inversus is the same as in the general population. A 61-year-old female patient with a history of four episodes of colicky, left hypochondrium and epigastric pain, without fever and jaundice, was admitted for elective laparoscopic cholecystectomy. CT of abdomen confirmed situs inversus totalis that was previously known to the patient. The patient was positioned in supine position and a mirror image configuration of the operating room was obtained, with surgeon and scrub nurse on the right side and assistant on the left side of the patient. Four trocars were introduced mirroring the standard position of the 5 mm trocars. During the dissection, second assistant was introduced for the laparoscope, due to the surgeon's limited motor skills in his left hand for delicate dissection, rendering him inapt to perform precise and safe dissection. The total operating time amounted to 110 minutes, which is three times longer than the standard operating time at our institution. The most critical point of the operation in constellation of situs inversus totalis is applying the clips, which requires precision and strength in the same moment. In the available literature, 40 open cholecystectomies before introduction of laparoscopy and 92 laparoscopic cholecystectomies were reported. To our knowledge, this is the first and the only reported laparoscopic cholecystectomy for situs inversus in North Macedonia.
完全性倒位是一种罕见的内脏器常染色体隐性形态异常,男女均可发生。遗传缺陷发生在胚胎生命的第二周,当原始消化管发生270度顺时针旋转时。胆囊倒位患者胆囊结石的发生率与一般人群相同。患者61岁,女,腹痛、左疑病症、上腹疼痛4次,无发热、黄疸,行择期腹腔镜胆囊切除术。腹部CT证实患者先前已知的完全性倒位。患者取仰卧位,取手术室镜像位,右侧为外科医生和擦洗护士,左侧为助手。4个套管针被引入,反映了5mm套管针的标准位置。在解剖过程中,由于外科医生左手的运动技能有限,无法进行精确和安全的解剖,在腹腔镜下引入了第二助手。手术总时间为110分钟,是我院标准手术时间的3倍。逆总位星座手术中最关键的一点是夹片的应用,它要求夹片的精度和强度在同一时刻。在现有文献中,有40例腹腔镜前胆囊切除术和92例腹腔镜胆囊切除术的报道。据我们所知,这是北马其顿第一例也是唯一一例报道的腹腔镜胆囊逆行切除术。
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引用次数: 1
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