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Langenbecks Archiv fur Chirurgie. Supplement II, Verhandlungen der Deutschen Gesellschaft fur Chirurgie. Deutsche Gesellschaft fur Chirurgie. Kongress最新文献

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[Value of sono- and computerized tomography as a localization procedure in primary hyperparathyroidism]. [超声和计算机断层扫描在原发性甲状旁腺功能亢进定位中的价值]。
H Grimm, W Padberg, F Schumacher, K H Muhrer

A total of 56 patients underwent preoperative high-resolution sonography (4 MHz); 33 had additional computed tomography (4 mm slices, contrast material as drip infusion) to localize abnormal parathyroid tissue in primary hyperparathyroidism. The sensitivity of sonography was 48% compared to 38% for computed tomography. The efficiency of both techniques was mostly dependent on size and location of the parathyroid. Computed tomography was superior in detecting ectopic parathyroids. Because of its low sensitivity sonography is only of facultative importance as a localization procedure for primary hyperparathyroidism. Computed tomography is indicated only for localizing ectopic parathyroid tissue after initial operation has failed.

共有56例患者接受术前高分辨率超声检查(4mhz);33例原发性甲状旁腺功能亢进患者进行了额外的计算机断层扫描(4毫米切片,造影剂滴注)以定位异常甲状旁腺组织。超声的灵敏度为48%,而计算机断层扫描为38%。两种技术的效率主要取决于甲状旁腺的大小和位置。计算机断层扫描在发现异位甲状旁腺方面具有优势。由于其低灵敏度,超声检查仅作为原发性甲状旁腺功能亢进的定位程序具有兼性的重要性。初次手术失败后,计算机断层扫描仅用于定位异位甲状旁腺组织。
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引用次数: 0
[Fluid balance and postoperative lung function]. [体液平衡和术后肺功能]。
J A Sturm

Postoperative volume therapy: 1. Replacement of fluid loss. 2. Therapy of intravasal hypovolaemia in case of permeability damage or intracellular fluid shift. Monitoring: 1. Circulation (HR, CVP, art. pressure). 2. Homeostasis (Na, K). 3. Metabolic changes (BE, pH). 4. Kidney function. In complications like sepsis or ARDS with pulmonary problems and increase of pulmonary vascular resistance the use of a pulmonary artery catheter is necessary. Differential treatment has to be based on additional measurement of cardiac output and pulmonary capillary pressure. Volume treatment in postoperative complications is essential because of intravasal hypovolaemia. Kidney and cardiac failure have to be ruled out.

术后容积治疗:补充流失的液体。2. 通透性损伤或细胞内液移位时静脉内低血容量的治疗。监控:1。循环(HR, CVP,美术)压力)。2. 动态平衡(Na, K);代谢变化(BE, pH)。4. 肾脏功能。在脓毒症或ARDS合并肺部问题和肺血管阻力增加的并发症中,使用肺动脉导管是必要的。鉴别治疗必须基于额外的心输出量和肺毛细血管压力测量。由于静脉内低血容量,术后并发症的容量治疗是必不可少的。必须排除肾衰竭和心力衰竭的可能。
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引用次数: 0
[Fractures of the mid-hand area--classification, management, results and problems]. [掌中区骨折——分类、处理、结果和问题]。
K Lowka

Of the various types of hand fractures, metacarpal fractures occur quite frequently, predominantly in younger people. In order to maintaining hand function man's most important tool, the treatment of coice in recent years has shifted from predominantly conservative measures to more surgical procedures. From 1980 to 1988, 33 patients with metacarpal fractures were treated: 66% received surgical and 34% conservative treatment. We report on the results as regards hand function, the length of unemployment, the patient's subjective complaints and the peri- and postoperative complications.

在各种类型的手部骨折中,掌骨骨折非常常见,主要发生在年轻人中。为了保持手的功能,人类最重要的工具,近年来的治疗方法已经从主要的保守措施转向更多的外科手术。1980 ~ 1988年,33例掌骨骨折患者接受手术治疗,66%接受手术治疗,34%接受保守治疗。我们报告的结果,关于手的功能,失业的时间,病人的主观抱怨和周围和术后并发症。
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引用次数: 0
[Significance of primary diagnosis of carpal instability]. 【腕关节不稳的初步诊断意义】。
U Heitemeyer, G Hierholzer

In general the dislocation of the carpal bones with subsequent carpal instability is rare. The diagnosis depends on a correct interpretation of the X-ray. In a follow-up study 25 patients with closed carpal instabilities were examined. In 14 the carpal instability had been established in the primary diagnosis and treated adequately. The functional results were good. 11 patients, in whom the dislocation of the carpal bones had been overlooked, did not receive primary therapy and had unsatisfactory function of the hand.

一般来说,腕骨脱位并伴有腕关节不稳定是很少见的。诊断取决于对x光片的正确解释。在一项随访研究中,对25例闭合性腕关节不稳患者进行了检查。在14例中,腕骨不稳在初步诊断中得到了确定,并得到了适当的治疗。功能结果良好。11例腕骨脱位被忽视的患者未接受初级治疗,手部功能不理想。
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引用次数: 0
[What is the place of "selective thyroid gland resection" in surgery of benign nodular struma]. 【选择性甲状腺切除在良性结节性甲状腺肿手术中的位置】。
R A Wahl, A W Seel, B Müller, P Vietmeier

Remnants after "classic" Subtotal Thyroidectomy are of constant size in constant position. "Selective" thyroidectomy intends to remove all nodules, but to save normal tissue--irrespective of their localization. From July 1985 to Dec. 1989 in 48.5% of 1124 thyroid lobes sel. surgery was performed, in 27.8% subtotal, in 23.8% total lobectomy. Primary postop. recurrent lar. palsy occurred in 1.3% after sel., 1.0% after subt. and 2.7% after total lobectomy. 90% of primary r.l.n.p.'s were transient--after sel. lobectomy only one persistend (0.2%). Hypocalcemia: 0.7% after sel., 1.4% after subt. thyroidectomy. Besides better quality and quantity of remnants selective thyroidectomy is supported by low rate of complications.

“经典”甲状腺次全切除术后的残余在固定位置上大小不变。“选择性”甲状腺切除术旨在切除所有结节,但保留正常组织-无论其定位如何。从1985年7月到1989年12月,1124个甲状腺叶中有48.5%的人死亡。27.8%的患者行手术,23.8%的患者行全肺叶切除术。。主要存在切口漏复发性守护神。术后瘫痪发生率为1.3%。,盘后1.0%。全肺叶切除术后为2.7%。90%的原发性rl.n.p.这些都是短暂的——在我离开之后。肺叶切除术只有一例持续存在(0.2%)。低钙血症:售后0.7%。,盘后1.4%。甲状腺切除术。此外,选择性甲状腺残余切除术的质量和数量都较好,并发症发生率低。
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引用次数: 0
[Differentiated cancers]. (区分癌症)。
G Görtz, R Häring

A total of 119 papillary and 67 follicular thyroid carcinomas were subdivided according to the WHO classification of 1988 in the morphological subtypes of occult, encapsulated and invasive carcinomas. The patients were monitored over a followup period of 16 years postoperatively. Initially 10.6% of all patients with early follicular carcinoma had distant metastases and 2 of 19 died of carcinoma. In cases of early papillary carcinoma there were no distant metastases and no deaths. Limited thyroid surgery is recommended as curative surgery only for such patients.

根据1988年WHO的分类,将119例乳头状甲状腺癌和67例滤泡性甲状腺癌再细分为隐匿性、包膜性和浸润性甲状腺癌的形态学亚型。患者术后随访16年。最初10.6%的早期滤泡癌患者发生远处转移,19例患者中有2例死于癌。早期乳头状癌无远处转移,无死亡。限制甲状腺手术只推荐作为治疗性手术。
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引用次数: 0
[Prevention of adhesions in abdominal surgery. A dose finding study with streptokinase/streptodornase]. 腹部手术粘连的预防。链激酶/链脲酶的剂量发现研究。
A Tuchmann, K Dinstl, D Depisch, P Wendt, G Blümel

Unlabelled: Measurement of intraperitoneal fibrinolytic activity on 50 patients having undergone abdominal surgery (four of them controls). Instillation of streptokinase/streptodornase (Varidase) into the abdominal cavity. Determination of total protein, plasminogen, antiplasmin, alpha 2 Mx-plasmin-complex, spontaneous fibrinolysis and fibrinolysis + activator at different points in time p.op.

Results: Intraperitoneal fibrinolysis may be stimulated by local substitution of a plasminogen activator (Varidase). Systemic effects are confined to a high dose. No impaired wound healing nor increased propensity to hemorrhaging occurred.

未标记:测量50例接受腹部手术的患者(其中4例为对照组)的腹腔内纤溶活性。腹腔内滴注链激酶/链脲酶(变异酶)。不同时间点的总蛋白、纤溶酶原、抗纤溶酶、α - 2 mx -纤溶酶复合物、自发纤溶和纤溶+激活剂测定(p. p.)结果:纤溶酶原激活剂(变酶)的局部取代可刺激腹腔内纤溶。全身效应仅限于高剂量。没有出现伤口愈合受损或出血倾向增加的情况。
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引用次数: 0
[Special forms of distal radius fractures]. [特殊形式的桡骨远端骨折]。
K P Schmit-Neuerburg, R Letsch, K M Stürmer, K Koeser

The severity of a fracture of the distal radius is not only determined by the type of the fracture but also by concomitant ligamentous and carpal injuries, which are often underestimated and imply a higher degree of instability than the bony lesion alone. Therefore classifications are valuable, which combine fracture type and associated lesions, thus permitting conclusion about the therapeutic method of choice. The article discusses indication, operative technique and special features of radial fractures in combination with carpal injuries, of radial styloid fractures as well as Barton's and Reverse-Barton's fractures, of bilateral radial fractures and of radial fractures as part of a chain fracture. It is important to perform an early fasciotomy and carpal tunnel release in cases of severe soft tissue damage and threatening compartment syndrome.

桡骨远端骨折的严重程度不仅取决于骨折的类型,还取决于伴随的韧带和腕关节损伤,这些损伤往往被低估,并且意味着比单独的骨损伤更高程度的不稳定性。因此,结合骨折类型和相关病变进行分类是有价值的,从而得出选择治疗方法的结论。本文讨论了桡骨骨折合并腕骨损伤、桡骨茎突骨折、巴顿骨折和逆巴顿骨折、双侧桡骨骨折和部分链状骨折的适应证、手术技术和特点。在严重的软组织损伤和威胁室综合征的情况下,早期进行筋膜切开术和腕管松解是很重要的。
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引用次数: 0
[Laparoscopic appendectomy--alternative therapy in all stages of appendicitis?]. 腹腔镜阑尾切除术——阑尾炎各阶段的替代疗法?
F Götz, A Pier, C Bacher

1989 we reported on our first series of 277 laparoscopic appendectomies. This technique was introduced by Semm in 1982. We acquired this procedure in 1987 and modified this operation-technique for surgical routine. We could demonstrate that laparoscopic appendectomy can be performed in chronic, acute and even in peracute cases. We introduce the facts of 500 laparoscopic appendectomies.

1989年,我们报道了第一批277例腹腔镜阑尾切除术。这项技术是Semm在1982年引入的。我们于1987年获得了这种手术方法,并将其修改为常规手术技术。我们可以证明腹腔镜阑尾切除术可以在慢性、急性甚至过急性病例中进行。我们介绍了500例腹腔镜阑尾切除术的情况。
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引用次数: 0
[Modification of non-hemispheric symptoms by carotid endarterectomy]. 颈动脉内膜切除术后非半球症状的改变
D Raithel

In case of multi-locular supra-aortic lesions the correction of a hemodynamic carotid stenosis has priority over any reconstruction of another supra-aortic lesion. Thus carotid endarterectomy leads to an improvement of the global cerebral perfusion. Patients with a classical vertebro-basilar insufficiency profit most by these operations. A subclavian or vertebral reconstruction or PTA is indicated only if the patient is not symptom-free after the carotid endarterectomy.

在多房主动脉上病变的情况下,血流动力学颈动脉狭窄的矫正优先于其他主动脉上病变的重建。因此,颈动脉内膜切除术可改善全脑灌注。典型椎基底动脉功能不全的患者从这些手术中获益最多。锁骨下或椎体重建或PTA只有在患者颈动脉内膜切除术后症状未消除时才适用。
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Langenbecks Archiv fur Chirurgie. Supplement II, Verhandlungen der Deutschen Gesellschaft fur Chirurgie. Deutsche Gesellschaft fur Chirurgie. Kongress
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