Video-assisted thoracoscopic surgery （VATS） for bilateral primary spontaneous pneumothorax

Objective:To review our experience of the treatment of bilateral primary spontaneous pneumothorax (PSP) by video-assisted thoracoscopic surgery (VATS). Materials and methods: Retrospective chart review was followed by an on-clinic or telephone interview. Patients were cared for by one thoracic surgeon in four medical centers or community hospitals in Northern and Central Taiwan. Thirteen patients with bilateral PSP underwent bilateral VATS simultaneously or sequentially from July 1994 to December 2005. Results: Twelve males and one female, with age ranging from 15 to 36 years (mean 23.1 years), were treated with VATS for bilateral PSP, under the indications of bilateral pneumothoracis simultaneously (n=4) or sequentially (n=9). The interval between the first and second contra-lateral VATS procedure for non-simultaneous PSP patients ranged from 7 d to 6 years. Eleven of 13 patients (84.6%) had prominent pulmonary bullae/blebs, and underwent bullae resection with mechanical or chemical pleurodesis. The mean operative time was (45.6±18.3) min (range 25-96 min) and (120.6±28.7) min (range 84-166 min) respectively for the non-simultaneous (second VATS for the recurrence of contralateral side after first VATS) and simultaneous (bilateral VATS in one operation) procedures. There was no postoperative mortality. However, prolonged air leakage (>7 d) occurred in one patient (7.7%) who recovered after conservative treatment. The mean duration of chest tube drainage was 3.1 d and the median follow up period was 3.4 years. Conclusions: VATS is a safe and effective procedure in the treatment of bilateral PSP. Bilateral VATS is only recommended for patients with simultaneously bilateral PSP, because the incidence of recurrence, even with visible bullae, was not so high in my group and in some previous literature. Bilateral VATS in a supine position should only be used in selective cases, because of possible pleural adhesion or hidden bullae on the posterior side.     

孩子先天性耳前瘘管发炎怎么办

vivid803490@sina.com问:我的儿子快4岁了,前几天左脸有点儿红肿,一摸左耳后发现有小包,医生检查后说是先天性耳前瘘管发炎,开了抗生素针剂。经过两天的注射,他脸部的     

我们需要什么样的语文探究课

《南方周末》曾以《教科书:删得掉的文字,删不掉的秘密》为题,做了一篇有板有眼的报道。80后网友洞庭湖边的野草读《古本小说集成》时,有个发现,初一语文课本里的文言文《口技》被人做过微创手术了,在     

黄连素与复方黄连素有别

包括复方黄连素片在内的70种化学药品，于2003年6月18日被国家食品药品监督管理局公布停止使用后，一些市民慌忙把家庭药箱里的“黄连素”拿出来准备扔掉。同时，还有不少人担心，“黄连素”不能吃了，夏天拉肚子怎么办？对此，国家     

替罗非班在急性冠脉综合征PCI围手术期的应用

急性冠状动脉综合征(acute coronary syndrome,ACS)是指冠状动脉内不稳定的动脉粥样斑块破裂或糜烂引起血栓形成所导致的心脏急性缺血综合征.在其治疗措施中,经皮冠脉介入治疗(percutaneous coronary intervention,PCI)占有越来越重要的地位[1],但是PCI时球囊扩张对血管壁产生的压力会引起粥样硬化斑块破裂及内膜、中膜损伤(置入支架更加重血管内皮损伤),引起强烈的血小板活化,促进血小板黏附、聚集和血栓形成.因此,抗血小板治疗不仅是针对ACS治疗的重要策略,而且是预防PCI围术期和术后远期发生血栓事件的重要环节.替罗非班(欣维宁)为一种可逆性非肽类血小板膜GPⅡb/Ⅲa受体拮抗剂,于1998年5月首次在美国应用上市,2004年8月在国内上市,是目前国内唯一的血小板膜GPⅡb/Ⅲa受体拮抗剂[2].其主要通过阻止纤维蛋白原与糖蛋白Ⅱb/ Ⅲa结合,从而阻断血小板的交联及血小板的聚集[3].     

白内障手术便宜了

今年2月,Raj Kaliya Dhanuk躺在尼泊尔的一张手术台上准备接受白内障手术。她的眼部周围压上了一些重物。这些重物能减少手术前眼球受到的压力,使手术过程更容易。     

华为(Huawei)全高清手术示教系统的建立

通过全高清手术示教的建设,结合信息化医院的网络传输和负载均衡,以及建设过程中的具体问题的分析,阐述了如何在现代信息化医院中建立全高清手术示教系统,及如何优化网络传输。及采用最新的华为手术视教系统相比传统手术视教系统的优势。     

牙源性角化囊肿的临床分析

目的 研究牙源性角化囊肿的诊断特点和治疗方法。方法 对78例牙源性角化囊肿的临床症状，x线及手术方法进行回顾性研究。结果 78例患经过2～5年随访，复发率为11．54％，手术加冷冻的治疗效果最佳。结论 通过临床和x线特征可正确诊断和治疗牙源性角化囊肿。