简介:<link href="http://yyk.39.net/chaos/WmAJNAM2AzpQMw.css" rel="stylesheet" type="text/css" /> 鹤岗市人民医院普
<span class="WmUJNwMxAz5QMA">外科</span>
<span class="WmUJNwMxAzhQNQ">多例</span>位于第一
<span class="WmUJNwMxAzxQMA">住院</span>
<span class="WmUJNwMxAzpQMw">提出</span>部五楼
,由普
<span class="WmUJNwMxAzhQMA">外科</span>
<span class="WmUJNwMxAzxQMw">目前</span>
、微创
<span class="WmUJNwMxAzxQMA">外科</span>
<span class="WmUJNwMwAzdQOQ">突出</span>(内镜-腔镜
<span class="WmUJNwMxAzhQNA">外科</span>
<span class="WmUJNwMxAztQMw">长沙</span>)
、血管
<span class="WmUJNwMxAzpQOQ">一项</span>
<span class="WmUJNwMxAz1QOA">外科</span>
、小儿
<span class="WmUJNwMxAz1QNw">硕士</span>
<span class="WmUJNwMxAz9QNg">外科</span>组成的
<span class="WmUJNwMwAzdQMg">综合</span>
<span class="WmUJNwMxAzxQMw">腹腔</span>性
<span class="WmUJNwMwAzdQNg">科室</span>
<span class="WmUJNwMxAzxQMw">主任</span>
。医务
<span class="WmUJNwMxAzZQMw">腹腔</span>
<span class="WmUJNwMxAzpQOA">工作</span>人员二十三名
,
<span class="WmUJNwMxAz5QOA">主任</span>
<span class="WmUJNwMxAzhQNQ">四川</span>
<span class="WmUJNwMxAzlQOQ">浙江</span>
<span class="WmUJNwMxAzlQMg">医师</span>一名
,
<span class="WmUJNwMxAzpQMQ">出生</span>
<span class="WmUJNwMxAz9QNg">副主任</span>
<span class="WmUJNwMxAz5QNA">医师</span>
<span class="WmUJNwMxAzlQOQ">结合</span>二名
,
<span class="WmUJNwMxAzxQNA">副主任</span>
<span class="WmUJNwMwAzdQOQ">基础</span>护师一名
,铺设床位五十二张
,病房内采用管道式集中供氧
、
<span class="WmUJNwMxAzlQNg">中心</span>
<span class="WmUJNwMxAztQOQ">中华</span>负压吸引
、悬吊式静脉输液
,配有重症监护室(ICU)
、静脉营养液配制室(TPN配制室)
、红外线乳腺扫描仪
,微波理疗仪
、小儿肠套叠复位仪等
<span class="WmUJNwMxAztQOA">医疗</span>
<span class="WmUJNwMxAzpQMQ">医疗</span>设施
。每年
<span class="WmUJNwMwAzdQOA">发表</span>
<span class="WmUJNwMxAzhQNQ">学会</span>省级以上
<span class="WmUJNwMxAz5QOA">论文</span>
<span class="WmUJNwMwAzZQNQ">完成</span>四到五篇
,
<span class="WmUJNwMxAzlQMw">妇产</span>
<span class="WmUJNwMxAz1QNA">获得</span>鹤岗市科技进步
<span class="WmUJNwMxAzhQOQ">参与</span>
<span class="WmUJNwMxAzpQNA">成果</span>奖五项
,
<span class="WmUJNwMxAzpQMQ">工作</span>
<span class="WmUJNwMxAzhQNA">医疗</span>技术水平处于鹤岗
<span class="WmUJNwMxAzhQOA">地区</span>
<span class="WmUJNwMxAzpQOQ">培养</span>领先地位
。
<br /> 一
、普
<span class="WmUJNwMxAzxQMw">众多</span>
<span class="WmUJNwMxAzhQNg">外科</span>
、微创
<span class="WmUJNwMxAz1QOA">外科</span>
<span class="WmUJNwMxAzpQOQ">相同</span>
<br /> 甲状腺
<span class="WmUJNwMxAzxQOQ">核心</span>
<span class="WmUJNwMwAzdQNA">疾病</span>:需要
<span class="WmUJNwMwAzdQNw">协和</span>
<span class="WmUJNwMxAzhQNg">手术</span>
<span class="WmUJNwMxAz9QOQ">教授</span>
<span class="WmUJNwMxAz5QOA">治疗</span>的甲状腺
<span class="WmUJNwMxAz5QMg">疾病</span>
<span class="WmUJNwMwAzdQOQ">经过</span>
,采用小切口不离断舌骨下肌群
,可吸收线皮下缝合法
,满足美容的要求
。在九百余例甲状腺大部切除术中
,甲亢术后复发率
2%
,无永久性喉上神经
、喉返神经
、甲状旁腺损伤
。
<br /> 乳腺
<span class="WmUJNwMxAzlQOQ">地区</span>
<span class="WmUJNwMwAzdQMA">疾病</span>:对乳腺癌的
<span class="WmUJNwMxAzlQNA">治疗</span>
<span class="WmUJNwMwAzZQOQ">多次</span>
,采用
<span class="WmUJNwMwAzdQNA">国际</span>
<span class="WmUJNwMxAztQMw">高尚</span>抗癌联盟(URCC)TNM分类分期标准
,对Ⅰ
、Ⅱ期乳癌患者
,采用改良根治术
,既达到肿瘤A级根治标准
,又保证了胸部外形的美观
,患侧上肢功能不受限
,利于乳房再造
,减少了传统
<span class="WmUJNwMxAz9QNw">因此</span>
<span class="WmUJNwMxAzxQMA">手术</span>常并发的上肢水肿
、胸部畸形
、皮瓣坏死
、伤口 延期愈合等并发症
。术后采用标准的
<span class="WmUJNwMxAz1QMQ">青年</span>
<span class="WmUJNwMxAztQNg">治疗</span>方案给予辅助化疗
,及内分泌
<span class="WmUJNwMxAzpQMQ">方面</span>
<span class="WmUJNwMxAz1QNA">治疗</span>等
<span class="WmUJNwMxAzhQMQ">问题</span>
<span class="WmUJNwMwAzdQMg">综合</span>措施
,提高十年生存率
。
<br /> 胃肠道肿瘤:胃肠道癌 (胃癌
、结肠癌
、直肠癌)的根治性
<span class="WmUJNwMxAzpQNg">手术</span>
<span class="WmUJNwMwAzZQNQ">医生</span>切除
,是最有效的
<span class="WmUJNwMxAz5QMg">治疗</span>
<span class="WmUJNwMxAz9QNQ">协和</span>手段
。
<span class="WmUJNwMxAzhQMA">严格</span>
<span class="WmUJNwMxAz1QNw">免疫</span>按照
<span class="WmUJNwMxAz5QNQ">编委</span>
<span class="WmUJNwMxAz1QNg">国际</span>TNM分期法
,根据
<span class="WmUJNwMxAz1QNg">不同</span>
<span class="WmUJNwMxAz9QOQ">发现</span>病期
,采用
<span class="WmUJNwMxAzxQMg">不同</span>
<span class="WmUJNwMxAz5QMw">协和</span>的根治
<span class="WmUJNwMxAztQMw">腹腔</span>
<span class="WmUJNwMxAzpQMg">手术</span>方式
,遵循根治
<span class="WmUJNwMxAztQMQ">参与</span>
<span class="WmUJNwMxAzpQOA">手术</span>的原则
,术后给予辅助化疗
,提高
<span class="WmUJNwMxAzlQNA">病人</span>
<span class="WmUJNwMwAzdQNw">常见病</span>生活质量和
5年生存率
。
<br /> 门静脉高压症:门静脉高压症约
8
0%左右由肝硬化引起
,
<span class="WmUJNwMxAztQNg">病人</span>
<span class="WmUJNwMxAz5QMw">提出</span>会出现呕血
、便血
、脾肿大
、脾功能亢进
、腹水
、肝性脑病等症状
,其并发症率和死亡率很高
,最致命的症状是食道下段和胃底静脉破裂大出血
。对于门静脉高压症合并上消化道大出血的
<span class="WmUJNwMxAztQNw">年青</span>
<span class="WmUJNwMxAzxQMg">外科</span>
<span class="WmUJNwMxAzlQNg">治疗</span>
<span class="WmUJNwMxAz1QNQ">最后</span>
,分为急诊
<span class="WmUJNwMxAzhQOA">手术</span>
<span class="WmUJNwMxAzhQMw">已经</span>和择期
<span class="WmUJNwMxAzlQNg">手术</span>
<span class="WmUJNwMxAz5QNQ">中青</span>
。(
1)急症大出血时:积极非
<span class="WmUJNwMxAzhQMw">应用</span>
<span class="WmUJNwMwAzdQNA">手术</span>
<span class="WmUJNwMxAz1QMA">治疗</span>
<span class="WmUJNwMxAz5QNQ">特别</span>失败
,出血不能控制
,应急诊
<span class="WmUJNwMxAzxQNA">手术</span>
<span class="WmUJNwMxAz1QMQ">丰富</span>
。在过去的十五年间
,近
2
0
0名患者
,接受了急诊脾切除胃底贲门周围血管离断术
,近期和远期疗效满意
,术后再出血发生率
1
0%
,达到
<span class="WmUJNwMxAzhQMA">国内</span>
<span class="WmUJNwMxAztQMQ">应用</span>水准
。(
2)择期
<span class="WmUJNwMwAzdQMQ">相同</span>
<span class="WmUJNwMxAzpQMg">手术</span>:凡大出血后
,积极准备
,改善肝功
,尽量提前及时行决定性
<span class="WmUJNwMwAzZQNA">手术</span>
<span class="WmUJNwMxAzhQMQ">大学</span>
<span class="WmUJNwMxAzpQMQ">硕士</span>
<span class="WmUJNwMwAzdQMA">治疗</span>
。(
3)预防性
<span class="WmUJNwMxAz9QMQ">专业</span>
<span class="WmUJNwMxAzxQNg">手术</span>:脾肿大
,脾功能亢进
,食道胃底静脉明显曲张者
,可行预防性断流术
。
<br /> 重症胰腺炎:急性胰腺炎
<span class="WmUJNwMwAzdQMA">主要</span>
<span class="WmUJNwMxAz9QNw">科室</span>是由酒精和胆石引起
,近年来高脂血症已
<span class="WmUJNwMxAz1QNw">人才</span>
<span class="WmUJNwMxAzlQNA">成为</span>第三大发病因素
。
<span class="WmUJNwMxAzxQMw">知名</span>
<span class="WmUJNwMxAzhQOA">目前</span>
<span class="WmUJNwMxAz1QNQ">上海</span>
<span class="WmUJNwMxAz5QMg">治疗</span>重症胰腺炎策略:(
1)重症胰腺炎早期采取器官功能维护为
<span class="WmUJNwMxAzpQMg">中心</span>
<span class="WmUJNwMxAzhQMQ">中心</span>的非
<span class="WmUJNwMxAz1QOQ">成为</span>
<span class="WmUJNwMxAzxQOA">手术</span>
<span class="WmUJNwMxAz1QNw">博士</span>
<span class="WmUJNwMxAzpQOA">治疗</span>
。(
2)无菌性坏死尽量采取非
<span class="WmUJNwMwAzdQMQ">好评</span>
<span class="WmUJNwMxAzhQNg">手术</span>
<span class="WmUJNwMwAzdQOQ">造诣</span>
<span class="WmUJNwMxAzxQNA">治疗</span>
。(
3)出现坏死感染后采用
<span class="WmUJNwMxAz9QNQ">有着</span>
<span class="WmUJNwMxAzpQMA">外科</span>
<span class="WmUJNwMxAzxQNw">合作</span>
<span class="WmUJNwMxAz5QMA">治疗</span>
。不主张在发病
2周内
<span class="WmUJNwMxAzxQMQ">通过</span>
<span class="WmUJNwMxAz5QMg">手术</span>
,但在下列情况必须考虑早期
<span class="WmUJNwMxAzZQMQ">科研</span>
<span class="WmUJNwMwAzdQNg">手术</span>
<span class="WmUJNwMxAz1QNA">治疗</span>
<span class="WmUJNwMxAzhQNQ">成绩</span>:(
1)急性爆发性胰腺炎
。(
2)胆源性重症胰腺炎伴梗阻或胆管炎者应选择经鼻胆管引流
、内镜下十二指肠乳头切开或胆囊穿刺引流无效者
,应早期或急诊
<span class="WmUJNwMxAzxQOQ">师从</span>
<span class="WmUJNwMxAz5QNg">手术</span>
。(
3)坏死合并感染不宜拘泥于
3-
4周后
<span class="WmUJNwMwAzdQMQ">成立</span>
<span class="WmUJNwMxAzhQMA">手术</span>
,否则将延误
<span class="WmUJNwMxAz5QNA">手术</span>
<span class="WmUJNwMwAzZQNQ">疾病</span>时机
。(
4)腹内高压甚至出现
<span class="WmUJNwMxAzpQMw">多例</span>
<span class="WmUJNwMxAzxQNg">腹腔</span>间室
<span class="WmUJNwMwAzZQNA">综合</span>
<span class="WmUJNwMxAzlQOQ">介入</span>征
,早期
<span class="WmUJNwMwAzdQNw">中青</span>
<span class="WmUJNwMxAz1QMA">手术</span>减压引流
。近十年来
,我们遵循上述原则和
<span class="WmUJNwMwAzdQNA">国际</span>
<span class="WmUJNwMwAzdQNw">方面</span>胰腺病学联合会关于急性胰腺炎
<span class="WmUJNwMxAzlQNw">现任</span>
<span class="WmUJNwMxAz5QNA">外科</span>处理的
<span class="WmUJNwMxAzxQMA">指导</span>
<span class="WmUJNwMxAz5QMw">小组</span>建议
,对
1
0
0余例 急性胰腺炎的
<span class="WmUJNwMxAzZQMQ">著名</span>
<span class="WmUJNwMwAzZQNg">治疗</span>
,取得令人满意的疗效
,达到
<span class="WmUJNwMwAzZQNw">教学</span>
<span class="WmUJNwMxAzpQNA">国内</span>水准
。
<br /> 微创
<span class="WmUJNwMwAzZQNw">核心</span>
<span class="WmUJNwMxAzhQNg">外科</span>(腔镜-内镜
<span class="WmUJNwMxAzhQMQ">等奖</span>
<span class="WmUJNwMxAz1QOA">外科</span>):随着现代高科技和
<span class="WmUJNwMwAzZQNQ">重点</span>
<span class="WmUJNwMxAztQMg">医疗</span>技术的迅速发展
,
<span class="WmUJNwMxAzpQNA">腹腔</span>
<span class="WmUJNwMxAzpQNQ">处长</span>镜
,内镜已从以往单纯用于
<span class="WmUJNwMxAzhQNw">长期</span>
<span class="WmUJNwMwAzdQMg">诊断</span>
<span class="WmUJNwMxAz9QMA">疾病</span>
<span class="WmUJNwMwAzZQNw">基础</span>
,发展成一种先进的微创
<span class="WmUJNwMwAzZQOQ">而且</span>
<span class="WmUJNwMxAz1QNA">手术</span>
<span class="WmUJNwMwAzdQMA">治疗</span>
<span class="WmUJNwMwAzZQOQ">师从</span>技术
。它是现代高科技和传统
<span class="WmUJNwMxAzlQMw">临床</span>
<span class="WmUJNwMxAz9QMg">外科</span>技术的完美
<span class="WmUJNwMxAzhQNw">具有</span>
<span class="WmUJNwMxAz9QNg">结合</span>
,代表了当今微创
<span class="WmUJNwMwAzZQNw">经过</span>
<span class="WmUJNwMxAzpQMA">外科</span>的发展趋向
。这种微创新技术
<span class="WmUJNwMxAzhQOA">具有</span>
<span class="WmUJNwMxAz9QMQ">医药</span>创伤小
,痛苦轻
,生理干扰小
,恢复快
,进食早
,
<span class="WmUJNwMxAz9QOQ">教授</span>
<span class="WmUJNwMxAztQNg">住院</span>时间短
,美观等诸多优点
,在世界范围内蓬勃发展
,作为应该坚守“健康所系
,性命相托”这一永恒信念的医务
<span class="WmUJNwMxAzpQNg">工作</span>
<span class="WmUJNwMwAzdQMQ">长期</span>者
,我们有责任让每一位患者真正享受到微创技术带给他们心理上
、生理上的益处
。
<br />
<span class="WmUJNwMxAzpQMw">年青</span>
<span class="WmUJNwMxAz9QNA">目前</span>
,鹤岗市人民医院
<span class="WmUJNwMxAz9QOQ">贡献</span>
<span class="WmUJNwMxAz1QOA">腹腔</span>镜-内镜诊疗中心
,已经开展了电视腹腔胆囊切除术
,肝囊肿去顶引流术
,肝胃破裂修补术
,肠粘连松解术
,腹部创伤
,急腹症
,慢性腹痛等诊断及治疗
,输卵管卵巢切除术
,子宫肌瘤切除术
,肾囊肿去顶引流术
,经尿道前列腺气化电切术
,宫腔镜检查治疗
,胃镜下息肉切除术
,食道静脉曲张套扎术
,肠镜下息肉切除术
,纤维支气管镜切取活检及异物取出术
。十二指肠镜的临床应用
,将解决重症胰腺炎的胆道引流减压
,(INBD)
,胆道梗阻的定位诊断(ERCP)
,括约肌切开取石(ES)
,放置胆道支架解决胆道梗阻等临床棘手问题
。三镜(腹腔镜
、十二指肠镜
、胆道镜)或二镜(腹腔镜
、十二指肠
、或腹腔镜
、胆道镜)联合
,将使肝外胆管结石的治疗更加完美
。
<br /> 微创技术是当今医学领域发展的趋向
,微创外科向传统外科发起了强有力地挑战
,腹腔镜手术已成为某些疾病外科治疗的“金标准”
.不开腹
,治疾病
,这就是微创外科魅力所在
!这就是
2
1世纪外科发展的标志
!
<br /> 二
、 血管外科
<br /> 近几年来
,又成立了血管外科
,先后开展了下肢动脉硬化闭塞症人工血管旁路术
,腹主动脉瘤切除人工血管置入术;急性动脉栓塞取栓术;血管造影及腔内治疗;
2
0
0
3年成功的治疗
1例下肢深静脉血栓脱落造成急性肺动脉栓塞;(肺动脉导管内溶栓下腔静脉滤器置入术)开展了微创治疗下肢浅静脉曲张
,对雷诺氏病
,下肢深静脉血栓形成
,血栓闭塞性脉管炎
,糖尿病足治疗效果好
。
<br /> 三
、小儿外科
<br /> 开展了小横切口的疝囊高位结扎术
,鞘突管高位结扎术
,完成了巨结肠根治术
,先天性肛门闭锁肛门成型术
,引进了“电脑遥控肠套叠充气复位器”复位成功率
1
0
0%
,避免了开腹复位
,减轻患儿痛苦
。