中国医药指南2009年11月g 7卷g 22期Guide
ofChinaMedicine,November 2009,V01.7,No.22
[12】Kastrafi
A,Mehilli
J,Dirschinger
Let
a1.for the Stent
Va'SUS
Thromb-
olysis for Occluded Coronary Arteries in Patients with Acute
Myocardial Infarction(STOPAMI一2、Study.Myocardial
salvage af【cr
coronary
stenting plus abciximab
Vga'SUS
fibrinolysis
plus
abciximab
in patient with
acute
myocardial infarction.A randomized
trial[J].
Lancet,2002,359(93
1
0):920—925.
[1 3】Andersen
HR,Nielsen
TT'Rasmussen
K,et a1.A comparison of
coronary angioplasty、析tll fibfinolytic therapy in
acute
myocardial
infarction[J].N
Engl J
Med,2003,349(8):733・742.
【14】Widimsky
P,Budesinsky
T,Vorac
D,et a1.orl behalfofthe PRAGUE
Study Group Investigators.Long distance transport for primary
angioplasty
VS
immediate thrombolysis in
acute
myocardial
infarction.Final result of the randomized national multicentre
trial—the
PRAGUE・2[J】.Eur
Heart
J,2003,24(1):94・104.
【15】Grincs CL,Westerhausen
DR Jr,Grines LL,et a1.A randomized trial of
transfer
for
primary angioplasty
versus
on
site thrombolysis in
patients with high risk myocardial infarction:The Air
Primary
Angioplasty in
Myocardial
Infarction
study[J].J
Am Coil Cardiol,
2002,39(11):1713—1719.
【1 6】Bonnefoy
E,Lapostolle F,Leizorovicz A,et a1.on behalf of the
Comparison of Angioplasty and Prehospital Thrombolysis in Acute
Myocardial Infarction(CAPTIM)Study
Group.Primary angioplasty
versus
prehopital fibrinolysis in
acute
myocardial infarction:A
randomized
study[J].Lancet,2002,360(9336):825—829.
【1 7】Lee
DP,Herity NA,.Hiatt BL,et
a1.Adjunctive
platelet glycoprotein
II b/IHa inhibition、^itIl tirofiban
before
primary
angioplasty
impro-
vesangiographic outcome:Results of the Tirofiban give in the
Emergency Room before primary
angioplasty(TIGER2PA)pilot
35
trial[J].Circulation,2003,107(1 1):1497-1501.
[1
8]111e
GUSTOV Investigators.Reperfusion therapy for
acute
myoc—
ardial infarction with fibrinolytic therapy
or
combination lOW dose
fibfinolytic therapy and platelet glycoproteinⅡb/ItI
a
inhibition:
TheGUSTOVTrial[J].Lancet,2001.357(9272):1905—1914.
【19】LincoffAM,CaliffRM,vail
de
WeffF,et a1.Mortality
at
l year with
combination platelet glycoprotein
11
b/lⅡa inhibition and reduced—
dose fibrinol”ic therapy VerSUS conventional fibrinolytic therapy
for
acute
myocardial infarction:The GUSTO V
randomized[J].
JAMA,2002,288(17):2130—2135.
【20]Mukberjee
D,Gurm H,Tang
WH3N,et
a1.Outcome of
acute
myocardial
infarction in patient with prior
coronary
artery bypass surgery treated
with
combination
reduced fibrinolytic therapy and
abciximab[J].Am
JCardiol,2002,9001):1198・1203.
【2l】111eAssessmentoftheSaferyandEfficacyofaNewThrombolytic
Regimen(A:SSENT)-3
Investigators.Efficacy and safety of tenecteplase
in combination with
enoxapam,ak'iximab,or
unfracfionated
k呻
The ASSENT-3 randomized trial in acute
myocardial
infarction[J].
Lamer2001,358(9282、:605_613.
【22】Cohen M,Demers
C,Gurfinkel EP
et
al—for the Efficacy and Safety of
Subcutaneous
r_ax,xapa血in
Nen-Q-wave
Coronary
Events(ESSENCE)
Study Group.A
comparison
of low molecular weight heparin with
tmfiacfionated heparin for trustable coronary
army disease[J].N
Engl J
Mcd,1 997237(13):447-450.
【23】Antman
EM,McCabe
CH,Gurfinkel EP,et a1.Enoxaparin
prevents
death and cardiac
incbemic events
in
unstable/nonQ-wave
myocardial
infarctioll Results of the thrombolysis in myocardial
in缸6伽fT咖)
liB
trial忉.Circulation,1999,100(15):1593-601.
妇科腹腔镜手术护理进展状态综述
黄慧红
【关键词】腹腔镜手术;妇科;护理进展
中图分类号:R473.71
文献标识码:A
文章编号:1671-8194(2009)22-0035-03
妇科腹腔镜手术作为现代妇科手术发展的方向,正在逐步取代传
统的治疗模式。与传统开腹手术相比,腹腔镜手术具有创伤小,术后
恢复快,无碍美观等优点,已成为许多妇女首选的手术方式。许多妇
科良性疾病如良性肿瘤、异位妊娠等腹腔镜技术已逐渐成熟,在恶性
肿瘤方面腹腔镜手术的应用范围也在不断拓宽,如早期子宫内膜癌、
子宫颈癌、卵巢癌中的应用亦逐渐开展111。由于腹腔镜应用范围不断
扩大,其护理措施也相应地随之发展,现就腹腔镜手术的护理进展状
态综述如下。
1腹腔镜在妇科的临床应用
腹腔镜手术在妇科领域的应用越来越广泛,大多数妇科开腹手术
目前已逐渐被腹腔镜手术所替代。1989年Reich等首次报道腹腔镜子
官切除术,现已成为子宫切除术的一种新的手术模式”】。据文献报道,
目前腹腔镜盆腔淋巴结摘除术切除淋巴结的数目已达到开腹手术的要
求,淋巴结切除率为75%91%,手术分期的准确率达100%,而且手
术穿刺口肿瘤转移发生率近年来明显下降,在0.59仁1.3%,与常规开
腹手术的切口肿瘤转移率(0.8%-1.6%)相似。腹腔镜手术还可用于
盆腔重建,如盆腔缺损修补、阴道侧壁缺损修补。目前可经腹腔镜完
成的妇科手术已有32种”】。
2腹腔镜手术并发症
腹腔镜手术虽然对机体损伤小,但由于手术的复杂性及操作视野
的限制,腹腔镜手术也有其特殊的并发症,尤其对一些复杂的手术来
说.传统的手术方式已经历时间的考验,而腹腔镜手术则处于尝试阶
段,冷金花等”1对协和医院8年来3692例妇科腹腔镜手术并发症统
计结果显示,并发症发生率为1.49%(55例),中转开腹手术率为o.67%
广西中医学院第一附院妇科(550025)
万方数据