腹腔镜胆囊切除术术后护理经验与体会

目的探讨腹腔镜胆囊切除术术后的护理经验与体会。方法对我科自2006年1月至2009年1月50例腹腔镜腹腔镜胆囊切除术患者采取一系列的精心护理措施。结果手术时间15～120min,平均(50.8±6.0)min,术后住院时间3～7d,平均3.5d。胆总管损伤患者术中即时中转开腹行原位修补加T管引流术;大出血患者再次开腹止血;感染患者及时换药治疗。50例接受LC的病人中2例因胆囊壶腹部嵌顿结石、Calot三角区致密粘连而中转开腹。所有病人术后恢复顺利。1例于穿刺建立气腹时误穿入肿大的脾脏,但未做特殊处理。结论腹腔镜胆囊切除术术后采取针对性的护理干预措施,,可以增加手术及术后护理的安全,有利于患者术后疾病的恢复。     

腹腔镜在外科急腹症中的应用探讨

目的探讨腹腔镜在外科急腹症中的临床应用价值。方法回顾性分析2006年1月至2008年7月间应用腹腔镜诊治的78例急腹症患者的临床资料。结果本组78例急腹症中腹腔镜手术成功74例(94.8%),4例中转手术(6.2%),本组无死亡病例,无手术并发症。结论腹腔镜在外科急腹症中的应用具有损伤少、痛苦轻、术后恢复快等独特优点,能明确诊断又可同时进行治疗,可在基层医院进一步推广应用。     

术后早期炎性肠梗阻诊治体会(附31例报告)

目的探讨术后早期炎性肠梗阻的诊断和治疗措施。方法对我院自2005年1月至2008年8月收治的31例术后炎性肠梗阻患者的临床资料进行回顾性分析和整理。结果29例患者经保守治疗痊愈,2例中转手术,其中1例出现肠瘘而转上级医院治疗。结论术后早期炎性肠梗阻应以保守治疗为主,除非出现绞窄或内疝,一般经中西结合非手术治疗可治愈。     

软通道微创治疗幕上高血压性脑出血的应用评价

目的探讨软通道微创治疗幕上高血压性脑出血的应用。方法选择男性72例,女性38例,年龄32～84岁,平均57.2岁。有明确高血压病史76例患者,穿刺点定位,穿刺置管,液化引流进行治疗。结果 110例患者中,8例有穿刺道损伤少量出血,生存103例,死亡7例,死亡率6.3%。按照日常生活活动能力分级标准(ADL):Ⅰ级13例,Ⅱ级46例,Ⅲ级39例,Ⅳ级4例,Ⅴ级1例。结论软通道微创治疗幕上高血压性脑出血具有快速清除血肿、创伤小、操作简单、疗效较可靠的优势,特别适用于基层医院的开展。但缺点是不能有效止血,术后有再出血的可能,术后要严密观察引流管。     

软通道微创术治疗高血压脑出血的临床观察与分析

目的探讨软通道微创术治疗高血压脑出血的临床观察与分析。方法我院于2007年7月至2010年12月共收治40例高血压脑出血患者,采用软通道微创术治疗。结果软通道微创术治疗后,痊愈23例,显效9例,有效5例,无效3例,总有效率为92.5%。结论在神经专科病房开展此项手术,术前、术后由神经专科医生、护士全程管理,有利于患者的急救、系统性治疗与康复,在基层医院具有广泛的推广应用价值。     

腹腔镜胆囊逆行切除临床效果分析

目的 探讨用腹腔镜进行胆囊逆行切除的临床治疗效果。方法 对2003年1月至2011年1月期间我院收治的146例行腹腔镜胆囊逆行切除术的患者的临床资料进行回顾性分析,分析胆囊逆行切除的原因,观察有无胆囊损伤、结石残留、术中转开腹手术的发生,分析治疗效果。结果 逆行切除的原因主要是胆囊三角区粘连严重、胆囊管变异及Mirrize综合症;术中转开腹手术9例、发生胆管损伤1例。结论 腹腔镜胆囊逆行切除术可有效预防肝胆管损伤,治疗效果安全有效。     

无钛法腹腔镜胆囊切除术在基层医院的应用

目的 探讨无钛二孔法腹腔镜胆囊切除术在基层医院的应用价值。方法 将120例行腹腔镜胆囊切除术的患者随机分入对照组与观察组,其中64例对照组患者行钛夹传统四孔法手术治疗,56例观察组患者接受无钛二孔法腹腔镜胆囊切除术。比较2组手术时间、术中出血量、住院时间、术后疼痛及术后并发症发生率。结果 观察组患者均手术成功,无中转开腹病例。观察组手术时间长于对照组(P<0.05);观察组术中出血量、术后疼痛均显著少于对照组,差别具有统计学意义(P<0.01);2组住院时间、术后并发症发生率无显著差别(P>0.05)。结论 无钛二孔法腹腔镜胆囊切除术与钛夹传统四孔法相比疗效相当,同时对机体损伤较小,减轻患者痛苦,只要经过严格培训手术医生均可掌握,适合在基层医院推广应用。     

腹腔镜胆囊切除术中转开腹13例分析

目的探讨腹腔镜胆囊切除术中转开腹手术适应症及时机。方法回顾性分析我院腹腔镜胆囊切除术中转开腹病例情况。结果胆囊区致密性粘连10例,出血2例,胆总管损伤1例,给予中转开腹手术,均痊愈出院。结论熟悉胆囊解剖,规范操作,把握好中转开腹时机,及时果断地开腹是预防LC并发症的关键。     

小切口非超声乳化白内障囊外摘除人工晶体植入在光明工程中的应用

目的 探讨非超声乳化小切口白内障囊外摘除人工晶体植入的优点,及在基层开展复明行动的应用.方法 分析320例(340眼)白内障术后视力及并发症.结果 术后一周视力≥0.6者296例(占89.4%).结论 小切口白内障囊外摘除人工晶体植入术有广泛的实用性,适宜在基层医院开展.     

腹腔镜胆囊切除术并发出血的因素与治疗

我院自2004年5月至2009年3月年共实施LC手术579例,术中因为胆囊动脉,胆囊床出血3例(0.5%),大网膜出血2例(0.3%),膈肌破裂出血1例(0.17%),均开腹手术,术后出血3例(0.5%),1例开腹手术,2例保守治疗,均治愈,无死亡病例。现就笔者经验结合文献对LC手术中,手术后出血的因素和治疗进行讨论。     

Freezing the orientation of a nematic stretched elastomer by photocrosslinking

In this paper we tried to prepare shape memory main chain LC materials, by photopolymerizing (UV-curing) LC elastomers subjected to uniaxial stress. For this purpose, we prepared blends, having different compositions, of a well-known mesogenic diglycidyl-terminated monomer, namely 4,4′-diglycidyloxybiphenyl (DIF), with its homologous bearing lateral photocurable allyl groups (AllDIF). The obtained blends were thermally cured with an aliphatic diacid (decandioic acid, SA), and gave LC networks in all the cases but 100% AllDIF composition. LC networks corresponding to a selected blend composition were subsequently conditioned with a radical photoinitiator, namely 2-hydroxy-2-methyl-1-phenyl propan-1-one and photocrosslinked by UV-curing either as such or while subjected to uniaxial stress. The characteristics of the resulting networks were investigated by means of DSC, XRD, POM, FT-IR, DMTA, and TMA analyses. The effect of UV-curing under stretching and of photoinitiator uptake on the LC phase stability and on the orientation of the networks, as well as on their dynamic-mechanical and thermomechanical response are discussed.     

Static and Dynamic Mechanical Behavior of Electron Beam‐Cured Monomer and Monomer/Liquid Crystal Systems

Summary: This paper discusses static and dynamic mechanical properties of electron beam‐cured mixtures made of the nematic liquid crystal (LC) E7 and either tripropyleneglycol diacrylate (TPGDA) or propoxylated glycerol triacrylate (GPTA) as monomers differing essentially by their functionality. Dilution of the initial mixture with LC leads to a significant weakening of the film mechanical strength. Strong effects were found on Young modulus and rubbery state modulus. As the concentration of LC increases, these mechanical parameters drop significantly together with the glass transition temperature of the polymer showing a plasticizing effect. The results for the glass transition temperatures for the polymer and the LC were confirmed by thermograms obtained by differential scanning calorimetry.

Storage tensile modulus versus temperature of EB‐cured TPGDA/E7 films for different LC concentrations.     

腹腔镜手术治疗急性胆囊炎130例临床疗效观察

目的探讨急性胆囊炎患者施行腹腔镜手术的手术方式选择、安全性及可行性。方法回顾性分析2002年9月至2009年7月在我科行腹腔镜手术的130例急性胆囊炎患者的临床资料。结果112例行腹腔镜胆囊切除术,15例行腹腔镜胆囊大部切除术,3例中转开腹;所有患者均痊愈出院,均无手术死亡及严重并发症发生。结论急性胆囊炎患者采取急诊腹腔镜手术是安全可行的,值得临床推广应用。     

腹腔镜胆囊切除术并发症22例临床分析

目的探讨腹腔镜胆囊切除术并发症的治疗和预防。方法回顾性分析22例LC并发症患者临床资料。结果 22例LC并发症患者中10例胆瘘,8例术后出血,2例胆道结石残留,2例胆管损伤,22例患者均无切口感染现象。结论医护人员应熟悉LC的操作方法,严格遵循LC绝对禁忌证的规定,行腹腔镜胆囊切除术手术前应进行严格的病例筛选,术前的病例筛选对于保障LC手术的安全,减少并发症的发生有着积极的意义。     

Synthesis,phase behaviors,and mechanical properties of biphenyl‐type epoxy resins and composites

Diglycidyl ether of 3,3′,5,5′‐tetramethyl‐4,4′‐biphenyl (TMBPDGE) which has been found great applications in semiconductor packaging was synthesized. The liquid crystalline phases of diglycidyl ether of 4,4′‐dihydroxybiphenol (BPDGE) cured with phenol novolac (PN) were studied by wide angle X‐ray diffraction (WAXD) and polarized optical microscopy (POM). BPDGE was in situ copolymerized with TMBPDGE to improve its thermal and mechanical properties by means of the LC domains retained in the crosslinked networks. The results indicated that a nematic phase was formed and fixed with proper curing schedule when BPDGE was cured with PN that had no neighboring active hydrogens and the LC domains could also be efficiently embedded into the composite systems. Dynamic mechanical properties showed that epoxy networks containing LC domains displayed higher α‐relaxation temperature and linear elastic modulus traces. The impact toughness and T_g were improved with the addition of BPDGE. Scanning electron microscope observation of the fracture surfaces showed that there was a change in failure mechanism in the composite systems. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2007     

Synthesis of liquid–crystalline benzoxazines containing a biphenyl group in the mesogenic moiety

In this work, we describe a process to synthesize novel liquid–crystalline (LC) benzoxazines from a LC phenol that contains biphenyl, ester and azomethine groups in the mesogenic moiety, various alkyl amines and formaldehyde. The LC behavior of the biphenyl-containing benzoxazines was investigated by differential scanning calorimetry and polarized optical microscopy and compared with analogous phenyl-containing LC benzoxazines containing phenyl, ester and azomethine groups in the mesogenic moiety. While the LC benzoxazines containing the phenyl groups only exhibited a nematic phase upon heating, the LC benzoxazines containing biphenyl groups exhibited a smectic phase as well as a nematic phase. Additionally, the LC-isotropic transition temperatures were over 100 °C higher than that for the phenyl-containing LC benzoxazines. A film obtained by curing the biphenyl-containing LC benzoxazine at 180 °C for 1 h exhibited birefringence. Finally, the thermal diffusivity of the cured LC benzoxazines was also investigated.     

Formation of Liquid Crystalline Order and Its Effect on Thermal Conductivity of AlN/Liquid Crystalline Epoxy Composite

The liquid crystalline (LC) order was introduced on aluminum nitride particles by the surface effect to increase the thermal conductivities of aluminum nitride/LC epoxy composites. X-ray diffraction and grazing incidence small-angle X-ray scattering analyses revealed that the LC epoxy resin cured on the surface of an α-Al₂O₃ substrate formed homeotropically aligned smectic layers to increase the thermal conductivity. Therefore, thermally treated aluminum nitride particles, which formed α-Al₂O₃ layers on their surfaces, were applied to prepare the composites with high thermal conductivity. The thermal conductivities of the resulting composites were 11–36% higher than those with the composites prepared using untreated aluminum nitride particles.     

Thermal degradation of LC epoxy thermosets

A novel liquid crystalline (LC) epoxy monomer was cured with different types of hardeners. The thermal‐degradation properties of cured thermosets were evaluated by thermogravimetric (TG) analysis. Several widely used kinetic models were reviewed and used to fit the TG data. The experimental results showed that the methods from one constant heating rate are insensitive to the magnitude of reaction order n. The Kissinger and Osawa methods from multiple processes would give more confident kinetic parameters in these observed systems. © 2000 John Wiley & Sons, Inc. J Appl Polym Sci 75: 1514–1521, 2000     

The effect of chain packing on the thermal and dynamic mechanical behaviour of liquid‐crystalline epoxy thermosets

Liquid‐crystalline thermosets (LCTs) have received considerable attention since they exhibit many interesting properties. However, some aspects concerning LCTs are still unexplored. In particular, the structure–property relationships, as far as the organization of liquid‐crystalline (LC) domains in cured thermosets is concerned, have not been fully elucidated yet. We investigated the effect of the presence of a nematic mesophase on the thermal and dynamic mechanical behaviour of p‐(2,3‐epoxypropoxy)phenyl‐p‐(2,3‐epoxypropoxy)benzoate cured with 2,4‐diaminotoluene. Fourier transform infrared spectral analysis showed that epoxy group conversion was complete in both LC and isotropic (ISO) systems; moreover, a greater amount of intermolecular hydrogen bonding in the LC material was found. Thermogravimetric analysis evidenced similar thermal stability for the two systems, but a kinetic analysis of the data showed that the degradation process is more complex for the LC sample, and is characterized by higher activation energy. Dynamic mechanical thermal analysis (DMTA) showed lower glass transition temperature values for the LC system. Solid‐state NMR analysis evidenced lower paramagnetic oxygen absorption for this system. DMTA results show that the ISO material possesses a larger number of physical crosslinks, which act as extra constraints on the molecular motions. In the case of the LCT, the formation of a locally more dense structure is postulated, where the presence of more extended macromolecular segments leads to a smaller number of physical crosslinks, as also confirmed by solid‐state NMR analysis. A more compact molecular packing also leads to an increase of the activation energies of the thermal degradation process of the LC system. Copyright © 2010 Society of Chemical Industry     

Dielectric relaxation and mechanical properties of liquid crystalline epoxy thermosets

This article describes the dielectric relaxation behavior and mechanical properties of novel liquid crystalline (LC) epoxy thermosets. Thermal simulated current experiments show that there is an additional relaxation caused by the local orientation of mesogens. From the mechanical test, it is found that the LC thermoset exhibits higher tensile strength and even little more deformation. It shows that the cured networks can be strengthened by LC domain orientation. © 2000 John Wiley & Sons, Inc. J Appl Polym Sci 77: 1568–1573, 2000