目的探讨腹腔镜辅助下经脐"Z"形切口小儿美克尔憩室切除术的可行性。方法 2010年6月～8月,采用两孔法腹腔镜经脐孔"Z"形切口对6例小儿美克尔憩室行切除术。于脐孔及左下腹分别置入5 mm trocar,探查找到憩室后,延长...目的探讨腹腔镜辅助下经脐"Z"形切口小儿美克尔憩室切除术的可行性。方法 2010年6月～8月,采用两孔法腹腔镜经脐孔"Z"形切口对6例小儿美克尔憩室行切除术。于脐孔及左下腹分别置入5 mm trocar,探查找到憩室后,延长脐部切口成"Z"形,将憩室提出腹腔外行切除吻合。结果 6例均顺利完成经脐"Z"形切口腹腔镜辅助手术,无中转开腹手术。术后4 d进食流质,5～8 d出院。无脐疝、肠瘘及肠梗阻等并发症发生。结论经脐"Z"形切口腹腔镜辅助切除小儿美克尔憩室具有创伤小、切口更加隐蔽、美容效果好等优点,安全可行。展开更多
目的探讨经脐"Z"形切口腹腔镜辅助逆行切除小儿阑尾的临床价值。方法沿脐环2点与8点连线做直切口切开全层,至脐环边缘皱褶横纹时呈反向切开皮肤横跨腹白线,形成"Z"字形切口,共长约2～3 cm,置入10 mm trocar建立气腹...目的探讨经脐"Z"形切口腹腔镜辅助逆行切除小儿阑尾的临床价值。方法沿脐环2点与8点连线做直切口切开全层,至脐环边缘皱褶横纹时呈反向切开皮肤横跨腹白线,形成"Z"字形切口,共长约2～3 cm,置入10 mm trocar建立气腹,压力维持在10～12 mm Hg,置腹腔镜探查腹腔显露回盲部,吸净右下腹及盆腔渗出液,无损伤抓钳抓住阑尾近根部连同腹腔镜自"Z"形切口一并提出腹腔外,常规逆行切除阑尾。回盲部送还腹腔后,重建气腹,进镜观察阑尾残端及系膜有无出血等异常情况,退镜放气腹,清洗、消毒脐部切口,2-0可吸收线缝合关闭。结果 16例经脐"Z"形切口腹腔镜辅助逆行切除阑尾成功;3例因阑尾短粗、系膜较短、回盲部较固定,自脐孔提出困难,改为两孔法阑尾切除术;2例因阑尾脓肿形成中转开腹手术。6例术后脐部感染,经换药痊愈。16例随访1～3个月,无粘连性肠梗阻、阑尾残株炎、粪漏等并发症发生。结论脐"Z"形切口腹腔镜辅助逆行阑尾切除,安全可行,切口隐蔽,美容效果好。展开更多
In this study,the effect of influencing parameters on the stress distribution around a polygonal cutout within a laminated composite under uniform heat flux was analytically examined.The analytical method was develope...In this study,the effect of influencing parameters on the stress distribution around a polygonal cutout within a laminated composite under uniform heat flux was analytically examined.The analytical method was developed based on the classical laminated plate theory and two-dimensional thermo-elastic method.A mapping function was employed to extend the solution of a perforated symmetric laminate with a circular cutout to the solution of polygonal cutouts.The effect of significant parameters such as the cutout angular position,bluntness and aspect ratio,the heat flux angle and the laminate stacking sequence in symmetric composite laminate containing triangular,square and pentagonal cutouts was studied.The Neumann boundary condition was used at the edges of the thermally insulated polygonal cutout.The laminate was made of graphite/epoxy(AS/3501) material with two different stacking sequences of [30/45]sand[30/0/-30]_(s).The analytical solutions were well validated against finite element results.展开更多
文摘目的探讨经脐"Z"形切口腹腔镜辅助逆行切除小儿阑尾的临床价值。方法沿脐环2点与8点连线做直切口切开全层,至脐环边缘皱褶横纹时呈反向切开皮肤横跨腹白线,形成"Z"字形切口,共长约2～3 cm,置入10 mm trocar建立气腹,压力维持在10～12 mm Hg,置腹腔镜探查腹腔显露回盲部,吸净右下腹及盆腔渗出液,无损伤抓钳抓住阑尾近根部连同腹腔镜自"Z"形切口一并提出腹腔外,常规逆行切除阑尾。回盲部送还腹腔后,重建气腹,进镜观察阑尾残端及系膜有无出血等异常情况,退镜放气腹,清洗、消毒脐部切口,2-0可吸收线缝合关闭。结果 16例经脐"Z"形切口腹腔镜辅助逆行切除阑尾成功;3例因阑尾短粗、系膜较短、回盲部较固定,自脐孔提出困难,改为两孔法阑尾切除术;2例因阑尾脓肿形成中转开腹手术。6例术后脐部感染,经换药痊愈。16例随访1～3个月,无粘连性肠梗阻、阑尾残株炎、粪漏等并发症发生。结论脐"Z"形切口腹腔镜辅助逆行阑尾切除,安全可行,切口隐蔽,美容效果好。
文摘In this study,the effect of influencing parameters on the stress distribution around a polygonal cutout within a laminated composite under uniform heat flux was analytically examined.The analytical method was developed based on the classical laminated plate theory and two-dimensional thermo-elastic method.A mapping function was employed to extend the solution of a perforated symmetric laminate with a circular cutout to the solution of polygonal cutouts.The effect of significant parameters such as the cutout angular position,bluntness and aspect ratio,the heat flux angle and the laminate stacking sequence in symmetric composite laminate containing triangular,square and pentagonal cutouts was studied.The Neumann boundary condition was used at the edges of the thermally insulated polygonal cutout.The laminate was made of graphite/epoxy(AS/3501) material with two different stacking sequences of [30/45]sand[30/0/-30]_(s).The analytical solutions were well validated against finite element results.
