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Jingdong book

普通外科手术并发症

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Books Medical Science Surgery
Jingdong book

普通外科手术并发症

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《普通外科手术并发症》共分十二章，主要包括继发性腹膜炎引流术后并发症、腹膜后肿瘤手术并发症、胃十二指肠疾病手术并发症、普外科应激性溃疡、小肠术后并发症、大肠手术术前准备及并发症、大肠手术并发症、阑尾切除术后并发症、肝胆手术并发症、胰腺手术并发症、门静脉高压症术后并发症和腹腔镜手术并发症。每章都系统地阐述了普通外科手术常见并发症的原因、临床表现、处理方法和预防措施。《普通外科手术并发症》内容新颖，并发症介绍全面、系统，章节结构风格一致，读者查阅方便。
Catalogue

第一章 继发性腹膜炎引流术后并发症
第二章 腹膜后肿瘤手术并发症
第一节 术中出血
第二节 术后出血
第三节 腹腔及盆腔脏器损伤
第四节 肾、输尿管及膀胱损伤
第五节 腹膜后血肿和感染

第三章 胃十二指肠疾病手术并发症
第一节 胃大部切除术后近期并发症
第二节 胃大部切除术后远期并发症
第三节 高选迷走神经切断术后并发症
第四节 急性胃扩张
第五节 十二指肠憩室术后并发症
第六节 肠系膜上动脉压迫综合征术后并发症
第七节 贲门癌根治术术后并发症

第四章 普外科应激性渍疡

第五章 小肠术后并发症
第一节 粘连性肠梗阻
第二节 肠瘘
第三节 短肠综合征
第四节 盲襻综合征

第六章 大肠手术术前准备及并发症
第一节 肠道准备
第二节 结肠镜检查并发症

第七章 大肠手术并发症
第一节 大肠急症手术并发症
第二节 大肠根治切除术并发症

第八章 阑尾切除术后并发症
第一节 感染性并发症
第二节 腹腔内粘连
第三节 术后出血

第九章 肝胆手术并发症
第一节 肝损伤术后并发症
第二节 肝切除术后并发症
第三节 胆道手术并发症
第四节 脾切除术后并发症

第十章 胰腺手术并发症
第一节 胰腺手术常见并发症
第二节 胰腺癌手术并发症
第三节 急性出血坏死性胰腺炎腹腔引流术后并发症
第四节 胰腺囊肿手术并发症
第五节 胰腺内分泌肿瘤手术并发症

第十一章 门静脉高压症术后并发症
第一节 术后腹腔出血
第二节 术后消化道再出血
第三节 术后发热
第四节 肝性脑病
第五节 肝肾综合征
第六节 直视下胃冠状静脉栓塞术治疗门静脉高压症的并发症

第十二章 腹腔镜手术并发症
第一节 腹腔镜手术的共有并发症
第二节 腹腔镜胆囊切除术后并发症
Book Abstract

一、高选迷走神经切术后近期并发症
1.胃潴留随着对迷走神经解剖的不断了解以及手术方法的不断改进，此并发症已逐渐减少。多发生在术后3-4日，即拔除胃管后。表现为上腹饱胀不适，呕吐所进食物或带有胆汁。
2.胃小弯坏死穿孔这是一种少见但非常严重的并发症，也多见于高选择性迷走神经切断术后。胃小弯前后壁2cm的血运来自胃左动脉、胃右动脉的末端分支，且其黏膜下缺乏吻合支，是血运较差的部位，手术时分离胃小弯的血管范围过广，甚至损伤了胃壁，特别是同时损伤了胃短血管，造成胃小弯胃壁缺血、坏死和穿孔。术中分离切断小弯神经血管应尽量不损伤胃组织，一旦出现血运不良，应将胃小弯浆肌层进行缝合，即再浆膜化及加固血运差的区域，以免发生术后坏死穿孔。胃小弯坏死穿孔多在术后3~6日，应及时行穿孔修补或局部切除，必要时行上半胃切除（因穿孔多在胃小弯近贲门处）。
3.术后腹腔出血多因切断神经支时胃小弯血管回缩或结扎后牵拉胃壁使线结滑脱，故对胃小弯血管均应缝扎并修补剥离受损的小弯腹膜。术后发生腹腔出血表现者，应剖腹探查止血。
4.吞咽困难发生原因有食管下端迷走神经剥离时引起食管运动失调、分离食管时术后粘连及周围炎性反应，多在术后进食固体食物时出现症状。术中操作轻柔和避免反复揉捏是主要预防措施。多可自行缓解，如不能缓解，可行食管扩张术或粘连松解术。
二、高选迷走神经切术后远期并发症
1.复发性溃疡目前迷走神经切断术治疗溃疡病的复发率仍很高。从目前的报道看，迷走神经干切断术附加引流术和选择性迷走神经切断术加引流术溃疡复发最高。胃大部切除术、迷走神经切断术加胃窦部切除和高选择性迷走神经切断术的溃疡复发率基本相似。
复发原因：术前对术式选择不当；迷走神经切断不完善；胆汁反流等溃疡复发多在术后1-3年。首选内科疗法，对内科疗法无效而症状较重者应行手术治疗，具体术式依胃酸高低而定。
……

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