>患者女,24岁。1年前发现右下腹肿块,按压过程中出现心悸、出汗、头晕、乏力、面色苍白等症状。腹部增强CT扫描提示右肾门水平以下,腹主动脉旁直径约4.5 cm圆形肿块,压迫下腔静脉,紧邻肠系膜上动脉走形。诊断为"腹主动脉旁副神经节瘤"。入院后行正电子发射型计算机断层显像(PositronEmission Computed Tomography)后考虑全身骨转移。予以气管内插管,全麻,平卧,右侧垫高约45°。实时监测动脉和中心静脉压力。选择经腹膜途径,沿脐下缘皱褶处取长约2 cm弧形切口,逐层钝性分离腹直肌前鞘,腹直肌及腹直肌后鞘和腹膜,置入单孔多通道操作平台,保持气密性,分别在各通道置入一体化镜头,超声刀和专用加长四方可弯曲操作钳。常规建立气腹,压力维持在14～15 mm Hg(1 mm Hg=0.133 kPa),在肾下极水平游离输尿管,避免损伤。明确肿瘤的位置和边界后,将其解剖游离,确保肿瘤包膜完整,彻底止血,留置腹腔

目的探讨腹腔镜下通过改进的原位低温肾灌注方法实现肾脏低温保护的肾部分切除术的手术配合。方法根据手术特点,做好充分的术前准备工作,掌握手术步骤,术中密切配合,保证手术顺利完成。结果 5例均顺利完成。结论原位肾低温灌注腹腔镜下肾部分切除术安全可行,同时解决了腹腔镜下动脉阻断和低温灌注2个难题,有利于延长肾缺血时间、保护肾功能。

Objective To describe the cognitive levels about cervical cancer and it' s screening.Methods The investigated result of 100 women from a community in Beijing were analysed by a scale with convenience sampling method. Results The score of cervical cancer and the screening was lower than the average level. Only 38% can have medical checkups within last 2 years. There were also 38% have Palestinian cytology inspection and only 3% have the habit of having medical checkups at the regular intervals. Conclusions Women in community had lower cognitive levels about the cervical cancer and it's screening, and were short of relevance knowledge. They have prevention consciousness without pertinent activity.