目的了解本院手术医生执行防止异物遗留措施依从性的现状。方法采用现场观察的方法对本院胃肠科、妇产科、胸科、小儿外科、泌尿科共5个手术专科的200例手术,对实施手术的主刀医生现场执行防止异物遗留措施行为指针的情况进行调查。结果手术医生对防止异物遗留措施总体执行率为84%;择期手术执行率为86%,明显高于急诊手术执行率(79%);第一台手术执行率为95%,明显高于连台手术执行率78%;高级职称手术医生的执行率为87%,优于中级和初级职称手术医生执行率(83%和81%);关闭体腔后执行率为最高(100%),最低为术中管理仅92%。结论本院手术医生对防止异物遗留措施执行状况亟待改善,提高手术医生防止疏忽性异物遗留措施执行率是一项长期艰巨的任务,需要医院政策面、管理层以及医护人员携手努力。

Objective Understand our doctor surgery to prevent foreign body left what measures implementation. Methods Using field observation method in our gastrointestinal branch, gynecology and obstetrics, pediatrics, thoracic surgery, urology surgery were five col-lege of surgery in 200 cases, to carry out the operation of the surgeon field implementation to prevent foreign body left measures be-havior pointer were investigated. Results The operation to prevent foreign body left measures overall executions carried out have is 84%; Executions carried out have elective surgical procedures for 86%, much higher than executions carried out have emergency oper-ation (79%); The first executions carried out have surgery was 95%, much higher than even the station operation executions carried out have 78%; Senior professional title surgery doctor executions carried out have is 87%, which is higher than that of intermediate and primary title surgery doctor executions carried out have (83% and 81%); After

通过对云南省2所三级甲等医院洁净手术室各项运作性指标的动态监测,了解手术间使用率现状及其影响因素。方法:收集2013年1月至2014年1月云南省2所三级甲等医院的17 136例外科手术信息,收集范围为每家医院各5间洁净手术间周一至周五的择期常规外科手术。结果:手术间使用率为(99.52±1.19)%,其中使用率大于100%的占47.0%,使用率为80%~100%的占45.2%,使用率低于80%的占7.8%。回归分析结果显示,以下6个因素影响手术间使用率(P0.01):手术结束时间比预计提前、外科医生是否准时下刀、手术接台之间准备的时间、手术延迟时间、手术间是否被重新安排和手术间是否盈利。结论:有效评估手术间使用率的影响因素,对提高手术间使用率和优化洁净手术室管理、合理利用医疗资源具有积极意义。

Objective:To measure the dynamics of operating rooms using operational indexes that relfected the factors of optimization and resistance and also identiifed the factors associated with the utilization rate of operating room. Methods:The sample consisted of 17 136 cases of operation in two tertiary hospitals in Yunnan province. Data were collected during 12 months from January 2013 to January 2014. Results:The results of utilization rate of operating room was (99.52±1.19)%, of that the 47.0%cases were more than one hundred percent, 45.2%were between eighty percent and hundred percent, and 7.8%were lower than eighty percent. Among all independent variables, only six was signiifcantly associated with dependent variables (P<0.01). Conclusion:The effective assessment of factors affecting the operation efficiency of operation room for improving operation efifciency and optimizing the use of clean operation room management, rational use of medical resources is of positive signiifca

目的：系统评价显微外科和腹腔镜及开放手术治疗精索静脉曲张临床疗效及安全性。方法通过计算机检索系统检索有关显微外科治疗精索静脉曲张的文献，并行Meta分析。结果 Meta分析显示MV复发率及鞘膜积液发生率优于腹腔镜，妊娠率、早期并发症、睾丸萎缩率及住院时间与腹腔镜类似，手术时间长于腹腔镜；MV妊娠率、早期并发症，复发率及鞘膜积液发生率优于开放手术，睾丸萎缩率与开放手术类似，手术时间长于开放手术。结论 MV可以有效保护睾丸动脉及淋巴管，使术后睾丸萎缩、睾丸鞘膜积液、复发等并发症减少，妊娠率提高，但手术时间略长。

Objective To evaluate the efficacy and safety of microsurgical varicocelectomy (MV) and open and laparoscopic surgery for varicocele.Methods Clinical literatures about microsurgical varicocelectomy and varicocele were reviewed and identified for meta-analysis.Results The meta-analysis showed the incidence of varicocele recurrence and postoperative hydrocele was significantly lower in the MV group than that in the laparoscopic surgery group. The pregnancy rate, duration of hospital stays and incidence of testicular atrophy were similar in both groups. The pregnancy rate, incidence of varicocele recurrence and postoperative hydrocele was significantly lower in the MV group than that in the open surgery group. The incidence of testicular atrophy were similar in both groups. The MV group had a longer operation time, as compared with that of laparoscopic and surgery.Conclusion MV can protect testicular artery and lymph vessel, and has a lower incidence of varicocele recurrence, testicular a

目的：通过开展目标性监测，了解骨科手术部位感染率及骨科手术医生感染专率；建立骨科手术部位感染监测数据的比较体系；评价控制效果，有效降低骨科手术部位感染。方法采用前瞻性监测方法，监测2012年1月-2012年12月骨科所有手术患者，填写监测表格，出院后电话随访，并对感染发生率等多项指标进行统计分析。结果963例手术患者发生15例手术部位感染，感染率为1.56%；经对比，自身因素、年龄、及住院时间与切口感染相关，危险指数等级升高，感染率明显增高（P＜0.05）；急诊手术感染率高于择期手术；手术切口类型级别越高，感染发生率越高。结论目标监测是一种前瞻性的科学监测方法，通过监测骨科手术部位危险因素，并采取综合性预防控制干预措施来预防和降低感染发生率。

Objective To understand orthopedic surgical site infection rate and establish infection monitoring data system so as to evaluate control ing effect and reduce effectively orthopedic wound infection. Methods From Jan to Dec in 2012 ,al of the orthopedic surgical patients were monitored by fil ing in forms and fol owing-up with a prospective method, and were made a statistical analysis. Results There were 15 wound infections in 963 cases. The incidence was 1.56%. The infections were related to patient''s individual factors, age, and time of hospitalization. Infection rate in those who had a danger index increased significantly (P < 0.05). The infection rate in emergency patients was higher than in elective ones. The higher the grade of incision type was, the higher the rate of infection was. Conclusion The objective monitoring is a prospective and scientific method. We can take comprehensive prevention and control ing intervention measures to prevent and reduce the incidence of infection

腹腔镜手术具有减轻术后疼痛、创伤性小、恢复所需时间等优势，已被各大医院应用于临床手术治疗当中。本文主要通过对腹腔镜结直肠癌手术的优势、手术方式、安全性、根治性以及复发率与生存率进行论述，探讨腹腔镜结直肠癌手术研究进展。

Laparoscopic surgery can relieve postoperative pain,trauma small,recovery time and other advantages,Has been used in clinical surgery among major hospitals.In this paper,through the advantages of laparoscopic surgery in colorectal cancer,surgical procedures,security,radical and recurrence rate and survival are discussed,Progress Discussion laparoscopic surgery in colorectal cancer.