手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件

經(jīng)皮脊髓切斷術(shù)手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)經(jīng)皮脊髓切斷術(shù)于術(shù)資料:經(jīng)皮脊髓切斷術(shù)經(jīng)皮脊髓切斷術(shù)科室:神經(jīng)外科部位:盆腔麻醉:全身麻醉于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述傳導(dǎo)痛覺(jué)的二級(jí)神經(jīng)纖維自脊髓后角發(fā)出后,經(jīng)前連合進(jìn)入對(duì)側(cè)脊髓丘腦側(cè)束,因此沿脊髓中線通過(guò)一次手術(shù)將前白連合切斷,可使雙側(cè)軀體的痛溫覺(jué)節(jié)段性喪失以解除該區(qū)疼痛,同時(shí)又可不損傷其他脊髓傳導(dǎo)通路,避免了嚴(yán)重并發(fā)癥。這種手術(shù)最早始于Armour與Greenfield(1926)以后P經(jīng)皮脊髓切斷手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)經(jīng)皮脊髓切斷1于術(shù)資料:經(jīng)皮脊髓切斷術(shù)經(jīng)皮脊髓切斷術(shù)科室:神經(jīng)外科部位:盆腔麻醉:全身麻醉于術(shù)資料:經(jīng)皮脊髓切斷術(shù)2于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述傳導(dǎo)痛覺(jué)的二級(jí)神經(jīng)纖維自脊髓后角發(fā)出后,經(jīng)前連合進(jìn)入對(duì)側(cè)脊髓丘腦側(cè)束,因此沿脊髓中線通過(guò)一次手術(shù)將前白連合切斷,可使雙側(cè)軀體的痛溫覺(jué)節(jié)段性喪失以解除該區(qū)疼痛,同時(shí)又可不損傷其他脊髓傳導(dǎo)通路,避免了嚴(yán)重并發(fā)癥。這種手術(shù)最早始于Armour與Greenfield(1926)以后P于術(shù)資料:經(jīng)皮脊髓切斷術(shù)3于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述utnam(1934Lerich(1936)Wertheimer(1949)Arutiunov(1952)、Lermbcke(1964)等人均有報(bào)道。他們用胸髓下部或腰髓前連合切開(kāi)術(shù)以解除盆腔或下腹腔臟器癌腫,如前列腺瘤、宮頸癌、直腸癌和結(jié)腸癌等所致的疼痛。據(jù)Werthe于術(shù)資料:經(jīng)皮脊髓切斷術(shù)4于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述imer(1953)報(bào)道,在一組較多病例所進(jìn)行的腰段脊髓前連合切開(kāi)術(shù)治療下肢、骨盆與會(huì)陰部惡痛中,術(shù)后可發(fā)生根痛、下肢感覺(jué)異常、下肢肌力減退、括約肌功能障礙,其中有數(shù)例死亡,且病殘率較高。術(shù)后近期隨訪,33%疼痛解除,32%好轉(zhuǎn)35%無(wú)效。Dargent(1963)追隨這組病人于術(shù)資料:經(jīng)皮脊髓切斷術(shù)5于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述隨訪,發(fā)現(xiàn)此手術(shù)遠(yuǎn)期僅對(duì)陰道及內(nèi)臟疼痛有效,直腸及下肢疼痛不如脊髓前外側(cè)切開(kāi)術(shù)。以后Cook(1977)、King(1977)等采用顯微外科技術(shù)進(jìn)行這種手術(shù),脊髓切開(kāi)的范圍較長(zhǎng),且治療范圍除前述者外,還擴(kuò)展到上胸及下頸段脊髓前連合以解除上腹、胸、甚至上肢等部位,由肺癌、乳腺癌和胃于術(shù)資料:經(jīng)皮脊髓切斷術(shù)6于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述癌等所致的惡痛,其中還有少數(shù)因非腫瘤性疾病(如蛛網(wǎng)膜炎、脊髓外傷等)所致的疼痛綜合征,效果較前改善。于術(shù)資料:經(jīng)皮脊髓切斷術(shù)7于術(shù)資料:經(jīng)皮脊髓切斷術(shù)適應(yīng)證脊髓前連合切斷術(shù)適用于:于術(shù)資料:經(jīng)皮脊髓切斷術(shù)8于術(shù)資料:經(jīng)皮脊髓切斷術(shù)適應(yīng)證本手術(shù)適用于盆腔或胸、腹腔惡性腫瘤所致的胸、腹、盆腔、會(huì)陰或下肢的頑固性疼痛,經(jīng)一次手術(shù)便可解除兩側(cè)疼痛。此外,也適用于因脊髓蛛網(wǎng)膜炎、外傷、神經(jīng)根炎等非惡性腫瘤所致的頑固性疼痛。于術(shù)資料:經(jīng)皮脊髓切斷術(shù)9于術(shù)資料:經(jīng)皮脊髓切斷術(shù)手術(shù)禁忌無(wú)禁忌癥相關(guān)的內(nèi)容。于術(shù)資料:經(jīng)皮脊髓切斷術(shù)10手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件11手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件12手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件13手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件14手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件15手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件16手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件17手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件18手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件19手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件20手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件21手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件22手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件23手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件24手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件25手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件26手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件27手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件28手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件29手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件30手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件31手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件32手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件33手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件34手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件35經(jīng)皮脊髓切斷術(shù)手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)經(jīng)皮脊髓切斷術(shù)于術(shù)資料:經(jīng)皮脊髓切斷術(shù)經(jīng)皮脊髓切斷術(shù)科室:神經(jīng)外科部位:盆腔麻醉:全身麻醉于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述傳導(dǎo)痛覺(jué)的二級(jí)神經(jīng)纖維自脊髓后角發(fā)出后,經(jīng)前連合進(jìn)入對(duì)側(cè)脊髓丘腦側(cè)束,因此沿脊髓中線通過(guò)一次手術(shù)將前白連合切斷,可使雙側(cè)軀體的痛溫覺(jué)節(jié)段性喪失以解除該區(qū)疼痛,同時(shí)又可不損傷其他脊髓傳導(dǎo)通路,避免了嚴(yán)重并發(fā)癥。這種手術(shù)最早始于Armour與Greenfield(1926)以后P經(jīng)皮脊髓切斷手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)經(jīng)皮脊髓切斷36于術(shù)資料:經(jīng)皮脊髓切斷術(shù)經(jīng)皮脊髓切斷術(shù)科室:神經(jīng)外科部位:盆腔麻醉:全身麻醉于術(shù)資料:經(jīng)皮脊髓切斷術(shù)37于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述傳導(dǎo)痛覺(jué)的二級(jí)神經(jīng)纖維自脊髓后角發(fā)出后,經(jīng)前連合進(jìn)入對(duì)側(cè)脊髓丘腦側(cè)束,因此沿脊髓中線通過(guò)一次手術(shù)將前白連合切斷,可使雙側(cè)軀體的痛溫覺(jué)節(jié)段性喪失以解除該區(qū)疼痛,同時(shí)又可不損傷其他脊髓傳導(dǎo)通路,避免了嚴(yán)重并發(fā)癥。這種手術(shù)最早始于Armour與Greenfield(1926)以后P于術(shù)資料:經(jīng)皮脊髓切斷術(shù)38于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述utnam(1934Lerich(1936)Wertheimer(1949)Arutiunov(1952)、Lermbcke(1964)等人均有報(bào)道。他們用胸髓下部或腰髓前連合切開(kāi)術(shù)以解除盆腔或下腹腔臟器癌腫,如前列腺瘤、宮頸癌、直腸癌和結(jié)腸癌等所致的疼痛。據(jù)Werthe于術(shù)資料:經(jīng)皮脊髓切斷術(shù)39于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述imer(1953)報(bào)道,在一組較多病例所進(jìn)行的腰段脊髓前連合切開(kāi)術(shù)治療下肢、骨盆與會(huì)陰部惡痛中,術(shù)后可發(fā)生根痛、下肢感覺(jué)異常、下肢肌力減退、括約肌功能障礙,其中有數(shù)例死亡,且病殘率較高。術(shù)后近期隨訪,33%疼痛解除,32%好轉(zhuǎn)35%無(wú)效。Dargent(1963)追隨這組病人于術(shù)資料:經(jīng)皮脊髓切斷術(shù)40于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述隨訪,發(fā)現(xiàn)此手術(shù)遠(yuǎn)期僅對(duì)陰道及內(nèi)臟疼痛有效,直腸及下肢疼痛不如脊髓前外側(cè)切開(kāi)術(shù)。以后Cook(1977)、King(1977)等采用顯微外科技術(shù)進(jìn)行這種手術(shù),脊髓切開(kāi)的范圍較長(zhǎng),且治療范圍除前述者外,還擴(kuò)展到上胸及下頸段脊髓前連合以解除上腹、胸、甚至上肢等部位,由肺癌、乳腺癌和胃于術(shù)資料:經(jīng)皮脊髓切斷術(shù)41于術(shù)資料:經(jīng)皮脊髓切斷術(shù)概述癌等所致的惡痛,其中還有少數(shù)因非腫瘤性疾病(如蛛網(wǎng)膜炎、脊髓外傷等)所致的疼痛綜合征,效果較前改善。于術(shù)資料:經(jīng)皮脊髓切斷術(shù)42于術(shù)資料:經(jīng)皮脊髓切斷術(shù)適應(yīng)證脊髓前連合切斷術(shù)適用于:于術(shù)資料:經(jīng)皮脊髓切斷術(shù)43于術(shù)資料:經(jīng)皮脊髓切斷術(shù)適應(yīng)證本手術(shù)適用于盆腔或胸、腹腔惡性腫瘤所致的胸、腹、盆腔、會(huì)陰或下肢的頑固性疼痛,經(jīng)一次手術(shù)便可解除兩側(cè)疼痛。此外,也適用于因脊髓蛛網(wǎng)膜炎、外傷、神經(jīng)根炎等非惡性腫瘤所致的頑固性疼痛。于術(shù)資料:經(jīng)皮脊髓切斷術(shù)44于術(shù)資料:經(jīng)皮脊髓切斷術(shù)手術(shù)禁忌無(wú)禁忌癥相關(guān)的內(nèi)容。于術(shù)資料:經(jīng)皮脊髓切斷術(shù)45手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件46手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件47手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件48手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件49手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件50手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件51手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件52手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件53手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件54手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件55手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件56手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件57手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件58手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件59手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課件60手術(shù)講解模板：經(jīng)皮脊髓切斷術(shù)課