一、 传统胆囊切除术:於腹部正中位置,有一长条形伤口。 二、 腹腔镜胆囊切除术:以腹腔镜进入腹腔切除胆囊,肚脐周围有一个约 1 公分大小之伤 口,右上腹下肋缘有 2 ~3 个 0.5~1 公分的伤口。 这两种手术方式,达到目的及效果完全一 样,但在术后疼痛、住院天数、美观上有所差别: 胆囊切除术适应症 1.急性化脓性、坏疽性、出血性或穿孔性胆囊炎。 2.慢性胆囊炎反复发作,经非手术治疗无效者。 3.胆囊结石,尤其是小结石容易造成阻塞者。 4.胆囊无功能,如胆囊积水和慢性萎缩性胆囊炎。 5.胆囊颈部梗阻症医学教,育网|搜集整理。 6.胆囊肿瘤。 7.作俄狄括约肌切开成形术,或胆总管十二指肠吻合术的同时,应切除胆囊。 8.胆囊瘘管、胆囊外伤破裂而全身情况良好者。 各种不同类型有明显临床症状的胆囊结石, 如单纯慢性胆囊炎并结石、 慢性萎缩性胆囊炎并 结石、充满型胆囊结石、慢性胆囊炎结石嵌顿等。 2、胆囊息肉样病变。 3、陶瓷胆囊,因其胆囊癌发生率高达 25%;胆囊结石超过 3cm,即使无明显症状亦应积极 治疗,因结石大于 3cm 的胆囊结石患者,其胆囊癌发生率明显高于结石小于 3cm 者;无症 状性胆囊结石合并胆囊息肉者 4、糖尿病患者合并胆结石,一出现临床症状,应尽早手术治疗 5、虽然肝硬化病人不是 LC 的禁忌证,但属于困难的 LC 手术,因为门静脉高压症胆囊周 围及胆囊三角区血管丰富,易出血,易发生粘连,作此手术应慎重。 6、慢性胆囊炎并结石急性发作患者,大多数用解痉、止痛、抗炎等治疗后,急性胆绞痛的 临床症状和体征能迅速缓解,抓紧手术时机即可,而另一类型为胆囊结石嵌顿,虽对症用药 处理,体征和症状均不能缓解,胆囊壁易发生坏死、甚至胆囊穿孔形成腹膜炎,这种病人尽 早手术,超过 24 小时不宜作 LC 手术。 胆囊切除术禁忌症 急性梗阻性化脓性胆管炎。 2. 急性坏死性胰腺炎。 proje ct work, cadres , cadre s sele ction and ot her as pects of a total of 19, furt her defined t he dire ction of rectificati on, enhancing the perti nence and effectivene ss of democrati c life. 能 鉴 生 高 提 步 一 歌 诗 代 2古 修 必 是 图 意 置 设 元 单 本 。 受 美 审 富 丰 得 获 力 魅 术 艺 悟 析 赏 行 进 品 作 对 面 方 等 巧 技 现 表 、 容 内 从 习 学 , 上 础 基 的 知 感 体 整 在 Good for thi s meeting, we requested t he Standing Committee of the munici pal party Committee, munici pal Secretary General Ta ng Wenjin, t he City Commissi on for disci pli ne inspe ction Standi ng Committee Ya ng Xu, Jiang Jixue, D eputy Direct or of the personnel off ice, a nd other lea ding comrade s prese nt gui dance all ows us to warm a ppla use for their welcome a nd tha nks! Below, I first District Committee member of the 20XX team annua l democratic meeti ng implementati on of the corrective meas ures, a s well as mem ber of the team a nd of my own report gui delines for the im plementation of the indepe nde nt Commission against corr upti on stateme nt invited lea ders a nd comrade s criticis m. First, annual party on t he 20 XX team, M ember of democratic life acti on pl an impl ementation year 20 XX, distri ct democrati c meeting a mem ber of the team on "study and practi ce t he s cientific Outl ook on devel opment" theme, find a pr oject supporting strong e nough, t he industry well e nough, urba n constructi on ma nagement leve l nee ds t o be im proved, liveli hoo d impr ovement needs to be strengt hened, district team itse lf, such as t he five as pects . Year of 20 XX, w e find out t he probl ems menti one d above, based on act ual Shunqing construction and devel opme nt, conscie ntiously s um up improveme nts, a chievi ng sig nificant devel opment re sults and effectivenes s of their work. (A) highlight the project handle, mai ntain high gr owth of investment. A dhere to t he strategy as a Foundati on, carrying out proje cts to promote increased stamina im portant. One is t o increase t he inte nsity of proje cts towards. Actively s eek nati onal and provi nci al policy support, superi or special tra nsfer pay ments, a varie ty of a dditi onal i ncome will t op 7 00 million Yuan, a num ber of key infrastructure proj ects, l ivelihood proje cts, i ndustrial proje cts int o the cage. Second, i ncreasi ng the pr oject attra cts. T his year a total of 23 sig ned a major proj ect, of whi ch 14 billion proje ct, China Metall urgical group, vanke gr oup, G uang dong he ngda gr oup, Taiwan Ruentex group, on the RI group, S henzhe n Kaisa, jife ng agricult ural machi ner y, Mer cede s-Be nz, A udi 4S store and ot her large e nterpri ses a nd proj ects have s ettled i n Shunqing. Third, strengt hen proj ect construction . Annua l impleme ntation focus pr oje ct 39 a , fixed as sets inve stment total w ill bre akthrough 12 billion yua n, created district y ilai history high, S outh door dam, and five in shop ol d city tra nsformation, and Yi ng China industrial concentrated district construction, a nd city main r oad construction, a nd Nort heast steam Trade Ce nter, and modern farmers i ndustry Park, and vocational educati on city, and low rental, and als o room constr ucti on, a nd features blocks buil d, a nd f armers market transformati on, and "rural versi on" Street transformation, focus engine ering s peed up implementation, effectivene ss o bviousl y. Expe cted to be achieved t his year, are a-wi de G DP 17 billion thrift of excellent traditi onal a nd style lack dee p of understa ndi ng, one -si ded t hink i n now of good s ituation Xi a, economic sm ooth more fast devel opme nt, and reform made major progres s, a nd people living significantly improve , and s ocial t he care er made new pr ogress, no ne cessary always ha rd has, no a warene ss to Chi na als o ha s many poverty area, a nd al so has many poverty population of exists, m ore living impr ove ha s, more need ke ep hard of style . Thre e is not strictly honest. Total thought units i s a water se ctor, cle an s elf-dis cipline away from himself too far, no real pr oce ssing good living of impr ove and har d, and thrift excell ent traditional of relationshi p, no effective do comply with Constituti on a nd party of regulati ons must from I do up, no right mer cy good bitter Le, a nd wealt h of relati ons hip, no rig ht aware ness t o in comply with Constitution and party of regulations as pect s everyone ha s accountability. Four, f uture dire cti on a nd impr ovement meas ures 1, belief a nd faith, strengthe n party s pirit. One i s to firmly establi sh t he noble ideal s of struggl e for the i deals of communism, communist str uggle for life, ready t o sa crifice everyt hing for t he party a nd t he people. Se cond is t o conti nuously im prove the quality and standard of political, cons cienti ously study Deng Xi aopi ng the ory and "three re present s" important t hought a nd the scientific Outl ook on development, im plement t he party's basi c pr ogram for the pr imary stage of s ociali sm, adhere to t he corre ct politi cal orientation, maintai n hig hly consistent w ith the CPC Ce ntral Committee, is good at t heorie s of socialism wit h Chine se characteri stics t o ana lyze and s olve pr oblem s. Third, strengt heni ng the party s pirit and the w orld tra nsformation, per severance of the party Constitution, relive Party vows t o establish corre ct worl d Outlook, Outlook on life and the worl d, pra ctically em bodies i deals and be liefs into action, combi ne l ofty ideals a nd practi cal activitie s, transformi ng the obj ective w orld, actively participate i n the great pra ctice of buil ding s ocialism with Chi nese chara cteristics. 2, kee p the purpose i n concept, cha nging the styl e of work. First, kee p in mi nd that the pur pose of servi ng, a dhere to a ssumi ng power for the people, kee p in mind the people and care a bout pe ople, a nd t he joys a nd sorrows of the masse s, ... According to city dis cipli ne, and municipal organi zation Departme nt requireme nts, today we hel d "implement impl ementation independent Commissi on against corr upti on gui deli nes effective strengt heni ng led cadres style construction" topi c democratic life, main task i s cl ose conta ct thought, and work a ctual , control che ck distri ct Standi ng Committee team and the personal in im plementation independent Com missi on agai nst corr upti on guideli nes Shang exists of probl em, in-de pth carrie d out critici sm and self-criti cal, further clear re ctification dire ction and mea sures , effective enhanced cl ean politi cs of cons cious ness a nd i nitiati ve, firm set good of ruli ng image. Before t he meeting, t he way we take survey s soli cited a vie ws, combe d, related to team buil ding 饮食注意不要过分油腻, 手术后至少 15 天内,患者都应遵守如下的饮食规则(表 1),尽量避免 食用油炸食品(炸薯条、炸肉等)、甜食(蛋糕、巧克力、奶油等)、高胆固醇食物(鸡蛋、肝脏 和虾等)和绿色蔬菜(生菜、豆荚等)。之后可以逐渐恢复以前的饮食习惯,但建议患者日常饮 食中以软质食物为主,减少热量和精细碳水化合物的摄入,在减少脂肪和胆固醇摄入的同时还 应多摄入膳食纤维 胆囊术后早期宜采用低脂肪、低胆固醇、含充足的优质蛋白、维生素和微量元素的饮食,并 至少维持 2 周。 术后脂肪摄入量不超过每日 30 g,胆固醇摄入量不高于每日 300 mg,每日能量 摄入以 20~25 kcal/kg 为宜。膳食纤维应选择来自果胶、藻胶、豆胶的可溶性纤维,并保证足 量饮水。饮食应采用清炖、清蒸等方法制备的少渣软饭,避免油炸和油煎也很重要。