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邱尔钺 《白求恩军医学院学报》2013,11(3):260-261
目的扩大患者拇指旋转撕脱性离断再植手术的适应证,降低患者因拇指缺损而导致伤残的几率。方法回顾性分析我院收治的16例拇指旋转撕脱性离断再植患者的临床资料,拇指伸屈肌腱修复选取示指固有伸肌腱和环指指浅屈肌腱转位法,拇指血管神经束的缺损修复选取示指掌侧固有动脉神经转位法,指背静脉的缺损修复选用示指指背静脉转位法。合并背侧皮肤缺损修复选用示指指背静脉蒂皮瓣转位法。结果16例拇指旋转撕脱性离断再植均成活,术后随访2年,患者拇指外观及功能恢复良好。结论该方案是治疗拇指旋转撕脱性离断再植的一种操作可行、简单有效的方法,手术成功率高,患者其他各指功能受影响较小,适用范围广,术指功能及外观恢复满意。 相似文献
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拇指完全缺损以往多采用皮管带骨移植、足趾移植以及对侧手指移植等方法再造,这些方法不但需经多次手术,并且再造的拇指缺乏感觉,运动不灵,难以满足功能上的需要。本文介绍由伤手一期移植手指以代替缺损拇指的一种安全方法。此法可将中指、示指或环指连同其肌腱、血管及神经,经一次手术移植到拇指缺损处。作者等用此法再造2例完全性拇指缺损,获得满意的效果,兹报告于下。 相似文献
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我院急诊应用拇趾皮肤趾甲瓣(下称拇甲瓣)游离移植再造拇指获得成功,现报告如下:患者男,18岁,住院号044476。1987年5月16日左拇指被皮带轮绞入,致左拇指套脱伤而急诊入院。伤口检查:左拇指套状撕脱,末节指骨缺损,屈伸肌腱存在,掌指关节活动良好。皮肤缺损范围:掌侧达掌 相似文献
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1980年Morrison首先为一拇指皮肤套状撕脱患者选用蹲趾甲皮瓣移植,施行拇指再造手术获得成功,为拇指皮肤套状撕脱的治疗开拓了新方法。1997年1月~2007年12月,我们应用足趾皮瓣修复拇手指组织缺损50例62指,获得较好疗效,现报告如下。 相似文献
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目的 研究拇指套状撕脱伤的急诊一期修复的最佳方法。方法 运用显微外科技术 ,进行足趾游离组织移植 ,提供了拇手指复杂软组织套状损伤的早期覆盖方法 (附 1例报告 )。结果 应用游离拇甲瓣移植急诊一期拇指再造 ,术后伤口一期愈合 ,再造拇指成活 ,经术后 10个月随访 ,再造拇指外形美现 ,功能良好。结论 游离拇甲瓣移植是急诊一期修复拇指套状撕脱伤再造拇指的最佳方法。 相似文献
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目的观察急诊应用游离第二足趾(或)带足背皮瓣移植。一期修复拇指和手指缺授的临床疗效。方法对本组67例共83指不同程度拇指、示指和中指的缺损,急诊游离第二足趾(或)带足背皮瓣移植,通过不同的动脉和静脉吻合方式,重建血液循环,改进骨的内固定方法和肌腱吻夸方法,再造拇指和手指。结果所有再造指均全部成活,无一例患者出现肌腱断裂和骨不连。走部分病例获得随访6个月~5年,再造指外形皿功能良好,末梢感觉二点分辩率为5~12mm。供区所植的皮片均成活,感觉和外观令人满意。供足术后2~3个月可恢复正常的行走、负重功能。结论急诊游离第二足趾移植再造拇、手指具成活率高的优点,是值得广泛开展的修复手指缺顿的有效方法。 相似文献
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目的:扩大旋转撕脱性拇指离断再植的适应证、减少拇指缺损所致的伤残.方法:取环指指浅屈肌腱和手指固有伸肌腱转位修复拇指伸屈肌腱,取掌侧固有动脉神经转位修复拇指血管神经束缺损,用邻指指背静脉转位修复指背静脉缺损.合并背侧皮肤缺损可用邻指背静脉蒂皮瓣转位来修复皮肤与静脉.结果,自1995年以来,8例拇指掌指关节处旋转撕脱性离断再植均成活,随访半年以上,外现及功能良好.结论:使用该方案对拇指旋转撕脱性离断再植方法稳妥,操作可行,成功率高,适用范围广,对其他各指功能影响小,完全能达到修复拇指功能及外现的临床要求. 相似文献
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Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD. 相似文献
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Jiageng Zhu Jun Li Ruipeng Ji Jianghao Su Mingshun Shen Zhigang Cao 《南京医科大学学报(自然科学版)》2007,21(2):125-128
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment. 相似文献
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Tao Ye * Zhi-quan Liu Jian-jun Mu Xi-han Fu Jun Yang Bao-lin Gao and Xiao-hong Zhang Department of Cardiology First Hospital of Xi'an Jiaotong University Xi'an Hanzhong Cardiovascular Institute Hanzhong 《中国医学科学杂志(英文版)》2004,19(4):248-251
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure. 相似文献
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Xi-zhao Sun Zhi-wei Zhang 《中国医学科学杂志(英文版)》2005,20(3):221-221
Shock wave lithotripsy (SWL) is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it's difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath. 相似文献
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Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction. 相似文献
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INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5 相似文献
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People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia its metabolic origin in Tibetan population.…… 《中国医学科学杂志(英文版)》2007,22(2):F0003-F0003
People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population. 相似文献
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APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES 总被引:13,自引:0,他引:13
Hong Zhao Tie-hu Ye* Zhi-yi Gong Yang Xue Zhang-gang Xue and Wen-qi HuangDepartment of Anesthesiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing Department of Anesthesiology Zhongshan Hospital Fudan University Shanghai Department of Anesthesiology the First Affiliated Hospital Zhongshan University Guangzhou 《中国医学科学杂志(英文版)》2005,20(1):59-62
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle… 相似文献
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目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险. 相似文献
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Jingming Zhu Ningning Hui Xiuhong Jiang Huaxing Zhang Chengzhang Fu 《南京医科大学学报(自然科学版)》2007,21(6):386-389
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients. 相似文献