放射疗法在整形美容中的应用策略

目的探讨放射疗法在整形美容领域的正确应用,避免和预防并发症的发生。方法回顾放射疗法在良性病和整形美容方面的应用历史,结合笔者的经验,总结了射线对人体的伤害效应和可能出现的并发症,分析了引起并发症的原因。结果放射治疗在良性病和整形美容方面取得了一些成功经验,特别是对不适宜手术和药物治疗的患者,起到了独特的作用。但也有慢性皮炎、顽固性溃疡或发生癌变等较多的并发症发生。针对引起并发症的常见原因,提出了避免和预防并发症的对策。结论应以循证医学为理论依据,科学地选择适应证,根据个体特点制定合理的、个性化的放疗计划,加强医护人员的技术培训和责任感,从而使患者获得最佳的治疗效果,避免和预防并发症的发生。     

眼睑及眶周整形美容手术导致视力下降或失明—10例典型病例分析

目的：回顾分析眼睑及眶周整形美容手术导致视力下降或失明的临床病例资料，总结其经验和教训。方法：对以往文献公开报道过的和笔者诊治过的临床病例进行回顾和分析。结果：10例行眼睑及眶周整形美容手术的患者发生了视力下降或失明的严重并发症。其中5例失明，5例视力下降。对其发生的原因、预防和处理进行了详细的研究和讨论。结论：在行眼睑和眶周整形美容手术时，必须特别注意和预防视力下降或失明严重并发症的发生。倘若一旦发生此类并发症，应能及时发现和处理，以尽全力挽救患者的视力。     

眼睑及眶周整形美容手术导致视力下降或失明——10例典型病例分析

目的　回顾分析眼睑及眶周整形美容手术导致视力下降或失明的临床病例资料 ,总结其经验和教训。方法　对以往文献公开报道过的和笔者诊治过的临床病例进行回顾和分析。结果　 10例行眼睑及眶周整形美容手术的患者发生了视力下降或失明的严重并发症。其中 5例失明 ,5例视力下降。对其发生的原因、预防和处理进行了详细的研究和讨论。结论　在行眼睑和眶周整形美容手术时 ,必须特别注意和预防视力下降或失明严重并发症的发生。倘若一旦发生此类并发症 ,应能及时发现和处理 ,以尽全力挽救患者的视力     

眼睑及眶周整形美容手术导致视力下降或失明-10例典型病例分析

目的回顾分析眼睑及眶周整形美容手术导致视力下降或失明的临床病例资料,总结其经验和教训.方法对以往文献公开报道过的和笔者诊治过的临床病例进行回顾和分析.结果 10例行眼睑及眶周整形美容手术的患者发生了视力下降或失明的严重并发症.其中5例失明 ,5例视力下降.对其发生的原因、预防和处理进行了详细的研究和讨论.结论在行眼睑和眶周整形美容手术时,必须特别注意和预防视力下降或失明严重并发症的发生.倘若一旦发生此类并发症,应能及时发现和处理,以尽全力挽救患者的视力.     

整形美容术后78例并发症患者的病因分析及处理

目的：对整形美容术后78例并发症患者的病因和处理方法进行分析。方法：选取78例整形美容术后出现并发症的患者作为研究对象，对并发症的类型及处理方式进行归类分析，同时对医疗纠纷预防及处理措施进行探讨。结果：并发症经过积极处理，其中45例患者对治疗结果满意；33例患者并发症有所缓解，但对治疗结果不满意；医疗纠纷与风险化解方面，无投诉无纠纷45例，有投诉无纠纷20例，有投诉有纠纷13例，其中2例给予减免手术费，另外11例给予减免手术费并给予相关费用补偿；治疗前，轻度焦虑患者56例，中度焦虑患者17例，有病耻感患者19例。经过积极治疗及医护人员及时沟通与人文关怀，治疗后，轻度焦虑患者降低至18例，中度焦虑患者降低至5例；有病耻感患者降低至4例。结论：对于整形美容术后并发症要及时发现、及时处理，避免产生严重后果；在并发症恢复期间，要注重患者的康复锻炼与心理护理，帮助患者确立正确的审美观并增强其生活自信心。     

眼部整形美容术导致失明的教训

眼部及眶周整形美容手术导致视力障碍或失明是一种严重的并发症。为引起广大整形美容工作者对此并发症的高度重视,做好预防和处理,现收集10例典型病例,并对其发生原因,预防和处理进行分析和讨论,以期对从事整形美容的业内人士有所帮助。一、术后眶内出血致视力障碍或失明病例1:患儿,男,7岁,因双上睑下垂,行双侧提上睑肌缩短术。术前检查右眼视力为0.5,左眼视力0.6,术后左眼一直无光感,一     

重睑成形术并发症的原因及预防和处理（来稿综合）

重睑成形术并发症的原因及预防和处理（来稿综合）海军青岛疗养院美容科（２６６０７１）陈春海随着整形美容事业的不断发展，重睑成形术已成为一种常见的美容手术。由于从事整形美容人员技术水平参差不齐，常导致术后效果不佳以及各种并发症的发生，给病人造成不同程度的...     

采用整形美容技术及理念治疗成人包茎的疗效观察

目的:探究整形美容技术及理念在治疗成人包茎上的临床治疗效果。方法:选取本院收治的109例因包茎需要进行包皮切除的成年患者作为研究对象,按照患者主动选择手术方式的不同将上述所有患者分为美容组(68例)和传统组(41例),其中传统组患者给予传统包皮环切术进行手术治疗,美容组则应用美容整形技术对包茎患者进行包皮环切手术治疗。对两组患者的术中情况、术后恢复情况、术后外观满意度及并发症情况进行比较分析。结果:美容组患者的手术时间、术中出血量、术后疼痛持续时间及切口愈合时间均显著低于传统组,差异有统计学意义(P0.05);在术后恢复期间,美容组患者术后并发症发生率明显低于传统组,差异有统计学意义(P0.05);美容组患者对阴茎外观的总满意度为94.12%,明显高于传统组(78.05%),差异具有统计学意义(P0.05)。结论:应用美容整形技术对成人包茎进行包皮环切治疗,具有创伤小、术后恢复快等优点,降低了术后并发症的发生,同时可有效避免传统包皮环切术后所产生的形态不良、瘢痕明显等情况,患者对阴茎外观的满意度明显提高。     

单丝聚丙烯合成非吸收齿状线在美容整形应用中并发症的防治及应用改进

目的探讨单丝聚丙烯合成非吸收齿状线在美容整形中的并发症产生的原因及应用方法及技术的改进。方法对近两年的单丝聚丙烯合成非吸收齿状线在美容整形中的应用进行总结与分析。结果改进应用方法后，并发症明显减少，效果加强。结论单丝聚丙烯合成非吸收齿状线在美容整形中应用得当，可减少并发症、取得显著效果。     

精神护理在颌面部外伤患者美容整形清创缝合术中的应用效果

研究在颌面部外伤患者美容整形清创缝合术中应用心理支持护理的效果。方法 选取2022年 4月-2023年4月于我院行美容整形清创缝合术治疗的54例颌面部外伤患者，随机分为对照组和观察组，各 27例。对照组采用常规护理，观察组采用心理支持护理，比较两组不良情绪、应激指标及并发症发生情 况。结果 两组干预后焦虑、抑郁评分均低于干预前，且观察组低于对照组（P ＜0.05）；两组血清皮质醇 （COR）、去甲肾上腺素（NE）均低于干预前，且观察组低于对照组（P ＜0.05）；观察组并发症发生率 为7.41%，低于对照组的18.52%（P＜0.05）。结论 心理支持护理应用于颌面部外伤患者美容整形清创缝合 术中的效果确切，可减轻患者的不良情绪，改善其应激指标，有效预防并发症发生。     

腔镜手术治疗良性乳腺疾病技术要点

乳腺良性疾病的发病率很高。许多良性疾病与恶性疾病相关，或对病人产生疼痛、影响美观等负面影响。因此，许多良性乳腺疾病需要手术治疗。传统手术可能留下永久性的裸露瘢痕、乳头乳晕功能障碍和泌乳障碍，而腔镜乳腺手术在治疗乳腺良性疾病方面有其自身的优势，可以减少或避免上述问题。目前，绝大多数良性乳腺疾病的手术均可在腔镜下完成，例如：多发乳腺纤维腺瘤切除术、巨大乳腺纤维腺瘤切除术、纤维上皮性肿瘤扩大切除术、乳腺炎病灶扩大切除术、乳房体积整复、男性乳腺全切除术、奥美定取出术等。乳腺腔镜手术的准备不同于其他内镜手术，其在技术上也有其独特的操作要点。此外，还应注意准确定位肿物和切缘，减少感染，及时处理术中意外出血和术后血清肿、脓肿，切除乳房肿物而不造成乳房局部凹陷等方面的问题。     

Esophageal cancer surgery for patients with chronic respiratory diseases

Esophageal cancer frequently occurs in the elderly and many of the patients have smoking history. Therefore, some of them have pulmonary comorbidity such as chronic respiratory diseases. As postoperative pulmonary complications after esophagectomy can be a cause of hospital death, careful evaluation is needed before the decision of the indication for surgery. In order to prevent postoperative pulmonary complications in patients with pulmonary comorbidities, modifications in the surgical procedures are needed. Even for cases who can tolerate standard esophagectomy, both the bronchial arteries and pulmonary branches of the vagal nerve should be preserved as far as possible. For patients who cannot tolerate the thoracotomy, transhiatal esophagectomy or non-surgical treatment should be selected. Postoperatively, airway cleansing using a bronchoscopy or mini-tracheostomy should be performed for cases with difficulty in sputum excretion. An enhanced recovery program by multidisciplinary team is effective to prevent postoperative pulmonary complications. Perioperative use of corticosteroid and sivelestat may reduce the incidence of pulmonary complications. As aspiration pneumonia is sometimes fatal in patients after esophagectomy, care to avoid aspiration is needed. Respiratory care is essential during the follow-up period as well as perioperative period in esophagectomized patients with pulmonary comorbidities.     

腔镜手术治疗良性乳腺疾病技术要点

乳腺良性疾病的发病率很高。许多良性疾病与恶性疾病相关,或对病人产生疼痛、影响美观等负面影响。因此,许多良性乳腺疾病需要手术治疗。传统手术可能留下永久性的裸露瘢痕、乳头乳晕功能障碍和泌乳障碍,而腔镜乳腺手术在治疗乳腺良性疾病方面有其自身的优势,可以减少或避免上述问题。目前,绝大多数良性乳腺疾病的手术均可在腔镜下完成,例如：多发乳腺纤维腺瘤切除术、巨大乳腺纤维腺瘤切除术、纤维上皮性肿瘤扩大切除术、乳腺炎病灶扩大切除术、乳房体积整复、男性乳腺全切除术、奥美定取出术等。乳腺腔镜手术的准备不同于其他内镜手术,其在技术上也有其独特的操作要点。此外,还应注意准确定位肿物和切缘,减少感染,及时处理术中意外出血和术后血清肿、脓肿,切除乳房肿物而不造成乳房局部凹陷等方面的问题。     

Editorial Commentary: Trochlear Dysplasia: Can We Change its Natural History or Degenerative Prognosis?

Trochlear dysplasia may be asymptomatic and benign, or could engender patellar instability and degenerative arthritis. Autologous chondrocyte implantation is demonstrating promising outcomes for the treatment of patellofemoral cartilage lesions, but may not suffice for knees with underlying mechanical anomalies as trochlear dysplasia, where adjuvant trochleoplasty or tibial tubercle osteotomy may be required to prevent patellofemoral instability and to protect the graft from wear and damage. Rigorous radiographic assessment is important to discern the type of dysplasia, notably the presence of a potentially pathogenic supra-trochlear spur. Trochleoplasty or other realignment procedures such as tibial tubercle osteotomy should be considered where necessary to correct underlying trochlear deformities and thereby avoid iatrogenic complications or failure.     

微创技术在胆道外科应用的现状

Minimally invasive biliary surgery developed rapidly and laparoscopic cholecystectomy has become the"gold standard"for the treatment of benign gallbladder disease.Combined application of endoscopic and ultrasonic technology improved the diagnosis of biliary diseases.Endoscopic balloon dilation or sphincterotomy of duodenal papilla to remove connon bile duct stones and internal biliary stent placement under ERCP for obstructive jaundice caused by biliary tumors provided safe and satisfactory therapeutic effect.However,in the laparoscopic era,minimally invasive techniques should still be used in conjunction with traditional biliary surgery.Meanwhile,strict indication should be emphasized to avoid the occurrence of complications.     

Spinal teratoma: is there a place for adjuvant treatment? Two cases and a review of the literature

Spinal teratomas are rare intradural spinal tumours, commonly of benign histological profile. The main treatment remains surgical excision which often is incomplete as the tumour is frequently intimately related to surrounding nerve roots and adjacent spinal cord. The value of adjuvant treatment in the form of radiotherapy has not been clearly identified. We report two patients with spinal teratomas in the lower thoracic and conus region, who were treated with surgical excision and did not receive radiotherapy. One of the tumours recurred at 38 months following surgical excision and required a second operation. We review in addition another 20 patients reported in the literature with such tumours. With a mean follow-up of 25 months a local recurrence rate of 10% was observed, the same in both total and subtotal excision groups. No deaths were reported. Analysis of cumulative survival from surgery to treatment failure demonstrated that recurrence occurs late, verifying a slow biological progression of this tumour type. Although no reliable information of the effect of radiotherapy can be obtained, it is difficult to see how radiotherapy could have an impact on such a slow growing tumour. Initial treatment of choice remains surgical excision. If the teratoma shows any malignant histological features or germ cell elements radiotherapy should be employed after surgical excision, even if apparently totally excised. In the presence of benign histology it would seem appropriate to avoid radiotherapy after initial surgery. In case of tumour recurrence or progression to explore the possibility of further surgery first, before considering radiotherapy which even then may have doubtful efficacy.     

良性胆道狭窄的病因诊断策略和治疗方式选择

良性胆道狭窄（BBS）是肝胆胰疾病及外科手术的主要并发症之一。采用何种适当的诊断方法和策略明确病因,既不漏诊具有良性表现的恶性胆道狭窄,又避免良性疾病中不必要的手术探查,已成为胆道狭窄诊治的关键一环。在众多针对不同病因的治疗方法中,如何选择和制定合理的治疗策略,也是肝胆胰外科医生面临的问题。BBS的病因主要为医源性、感染性、炎症性、梗阻性、缺血性和自身免疫性因素等。在诊断方面,CT、MRI等影像学检查是发现胆道狭窄并初步判断良恶性的首选技术手段。结合病史、临床表现和实验室检查结果,通过肝胆外科学与影像学、病理学等多学科联合综合评估,可对BBS做出病因诊断。在治疗方面,经内镜逆行胰胆管造影（ERCP）目前仍是BBS的一线治疗手段;对于解剖结构改变或各种原因导致内镜无法通过十二指肠大乳头进入胆道的病例,可用经皮经肝胆管穿刺引流（PTBD）进行治疗;对于难治性BBS,外科手术可作为最终的保底治疗手段;磁压缩吻合、胆管内射频消融和可降解生物支架等新兴技术手段具有较好的应用前景,但仍需更多的研究数据评估疗效和安全性。     

Stellenwert der Anästhesie in multimodalen onkologischen Therapiekonzepten

Patients with malignant diseases are increasingly being treated with multimodal therapeutical concepts based on the three major modalities surgery, radiotherapy and chemotherapy. The perioperative period is crucial within this multimodal concept as the prognosis of patients may be directly influenced by perioperative measures. In addition, it is of major importance to avoid complications in the perioperative phase, as these might worsen the prognosis of the patient and in order to prevent a delay in the beginning of planned adjuvant therapies. These aspects demonstrate the important role of anesthesia in the treatment of patients with cancer. Further studies defining the relevance of anesthesiologic measures in oncologic patients are needed.     

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??Laparoscopic treatment of benign disease of gastro-esophageal junction QIN Ming-fang, ZHAO Hong-zhi. Tianjin Minimally Invasive Surgery Center, Tianjin Nankai Hospital,Tianjin 300100??China
Corresponding author: QIN Ming-fang, E-mail: qins88@sina.com
Keywords The common benign diseases of gastroesophageal junction includes gastroesophageal reflux disease, hiatal hernia and achalasia of the cardia. The patients with moderate to severe diseases usually require surgical treatment. The traditional open surgery causes more injury and higher perioperative complications. With the laparoscopic technology becoming mature, the laparoscopic operations such as fundoplication, repair of hiatal hernia and Heller myotomy were recommended as a feasible surgical procedure for the treatment of the common benign diseases of gastroesophageal junction. According to our clinical studies, laparoscopy operation should be the method to treat the common benign diseases of gastroesophageal junction, with the advantages of micro-trauma, rapid recovery, safety, feasibility and reliable efficacy.