奥克喷预防头颈部恶性肿瘤放射性皮肤粘膜炎的临床观察

目的探讨奥克喷预防头颈部恶性肿瘤放射性皮肤粘膜炎临床疗效。方法将头颈部恶性肿瘤患者60例,随机分为治疗组和对照组。治疗组在放射治疗前照射野内皮肤用奥克喷;对照组在放射治疗前照射野内皮肤常规护理,不采用特殊防护措施,并且统计两组放疗患者皮肤黏膜反应发生率。结果治疗组患者放射野皮肤黏膜损伤发生率均低于对照组,差异有统计学意义(P<0.05)。结论奥克喷能有效地预防放射性皮肤粘膜炎的发生,提高患者生活质量,减轻患者痛苦,保证放射治疗的顺利进行。     

造口护肤粉预防放射性皮肤反应的临床观察

放射治疗（放疗）是治疗恶性肿瘤的主要手段之一。放疗过程中，根据所用放射源、放疗剂量、照射面积和照射部位的不同，可出现不同程度的皮肤反应。放射性皮肤反应临床表现为损伤部位奇痒、剧烈疼痛、大量渗出、糜烂和水疱，一旦损伤破溃就不易愈合，形成久治不愈的溃疡。据统计肿瘤放疗病人皮肤损伤发生率为91．4％，因损伤严重而被迫中断治疗的发生率为58．1％。皮肤放射损伤不仅给病人带来了极大的痛苦，同时因其造成放射治疗的被迫中断，影响了对原发肿瘤的治疗，降低了肿瘤的局部控制率。为了确保病人放疗计划的顺利完成，提高病人的生存率和肿瘤局部控制率，照射野皮肤的预防显得特别重要。     

造口护肤粉预防放射性皮肤反应的临床观察

放射治疗(放疗)是治疗恶性肿瘤的主要手段之一.放疗过程中,根据所用放射源、放疗剂量、照射面积和照射部位的不同,可出现不同程度的皮肤反应.放射性皮肤反应临床表现为损伤部位奇痒、剧烈疼痛、大量渗出、糜烂和水疱,一旦损伤破溃就不易愈合,形成久治不愈的溃疡[1].据统计肿瘤放疗病人皮肤损伤发生率为91.4%,因损伤严重而被迫中断治疗的发生率为58.1%[2].皮肤放射损伤不仅给病人带来了极大的痛苦,同时因其造成放射治疗的被迫中断,影响了对原发肿瘤的治疗,降低了肿瘤的局部控制率[1].为了确保病人放疗计划的顺利完成,提高病人的生存率和肿瘤局部控制率,照射野皮肤的预防显得特别重要.以往有多种方法用于治疗放射性皮肤湿性反应[3-9],但是预防放射性皮肤反应的方法不多[10,11].2006年4月-2007年4月我科在常规护理的基础上,使用康乐保(中国)有限公司生产的造口护肤粉预防放射性皮肤反应,效果满意.现报告如下.     

贝优芬预防头颈部肿瘤放射性皮炎效果观察

放射治疗是恶性肿瘤主要治疗手段之一,所致损伤是一种不可逆的、潜在性的、累计性的损伤[1].头颈部肿瘤放射治疗致使放射野皮肤出现不同程度的放射性皮炎.2009年1～ 12月,我们对56例头颈部肿瘤放射治疗患者应用贝优芬凝胶预防放疗性皮炎,效果满意.现报告如下.     

生茶油预防放射性皮肤损伤效果分析

目的 分析生茶油对预防放射性皮肤损伤的效果.方法 将94例放疗肿瘤病人,随机分为观察组和对照组.观察组病人放疗当天开始分别于放疗前后用温水清洗放射野皮肤,再用温茶水(38～40℃)冲洗1次,30～60 rain用消毒棉签各外涂生茶油1次;对照组病人放射野皮肤按照常规护理,仅放疗前后用温水清洗皮肤.结果 两组病人放射野皮肤损伤程度经统计学处理P＜0.05,差异有统计学意义.结论 生茶油能有效预防放射性皮肤损伤,提高病人的生活质量,减轻病人的痛苦,保证放疗的顺利进行.     

放射治疗相关皮肤黏膜反应的护理

总结了216例患者放射治疗相关的皮肤黏膜反应的护理方法,包括放疗前护理教育使患者了解放射野皮肤护理的相关知识,积极预防;对已发生皮肤反应的患者,及时合理用药,加强皮肤护理.结果 216例患者均顺利完成放射治疗而没有发生严重的皮肤反应.认为加强对放射治疗患者照射野皮肤的观察与护理,对提高放射治疗效果及患者生存质量有重要意义.     

乳腺癌患者放射治疗后皮肤反应的护理

<正> 放射治疗是预防乳腺癌术后局部复发的最有效的手段之一。当放射线穿过皮肤时,会造成一定的损伤,引起放射性皮炎。由于乳腺癌患者在放射治疗过程中易发生急性放射性皮肤损伤,加之乳腺癌手术后局部血液供应及淋巴回流较差。因此,加强患者照射野皮肤的观察和护理,有利于放射治     

汞接触史食管癌患者皮肤放射性溃疡1例的护理体会

放射治疗(简称放疗)是当今治疗恶性肿瘤最常用的方法之一,在进行放射线外照射时相应部位皮肤不可避免亦受到照射,特别是放射野在颈、胸、腋窝、腹股沟、会阴等部位,放射性皮肤损伤是经常发生的问题,不仅增加了患者心身痛苦、经济负担,且常因此被迫停止放疗,影响了治疗效果。     

放射性皮炎的防护进展

放射治疗是恶性肿瘤的主要治疗手段之一.射线引起的皮肤反应是肿瘤放疗的常见副反应,放射性皮炎是肿瘤放射治疗最常见的并发症,约87 %的放疗患者会出现红斑及其以上的放射性皮肤反应,其中湿性脱皮的发生率为10%～15%.有资料显示,乳腺癌患者中放疗结束时约10 %会发生湿性脱皮,只有4%～8%的患者无明显皮肤反应.放射性皮炎给患者带来极大的痛苦,导致生活质量下降,甚至阻碍患者进一步治疗.如何最大限度地减轻皮肤放射性反应,提高正常皮肤放射耐受性,增进肿瘤放疗效果,目前还没有统一推荐的预防放射性皮炎的措施.现将国内外关于放射性皮肤损伤的防护研究新进展综述如下.     

69例脑胶质瘤术后病人配合三维适形放射治疗的护理

[目的]总结69例脑胶质瘤术后三维适形放射治疗的护理。[方法]对69例脑胶质瘤术后三维适形放射治疗的病人进行心理干预、放射野皮肤护理、饮食护理、安全护理、病情观察、防治脑水肿及做好功能锻炼。[结果]全部病人按计划完成放疗,放疗期间未发生严重并发症。[结论]加强脑胶质瘤术后三维适形放疗病人的护理,帮助其树立治疗信心,可最大限度减少放疗副反应的发生,保证放疗顺利完成。     

Celebrating a fortnight of skin to skin holding

The fortnight of skin-to-skin holding was a great event held together with the formal launch of the Integrated Family Delivered Care (IFDC) project; emphasising the importance of staff supporting parents to be part of their babies’ care and the vital benefits that closeness of skin-to-skin care brings to their baby. Our aim was to showcase this event in order to reinforce skin-to-skin practice within our neonatal service with customised supporting material designed for this purpose. Supporting skin-to-skin holding is often the first step on the road to family integrated care.     

Effects of local forearm skin heating on skin properties

This study investigated impacts of local skin heating on skin properties and tested whether skin changes depended on heat‐induced hyperaemia. It was reasoned that heat‐induced vasodilation impacts accompanying interstitial fluid changes. Forearm skin was locally heated from a baseline of 35°C to 40–42°C in 30 young adults (15 females, 15 males, 24.9 ± 2.1 years) and non‐heated in 10 others (5 females, 5 males, 25.2 ± 1.3 years. Skin blood flow (SBF) was continuously measured using a laser Doppler method and skin tissue dielectric constant (TDC), stratum corneum capacitance (SCC) and transepidermal water loss (TEWL) were measured before and after maintained heat for 12 min. TDC values were determined to effective measurement depths of 1.5 mm (TDC15) and 2.5 mm (TDC25). Results showed a large heat‐induced hyperaemia, with SBF increasing on average 8.8‐fold from its baseline of 35°C. Heating also caused significant increases in TDC, SCC and TEWL that, compared to preheating, increased approximately 1.1‐fold, 3.1‐fold and 4.5‐fold. None of these skin changes correlated with the magnitude of the SBF hyperaemic response. Absence of this correlation may indicate that in young healthy adults, increased capillary filtration due to heat‐induced arteriolar vasodilation is rapidly accommodated by postcapillary reabsorption, enhanced lymphatic activity and TEWL processes. An alternate explanation is that heating caused increased red cell oscillations that were detected as part of the laser Doppler increase without representing increased capillary flux. The major determinant of the Increases in TDC, SCC and TEWL is likely a consequence of heat‐induced eccrine gland activation. Studies of older persons or those with depressed function are warranted.     

Complicated infections of skin and skin structures: when the infection is more than skin deep

Skin and skin-structure infections are common, and range from minor pyodermas to severe necrotizing infections. Complicated infections are defined as involving abnormal skin or wounds, occurring in compromised hosts, or requiring surgical intervention. Classification schemes for these infections are varied and confusing. Distinguishing characteristics include the aetiological agent(s), clinical context and findings, depth of tissue involvement and rate of progression. The most common pathogens are aerobic Gram-positive cocci, but complicated infections frequently involve Gram-negative bacilli and anaerobic bacteria. Initial antibiotic therapy is usually empirical, and later modified by the results of stains and cultures of wound specimens. Broad-spectrum coverage is frequently needed for complicated infections. Ertapenem is a once-a-day parenteral Group 1 carbapenem antibiotic, recently licensed in the USA and Europe, which may assume an important role in treating some complicated skin and skin-structure infections. Surgical debridement is important for many complicated infections, and is the critical element in managing necrotizing fasciitis and myonecrosis.     

手术患者皮肤交接单的优化设计在手术全期患者皮肤管理中的应用

目的：应用优化后的手术患者皮肤交接单,对手术全期患者进行连续、动态、全面的评估,以降低患者皮肤损伤的发生率。方法：对原有手术护理记录单进行优化设计,采用表格、人体四面图示、文字书写相结合的方式,进行分层培训,规范手术患者皮肤交接单的临床应用,对比两组手术患者皮肤情况。结果：使用优化设计后的手术患者皮肤交接单的患者,皮肤异常情况的发生率降低。结论：手术患者皮肤交接单的使用利于手术全期患者皮肤的质量控制检查,有效减少了因问题皮肤的交接遗漏而致的患者皮肤损伤。     

皮肤钉合器在自体取皮植皮术中的应用

[目的]探讨皮肤钉合器在自体取皮植皮术中的应用.[方法]将52例需行自体取皮植皮术的病人随机分为皮肤钉合器组(植皮时边缘使用皮肤钉合器,将丝线缠绕钉打结,留长度15 cm用于打包)27例和常规丝线组(植皮时边缘缝合使用常规丝线,留长度15 cm用于打包)25例.对比两组病人植皮打包时间、植皮边缘伤口分泌物情况、皮片成活情况.[结果] 植皮打包时间皮肤钉合器组明显短于常规丝线组,植皮边缘清洁度皮肤钉合器组明显好于常规丝线组,两组比较,差异均有统计学意义(P<0.05).[结论]皮肤钉合器用于植皮术打包能达到省时、减少植皮边缘伤口分泌物、避免针刺伤的效果.     

OCT of healthy skin,actinic skin and NMSC lesions

ObjectiveOptical coherence tomography (OCT) is able to produce two-dimensional images of living skin in situ. We evaluated a frequency-domain OCT system (SR-OCT Imaging System, Thorlabs) with regard to its clinical impact.Material and methodsSeven healthy volunteers and 10 patients were recruited who had been referred for local photodynamic therapy (PDT) of suspicious dermal lesions (actinic lesions with different degrees of dysplasia (AK), Bowen's disease (BD) and basal cell carcinoma (BCC)). In a first step, OCT images were obtained from the healthy skin of the forearms and foreheads of all 17 subjects to compare interindividual differences. OCT images from the suspicious skin lesions (AK, BD, and BCC) were then taken for the 10 patients and compared with OCT images of corresponding healthy skin. Additionally, the OCT images of pathological sites were compared to histopathological preparations.ResultsIn healthy skin a good correlation was found between the images of standard histological samples and the two-dimensional OCT images with regard to the discrimination of epithelial layer with its different zones and borders and adjacent dermal structures. The thickness of skin layers in the forehead and the forearm varied between the subjects (of different ages), but showed similar patterns of ‘lucidity’ in the OCT images. In diseased skin, the typical histological features of epithelial dysplasia and changes in dermal layers could be recognized in the equivalent OCT images.ConclusionOCT may be used as investigative tool in the clinical evaluation of actinic keratosis and NMSC lesions. The comparison of images revealed a strong correlation with histological cross-section images for the dermis.     

组织工程化皮肤重建皮肤功能的研究进展

随着组织工程学的兴起和发展,组织工程化皮肤的研究有可能成为解决这一难题的有效途径。自从Rheinwald和Green成功建立表皮细胞培养方法以来,表皮培养的技术方法有了很大改进;胶原海绵、无细胞异体或异种真皮基质等真皮替代物的研究使复合皮的建立成为可能;干细胞的研究、基因转染在皮肤组织工程学中的应用将使组织工程化皮肤的研究更加成熟;组织工程化皮肤的生产和应用,使其成为第一个商品化的、也时目前成功应用的组织工程化产品,并且可能成为皮肤缺损后愈合时间短、愈合后效果好、瘢痕轻的创面愈合方法,以达到皮肤结构和功能的恢复。