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1.
目的:探讨Dermabond皮肤粘合剂对外科手术切口的愈合效果,为临床外科手术切口愈合提供参考。方法:选取2017年8月-2018年8月接诊的外科手术患者80例。按自愿原则照随机数表法分为观察组(46例)与对照组(34例)。对照组患者手术切口采用传统缝线缝合,观察组患者手术切口采用Dermabond皮肤粘合剂缝合。比较两组术后基本情况、切口愈合效果及切口美观满意度。结果:观察组切口闭合时间、术后8d切口护理费用明显少于对照组,观察组皮肤红肿、术后3d伤口疼痛、瘢痕形成发生率均明显低于对照组,差异有统计学意义(P<0.05)。观察组愈合质量明显优于对照组,切口美观满意度明显高于对照组,差异有统计学意义(P<0.05)。结论:Dermabond皮肤粘合剂用于外科手术切口闭合效果良好,能有效缩短切口闭合时间,降低并发症及瘢痕形成发生率,值得广泛应用。  相似文献   

2.
目的探讨防治全膀胱切除术后腹部切口脂肪液化的有效方法。方法将全膀胱切除术患者90例按照手术日期单双号分为两组,对照组(42例)使用传统敷料对切口进行换药护理,观察组(48例)术后早期采用水胶体敷料对切口行换药护理。结果两组术后第3、6、9天切口渗液量比较,差异有统计学意义(均P0.01);术后第6、9天换药时疼痛程度比较,差异有统计学意义(P0.05,P0.01);观察组出院前切口愈合情况显著优于对照组;换药次数、换药费用、住院时间显著少于对照组(P0.05,P0.01)。结论全膀胱切除术后腹部切口早期应用水胶体敷料能有效控制渗液,防治脂肪液化,促进伤口愈合,可减少换药次数,减轻患者病痛感和经济负担。  相似文献   

3.
目的分析急性阑尾炎经半月线小切口阑尾切除术的效果。方法选取2017-01—2019-02间在焦作市妇幼保健院接受阑尾切除术的90例急性阑尾炎患者,按照不同手术切口分为2组,各45例。对照组采用传统McBurney切口,观察组采用半月线小切口。回顾性分析患者的临床资料。结果观察组切口长度、手术时间、术后24 h的VAS评分、切口愈合不良发生率及住院时间均优于对照组,差异有统计学意义(P<0.05)。结论对急性阑尾炎患者应用半月线小切口行阑尾切除术,创伤小、术后疼痛轻、切口愈合不良发生率低、患者恢复快,亦属于一种微创手术,但需严格掌握手术指征。  相似文献   

4.
伤安素功能敷料治疗压疮效果观察   总被引:1,自引:0,他引:1  
目的探讨伤安素功能敷料治疗压疮的效果。方法将39例压疮患者随机分为观察组(21例)和对照组(18例)。两组均按常规外科换药方法处理压疮,观察组在此基础上采用伤安素功能敷料贴敷创面。结果观察组疗效显著优于对照组(P<0.05);治愈时间明显缩短(P<0.01)。结论伤安素功能敷料有促进压疮愈合的作用。  相似文献   

5.
目的:探讨两种引流方式用于甲状腺次全切除术后引流的效果.方法:选择2010年1月至2010年12月行甲状腺次全切除术的患者154例,随机分为观察组和对照组,每组77例.观察组采用负压引流瓶术后引流,对照组采用胶片正压引流,比较两组患者的引流效果及切口愈合情况.结果:观察组的术后2d平均换药次数、引流时间、拆线时间及组织复位时间均明显少于对照组,差异有显著性意义(P<0.01);切口愈合情况优于对照组,差异有统计学意义(P<0.05).结论:在甲状腺次全切除术后,负压瓶持续引流方法有着较好的临床应用价值.  相似文献   

6.
目的观察实施小切口与传统切口行阑尾切除术的疗效。方法将92例行阑尾切除术阑尾炎患者随机分为观察组和对照组,每组46例。对照组实施传统切口阑尾切除术,观察组实施小切口阑尾炎切除术。比较两组疗效。结果两组手术时间对比差异无统计学意义(P0.05),观察组切口长度及切口感染率明显小于对照组,观察组术后下床活动时间明显早于对照组,两组差异有统计学意义(P0.05)。结论实施小切口阑尾炎切除术创伤小、恢复快、术后并发症少,在严格掌握手术适应证和提高规范操作技术前提下,临床可广泛应用。  相似文献   

7.
目的探讨红外线烤灯照射在胃肠道肿瘤术后切口愈合过程中的临床疗效。方法将250例行胃、结直肠肿瘤手术患者分对照组和红外线照射组。对比两组患者,腹部切口平均愈合时间、切口感染率和住院总费用等三方面的差异。对照组:患者术后腹部切口用碘伏常规消毒换药,每两天一次至拆线。红外线照射组:患者术后腹部切口用烤灯照射20 min bid+碘伏常规消毒换药每两天一次至拆线。结果红外线照射组患者腹部切口愈合时间为6.92±1.81天,明显短于对照组患者切口愈合时间7.99±3.91天,P0.01。红外线照射组患者腹部切口感染率2.19%明显少于对照组患者切口感染率11.50%(P0.05)。红外线照射组患者的总住院费用5.61±0.70万元并不高于对照组5.64±0.73万元(P0.05)。结论红外线烤灯照射能明显缩短胃肠道肿瘤患者术后腹部切口愈合时间,降低切口感染率,且不增加患者住院总费用。  相似文献   

8.
目的探讨手术切口愈合不良的处理方法。方法将77例切口愈合不良患者随机分为实验组39例,对照组38例。实验组依据湿性愈合理论采用湿性疗法处理切口,对照组采用常规换药方法治疗创面,比较两组患者切口愈合时间、换药次数及换药疼痛程度。结果湿性疗法处理切口创面能减轻换药疼痛,减少换药次数,缩短愈合时间,两组比较差异均有统计学意义(P0.05)。结论湿性疗法在愈合不良切口处理中能减轻敷料与伤口粘连,加速坏死组织溶解,缩短清创时间,促进肉芽组织生长及上皮化进程,利于伤口愈合。  相似文献   

9.
目的比较湿性与干性愈合疗法对腹部二期愈合手术切口的疗效。方法腹部手术后切口二期愈合患者60例,随机分为治疗组(31例)和对照组(29例)。治疗组采用湿性愈合疗法处理伤口,对照组采用常规方法换药。结果治疗组治愈率为83.9%,总有效率为96.8%,对照组治愈率为51.7%,总有效率为69.0%,两组比较有统计学差异(P0.05)。治疗组换药(6.8±2.0)次,明显少于对照组的(26.6±6.8)次(P0.05);治疗组治疗时间为(16.2±4.0)d,明显短于对照组的(28.5±7.2)d(P0.05)。结论湿性愈合疗法治疗时间短,换药次数少,治愈率及总有效率高,优于传统的干性愈合疗法,值得临床推广。  相似文献   

10.
目的探讨阑尾切除手术围术期预防性应用抗菌药物的效果。方法随机将拟行阑尾切除术的168例阑尾炎患者分为2组,每组84例。对照组术前未予以抗菌类药物,观察组术前予以抗菌类药物。比较2组切口愈合效果、住院时间及术后并发症发生率。结果观察组切口甲级愈合率、术后合理用药率高于对照组,用药时间、住院时间短于对照组,差异均有统计学意义(P0.05)。结论阑尾切除术前预防性应用抗菌药物,可提高切口甲级愈合率,缩短用药时间,促进患者早日康复。  相似文献   

11.
Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI2) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI2), TXB2 (stabile metabolite of thromboxane A2) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI2 release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB2 (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI2 release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A2, presumably contributing to hemodynamic stability within 30 min after MT.  相似文献   

12.
Don Dame 《Artificial organs》1996,20(5):613-617
Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.  相似文献   

13.
Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H2O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg−1 followed by 0.15 mg · kg−1 · h−1, n=8) or verapamil (0.1 mg · kg−1 followed by 0.3 mg · kg−1 · h−1, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.  相似文献   

14.
Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.  相似文献   

15.
Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.  相似文献   

16.
Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.  相似文献   

17.
Abstract Immunoadsorption (1A) therapy with tryptophan (TR-350) or phenylalanine (PH-350) adsorbents has been used to reduce the concentration of serum antibodies in human lymphocyte antigen (HLA)-immunized patients. Other forms of plasma purification have been reported to reduce the level of fibrinogen, which affects the blood properties. In this study we investigated the effects of IA therapy using both adsorbents on plasma fibrinogen and immunoglobulins G and M in 13 patients (8 patients were treated with TR-350, and 5 patients were treated with PH-350). During each session 1 plasma volume (2.8 ± 0.4 L of plasma) was processed through the immunocolumn and then returned to the patient together with the blood cells. Compared with the pretreatment values, the plasma fibrinogen, IgG, and IgM concentrations were significantly reduced after IA therapy (p < 0.01 for TR-350; p < 0.04 for PH-350). There was a positive correlation between the degree of reduction of plasma proteins and the number of IA treatments given. A nonpara-metric test (Wilcoxon's signed-rank test or the Mann-Whitney test) was used for statistical analysis. We conclude from our study that IA therapy effectively lowers the plasma levels of fibrinogen, IgG, and IgM and thus can be considered a valuable alternative to other blood purification methods.  相似文献   

18.
Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.  相似文献   

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20.
Abstract: Photopheresis is a technique in which peripheral blood mononuclear cells, in the presence of a photoacti-vatable compound, are exposed extracorporeally to ultraviolet A light and reinfused, inducing a host autoregula-tory immune response. Experimental work and ongoing clinical studies are helping to define the role of this novel, safe, and non-toxic immunomodulating technology in the field of transplantation.  相似文献   

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