聚丙烯酰胺水凝胶软组织填充并发水凝胶移位的分析处理

目的探讨聚丙烯酰胺水凝胶软组织填充并发水凝胶移位的原因及处理方法。方法总结50例聚丙烯酰胺水凝胶软组织填充并发水凝胶移位的临床资料,对其进行分析,针对不同情况进行相应的处理。结果本组隆乳并发水凝胶移位的38例患者中,25例经穿刺抽吸处理后治愈;13例经切开取出水凝胶的同时,置入硅胶假体治愈,疗效满意。面部填充并发水凝胶移位者9例。臀部、下肢等部位填充并发水凝胶移位者3例。其多数者采用切开取出或经破溃处冲洗取出水凝胶后治愈,或在行其他手术的同时,取出水凝胶后治愈。结论聚丙烯酰胺水凝胶软组织填充并发水凝胶移位的原因主要是操作方法、术后处理不正确和受术者保护不当的结果,及时正确地处理,均能获得满意的疗效。     

聚丙烯酰胺水凝胶临床应用并发症及其处理

目的：探讨聚丙烯酰胺水凝胶软组织注射填充并发症的成因及防治方法。方法：总结214例聚丙烯酰胺水凝胶临床应用并发症临床资料，对并发症统计、分析，针对不同情况进行相应处理。结果：隆乳并发症194例，其中硬结116例：血肿17例；创伤性无菌性炎症18例；胸大肌炎6例；乳房不对称14例；凝胶移位12例；感染8例；其他3例。面部填充并发症15例，其中隆颞不对称4例，凝胶移位2例；隆颊凝胶移位2例，感染1例，其他6例。臀部，下肢等部位填充局部感染、不对称、凝胶移位等5例。经对症治疗、按摩、理疗、穿刺抽吸处理后，多数患者获得满意疗效。结论：聚丙烯酰胺水凝胶软组织注射填充并发症主要是操作方法不正确和使用不当的结果，及时正确地处理大多能获得满意的疗效。     

聚丙烯酰胺水凝胶注射隆乳后并发硬结的原因及其处理

目的:探讨聚丙烯酰胺水凝胶注射隆乳并发硬结的成因及防治方法。方法:总结146例聚丙烯酰胺水凝胶临床应用并发硬结的临床资料,对其进行统计,分析发生的原因,针对不同情况进行相应处理。结果:隆乳并发硬结146例中,硬结一次性处理治愈122例(含同时置换乳房假体隆乳者14例),二次以上处理治愈24例。经对症治疗、按摩、理疗、穿刺抽吸处理后,多数患者获得满意疗效。结论:聚丙烯酰胺水凝胶软组织注射填充并发症主要是操作方法不正确和使用不当的结果,硬结发生的原因是材料配制和稀释不当,注入腔隙内张力过大所致。在处理上笔者认为对大多数病例仍应坚持抽吸,反复冲洗为主要治疗方法,必要时可以做小切口处理,但应争取不切除正常有血运的乳房组织,以减少再次损伤。经过及时正确地处理,大多数病例可获得满意的疗效。     

聚丙烯酰胺水凝胶在颜面软组织填充中的应用

目的：探讨聚丙烯酰胺水凝胶在颜面软组织填充中的临床效果及操作要点。方法：颞部、下颌采用骨膜浅层注射填充；颊部、鼻唇沟采用皮下注射填充。结果：共填充560例，其中一次填充满意者510例，2次填充满意者44例，不满意者6例。结论：聚丙烯酰胺水凝胶注射填充颜面部疗效满意，操作简单，相应处理容易；临床应用时应注意掌握注射量和正确的解剖层次及填充范围，以达到最佳的整形效果。     

聚丙烯酰胺水凝胶在颜面软组织填充中的应用

目的探讨聚丙烯酰胺水凝胶在颜面软组织填充中的临床效果及操作要点.方法颞部、下颌采用骨膜浅层注射填充;颊部、鼻唇沟采用皮下注射填充.结果共填充560例,其中一次填充满意者510例,2次填充满意者44例,不满意者6例.结论聚丙烯酰胺水凝胶注射填充颜面部疗效满意,操作简单,相应处理容易;临床应用时应注意掌握注射量和正确的解剖层次及填充范围,以达到最佳的整形效果.     

聚丙烯酰胺水凝胶注射隆乳术后并发症处理

目的探讨聚丙烯酰胺水凝胶注射隆乳术后各种并发症及处理方法。方法自2003年2月至2007年2月收治45例聚丙烯酰胺注射隆胸术后病人,采用注射器抽取及手术切开直视下水凝胶取出术,其中20例取出同时行假体隆胸术。结果本组病例治疗均获得了满意效果。结论聚丙烯酰胺水凝胶取出术是目前治疗并发症的较好方法,假体隆胸术可以改善水凝胶取出后的乳房形态。     

聚丙烯酰胺水凝胶乳房填充术并发症的防治

目的 探讨聚丙烯酰胺水凝胶乳房填充术后并发症产生的原因与处理方法。方法 回顾62例注射聚丙烯酰胺水凝胶隆乳术并发症的临床资料，对基进行统计，分类，针对不同情况进行相应的处理。结果 62例并发症中，感染12例，硬结11例，材料漏11例，血肿10例，乳房不对称8例，创伤性无菌性炎症5例，胸大肌炎5例，经对症治疗后，多数患者获得满意疗效，结论 聚丙烯酰胺水凝胶乳房填充术后并发症主要是手术操作不当引起，如能及时妥善地处理均能获较满意的疗效。     

聚丙烯酰胺水凝胶乳房填充术并发症的防治

目的探讨聚丙烯酰胺水凝胶乳房填充术后并发症产生的原因与处理方法.方法回顾62例注射聚丙烯酰胺水凝胶隆乳术并发症的临床资料,对其进行统计、分类,针对不同情况进行相应的处理.结果 62例并发症中,感染12例,硬结11例,材料漏11例,血肿10例,乳房不对称8例,创伤性无菌性炎症5例,胸大肌炎5例.经对症治疗后,多数患者获得满意疗效.结论聚丙烯酰胺水凝胶乳房填充术后并发症主要是手术操作不当引起,如能及时妥善地处理均能获得较满意的疗效.     

聚丙烯酰胺水凝胶注射隆鼻术后并发症的处理及临床分析

目的探讨聚丙烯酰胺水凝胶注射隆鼻术后并发症产生的原因及相关的处理。方法通过总结处理52例聚丙烯酰胺水凝胶注射隆鼻术后并发症的经验体会，分析并发症产生的原凶及处理补救措施。结果52例中产生的并发症有感染、肉芽肿、皮肤破溃、外形不良、疼痛和严重的心理压力等。每例有1～4种并发症。根据不同情况采取不同处理方法，并选取适当病例在取出聚丙烯酰胺水凝胶的同期或二期置入硅胶或膨体聚四氟乙烯假体，多数病例能取得较满意的效果，少数病例遗留后遗症和长久的心理压力或鼻部隐痛。结论聚丙烯酰胺水凝胶注射隆鼻术后并发症种类多样，与聚丙烯酰胺水凝胶的同有性质、鼻部软组织解剖特点有关。出现并发症后反复抽吸，会导致聚丙烯酰胺水凝胶分布更加紊乱，损伤加重。只有采取综合的手术方法才能较彻底地清除聚丙烯酰胺水凝皎。     

聚丙烯酰胺水凝胶注射隆乳术后并发症处理临床分析

目的探讨聚丙烯酰胺水凝胶注射隆乳术后并发症的处理方法。方法本组病例12例，注射聚丙烯酰胺水凝胶隆乳术后14～51个月，出现乳腺感染脓肿2例，多发性硬结形成或移位8例，有恐惧心理要求取出水凝胶2例。所有患者术前均行彩超或MRI检查定位。经乳晕切口取出9例，其中3例行一期硅胶假体隆乳术，2例乳腺脓肿感染经乳房下皱襞切口切开引流。结果随访3～12个月，患者均对取出术效果满意，乳房外形对称，无明显硬结扪及，无感染复发。术后B超检查仍可见少量水凝胶存在于乳腺组织中。结论水凝胶取出术采用乳晕切口直视下手术较为合理，对于乳腺脓肿选择乳房下皱襞切口。是否一期硅胶假体隆乳取决于胸大肌组织受累程度、患者的要求和术者的经验。水凝胶注射降乳术后假体很难彻底清除．府加强对患者的术后随访和心理疏导．     

Prospective randomized crossover trial of lubricant gel against an anaesthetic gel for outpatient cystoscopy

OBJECTIVE: Flexible cystoscopy is routinely performed under local anaesthetic. The aim of this study was to compare the outcomes of using an anaesthetic gel and a non-anaesthetic gel in the same patient. MATERIAL AND METHODS: Men undergoing 3-monthly check cystoscopies were recruited to this prospective, randomized, double-blind, crossover trial. Primary outcome measures were visual analogue scale scores for pain and the incidence of infection. A total of 51 men were randomized to receive 11 ml of either a non-anaesthetic gel or Instillagel as a lubricant on their first visit; they then crossed over to the other agent on their next visit. A nurse who was blinded to the type of lubricant used recorded post-procedural visual analogue scale scores for pain and contacted the patients 48 h postoperatively to check the incidence of infection. RESULTS: The median difference in pain score (non-anaesthetic minus anaesthetic) was 0 (range -5.3 to 7.5) and the mean difference 0.24 (SD 2.3), with no evidence of a 'time period effect' between instillations, i.e. the sequence of instillation with Instillagel followed by aqueous gel or aqueous gel followed by Instillagel in an individual did not have a significant effect. One patient had a urinary tract infection after using each type of gel. A non-inferiority test gave strong evidence that the mean difference in pain score was < 1 (p = 0.011). CONCLUSIONS: Our study suggests that the pain experienced with the non-anaesthetic gel is no greater than that experienced with the anaesthetic gel. The non-anaesthetic gel is as effective as the anaesthetic gel and its regular use should be advocated in routine practice.     

A comparison of intramuscular temperatures during ultrasound treatments with coupling gel or gel pads

STUDY DESIGN: A repeated-measures design was used. The independent variable was ultrasound coupling medium with 2 levels: gel pad and traditional gel. The dependent variable was peak intramuscular (IM) tissue temperature. OBJECTIVE: To compare changes in IM temperature during similar ultrasound treatments with 2 different coupling media. BACKGROUND: Gel pads are gaining popularity as an ultrasound coupling medium. Intramuscular temperatures during ultrasound with gel pads and standard gel have not been compared. METHODS AND MEASURES: Subjects were 13 student volunteers (21.3 +/- 1.4 years of age) without lower-extremity pathology. Ultrasound treatments were administered in a laboratory on two separate occasions 48 hours apart, each with a different coupling medium (standard ultrasound gel or gel pad). One-MHz continuous ultrasound was administered for 7 minutes at 1.5 W/cm2 with the transducer head moving 3 to 4 cm/s over an area approximately twice the size of the transducer head. Tissue temperature was measured every 10 seconds using implantable thermocouples inserted at a 3-cm depth to the surface of the right medial calf. Data were analyzed using an ANCOVA with pretreatment temperature as the covariate. RESULTS: Tissue temperatures increased during both treatments, with the mean and standard deviation peak temperature during the gel pad treatment reaching 39.40 +/- 1.5 degrees C compared to 39.20 +/- 2.4 degrees C during the normal gel treatment. Statistical analysis revealed no difference in temperature between ultrasound treatments using gel and those performed using gel pads. CONCLUSIONS: Because temperature changes were similar with both treatments, we conclude that these coupling methods are equivalent under the ultrasound application parameters tested.     

Hyaluronate gel stapedotomy.

OBJECTIVE: To evaluate hearing results and postoperative dizziness after stapedotomy with application of sodium hyaluronate gel (HG) to the oval window niche during fenestration of the footplate. STUDY DESIGN: Case-control study comparing 27 stapedotomies with HG and 32 stapedotomies without HG. OUTCOME MEASURE: Preoperative and postoperative audiometric data, postoperative dizziness (vertigo or dysequilibrium), and nystagmus. RESULTS: Postoperative hearing results were not statistically different for the 2 groups. There were no cases of postoperative sensorineural hearing loss greater than 10 dB. Early postoperative dizziness (chi(2) = 4.08, P = 0.043) and nystagmus (chi(2) = 5.05, P = 0.024) were reduced in the HG group. CONCLUSIONS: HG stapedotomy is safe and effective and results in less early postoperative dizziness and nystagmus when compared with the standard technique of stapedotomy. The application of HG to the oval window niche to prevent blood from entering or perilymph from escaping the vestibule during fenestration of the stapes footplate may contribute to a quicker recovery in outpatient otosclerosis surgery.     

丸美伊豆凝胶与红霉素过氧苯甲酰凝胶治疗寻常痤疮疗效比较

目的评价丸美伊豆凝胶治疗寻常痤疮的疗效及安全性。方法将40例寻常痤疮患者随机分为实验组和对照组,分别用丸美伊豆凝胶(实验组)和红霉素过氧苯甲酰凝胶(对照组)治疗,2周后观察各组皮损变化情况。结果疗程结束时实验组总皮损数从31.45个降至11.35个,痊愈4例,显效10例,进步6例,有效率70%;对照组总皮损数从27.85个降至8.95个,痊愈1例,显效15例,进步4例,有效率80%。两组有效率经统计学检验,差异无统计学意义(P>0.05)。实验组于治疗过程中仅有少数患者出现皮肤刺激症状,未见严重不良反应。结论丸美伊豆凝胶治疗痤疮效果不优于红霉素过氧苯甲酰凝,但安全、有效。     

Titania gel reduces thrombin generation

Titanium alloy (Ti) commonly is used for long-term blood pumps as a conventional blood contacting material. Thrombus formation in the pump, however, is still a critical problem. Once thrombin is generated on the Ti surface, it activates platelets and the coagulation cascade, leading to thrombus formation. It would be expected that an inhibition of thrombin generation on a blood-contacting surface would prevent thrombus formation. In this study, the titania gel (Ti-gel) on the surface of Ti was formed with chemical modification. The surface structure and its effects on the coagulation cascade were evaluated. Scanning electron microscopic study revealed numerous cracks on the dried surface of Ti-gel, indicating a water-enriched layer. Blood coagulation on the Ti-gel was less than that on the Ti. Generated thrombin on the Ti-gel was less than that on the Ti in both the extrinsic and intrinsic pathways. There was no statistical difference of thrombin degradation. These results suggest that coagulation cascade on the Ti surface was inhibited by the Ti-gel formation. The Ti-gel may have better antithrombogenic characteristics for blood pumps because of its antiblood-coagulation effects.     

Randomized double-blind comparison of lidocaine gel and plain lubricating gel in relieving pain during flexible cystoscopy

PURPOSE: To compare the pain induced by outpatient flexible cystoscopy in men having local lidocaine jelly application or plain lubricant. PATIENTS AND METHODS: We performed a randomized, double-blind study to compare the anesthetic effect of intraurethral 2% lidocaine gel (N = 45) and plain lubricant (N = 46) in men undergoing outpatient flexible cystoscopy. The age, prostate size, and examination time were similar in the two groups. Before cystoscopy, we filled the urethra with 20 mL of gel, which was held for 15 minutes. A 15.5F flexible cystoscope was then used for examination. A 10-point visual analog pain scale (1 = least to 10 = most painful) and a four-point pain grade (grade 1 = least to grade 4 = most painful) were used to measure the pain perception. The amount of postoperative analgesic used and willingness to adopt the same anesthesia for future cystoscopy were also recorded. RESULTS: The mean pain scores for the lidocaine and plain gel groups were 2.8 +/- 1.1 and 2.5 +/- 1.1, respectively (P = 0.06), while the pain grades for the lidocaine gel and plain gel groups were 1.6 +/- 0.6 and 1.8 +/- 0.7, respectively (P = 0.19). In both groups, many patients (42.2% in the lidocaine gel group and 37% in the plain lubricant group) felt the external sphincter and prostatic urethra were the most uncomfortable areas during cystoscopy. Postcystoscopic analgesics were requested by 12 of 45 patients in the lidocaine group, but only 6 of 46 of the plain-gel group (P = 0.103). When patients were asked if they would desire general anesthesia for better pain control in future examinations, five of the lidocaine group responded positively, while three of the plain-gel group said they would (P = 0.62). The cost of lidocaine gel is about thrice that of the plain gel. CONCLUSION: Using plain lubricant is cheaper and faster than applying lidocaine gel. The pain score, pain grade, postcystoscopic analgesic requirement, and anesthetics requested for the next cystoscopy were similar in the two groups. However, a larger investigation will be needed to achieve more significant statistical power.