MEBO治疗老年烧伤临床体会

目的:观察MEBO治疗老年烧伤创而的临床疗效.方法:局部应用MEBO外涂,及时清除坏死组织,充分引流,加强全身营养支持,抗感染,保护脏器功能,提高自身免疫力等综合措施治疗.结果:80例患者的平均年龄为73.3岁,烧伤而积10%TBSA～40%TBSA,创面预期愈合,无明显功能障碍.结论:MEBO治疗老年烧伤可缓解疼痛,预防感染.     

烧伤残余肉芽创面26例治疗体会

<正>烧伤残余肉芽创面临床上治疗比较困难。近年来我门诊对26例烧伤残余肉芽创面患者进行了有针对性的换药及手术等综合治疗,取得了良好的疗效,现将结果报告如下。1临床资料1.1一般资料本组26例均为因各种原因失去早期手术修复治疗的烧伤残余肉芽创面患者。男19例,女7例,年龄15⁶5岁。病程165岁。病程1⁵个月,受伤时烧伤总面积1%5个月,受伤时烧伤总面积1%⁷5%TBSA,残余肉芽创面为1%75%TBSA,残余肉芽创面为1%¹0%TBSA,有7例合并感染,5例合并糖尿病。     

悬浮床治疗背臀部烧伤205例临床分析

目的观察流体悬浮床在治疗臀背部烧伤患者的临床效果。方法临床使用6张悬浮床治疗臀背部烧伤患者205例,其中包括中小面积烧伤患者,创面简单清创后仰卧于悬浮床上。结果<50%TBSA患者全部治愈,>50%死亡8例,均因脓毒症、肺部感染等导致多器官功能障碍综合征死亡。背臀部创面结痂时间为伤后1～4 d,创面愈合时间缩短,浅Ⅱ度为(9±2)d,深Ⅱ度为(14±2)d,Ⅲ度创面焦痂完整,无明显溶痂现象。结论 卧悬浮床可以使创面愈合加速,减少感染及各种并发症发生,减轻工作量,降低患者的住院成本,可以进一步推广应用到中小面积臀背部烧伤的患者。     

湿性医疗技术治愈一例HIV感染特重度烧伤护理体会

目的 总结大面积烧伤合并HIV感染患者应用烧伤湿性医疗技术(MEBT/MEBO)的创面治疗、护理方法和效果.方法 对1例大面积烧伤合并HIV感染的患者实施MEBT/MEBO治疗,严格消毒,注意对创面护理并密切观察病情及全身治疗情况.结果 全程应用MEBT/MEBO进行创面治疗及护理达到满意效果,未出现并发症,患者痊愈出院.结论 大面积烧伤合并HIV感染的患者应用MEBT/MEBO治疗,严格掌握正确的治疗方法和落实细致的创面护理措施,在治疗期间未出现HIV发病症状,疗效确切安全.     

第十二届全国烧伤康复明星病例介绍

正病例1:曹某某,男,65岁患者因特重度烧伤于2017年7月17日入院治疗。专科检查:烧伤总面积达95%TBSA,其中浅Ⅱ度烧伤面积为10%TBSA,深Ⅱ度浅型烧伤面积为20%TBSA,深Ⅱ度深型烧伤面积为25%TBSA,Ⅲ度浅型烧伤面积为34%TBSA,Ⅲ度深型烧伤面积为6%TBSA,合并吸入性损伤。患者入院后,在全身综合治疗的同时,创面全程规范应用烧伤创疡再生医疗技术治疗。治疗6 d后     

MEBT/MEBO治愈一例大面积烧伤伴糖尿病临床体会

大面积烧伤伴有糖尿病的患者,较正常人抵抗力低,创面易出现感染,身体耐受力亦降低,并发症会增多,给临床治疗带来一些难度。我科2005年7月收治1例烧伤面积69%TBSA、54岁男性患者,全程采用MEBT/MEBO治疗,取得较好的效果。现报道如下：     

应用皮肤再生医疗技术结合自体皮簇内植术治疗关节部位深Ⅲ度烧伤的临床观察

目的:观察应用皮肤再生医疗技术结合自体皮簇内植术治疗关节部位深Ⅲ度烧伤创面的疗效.方法:选择四肢关节部位深Ⅲ度烧伤病例94例104个关节,烧伤面积2%TBSA～5%TBSA,应用皮肤再生医疗技术结合自体皮簇内植术治疗.结果:本组94例患者全部愈合,未出现创面感染与皮簇坏死,治愈率为100%.结论:应用皮肤再生医疗技术结合自体皮簇内植术治疗关节部位深Ⅲ度烧伤创面能缩短创面愈合时间,减轻创面瘢痕,增加皮肤弹性,改善关节功能.     

传统治疗与MEBO治疗烧伤效果比较——附一对老年夫妻烧伤患者病例

目的:临床观察深Ⅱ度、浅Ⅲ度烧伤创面手术植皮治疗与完全应用MEBT/MEBO治疗效果的差异.方法:一对老年夫妻烧伤患者,年龄、烧伤部位、面积、深度相似,男性患者全程MEBT/MEBO治疗,女性患者早期保痂治疗,中期手术植皮治疗,后期残余创面MEBT/MEBO治疗,对出院时疗效、出院后半年随访结果及经济投入进行比较.结果:治疗40天出院时,男性患者有5%TBSA的肉芽创面未愈,女性患者为植皮术后散在残余创面,面积约1%TBSA,出院后均行MEBT/MEBO治疗,半年后随访,两位患者创面均愈合,男性患者治愈后创面瘢痕柔软、平坦,无功能障碍;女性患者瘢痕硬、挛缩、有轻度功能障碍;治疗成本男性小于女性.结论:MEBT/MEBO方法优于传统方法治疗.     

儿童重度烧伤72例救治体会

儿童重度烧伤救治难度较大。 1997年 10月～2 0 0 3年 2月 ,我们共收治儿童烧伤 30 2例 ,其中Ⅱ或Ⅲ度烧伤面积 >15 %TBSA(总体表面积 )的重度烧伤 72例[1、2 ] 。救治体会如下1　临床资料1 1　一般情况　 72例中 ,男 4 5例 ,女 2 7例 ;年龄 4个月～ 12岁。烧伤面积 :15 %～ 6 5 %TBSA ,平均2 1 9%TBSA。烧伤深度 :深、浅混合Ⅱ度 6 1例(84 7% ) ,Ⅲ度 11例 (15 3% )。致伤原因 :热液烫伤 6 2例 (86 1% ) ,液化气烧伤 6例 (8 3% ) ,其他(碱烧伤、汽油烧伤、乙醇烧伤、电烧伤 ) 4例。1 2　治疗方法1 2 1　抗休克　正规、有效、全面…     

艾滋病病毒感染者罹患皮肤烧伤治疗体会

目的：总结艾滋病病毒HIV感染罹患皮肤烧伤的治疗和预防措施。方法：对1997年1月-2001年10月收治的两例烧伤前伴有艾滋病病毒感染病人隔离治疗，同时上报主管部门。结果：两例患烧伤创面均治愈出院，未发生并发症。建议到国家指定医疗单位采取强制性隔离治疗。结论：加强对入院烧伤病人HIV检测，避免HIV感染扩散。     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].     

U50,488H对正常及缺氧心肌细胞L型钙电流的作用

目的 探讨心脏阿片受体和β-受体相互作用的机制。方法 采用全细胞膜片钳技术，观察U50，488H(β-阿片受体选择性激动剂)对正常和缺氧心肌细胞L型钙电流的作用。结果 U50，488H剂量依赖性(0．1～100μmol／L)抑制正常心肌细胞的L型钙电流及异丙肾上腺素(0．1μmol／L)激动的钙电流，而细胞缺氧后，这一抑制作用减弱；U50，488H对Forskolin(10μmol／L)激动的L型钙电流无明显影响。结论 β-阿片受体对β-受体信号的负性调节作用在细胞缺氧后减弱，其作用位点可能发生于β-受体与腺苷酸环化酶环节之间。     

Overtraining syndrome : la piste de la suractivité ?

Introduction

Overtraining is clearly a multifactorial disturbance. We aimed at evaluating the relative importance of overactivity and nutritional imbalances.

Methods

A comparison of 17 footballers with seven subjects with a diagnosis of overtraining evidenced that the two groups differ by energy expenditure resulting from physical activity (1573 ± 378.6 kcal/d from 804.7 ± 184.7 kcal/d) while food intake does not exhibit significant differences.

Conclusion

In this sample of subjects, inadequate food intake is found in both groups, so that overtraining appears rather characterized by a higher level of physical activity. Therefore, a relative energy deficit resulting from overactivity rather than dietary mistakes appears to explain the syndrome in these athletes, who are thus truly “overtrained”.     

Prenatal detection of brain anomalies with ultrasonography

Ultrasound is the first-line imaging study of the fetal brain performed at 12, 22 and 32 weeks of gestation. The very structured evaluation of biometric and morphological data, facilitated by the use of a checklist, ensures a high quality examination. All patients where an anomaly of any key element is suspected should be referred to a center dedicated to prenatal diagnosis for confirmation irrespective of the gestational age. Prenatal diagnosis plays a significant role in France since medical interruption of pregnancy until term is authorized.