湿润烧伤膏治疗小儿头面颈部Ⅱ度烧伤128例的临床体会

目的:观察湿润烧伤膏(MEBO)对小儿头面颈Ⅱ度烧伤的疗效.方法:对自2006年1月至2008年9月住院的128例头面颈部Ⅱ度烧伤患者采用美宝湿润烧伤膏治疗后,观察疗效及愈后3个月瘢痕形成情况,并对其进行临床总结分析.结果:美宝湿润烧伤膏治疗头面颈部烧伤创面愈合快,色素轻,无瘢痕形成.结论:美宝湿润烧伤膏治疗头面颈部Ⅱ度烧伤,具有促进创面再生修复,减轻疼痛,控制创面感染等治疗作用.     

湿润烧伤膏治疗面部深度烧伤临床疗效分析

目的:观察湿润烧伤膏(MEBO)治疗面部深度烧伤的临床效果.方法:对78例面部深度烧伤创面外用MEBO治疗,早期辅以耕耘处理,观察创面愈合时间和创面愈合后瘢痕增生情况.结果:78例面部深度烧伤全部治愈,仅1例深Ⅱ度深型、2例Ⅲ度浅型创面愈后留有表浅瘢痕,全部患者愈后无五官功能障碍和畸形.结论:MEBO治疗面部深度烧伤方法简单,能促进创面愈合,减轻瘢痕增生,效果明显.     

美宝(MEBO)治疗面颈部深Ⅱ度烧伤76例临床体会

目的：观察 MEBO(湿润烧伤膏)对面颈部深Ⅱ度烧伤的疗效。方法：自2002年1月～2003年12月住院的76例面颈部深Ⅱ度烧伤创面采用烧伤湿润医疗技术(MEBT/MEBO)治疗。观察疗效和瘢痕形成等。结果：76例创面均于20天内愈合,仅3例愈合后遗留散在非增生性瘢痕。结论：烧伤湿润医疗技术治疗面颈部深Ⅱ度烧伤创面,有促进创面再生、修复和生理性愈合的作用。愈后瘢痕增生情况显著减少。     

湿润烧伤膏治疗头面颈部深Ⅱ度烧伤的体会

目的：观察湿润烧伤膏对头面颈部深Ⅱ度烧伤的疗效。方法：自2003年1月至2003年12月住院的31例共38个部位头面颈部深Ⅱ度烧伤创面采用烧伤湿润医疗技术治疗，观察疗效及愈合后3个月疤痕形成情况。结果：所有创面均一期愈合，仅1例2个部位形成散在性非增生性疤痕，疤痕形成率5．25％。结论：烧伤湿润医疗技术有促进特殊部位深Ⅱ度烧伤创面再生、修复和生理性愈合的作用，有效地减少了疤痕增生的机会。     

湿润烧伤膏在治疗中小面积烧伤创面中的应用

目的:总结湿润烧伤膏在治疗中小面积烧伤创面中的疗效。方法:对中小面积烧伤创面给予湿润烧伤膏包扎治疗。结果:60例Ⅱ度创面在应用湿润烧伤膏后均在不同时间愈合。浅Ⅱ度创面约8±2天愈合, 且无瘢痕。深Ⅱ度创面愈合时间约15±2天。结论:湿润烧伤膏用于中小面积烧伤创面可改善创面局部微循环, 促进创面愈合效果明显。     

湿润暴露疗法治疗小儿头面颈部Ⅱ度烧伤的体会

目的：探讨湿润暴露疗法（MEBT）治疗小儿头面颈部Ⅱ度烧伤的临床疗效。方法：对2000年以来应用湿润烧伤膏（MEBO）治疗的52例小儿头面颈部Ⅱ度烧伤进行临床回顾性总结分析。结果：MEBT治疗的小儿头面颈部Ⅱ度烧伤创面止痛效果明显，愈合快，色素轻，不易形成瘢痕。结论：湿润暴露疗法对小儿头面颈部Ⅱ度烧伤创面具有促进愈合，减轻疼痛，减少并发症等治疗作用。     

皮肤原位再生复原技术治疗小儿烧伤的临床体会

目的观察皮肤原位再生复原技术(Moist Exposed Burn Treatment/Moist Exposed Burn Ointment,MEBT/MEBO)治疗小儿烧伤的临床疗效。方法对2011年6月-2013年8月收治的113例烧伤患儿,在给予抗休克、抗感染、营养支持等全身综合治疗的同时,创面全程应用湿润烧伤膏(Moist Exposed Burn Ointment,MEBO)包扎或暴露治疗,包扎治疗者每天换药1~2次,暴露治疗者每天换药3~4次,并根据创面情况进行必要的耕耘减张处理,观察其治疗效果。结果 113例患儿烧伤创面全部自行愈合,浅Ⅱ度烧伤创面于治疗后6~11 d愈合,深Ⅱ度烧伤创面于治疗后13~24 d愈合,浅Ⅲ度烧伤创面于治疗后27~45 d愈合;所有患儿治疗过程中均未新发感染,且疼痛较轻;随访6个月~1年,5例深Ⅱ度烧伤创面愈后留有轻微色素沉着;3例浅Ⅲ度烧伤创面愈后留有平软瘢痕,无功能障碍。结论皮肤原位再生复原技术治疗小儿烧伤痛苦小,瘢痕少,疗效显著,是治疗小儿烧伤的首选疗法。     

湿润烧伤膏联合创疡贴治疗深度烧伤

目的:探讨湿润烧伤膏与创疡贴联合应用治疗深度烧伤创面的临床疗效.方法:对2007年～2009年两年内,采用湿润烧伤膏与创疡贴联合应用治疗的28例深度烧伤病历资料作回顾性总结分析,创面局部先用湿润烧伤膏治疗,在新生肉芽组织布满创面之时,改用创疡贴外敷治疗;在加强局部治疗的同时,积极予以抗感染,防治并发症,营养支持等综合措施治疗.结果:原发性休克得到了有效控制,肺部感染和心功能不全进行综合治疗后痊愈;28例患者创面全部愈合,无继发感染,深Ⅱ度创面在18天～22天之间愈合,未见瘢痕增生;浅Ⅲ度创面的愈合时间为31天～42天,留有少量瘢痕,但无功能障碍.结论:湿润烧伤膏与创疡贴联合应用治疗深度烧伤创面,方法简便、有效.     

原位再生医疗技术治疗儿童烧伤的疗效观察

目的总结、分析原位再生医疗技术治疗儿童烧伤的临床疗效。方法对2012年1月-2014年12月北京市丰台区南苑医院收治的50例烧伤患儿创面采用原位再生医疗技术治疗,同时给予补液、抗感染、营养支持等全身综合治疗,观察创面愈合时间及愈合效果。结果 50例患儿在治疗和护理过程中依从性良好,所有患儿创面全部愈合,治愈率达100%,其中浅Ⅱ度创面愈合时间为5~7 d,平均6.25 d;深Ⅱ度创面愈合时间为12~19 d,平均14.50 d;Ⅲ度创面愈合时间为27~35 d,平均29.50 d;浅Ⅱ度创面愈合后均无瘢痕增生,深Ⅱ度和Ⅲ度创面愈合后有瘢痕增生者3例,瘢痕增生率为6.0%。结论原位再生医疗技术治疗儿童烧伤方法简便,患儿痛苦小、依从性好,值得临床推广应用。     

湿润烧伤膏治疗中小面积深度烧伤创面疗效观察

目的:总结湿润烧伤膏(MEBO)治疗中小面积深度烧伤创面的疗效,评价MEBO的临床应用价值.方法:回顾性调查2003年3月～ 2008年3月期间,接受MEBO治疗的中小面积深度烧伤病历资料,主要指标为病人预后、创面愈合与功能恢复状况及有无并发症发生.结果:22例病人全部治愈出院,深Ⅱ度创面愈合后无瘢痕增生,Ⅲ度创面留有浅平软性瘢痕,关节部位无功能障碍.结论:MEBO治疗中小面积深度烧伤创面操作简便,深Ⅱ度创面生理性愈合,无创面加深、局部感染等并发症.     

Dealing with cancer--conversations with radiotherapy patients

Thirty in-patients treated by radiotherapy were questioned in qualitative interviews about the information they had received from the physicians and their way to deal with the disease and the physicians. Furthermore 18 persons out of this group were accompanied continuously. The confidential relationships between the patients and the author of the study brought about spontaneous conversations showing some new aspects of the way to experience disease and therapy. Despite a poor prognosis and an initially insufficient information, the patients formulated their questions openly. Generally they desired a clearer communication. They criticized above all the lack of information and attention from the physicians. A need for confidence, frankness, and the conveyance of a justified hope was expressed. The physician's stress and resulting lack of time was complained of. During the time of accompanying which lasted several weeks, it became evident that information means a way to deal with the disease to which the patient can make his individual contribution. The majority of questions as well as emotional reactions as fear or depression came from those patients who seemed to be quiet persons.     

湿润烧伤膏与手术联合治疗褥疮的护理

目的 :减少溃疡期褥疮的术前准备时间 ,缩短褥疮的总病程。方法 :将 1996年 5月至 2 0 0 2年 5月收住院的 4 2例溃疡期褥疮病人按随机原则分为 2组 ,2 1例术前用湿润烧伤膏纱换药处理 ,为A组 (试验组 ) ;2 1例用庆大霉素紫草油纱布换药处理 ,为B组 (对照组 )。 2组病例的年龄、性别、发病原因、病灶部位、病灶范围等经统计学处理 ,无显著性差别 ,有可比性。两组病人均换药至创面新鲜行皮瓣转移手术 ;比较两组平均术前换药时间 ,及换药 +手术的总住院日。术前术后两组患者均运用护理程序施行整体护理。结果 :A组术前平均换药时间为 8 4 9± 2 2 3天 ,B组为 15 6 0± 6 70天 ;A组平均治愈时间为 2 0 5 0± 4 81天 ,B组为 35 31± 7 70天。结论 :湿润烧伤膏换药与庆大霉素紫草油纱布换药比较 ,前者可明显缩短褥疮手术的术前准备时间及病人的总住院天数。     

Radiochemotherapy with temozolomide for patients with glioblastoma

Background

The objective of this retrospective analysis was to assess long-term outcome and prognostic factors of unselected patients treated for glioblastoma (GB) at a single center with surgery, standard radiotherapy (RT), and concomitant temozolomide (TMZ). From 1999?C2005, the institutional protocol included surgery and RT with TMZ. From 2005 on, adjuvant TMZ was routinely added.

Patients and Methods

Between April 1999 and September 2009, 181 patients with GB were treated with RT (60 Gy in 30 fractions) and concomitant TMZ (75 mg/m²/day throughout RT). Biopsy only had been performed in 53 patients (29.3%), 128 patients (70.7%) had undergone resection, which was complete based on postoperative MRI in 51 patients (28.2%). Adjuvant TMZ was applied in 67 of 181 patients (37%).

Results

Median overall survival (OS) and progression-free survival (PFS) were 15.0 (95% CI, 13.1?C16.8) and 7.2 months (95% CI, 5.9?C8.5), respectively. After complete resection, partial/subtotal resection and biopsy, median OS was 23.20, 14.75, and 7.89 months (p < 0.001), respectively. In multivariate Cox proportional hazards regression models, extent of resection (p < 0.0001), Karnofsky??s performance score (p < 0.0001) and adjuvant TMZ (p = 0.001) were significant independent prognostic factors for OS. RT with concomitant TMZ was well tolerated in the majority of patients and could be completed as scheduled in 146 patients (80.7%), while 11 patients (6.1%) discontinued RT. Another 35 patients (19.3%) interrupted concomitant chemotherapy.

Conclusion

RT with concomitant TMZ is a feasible regimen with acceptable toxicity in routine practice. Our data are compatible with a beneficial effect of adjuvant TMZ on OS and PFS.     

MEBO药纱门诊治疗烧(烫)伤71例的体会

作者报道用MEBO药纱敷盖门诊治疗烧（烫）伤71例，均获治愈。经随访1年，深Ⅱ度创面疤痕发生率为15％（3／20），浅Ⅲ度创面疤痕发生率为38．9％（7／18）。     

Bronchogenic carcinoma: staging with MR compared with staging with CT and surgery

Thirty-three patients suspected of having bronchogenic carcinoma were studied prospectively using magnetic resonance (MR). In this group, 30 underwent examination with computed tomography (CT), 15 underwent thoracotomy, six had mediastinal biopsy procedures performed, and eight underwent bronchoscopy. MR studies, which included transaxial spin-echo imaging (TR, 0.5 and 2.0 sec; TE, 28 and 56 msec) of all patients and sagittal or coronal imaging of 18, were performed without knowledge of CT findings, using only plain radiographs as a guide. CT and MR studies were interpreted separately. CT and MR provided comparable information regarding the presence and size of mediastinal lymph nodes. MR better discriminated mediastinal nodes from vascular structures. However, in two of 11 patients who had multiple mediastinal lymph nodes that were normal in size at CT examination and surgery, MR suggested a confluent abnormal mass, probably because of its poorer spatial resolution. MR was superior to CT in showing enlarged hilar lymph nodes, but CT was better for demonstrating bronchial abnormalities. In three of four patients who had a proved hilar mass with distal obstructive pneumonia, MR (TR, 2.0 sec) helped distinguish between the mass and collapsed lung.     

多虑平、雷尼替丁治疗消化性溃疡81例临床观察

1995年 1月～ 1 998年 2月 ,我们采用多虑平、雷尼替丁治疗消化性溃疡 (ＰＵ) ,并与雷尼替丁为对照组进行治疗观察 ,疗效满意 ,现总结报告如下。1　临床资料1 1　一般资料　本组 81例ＰＵ均因上腹痛、返酸、腹胀及食欲不振等症状 ,经胃镜诊断为溃疡活动期患者。病程 2个月～ 5ａ,平均 1 7ａ。伴有焦虑、抑郁及夜眠欠佳等症者59例。随机分为 2组 :治疗组 4 1例 ,男 3 8例 ,女 3例 ;年龄 1 8～ 3 6岁 ,平均 2 4岁。其中胃溃疡 1 1例 ,十二指肠球部溃疡 3 0例。对照组 4 0例 ,男 3 7例 ,女 3例 ;年龄 1 9～ 3 5岁 ,平均 2 4 5岁 ;胃溃疡 1 2…     

Long-term follow-up of patients with primary amyloidosis with MRI

The effect of chemotherapy on subjects with primary amyloidosis (AL-amyloidosis) were studied with MRI in five patients. The MRI was performed every 3–5 months for 23–60 months, and the T1 and T2 relaxation times were determined in liver and subcutaneous fat. In the patients as a whole T1 was significantly prolonged (P < 0.05), whereas T2 was within normal range. On follow-up with repeated MRI increasing T1 values could be measured in progressive disease (one patient) whereas decreasing T1 values seemed to parallel clinical improvements in four patients. The effect of different treatment schedules in AL-amyloidosis may be evaluated with MRI and the amount of amyloid deposits may be quantified. Correspondence to: K.-Å. Thuomas     

原发性肝癌伴门脉高压的TIPSS治疗

本文对伴有门脉高压症的５名原发性肝癌（ＰＨＣ）患者的ＴＩＰＳＳ治疗进行报道。在ＴＩＰＳＳ术中，成功地建立了肝内门腔分流道，未发生肝内病变的误穿；术后患者的门脉压力得到下降，食管胃底静脉曲张得以减轻和消失。４名曾于ＴＩＰＳＳ术前有上消化道出血者术后有３例未再出血。作者认为：ＰＨＣ不是ＴＩＰＳＳ治疗门脉高压症的禁忌症；ＰＨＣ患者经ＴＩＰＳＳ治疗后，由于避免了门脉高压合并症的出现，因此生活质量得以提高。