医用可吸收合成缝合线的细胞毒性及致突变性研究

应用Ｌ－９２９细胞培养、Ａｍｅｓ试验和显性致死试验对医用可吸引合成缝合线进行细胞毒性和致突变研究。实验结果表明：医用可吸收缝合线对细胞增殖度的影响，Ｄ４为９７．６％，Ｄ７为９４．０％。对细胞形态的正常发育没有影响。Ａｍｅｓ试验ＭＲ〈２，显性致死试验、致突变指数与阴性对照组比较无显著差异（Ｐ〉０．０５）均显示阴性反应。表明医用可吸引缝合线不具有潜在的致突变效应。     

缝扎动脉前列腺切除术

耻骨上经膀胱前列腺切除术先缝扎前列腺动脉的手术方法，与其它术式比较，该术式具有易于掌握，出血少，适应症广，可在基层医院推广等优点。     

A COMPARATIVE STUDY OF GUT SUTURE ,HUMAN AMNION COLLAGEN,BOVINE SKIN COLLAGEN AND VICRYL SUTURE IMPLANTS IN RATS

This study compares the persistence and histological characteristics of gut suture with those of human amnion collagen ,bovine collagen ,and Vicryl suture implants in rats. Gut suture and human amnion collagen more resembled living tissue than did bovine collagen and were characterized by their cellularity and the presence of numerous capillaries. The Vicryl suture implants were quickly absorbed. Picrcalrius polarization revealed the synthesis of host collagen by rat fibroblasts which immigrated into the gut suture and human amnion collagen implants. The authors suggest the potential of gut suture as a soft tissue substitute to improve linear skin contour deficits.     

巩膜瓣可调整缝线小梁切除术的临床观察

目的 探讨巩膜瓣可调整缝线小梁切除术的临床效果。方法 对31例（40眼）青光眼患者施行巩膜瓣可调整缝线小梁切除术。术后在裂隙灯显微镜下观察前房深度，并用非接触眼压计测量眼内压。结果 术后4眼发生浅前房（10%），经调整缝线后浅前房持续时间小于24小时，其余36眼前房深度正常。随诊6-12月，1例2眼需再次手术，余38眼眼压均在7-15mmHg。所有患者视力均无下降。其中8眼视力有不同程度的提高。结论 巩膜瓣可调整缝线小梁切除术是目前较为理想的预防小梁切除术后浅前房的好方法。     

Nerve grafts in nerve roots

Summary The positive results of microsurgical technique in suturing and grafting of peripheral nerves have encouraged us to consider grafting of nerve roots. Experimental replantation of anterior nerve root fragments on dogs and rats were performed. Microsurgery was used in all operations. By bioelectrical stimulation, as well as histologically, it is shown that functional regeneration in these animals occurs after grafting of motor nerve roots. The consequences of these experiments in human surgery are discussed.Presented in parts at the annual meeting of the Swiss Society for Plastic and Reconstructive Surgery, Sion, Switzerland, September 1973     

Flexor tendon repair in the hand in the prevention of suture “rake-out”

It is important to understand the mechanical properties of tendons and sutures as well as the modes of failure in flexor tendon repair. We have described a failure mode in which the suture pulls through the tendon and have coined this “rake-out.” Our laboratory results suggest that it is necessary for the core suture to grasp each end of the tendon at a distance of at least 1 cm from the transected end to minimize failure of the repair by suture “rake-out.” We also further describe our approach to flexor tendon repair.     

纵切横缝术与改良纵切横缝术治疗慢性肛裂的临床对比研究

目的：寻求慢性肛裂的最佳手术方法。方法：将80例慢性肛裂病人随机分成2组，对照组（40例）采用常规纵切横缝术；治疗组（40例）采用改良纵切横缝术。对2组患者的术后疗效、愈合时间、术后并发症等进行观察分析。结果：对照组与治疗组在愈合时间，术后并发症方面有显著差异。结论：改良术式操作简便，疗效确切，便于临床推广使用。     

子宫动脉结扎术联合改良式子宫压缩缝合术在剖宫产产后出血中的应用

目的：观察子宫动脉结扎联合改良式B-lynch缝合术在剖宫产产后出血中的应用效果,并评价其临床应用价值。方法选择2013年1月至2014年12月在玉林市妇幼保健院的180例难治性产后出血产妇,将行子宫动脉结扎联合改良式B-lynch缝合术治疗的98例患者纳入观察组,将行子宫动脉结扎术的82例患者纳入对照组。比较两组患者的手术时间、产后出血量、产褥病率以及治疗效果。结果观察组患者的止血有效率为98.98%(97/98),明显高于对照组的43.90%(36/82),差异有统计学意义(P<0.05);观察组术中出血量和术后24 h内出血量分别为(1051±449.86) ml和(68.95±27.20) ml,对照组则分别为(645.72±287.54) ml和(62.33±21.30) ml,两组比较差异均具有统计学意义(P<0.05);观察组输血率为18.37%(18/98),与对照组的9.76%(8/82)比较差异有统计学意义(P<0.05);观察组手术操作时间为(79.83±21.96) min,明显长于对照组的(67.31±11.61) min,差异具有统计学意义(P<0.05);两组患者产褥病率比较差异无统计学意义(P>0.05)。两组术后均无异常恶露,切口均为Ⅱ/甲愈合,未发生相关不良反应及严重并发症。结论子宫动脉结扎联合改良式B-lynch缝合术操作简便、止血效果良好,明显提高患者预后效果,提高了产科质量,可作为抢救剖宫产产后出血的手术措施之一,具有较好的应用前景。     

关节镜下钢丝引导缝合联合微骨折术修复膝关节外侧半月板后根部撕裂对膝关节本体感觉的影响

目的 分析关节镜下钢丝引导缝合联合微骨折术修复膝关节外侧半月板后根部撕裂对膝关节本 体感觉的影响。方法 选取2015年3月—2018年2月成都医学院第二附属医院收治的膝关节外侧半月板后根 部撕裂患者118例作为研究对象。根据手术方式分为观察组60例和对照组58例。对照组行保守治疗,观察 组采用关节镜下钢丝引导缝合联合微骨折术治疗。比较两组治疗前后视觉模拟评分（VAS）评分、国际膝关 节评分委员会 （IKDC） 评分及Lysholm膝关节功能评分;分析观察组并发症发生情况。两组均接受1年随 访,比较两组膝关节本体感觉测试的差值。结果 观察组治疗前后VAS评分的差值高于对照组 （P <0.05）。 观察组治疗前后的 Lysholm 膝关节功能评分、IKDC 评分的差值高于对照组 （P <0.05）。观察组治疗前后 15°、45°及75°时的膝关节本体感觉测试差值的差值低于对照组 （P <0.05）。观察组与对照组并发症发生率 分别为0.00%和13.79%,观察组低于对照组 （P <0.05）。结论 关节镜下钢丝引导缝合联合微骨折术治疗膝 关节外侧半月板后根部撕裂的效果理想,有利于改善膝关节本体感觉。