显微吻合术治疗外伤性下泪小管断裂56例

目的:探讨下泪小管断裂显微吻合术的疗效。方法:在显微镜下寻找断裂的下泪小管鼻侧断端,以硬膜外导管作为支撑吻合泪小管断端。结果:共56例(56眼)在显微镜下全部吻合,51例成功,5例好转。结论:该手术操作简单,成功率高,临床效果好,值得广泛推广。     

双路泪道插管法行外伤性泪小管断裂吻合术

目的 探讨双路泪道插管法并置管固定治疗泪小管断裂的手术方法及术后效果.方法 23例(23眼)外伤性泪小管断裂,在手术显微镜直视下寻找、吻合断端,以硬膜外导管为支撑物,另一端自上泪小管插入,两端于鼻腔拉出后固定藏于鼻腔内.结果 23例术后泪管冲洗均通畅,1例有轻度溢泪,1例患者诉眼部轻度异物感,所有患者无外观不满意抱怨,均能顺利配合治疗至拔管.结论 双路泪道插管法行外伤性泪小管断裂吻合术,其固定效果牢固,外观较满意,易于被患者接受.     

亚甲兰透明质酸钠在下泪小管断裂吻合术中的应用

目的:探讨寻找泪小管断端方法,提高吻合泪小管成功率。方法:从上泪小点注入亚甲兰透明质酸钠,在显微镜下寻找下泪小管鼻侧断端,行泪小管吻合术。结果:本组患者22例(22眼),经泪小管鼻侧断端亚甲兰透明质酸钠标记明显,寻找断端的成功率100%。术后随访6~12mo,19例患者治愈(86%),3例未愈(14%)。结论:注入亚甲兰透明质酸钠,寻找泪小管断端,方法简便易行,容易成功,值得推荐。     

16例颜面软组织损伤二期处理的体会

目的:探讨颜面软组织损伤的二期处理方法。方法:对16例陈旧性颜面部裂伤的患者,采用快速清创术治疗。结果:全部病例的伤口均一期愈合。结论:快速清创术是治疗颜面部陈旧性裂伤的一种理想方法。     

整形技术在会阴部畸形中的临床应用

目的探讨会阴部畸形的分型及整形技术的临床应用与治疗后临床转归情况进行分析。方法将13例会阴部畸形患者运用上述整形技术进行整形,并对其治疗后临床转归评价。结果 13例会阴部畸形患者分型进行整形治疗后临床转归：痊愈7例占53.8%;基本痊愈3例占23.1%;好转2例占15.4%;未愈1例占7.7%。结论我们对会阴部畸形患者手术后采用湿润暴露疗法和湿润包扎疗法联合应用,有效隔离,可防止大小便直接污染手术创面。同时使会阴部畸形患者的功能恢复与形态改善达到理想治愈效果。     

Episiotomy closure comparing enbucrilate tissue adhesive with conventional sutures.

OBJECTIVES: The purpose of the study was to evaluate the use of enbucrilate tissue adhesive compared with subcuticular polyglycolic acid sutures in episiotomy wound closure. METHODS: In a prospective controlled trial, two groups were studied after undergoing an episiotomy skin wound repair using either enbucrilate tissue adhesive (n=32) or a subcuticular polyglycolic acid suture (n=30). The variables measured included pain scores during selected activities in the first 5 postnatal days, the time taken to become pain free after childbirth and the time taken to resume pain free sexual intercourse. Suitable patients were invited by the midwives to participate in the trial. If they gave consent to the trial, the gynecologist was contacted. If available, he would perform a repair using enbucrilate tissue adhesive. If he was not available, one of the midwives would perform a repair using subcuticular polyglycolic acid sutures. In this group, 90% of the women were recruited and sutured by one midwife. RESULTS: Patients treated with enbucrilate were found to have significantly less postnatal pain while walking, became pain free in a shorter period (mean=25 days vs. 18 days; P<0.01) and were able to resume pain-free intercourse sooner (mean=34 days vs. 52 days; P<0.001). CONCLUSIONS: Tissue adhesives incorporate the qualities of an ideal skin-closure material. The results demonstrate their advantage over the current standard suture-based methods of repair in the perineum. The use of adhesives merits further evaluation.     

硫酸镁湿热敷对会阴切口护理的效果观察

目的：寻找一种适用于会阴切口护理的有效方法,提高会阴切口甲级愈合率,减轻产妇痛苦。方法：选取2006年5月-2008年10月在我院自然分娩且采用会阴侧切术的初产妇240例,其中120例为观察组,120例为对照组。于产后切口缝合完毕,观察组用碘伏擦洗会阴后加50%硫酸镁浸润无菌纱块湿敷,而对照组则单纯用碘伏擦洗会阴护理法。观察2组产妇会阴切口肿胀程度、疼痛程度、切口愈合情况。结果：与对照组比较,观察组产后会阴切口肿胀例数明显低于对照组,切口疼痛程度也低于对照组,切口愈合率显著高于对照组。结论：采用碘伏擦洗会阴后加50%硫酸镁湿热敷护理会阴切口效果优于单纯用碘伏擦洗法,能减轻会阴肿胀,缓解疼痛,疗效短,见效快,促进切口愈合且操作简便。