阴道镜辅助下聚焦超声在慢性宫颈炎治疗中的应用

慢性宫颈炎是生育年龄妇女的常见病,可有宫颈糜烂、宫颈肥大、子宫息肉、宫颈腺体囊肿、宫颈内膜炎等变化.治疗方法有电熨,冷冻疗法,激光治疗,患者易出现脱痂出血.本文探讨了阴道镜辅助下聚焦超声在慢性宫颈炎治疗中的应用,现报告如下.     

舒芬太尼用于烧伤病人切痂植皮术后静脉自控镇痛效果的观察

由于烧伤病人局部组织遭受严重破坏,其切痂、取皮、植皮等手术常需多次进行,这些手术对患者的浅表刺激很大,对镇痛要求较高,尤其在烧伤后期整形阶段,病人对疼痛较敏感,而良好的术后镇痛可改善病人的预后和转归。本文观察了舒芬太尼复合昔康类非甾体抗炎药氯诺昔康用于烧伤病人切痂植皮术后镇痛的效果及安全性,报道如下。     

接骨紫金丹对实验性骨折愈合不同时相骨痂的生物力学性能的影响

本实验动态地观察了中医传统接骨名方－接骨紫金丹对家兔实验性骨折愈合过程不同时相骨痂的抗扭转生物力学性能的影响。结果显示，接骨紫金丹能提高骨痂的极限扭矩值及极限载荷，并能降低其极限扭角值，与对照组比较，各时相都有显著性差异。提示：接骨紫金丹有较好的增强实验性骨折愈合骨痂抗扭转强度和刚度的作用。     

Experimental studies on the treatment and pathological basis of combined radiation and burn injury

Objective To investigate therapeutics for and the pathological basis of combined radiation and burn injuriesMethods Combined radiation and burn injuries on mice and rats were inflicted by γ ray irradiation from a (60)Co source and thermal radiation from a 5 kW bromotungsten lampResults The dysfunction of myocardium played an important role in the development of early stage shock. Transfusion of irradiated (in vitro, 20 Gy) or stored (4℃, 7 days) blood after irradiation was done to promote the success of allo-transplantation of bone marrow. Decrease of IL-4 mRNA expression was the molecular basis of depression of intestinal mucosa immune and intervention of IL-4 showed an antagonistic effect on enterogenic infection. A new lipid component extracted from burn eschar was documented for the first time and its toxic effects were elucidated. The survival rate of alloskin grafts after removal of burn eschar from the recipient animals was obviously increased in combined injury due to reduction of immune rejection activity by the radiation effect. In contrast, in animal models with simple burn, the alloskin grafts were all rejected within ten days after the procedure. A successful therapeutic result (survival rate: 92% for 30 days and 67% for 100 days) was obtained by comprehensive management of treated animals, while the untreated control animals all died within 3-7 days after injury. Conclusion The pathogenesis of injury caused by simultaneous radiation and burn is extremely complicated and the treatment is very difficult. A comprehensive management program consisting of several therapeutic measures aimed at key links of the pathogenesis may achieve significantly improved results.     

大面积深度烧伤切削痂延迟植皮术护理体会

大面积深度烧伤早期切削痂手术中大量的出血是术中和术后病情不稳定的重要因索，另外，术后因输血引起的传染性疾病和其它并发症也越来越多地困扰着医院和患者，因此寻找术中减少出血的手术方式势在必行。我科自2004-01—15—2005-09—30对96例烧伤患者采用大面积烧伤早期切削痂延迟植皮的手术方法进行治疗。现将护理体会介绍如下。     

手背Ⅲ度烧伤早期切痂植皮的体会

在日常生活和生产劳动中，一旦发生火灾，裸露在外的双手被烧伤的机会较多，深度烧伤后常留有畸形和功能障碍，严重者可丧失劳动能力，甚至于难以生活自理。因此，治疗手烧伤的目的，不仅仅限于修复创面，而应最大限度地保存手的功能，以利于病人独立生活和工作。我们为84例手背Ⅲ度烧伤患者的132只手进行了早期切痂植皮手术，并经半年以上的随访。现将体会报告如下：     

彩色多普勒超声与X线在监测骨折术后骨痂愈合过程中的价值

目的：应用彩色多普勒超声监测骨折术后骨痂愈合过程及其血运的变化，探讨早期预测骨折愈合趋势及预后。方法：用彩色多普勒超声对19例骨折患者在内固定术后第1、2、3、4、9周及第15周内依次观察患者骨折骨痂形成的声像特征及其血运情况，并与X线摄片进行对比分析。结果：在X线检查难于显示的血肿机化期，彩色多普勒超声可清晰显示；在原始骨痂形成期彩色多普勒超声显像早于X线。结论：应用彩色多普勒超声监测骨折端骨痂愈合的过程及其血运的变化，能早期预测骨折愈合的趋势和预后。     

自制电动磨痂仪在烧伤深度创面中的应用

目的:探讨自制电动磨痂仪治疗烧伤深度创面的效果。方法:50例70个深度烧伤创面随机分为磨痂组(n=25,40个部位)、削痂组(n=25,30个部位),两组的手术面积相当,磨、削痂后均覆盖辐照猪皮。对磨、削痂而除下的组织进行相关检测,观察创面愈合时间及质量。结果:磨痂能保留更多的真皮活性组织及皮肤附件;创面愈合时间较削痂组缩短且质量好。结论:自制的电动磨痂仪性能稳定、安全、易于操作;能有效地保留更多的有活性的组织,创面修复快,瘢痕轻。     

大面积烧伤创面切痂植皮的围手术配合

目的:切痂植皮是治疗大面积深度烧伤的有效手段。方法:这类手术对病情严重的烧伤病人,风险较大,如何配合手木,缩短手术时间非常重要。结果:本文通过总结84例切痂植皮手术的配合,体会到加强术前准备做好病人心理护理,熟悉手术方法及良好的无菌操作对配合医生手木成功是非常必要的。     

2例特殊类型儿童气管异物的临床分析

目的:分析儿童气管异物误诊原因,减少临床误诊率。方法:对2例诊断为儿童气管异物的病例进行回顾性分析。结果:1例无明确异物吸入史的患者证实为鼻腔脓性痂皮致主气管异物,1例高度怀疑为气管异物患儿最终诊断为有机磷中毒。结论:对疑似气管异物的儿童患者,应仔细采集病史,注意特有体征,减少误诊。