气管切开术在胸腹联合伤中的诊治体会

目的:减少严重胸腹联合伤病人的并发症,提高临床治愈率.方法:严重胸腹联合伤的12例病人于伤后2～20h急诊行开腹手术,腹腔闭式引流术.结果:同时行气管切开术的8例病人治愈7例,死亡1例为合并严重颅脑损伤者.术后第2日行气管切开者2例因气道阻塞,窒息至植物状态.结论:对严重胸腹联合伤的病人,术后立即行气管切开术,有助于防止因气道阻塞而窒息,并发感染,甚至继发ARDS,放宽此类病人的气管切开指征,有助于术后气道内分泌物的清理,呼吸机的及时应用有利于提高治愈率.     

腹部手术切口感染病原菌调查与防治对策

目的探讨腹部手术切口感染病原菌的耐药性并制定防治对策。方法调查2000年1月-2004年12月,某院4 564例患者腹部手术切口感染率;菌株分离鉴定按《全国临床检验操作规程》进行,药敏监测采用KB法。结果手术切口感染率为4.1%,病原菌以革兰阴性杆菌(G-杆菌)为主,占71.1%;G-杆菌中分离率最高的为大肠埃希菌(17.2%)、铜绿假单胞菌(16.7%)、肺炎克雷伯菌(12.7%),均显示出较高的耐药性。结论必须采取切实的防治对策,预防与控制腹部手术切口感染。     

颅脑伤后双瞳散大62例临床分析

目的探求颅脑损伤后双瞳散大的救治措施,提高其生存率与生存质量。方法自1996年8月￣2005年4月,对因颅脑伤后双瞳散大的62例患者救治转归情况回顾性分析。结果62例经多方及时抢救和恢复治疗,存活41例(66.13%),死亡21例(33.87%)。经ADL统计,其中恢复良好25例(60.98%),中、重残13例(31.71%),植物性生存3例(7.32%)。结论对颅脑伤患者的动态密切观察是提高此类患者成功救治的关键,查明原因、果断决策、针对病因、紧急稳妥的处理是成功救治的保证。     

明胶海绵在肾损伤性血尿介入治疗中应用

目的 探讨肾损伤血尿介入治疗术中明胶海绵应用的可行性与安全性。方法 应用低压流控和层流效应原理，以明胶海绵为主要栓塞剂，对10例肾损伤血尿保守治疗无效患者进行栓塞止血。结果 造影显示创伤性动脉瘤3例；血管狭窄／闭塞，并区域性肾实质显影缺失9例；动-静脉瘘3例；动脉-肾盏痿5例；肾轮廓异常3例。损伤范围累及1／2肾或以上者5例，累及1／2肾以下者5例；单纯使用明胶海绵者8例，弹簧钢圈加明胶海绵者2例；全部病例均止血成功；保肾效果满意。结论 （1）明胶海绵栓塞可用于多数肾损伤后血尿保守治疗无效者，止血效果肯定。（2）低压流控技术对提高明胶海绵栓塞的安全性十分重要。（3）对于分流量大者，需以导管限流或在钢圈应用基础上使用明胶海绵，以免顺行性误栓。     

Influence of selant fibrin on the wound healing of the pigs vocal folds

Fibrin sealants or fibrin glue are products made from human plasma proteins, which mimic the final pathway of the coagulation cascade. Its application to stimulate the healing process has been a topic of debate in the literature. The use of fibrin sealants in phonosurgery has been empirical; there have been no studies that investigate the action of fibrin sealant in Reinke's space.AimTo evaluate the effect of fibrin glue in healing of the vocal folds of pigs after surgical manipulation.Materials and MethodsThis was a prospective and experimental study. Six animals had both vocal folds incised. Sealant was applied in one of them; the other served as a control. After three months, the animals were sacrificed and a collagen count was carried out.ResultsThe side on which glue was applied had an average of 27.8% against 20.4% of the side without glue.ConclusionThe collagen concentration in the samples where the fibrin sealant was applied was significantly higher compared to samples without glue. Thus, the presence of a fibrin sealant stimulates fibrogenesis in this tissue.     

Caries Frequency and Nutrition Before,During and After World War II

This study was carried out in order to observe the changes in amino-peptidase activity which might occur in the palatal mucosa and gingiva of the rat in the initial phase of healing after tooth extractions. The material consisted of 115 male Sprague-Dawley rats. Amino-peptidase activity was studied at time intervals of 30 min., 1, 2, 4, 8, 16 hours and 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 days after the extractions. The azocoupling principle was used for the histochemical demonstration of enzyme activity. However, the incubation solution was in gel form. A semipermeable membrane was placed between the tissue sections and the incubation medium in order to prevent enzyme diffusion and dissolving of enzymes into the incubation medium. The substrates used were N-aminoacyl 2-naphthylamines of L-leucine and L-arginine. Histological investigations were carried out simultaneously with the histochemical study. The principal increase in aminopeptidase activity occurred relatively late after the tooth extractions. The most intense staining was observed in 4- to 7-day wounds. During the same period the most active fibroblastic proliferation was observed histologically. The changes were demonstrable using both of the substrates. However, the staining was more intense when N-L-leucyl-2-naphthylamine was used as the substrate. By using N-L-arginyl-2-naphthylamine as the substrate, chloride ions caused a marked increase in staining intensity. It was thus assumed that aminopeptidase B would also be activated during the healing.