月牙形切口在乳腺癌改良根治术中的应用

目的 探讨月牙形切口在乳腺癌改良根治术中的应用效果.方法 分析近10多年129例行乳腺癌改良根治术的乳腺癌患者的临床资料,129例均行乳腺癌改良根治术.随机分为两组:A组,51例,采用月牙形切口;B组,78例,采用Steward横切口.观察患者的切口愈合情况、腋窝淋巴结清扫的数目、肩关节功能恢复满意度.结结果 A组月切口Ⅰ期愈合率90.2%(46/51),B组75.6%(59/78)(P＜0.05);患侧肩关节功能恢复满意度A组96.1%(49/51),B组84.6%(66/78)(P＜0.05).结论 月牙形切口张力低,愈合好,暴露满意,对肩关节的功能影响小,是乳腺癌改良根治术的一种理想切口.     

切开挂线配合留置梅花头导尿管引流术治疗高位肛周脓肿50例临床观察

为探讨高位肛周脓肿的更佳治疗方法,将100例高位肛周脓肿患者随机分为两组,采用切开挂线同时脓腔内留置梅花头导尿管引流术治疗50例为观察组,切开挂线引流术治疗50例为对照组。对术后疼痛、换药时疼痛、体温改善、疗程、遗留肛门锁眼畸形、肛门松弛、后遗肛瘘等情况进行观察。结果显示,观察组明显优于对照组（P〈0．05）。结果表明,采用切开挂线引流术的同时,脓腔内留置梅花头导尿管引流术治疗高位肛周脓肿,可提高一次性根治效果,该法既缩短了疗程,减少患者的痛苦,又保护了肛门括约肌的功能。     

自然分娩会阴切开术切口感染相关因素的病例对照研究

目的探讨引起自然分娩会阴切开术切口感染的相关因素。方法回顾性分析8年来在达州市中心医院阴道自然分娩的行会阴侧切术2170例产妇的临床资料,发生会阴切口感染的的产妇作为观察组,同期术后切口无感染的的产妇作为为对照组,对可能影响切口感染的因素资料进行单因素分析与Logistic回归分析。结果2170例产妇发生会阴切口感染50例,单因素分析共筛选出13个因素与切口感染有关;以切口感染为应变量,其他统计量作为自变量赋值后进行非条件多因素分析,年龄大、皮下组织厚、产程时间长、急诊手术、合并基础疾病与切口感染有着因或果的关系。结论引起自然分娩会阴切开术切口感染的与多种因素有关,应该针对上述因素预防切口感染。     

The boomerang incision for periareolar breast malignancies

Breast-conservation surgery has been shown to be equivalent to mastectomy in terms of long-term survival for the treatment of breast cancer. Various techniques have been described on how to achieve clear margins and good cosmetic outcomes and therefore expand the indications for breast conservation. A novel incision is detailed to augment the options already available.     

Bioassay-guided isolation of anti-inflammatory, antinociceptive and wound healer glycosides from the flowers of Verbascum mucronatum Lam.

Ethnopharmacological relevance

The leaves, flowers and whole aerial parts of Verbascum L. species have been used to treat respiratory problems, haemorrhoids and other types of inflammatory conditions in traditional Turkish medicine.

Aim of the study

In order to evaluate this traditional information, the anti-inflammatory, antinociceptive and wound healing activities of Verbascum mucronatum Lam. which is used as haemostatic in Turkish folk medicine were investigated.

Materials and methods

In vivo inhibitory effect of the extracts on the carrageenan-induced hind paw edema model in mice was studied for the assessment of anti-inflammatory activity. Moreover, the wound healing potential of the plant were evaluated by using in vivo wound healing experimental models, i.e. incision and excision models on mice and rats, were comparatively assessed with a reference ointment Madecassol^®. Skin samples were also evaluated histopathologically.

Results

The results of these experimental studies exhibited that Verbascum mucronatum displays anti-inflammatory, antinociceptive and wound healing activities. Through bioassay-guided fractionation and isolation procedures four iridoid glucosides, ajugol (1), aucubin (2), lasianthoside I (3), catalpol (4), two saponins, ilwensisaponin A (5) and C (6) and a phenylethanoid glycoside, verbascoside (7) were isolated and their structures were elucidated by spectral techniques. Verbascoside (7) was found to possess significant wound healing activity as well as antinociceptive and anti-inflammatory potentials, per os without inducing any apparent acute toxicity or gastric damage.

Conclusion

The experimental study revealed that Verbascum mucronatum displays remarkable antinociceptive, anti-inflammatory and wound healing activities.     

口底多间隙感染30例临床分析

目的探讨口底多间隙感染的临床特点和治疗方法。方法收集2001—2008年诊治的口底多问隙感染患者资料30例,分析病情特点、治疗方案。结果30例患者中,有5例为腐败坏死性口底多间隙感染,其余25例为化脓性口底多间隙感染;25例为牙源性感染,4例腺源性感染均为儿童,1例为医源性感染,无血源性感染;30例患者的脓液、血液标本经送检细菌培养,15例培养出金黄色葡萄球菌,6例培养出链球菌。治疗方面,先给予头孢他啶联合甲硝唑或替硝唑,酌情使用激素,然后根据药敏实验结果尽早选用敏感抗生素。同时注意全身营养支持,局部及时切开引流,注意防治呼吸困难等并发症。28例痊愈,2例因并发症而救治无效死亡。结论口底多间隙感染全身症状重,易出现并发症,病情进展快,需积极进行合理的全身及局部综合治疗,才能有效控制病情,尽快治愈。     

自然分娩会阴切开术切口感染经济损失的研究

目的了解自然分娩会阴切开术后切口感染所造成的经济损失。方法采用1∶1配比病例对照方法,比较切口感染者与对照组之间的住院时间、住院费用及各支出情况。结果切口感染组住院时间比对照组平均多4.2d,两组有显著性差异(p<0.05);住院费用比对照组多896元,有显著性差异(p<0.05),主要增加的是药费、床位费及治疗费用。结论会阴切开术后合并切口感染延长了住院时间,增加了住院费用,增加了患者直接经济损失及痛苦,使患者身心受到伤害。     

乳腺良性病灶行Mammotome微创旋切术时切口的选择

目的探讨乳腺良性病灶Mammotome微创旋切术选择不同切口的应用效果。方法对885例1356处乳腺良性病灶进行超声引导下Mammotome微创旋切术,针对乳腺病灶不同的位置、数目,分别采用乳房下皱襞、腋中线、乳晕边缘及病灶附近切口。结果根据具体病灶的位置可选择腋中线、乳房下皱襞、乳晕边缘及病灶附近的切口;同侧乳房多个病灶者．尽可能选择能兼顾多个肿块切除的进针部位。结论超声引导下的Mammotome微创旋切系统对乳腺良性病灶成功进行微创切除术,切口的选择得当能减少损伤,获得更好的美观效果。     

主管切开加支管隧道式引流治疗低位复杂性肛瘘50例临床分析

为观察主管切开加支管隧道式引流治疗低位复杂性肛瘘的疗效,我们对50例低位复杂性肛瘘患者探清内口后行主管切开,彻底清除感染的病灶,各支管末端做放射状隧道式开窗切口,橡皮筋置于瘘管内引流。观察结果显示,48例一次性治愈,2例经二次手术治愈,总治愈率100%。无1例出现肛门失禁、肛门畸形等并发症。随访2～4年均无复发。结果表明,主管切开加支管隧道式引流治疗低位复杂性肛瘘,能减少对创面的损伤,减轻患者痛苦,最大限度地保留肛门括约肌形态和功能的完整。