VSD技术在四肢严重创伤创面应用中的护理策略

目的:探讨VSD技术(负压封闭引流)在肢体复杂创面应用中的护理要点。方法:选择67例应用VSD技术治疗的四肢复杂创伤患者,进行护理观察并总结经验,形成模式化管理。结果:按照模式化的护理策略对患者进行护理,67例患者早期创面均未出现感染,无护理并发症出现。结论:模式化的护理策略对VSD在肢体创面中的应用中有明显意义。     

化脓性骨髓炎置管持续冲洗引流的疗效观察

目的：观察不同置管持续冲洗引流方法用于化脓性骨髓炎的实际疗效。方法：选择76例化脓性骨髓炎患者,随机分为观察组38例,采用负压封闭引流术（VSD）进行治疗,以及对照组38例,采用闭式灌洗引流（CCD）进行治疗,记录两组患者1年复发率及2年复发率并进行比较。结果：观察组1年复发率为2.63%（1/38）,对照组为15.79%（6/38）,组间差异有统计学意义（P〈0.05）;观察组2年复发率为21.05%（8/38）,对照组为39.47%（15/38）,组间差异有统计学意义（P〈0.05）。结论：VSD用于化脓性骨髓炎的治疗,较传统CCD方法疗效显著,值得临床推广应用。     

VSD敷料填塞治疗骨折术后深部感染疗效分析

目的：探讨负压封闭引流（ VSD）敷料填塞治疗骨折术后深部感染的临床效果。方法对2009年6月-2013年6月大连医科大学附属第二医院收治的26例骨折术后深筋膜下感染患者进行VSD敷料填塞治疗,并观察感染得到控制、创腔愈合时VSD使用期数。结果26例患者均获随访,随访时间3～18个月,平均12个月,26例骨折术后深部感染患者经过1～8期（平均3．6期） VSD治疗,创腔感染均得到控制,创腔内均长满肉芽组织,创面皮肤均愈合,平均创面愈合时间28．8 d,术后随访均无感染复发。结论 VSD能够控制骨折术后深部组织感染,促进创腔内肉芽组织生长,缩短病程,是治疗骨折术后深部组织感染的有效方法,这种方法值得在临床上推广。     

The usefulness of cross-sectional Doppler flow imaging in the detection of small ventricular septal defects with left-to-right shunt

Small ventricular septal defects (VSDs) with left to right (L–R)shunt have been difficult to diagnose with conventional ultrasoundtechniques. Using the cross-sectional Doppler flow imaging system,additional information can be obtained. In a group of 60 patientswith a clinical diagnosis ofVSD with L–R shunt, the newtechnique proved valuable, especially in detecting muscularand apical VSDs.     

先天性室间隔缺损室上嵴解剖形态观察

本组３８例先天性室间隔缺损标本，共有４３个缺损，除去３个膜部小室间隔缺损、１个前窦部伴１个后窦部肌肉缺损外，其余３４例３８个缺损均与漏斗间隔及隔缘肉柱畸形有关。最常见为隔缘肉柱下肢发育不良，或隔缘肉柱下肢与漏斗间隔未对合；次之为漏斗间隔上股或下股肌肉缺如，或上、下股肌肉对合不良；漏斗间隔向隔缘肉柱深层所发出的隔束有缺损者少见。本组漏斗乳头肌起点异常者有２８例。常见异常起点有漏斗间隔下缘、漏斗间隔所发出的壁束或隔缘肉柱上肢等。     

Present status of axially angled angiocardiography

Axial angiography visualizes anatomical details of normal and pathological hearts not previously demonstrated by conventional angiography. Progress in the diagnosis of congenital heart malformations using axial projection technique has been reconsidered, emphasizing that the anatomical details of each congenital heart malformation and their associated anomalies that can be revealed by axial angiography. Three angiographic views form the basis of this study: long axial, four chamber, and elongated right anterior oblique. Relevant findings are presented in isolated ventricular septal defect, tetralogy of Fallot, atrioventricular septa defects, common ventricle, and stradding atrioventricular valves. Variability in the position and orientation of the heart requires adjustment of the degree of obliquity and/or angulation of the X-ray beam in individual patients to obtain the appropriate angiographic views.     

彩色多普勒成像在预防与观察室间隔缺损修补术后残余瘘的应用

目的：探讨CDFI对VSD修补术后残余疾的价值。材料与方法：用彩色多普勒超声诊断仪检查所有室间隔缺损病人，发现5例病人有残余瘘，并对病人进行跟踪观察。结果：2例病人于12周后自然愈合，其Vamx＜2m／s；另外3例术后52周内尚未闭合，其Vamx均＞2m／s；提示Vamx2m／s可以作为判断残余瘘自然愈合的量化界限。结论：CDFI能够很好地显示VSD与周边结构的关系，可以指导术者采取恰当的修补方法避免残余瘘。     

Observable tumours, risk assessment and experimental design

The first goal of this article is to outline a design for an efficient experiment for testing each of many chemicals for carcinogenic potential by dermal exposure, including a risk assessment when appropriate. The second is to validate a general mathematical model for the dose-response function in this situation by using the results from a large experiment in skin painting done by the Oak Ridge National Laboratory. These two goals are related because the general model is used as a guide in the choice of an efficient design for testing the many chemicals on which information is required.