聚氨酯凝胶体位垫联合自制棉纱垫预防胸科手术致急性压疮的效果观察

目的：观察聚氨酯凝胶体位垫联合自制棉纱垫预防胸外科侧卧位手术致急性压疮的效果。方法选取2012年9月－2013年9月在我院施行胸科侧卧位手术的122例患者为实验组，采用聚氨酯胶体位垫联合自制棉纱垫预防压疮，2011年8月－2012年8月施行胸科侧卧位手术的125例患者为对照组，常规采用聚氟酯凝胶体位垫预防压疮，比较两组对术中急性压疮的预防效果。结果实验组手术患者急性压疮的发生低于对照组，差异有统计学意义（P＜0．05）。结论聚氨酯凝胶体位垫联合自制棉纱垫能有效预防胸科侧卧位手术中急性压疮的发生。     

帕瑞昔布钠预防腹腔镜胆囊切除术后咽喉痛疗效观察

目的观察帕瑞昔布钠预防腹腔镜胆囊切除术后咽喉痛的疗效。方法选取2018年6月至2019年1月在重庆市北碚区中医院择期行腹腔镜胆囊切除术的130例全身麻醉患者作为研究对象,性别不限,年龄21~67岁,美国麻醉医师协会分级为Ⅰ、Ⅱ级,随机分为帕瑞昔布钠组(P组)和生理盐水组(S组)。手术结束前10 min P组患者静脉注射帕瑞昔布钠40 mg,S组患者静脉注射等容量生理盐水。记录两组患者术后拔管即刻,术后2、6、12、24 h咽喉痛的视觉模拟评分(VAS评分)。观察并记录拔管期间出现不良反应情况,随访记录患者术后6 h咽喉部并发症发生率、静脉自控镇痛(PCIA)使用情况,以及术后24、48 h 15项恢复质量量表评分。结果P组患者术后拔管即刻,术后2、6、12 h VAS评分均低于S组,PCIA按压次数均少于S组,拔管期间不良反应发生率、术后6 h咽喉部并发症发生率均明显低于S组,术后24、48 h QoR-15项恢复质量量表评分均明显高于S组,差异均有统计学意义(P<0.05)。结论帕瑞昔布钠能有效减轻腹腔镜胆囊切除术后咽喉痛发生情况。     

Philtrum reconstruction in unilateral cleft lip repair

The philtrum is an important aesthetic structure in the midface. A number of philtrum reconstruction techniques have been advocated for secondary cleft lip revision procedures. Conventional surgical management involves end-to-end orbicularis oris muscle approximation during primary cleft lip repair, often resulting in a flat lip appearance that requires secondary revision surgery at a later stage. A novel modification of the approximation of the orbicularis oris muscle is described that may be implemented with any cleft lip technique in order to create an accentuated philtrum column for a natural looking philtrum. The muscle roll technique results in eversion of the orbicularis oris muscle, successfully recapturing the philtrum column topography. This is achieved by utilizing two inverted horizontal sutures, with an additional philtrum takedown suture placed in the region of the dimple to accentuate the philtrum anatomy and three-dimensional profile. This novel technique in unilateral cleft lip repair addresses philtrum architecture during primary surgery, which may reduce the requirement for secondary surgical intervention. Its application may be particularly suitable in outreach programmes where postoperative follow-up may be compromised.