Postoperative management of Dupuytren’s disease with topical nitroglycerin

Dupuytren’s contracture remains a significant clinical challenge due to associated complications and a recurrence rate of up to 60%. Commonly, the operated skin tends to rebuild scar in the area of surgery. Assuming local ischemia as an etiological factor, two cases in which topical nitroglycerin was used following surgical treatment of Dupuytren’s disease are presented. In these patients, no raised scar formation developed during healing. At least six months after surgery, disease recurrence was not noted and the patients and surgeon reported improved skin quality. In the present study, the use of topical nitroglycerin, a local vasodilator, appeared to prevent recurrent scar formation, possibly through prevention of local ischemia. Further study and follow-up is necessary.     

高龄备孕妇女常见妇科疾病及处理

目前高龄备孕,尤其是超过40岁甚至45岁的超高龄人群备孕皆在增多,妇产科医生面临的除高龄所带来的高危产科外,如何最优化处理此类人群的妇科疾病同样是项巨大挑战。高龄孕妇常见妇科疾病如子宫肌瘤、卵巢囊肿、宫颈上皮内瘤变、瘢痕憩室等,临床关注的焦点在于能否妊娠、孕前是否需手术、手术治疗对妊娠影响以及尽少破坏生育功能的手术技巧等方面。文章结合相关文献,对上述问题进行阐述。     

疤痕子宫经阴道分娩的护理体会

目的总结疤痕子宫再妊娠经阴道分娩产妇的护理体会。方法选取2015年8月-2016年1月疤痕子宫再妊娠经阴道分娩产妇39例,采取严密监护及加强心理护理。结果 39例疤痕子宫再次妊娠经阴道分娩的产妇中,足月产37例,早产2例,均顺利阴道分娩,新生儿平均体重(3.2±0.62)kg,无产后出血,无子宫破裂,产后恢复良好,母婴安全,结局满意。结论在疤痕子宫产妇行阴道试产过程中加强产程护理和心理护理,有助于提高阴道试产成功率,提升护理工作质量。     

Ki67在瘢痕癌中的表达及其临床意义

目的探讨Ki67在瘢痕癌组织中的表达及与患者临床特征的关系。方法应用免疫组化SP法检测Ki67在27例患者瘢痕癌组织中的表达,并结合瘢痕癌患者的临床特征进行分析。结果 27例患者瘢痕癌组织的Ki67检出率为100%。根据Ki67阳性细胞百分率将患者分为3组,≤10%组10例,11%~40%组10例,≥41%组7例。进一步分析发现各组的Ki67阳性细胞百分率与瘢痕溃疡持续时间长短、浸润深度和手术后复发相关,Ki67阳性细胞百分率越高,溃疡持续时间越短(P0.05)、浸润越深(P0.01)、手术后越易复发(P0.05);而与瘢痕病程、溃疡面积无关(P0.05)。结论 Ki67的表达在瘢痕癌浸润深度和术后复发的临床评估中具有重要的指导意义。     

Looped,Broad, and Deep Buried Suturing Technique for Wound Closure

This study explores the clinical application of the circular wide and deep (looped, broad, and deep buried, LBD) suture technique for scar resection and examines its clinical effectiveness for scar treatment. From June 2017 to March 2019, a total of 68 patients with scars were sutured using LBD technique, and recovery was achieved 24 months postoperatively. In all 68 patients, postoperative scars were slightly evident in two cases of cervical scar, one case of leg scar, and one case of chest scar. In addition, the remaining 62 patients were completely satisfied with the outcome. The LBD suturing technique could provide sustained and stable tension-reducing effects postoperatively and significantly improve scar formation in patients. This method is most applicable to incisions with tension. Therefore, it should be more widely used for clinical scar treatment.     

曲马多配伍安定在瘢痕子宫妊娠引产中的应用

目的探讨曲马多配伍安定在瘢痕子宫妊娠引产中镇痛及缩短产程的作用。方法选择2009~2011年自愿要求终止妊娠的瘢痕子宫患者112例,采用完全随机分组方法,分为观察组和对照组各56例,观察组引产中给予安定10 mg,盐酸曲马多100 mg,对照组引产中不另给药。观察两组产程时间和镇痛效果。结果观察组产程时间、镇痛效果均优于对照组(P0.05)。结论瘢痕子宫引产中使用曲马多配伍安定,能缩短产程,减轻患者疼痛,适合基层医院应用推广。