两种保留SMAS术式对腮腺肿瘤术后复发和预防Frey综合征的对比研究

目的:评价在腮腺肿瘤切除术中两种保留面部表浅肌肉腱膜系统(Superficial musculoaponeurotic system,SMAS)术式对味觉出汗综合征的预防效果和对腮腺肿瘤术后复发的影响.方法:125例良性腮腺肿瘤患者随机分为3组.Ⅰ组(游离保留SMAS法)39例,Ⅱ组(非游离保留SMAS法)46例,Ⅲ组...     

内膜下血管成形术治疗下肢股浅动脉硬化闭塞症

目的探讨内膜下血管成形术（SIA）治疗下肢股浅动脉硬化闭塞症的安全性和有效性。方法采用内膜下血管成形术（SIA）治疗下肢股浅动脉硬化闭塞症32例（36条肢体）。结果手术均成功,术后踝肱指数（ABI）平均提高0.35,术后临床症状均有明显改善,SIA术后6个月,治疗动脉的通畅率为86.11%。结论SIA用于治疗下肢股浅动脉硬化闭塞症安全,有效。     

Observation of the analgesic effect of superficial or deep anterior serratus plane block on patients undergoing thoracoscopic lobectomy

The effectiveness of anterior serratus plane block in postoperative analgesia of thoracic surgery is beginning to emerge. Currently, there are 2 methods of anterior serratus plane block: deep serratus plane block (DSPB) and superficial serratus plane block (SSPB). In clinical practice, there is no an unified view regarding the advantages and disadvantages between 2 methods. This study aimed to observe and compare the analgesic effects of 2 methods on patients undergoing thoracoscopic lobectomy, in order to provide some suggestions for anesthesiologists when they choose anterior serratus plane block to perform postoperative analgesia for patients.Patients were randomly divided into 3 groups (21 patients/group):

• 1.general anesthesia group (P group);
• 2.combined general anesthesia and SSPB group (S group), and
• 3.combined general anesthesia and DSPB group (D group).

The patients in groups S and D received 0.4 ml/kg of 0.375% ropivacaine for ultrasound-guided block after surgery. Postoperatively, flurbiprofen was used for rescue analgesia.Visual analog scale (VAS) pain scores were recorded at 6 hours, 12 hours, and 24 hours after surgery, and rescue analgesia, post-operative nausea, and vomiting were reported within 24 hours after surgery. At 6 hours, 12 hours, and 24 hours, the VAS scores and the rescue analgesia rates in groups S and D were significantly lower than those in group P (all P < .001). With prolonging time, the VAS in group D was significantly increased by 0.11 per hour as compared with that of group P (P < .0001); VAS in group D was significantly increased by 0.12 per hour as compared with that of group S (P < .0001).Ultrasound-guided anterior serratus plane block can provide adequate analgesia for patients undergoing thoracoscopy lobectomy. SSPB can significantly improve VAS scores as compared to DSPB at 24 hours.     

Thyroid Hemangiomas Diagnosed on Sonography

Primary thyroid hemangiomas are extremely rare, and only a few cases have been previously reported. Primary hemangiomas are developmental anomalies resulting from the inability of the angioblastic mesenchyme to form canals. Thyroid hemangiomas are generally considered difficult to diagnose preoperatively because of their low incidence and nonspecific imaging findings. Here we report 2 cases of thyroid hemangiomas that were diagnosed correctly on preoperative sonography. Our cases showed similar sonographic findings, such as well‐circumscribed hypoechoic lesions with internal channel‐like linear lines, and bloody content was aspirated during fine‐needle aspirations. Our report shows that thyroid hemangiomas can be diagnosed correctly by sonography with or without confirmation of bloody content in the lesions by fine‐needle aspiration.     

G实验和真菌培养联合检测对临床深部真菌感染的诊断价值

目的评估血清1,3-β-D-葡聚糖定量分析(G实验)和真菌培养联合检测对临床深部真菌感染的诊断意义。方法通过回顾性分析75例怀疑深部真菌感染住院患者的G实验和真菌培养结果,分别计算两种方法及联合检测的灵敏度、特异度、阳性和阴性预测值。结果 G实验和真菌培养联合检测的灵敏度、特异度、阳性和阴性预测值分别为88.0%、96.0%、91.7%和94.1%。G实验的灵敏度和阳性预测值高,真菌培养的特异度高。结论G实验和真菌培养联合检测可提高实验的灵敏度,减少假阴性的发生,对早期诊断深部真菌感染有一定临床意义。     

成年大鼠下颌功能性前伸后嚼肌浅层的超微结构改变

目的：观察成年大鼠下颌功能性前伸后嚼肌浅层的超微结构变化。方法：成年雄性SD大鼠40只,随机分为4个实验组和4个对照组,每组5只。实验组大鼠配戴固定的前伸下颌矫治器,对照组不配戴矫治器。分别于下颌前伸7d、14d、28d和60d处死实验组和对照组大鼠。取大鼠左右侧的嚼肌浅层,制作电镜标本,透射电镜下观察成年大鼠嚼肌浅层的超微结构变化。结果：实验组大鼠嚼肌浅层部分细胞在大鼠下颌功能性前伸7d时萎缩,前伸60d时形态不规则。实验组大鼠下颌前伸7d,部分嚼肌浅层细胞内肌丝断裂;前伸14d和28d时,嚼肌浅层细胞内肌丝的排列方向紊乱;前伸60d时,嚼肌浅层细胞内局部可见肌丝方向紊乱。大鼠下颌功能性前伸7d和14d时,实验组大鼠嚼肌浅层细胞内肌浆网多见;前伸28d时线粒体多见、形态改变;前伸60d时,肌丝间的线粒体仍多见。结论：成年大鼠下颌功能性前伸后嚼肌浅层细胞的形态、肌丝的排列和结构、线粒体和肌浆网的功能发生了改变。     

PICC在自发性蛛网膜下隙出血病人中的应用

[目的]探讨经外周静脉置入中心静脉导管(PICC)在自发性蛛网膜下隙出血病人中的应用。[方法]将70例自发性蛛网膜下隙出血病人随机分为观察组和对照组,每组35例,观察组采用PICC穿刺置管,对照组采用浅静脉留置针。比较两组病人静脉炎、堵管、渗漏的发生情况。[结果]观察组静脉炎、堵管、渗漏发生率均低于对照组(P<0.05)。[结论]在自发性蛛网膜下隙出血病人中采用PICC穿刺置管,可降低静脉炎、渗漏、堵管的发生率,效果优于浅静脉留置针。