筋膜间隔综合征的高压氧治疗与血浆纤粘素变化的关系

本文首次报道采用253kPa的高压氧治疗24例创伤后筋膜间隔综合征(PACS)病人并采用免疫单扩散法检测了治疗前后血浆纤粘素(FN)的变化与预后的关系。30例健康人作为血浆FN的对照组。结果表明:16例早期PACS病人,经3～5次高压氧治疗,症状和体征逐渐好转,无1例作筋膜切开减压。6例筋膜切开减压后行高压氧治疗者,水肿、炎症消退,体温降低,临床症状好转。2例坏死期PACS虽然临床症状好转,但效果差。高压氧治疗后,病人血浆FN显著高于治疗前。分别较治疗前高43(18.9％;P<0.01)、61(24.7％;P<0.01)、49(17.2％;P<0.01)、57(17.4％;P<0.05)和55mg/L(16.6％;P<0.05)。根据本组研究的结果,提示高压氧是治疗早期PACS的有效非手术疗法和筋膜减压后有效辅助疗法。     

月骨、月骨周围脱位(附15例延误诊断病例分析)

腕关节损伤比较常见。由于其结构复杂,腕关节的X线片又象万花筒样变化,往往给诊断带来困难,特别是月骨及其周围脱位,更容易误诊。若不能及时整复或复位不确切,晚期常导致创伤性关节炎而严重影响关节功能。本文复习腕部解剖及其损伤机制,重点分析误诊的原因及其治疗。临床资料我院自1982年11月至1986年10月于门诊     

老年人腰椎间盘突出症的特点及手术治疗体会

近年来，随着社会结构年龄老化，老年人腰椎间盘突出症有明显增多的趋势，我院自1994年3月～2001年9月收治53例老年腰椎间盘突出病人，经手术治疗，随访效果良好，现报告如下。     

Relationship of Hyperbaric Oxygen Therapy of Acute Compartment Syndrome with Changes of Plasma Fibronectin Concentration

This report describes for the first time the effects of hyperbaric oxygen therapy with 253kPa on patients(n=24) with post - trauma acute compartment syndrome, and the relationship be-tween the prognosis of the syndrome and the changes of plasma fibronectin. Plasma fibronectin wasmeasured using single radial immunodiffusion both before and after therapy with hyperbaric oxygen,with 30 healthy people as control for plasma fibronectin. The results showed that the clinical symp-toms and signs of all 16 patients with acute compartment syndromes in early stage were significantlyimproved after 3 times of hyperbaric oxygen therapy and disappeared after 5 times withoutfasciotomy. Six patients who were treated with hyperbaric oxygen after fasciotomy showed reductionin the infection, and, edema of the injured limb However, the effects were less favorable for 2 pa-tients with necrosis although their clinical symptoms and signs were partially improved. Besides,we found that these patients' plasma fibronectin concentrations were significantly afterhyperbaric oxygen therapy. The mean increase was 43 (18. 9％; P<0. 01), 61( 24. 7%, P<0. 01),49 (17. 2%, P<0. 01), 57 (17. 4%; P<0. 05) and 55 mg/L ( 16. 6%; P<0. 05) after 1, 2, 3, 4and 5 times of therapy, respectively. Plasma fibronectin concentrations returned to the level of thecontrols after 3 times of therapy (P>0. 05). After fourth and fifth therapy plasma fibronectin lev-els of the patients rose higher than those of the controls (P<0.05). The results suggest that hyperbaric oxygen therapy has a beneficial effect on patients withacute compartment syndrome in the early stage Hyperbaric oxygen therapy can reduce edema andskeletal muscle necrosis The method can be used to treat patients with acute compartmentsyndrome in early stage and as an effective adjunctive treatment after fasciotomy.     

益保世灵在创伤外科中的应用

益保世灵(Epocelim~((R));Ceftizoxime Sodium)是日本藤泽药品公司所开发的第三代头孢菌素族抗生素。其特点是:抗菌谱广,特别是对革兰氏阴性杆菌、厌氧菌,具强大杀灭力。益保世灵在血中浓度高,向组织或体液中渗透好。在体内几乎不     

缺血再灌流对心肌的损伤及参麦注射液的保护作用的研究

本实验通过结扎复制心肌缺血再灌流损伤模型，观察参麦注射液血浆丙二醛含量、溶酶体组织蛋白酶活性的影响。结果发现，心肌缺血30min和再灌流60min时，血浆丙二醛含量分别由缺血前1．53±0．36nmol／ml上升到3．86±0．47和4．82±0．53nmol／ml（P值均＜0．01），血浆组织蛋白酶D活性由缺血前的0．025±0．005U／mg蛋白质分别上升到缺血后30min时的0．049±0．003和再灌流60min时的0．087±0．008U／mg蛋白质（P值均＜0．01）。注射参麦注射液后再灌流60分钟，血浆丙二醛含量为3．83±0．36nmol／ml（与对照组相比P＜0．01）；组织蛋白酶D活性为0．055±0．007U／mg蛋白质（与对照组相比P＜0．01）。提示参表注射液在体内通过对抗心肌缺后再灌流中的氧自由基损伤和稳定溶酶体膜作用，保护心肌的缺血再灌流损伤。     

绞肉机致小儿手严重绞榨伤四例

4例患儿均为男性，年龄5～7岁，共绞伤3只右手，一只左手，2例伤及五指及手掌，1例拇指第一、二节及其余四指全损，另一例除拇指外其余四指至掌指关节处全毁。患儿均为外来个体肉摊主子女．因在自家小绞肉机工作时用手向绞肉机内加肉或玩耍时不慎致使手被带入转动的绞肉机中绞伤，家属在受伤现场无法将手退出，故就诊时均连同绞肉机一起带来。4例中，1例为老式组合式绞肉机，     

急腹症的超声诊断

急腹症的超声诊断李卫萍，赵玉华，杨瑞和审校急腹症是指引起急性腹痛的各种腹腔急性疾患和腹部外伤。超声诊断迅速可靠，因而在急腹症诊断中有独特价值。１超声检查方法超声检查一般在急诊情况下进行。非外伤性急腹症时，除立即饮水外，也可用导尿管注入灭菌生理盐水２０...     

脑缺血的全脑保护概念

就卒中后功能恢复而言，所有脑区、细胞类型和细胞成分均应受到保护，而不仅仅是保护某一脑区或某一细胞类型。神经保护治疗的临床试验至今依然令人失望，未来脑缺血的治疗可能有赖于全脑保护，而不是选择性地保护灰质或神经元核周质。在脑缺血的全脑保护概念中，脑白质和神经胶质细胞的保护以及远离缺血核心的脑保护尤为重要。