丹参对重度烧伤器官缺血-再灌注损伤保护作用的临床观察

[目的]探讨丹参对严重烧伤后重要脏器功能的治疗、促进创面愈合的临床疗效。[方法]选取2006年12月～2010年5月住院的74例重度烧伤病人,采用随机对照方法分为丹参治疗组(37例)和对照组(37例),治疗组应用注射用丹参冻干20mg/kg静滴,观察用药后5d、10d血常规、肝功能、肾功能和心肌酶谱、血清肿瘤坏死因子-α(TNF-α)及白介素-6(IL-6)水平,器官功能不全(OD)的发生率及病死率及平均愈合时间(d),并统计学分析。[结果]d5治疗组与对照组的各项检验指标改善有差异,P﹤0.05;d10部分检验指标改善有明显差异;治疗组5例出现OD,对照组10例死亡1例。[结论]注射用丹参冻干药用有活血化瘀的功效;烧伤早期大剂量使用可明显改善重要脏器的微循环,减轻缺血再灌注损伤,有效支持和保护重要脏器功能,能有效防止OD的发生、发展。     

补片大网膜联合植皮修补腹壁巨大肿瘤术后缺损

腹壁恶性肿瘤并不少见,部分病情延误致肿瘤巨大,切除后因腹壁巨大缺损而修复困难,尤其是腹直肌切除后,术后腹壁缺损,术后可造成巨大切口疝引成,早期应用补片修补,植皮难以成活,治疗困难。2004年6月至2007年3月,我们对5例腹壁巨大恶性肿瘤切除后行一期补片(巴德Kugel疝修补片)联     

注射器抽脂法脂肪瘤切除64例

高脂饮食和部分人群活动量减少,肥胖人群增加,体表脂肪肿瘤和脂肪垫的发生率也渐步增多,脂肪肿瘤必需行手术才能治愈。因大部分病人脂肪瘤为多发,常规术后全身留下许多切口瘢痕,影响美容,因此许多人恐惧手术。我们2004年7月至2006年11月采用注射器行局部脂肪瘤和脂肪垫的抽吸切     

高压氧预处理超长皮瓣组织血管内皮生长因子、转化生长因子β的表达

BACKGROUND: Hyperbaric oxygen (HBO) therapy can alleviate the skin flap congestion by improving the angiogenesis and increasing the oxygen content of blood in skin flaps. Although the HBO therapy ability to increase flap survival has been well described, the research on the application of HBO pretreatment in skin flap transplantation does not arouse adequate concern. OBJECTIVE: To investigate the effect of HBO pretreatment on early-stage flap congestion in the rat model of over-length dorsal random skin flaps. METHODS: Thirty-six SD rats were randomly divided into control group (n=12), HBO pretreatment group (n=12) and HBO treatment group (n=12). Rats in the HBO pretreatment group received 4 days of HBO therapy prior to transplantation, once a day. Rats in the HBO treatment group received 4 days of HBO therapy after transplantation. Rats in the control group were raised in the normal conditions after flap transplantation. At postoperative days 3 and 5, rats were sacrificed and the samples were collected. The inflammation of flap tissues was detected using hematoxylin-eosin staining. The expression of vascular endothelial growth factor and transforming growth factor-β was analyzed by immunohistochemistry staining. The flap survival rate was calculated at postoperative day 5. RESULTS AND CONCLUSION: The flap survival area of the HBO pretreatment group and HBO treatment group was larger than that of the control group (P < 0.05). At postoperative days 3 and 5, the expression levels of vascular endothelial growth factor and transforming growth factor-β in the flap tissue were higher in the HBO pretreatment group and HBO treatment group than the control group (P < 0.05). However, there was no significant difference in the flap survival area and the expression of vascular endothelial growth factor and transforming growth factor-β between HBO pretreatment and HBO treatment groups  (P > 0.05). HBO pretreatment can increase the expression of vascular endothelial growth factor and transforming growth factor-β and promotes angiogenesis in random pattern flaps, thereby improving skin flap survival.      

降钙素原在胸腔积液诊断及治疗中的应用

胸腔积液为临床常见症状,多种致病因素均可导致,特别是胸腔积液肿瘤细胞学及结核菌痰涂片阳性率低,有时给鉴别诊断带来困难,而通过将降钙素原与肿瘤标志物联合检测,可以有助于结核性与肿瘤性胸腔积液的鉴别.对肺炎患者进行降钙素原监测,可以起到判断预后的作用.降钙素原做为新的炎性标志物,较传统标志物显示出明显的优势,目前已被广泛认可.     

非手术脊柱减压技术治疗腰椎间盘突出症疗效观察

目的 探讨非手术脊柱减压系统治疗腰椎间盘突出症（LDH）患者的临床及影像学疗效与普通牵引相比的优势所在.方法 选取LDH患者40例,随机分为试验组和对照组,每组各20例.在常规综合康复治疗基础上,对照组予普通腰椎牵引治疗,试验组予SDS9800非手术脊柱减压系统治疗.两组患者均于治疗前及治疗4周后,予腰椎MRI测量,并于治疗前后对患者进行临床疗效评估.结果 治疗前两组患者临床及影像学表现相近,差异无统计学意义（P〉0.05）.经4周治疗后两组患者临床及影像学均有改善,但试验组较对照组改善更显著,差异有统计学意义（P〈0.05）.结论 非手术脊柱减压技术是无创、安全、有效、舒适的治疗LDH方法,其临床及影像学疗效优于普通牵引.     

神经根型颈椎病的功能评估及非手术治疗进展

神经根型颈椎病是最常见的颈椎病类型,患者多由于颈椎椎间盘、颈椎钩椎关节或关节突关节增生,因而导致椎间孔狭窄和颈神经根受累.主要临床表现为颈肩臂痛,向前臂或手指放射,手麻,手或臂无力感,持物不稳或失落[1].目前,临床针对神经根型颈椎病患者的治疗多采用非手术治疗,其中以推拿、牵引、物理因子等治疗较为常见[2].而在治疗前、后对患者的病情及预后进行有效的功能评估[3,4]是制订正确治疗方案的基础.故本文目的就是对神经根型颈椎病常见的功能评估方法和非手术治疗进展进行综述,为其今后的临床治疗和研究提供参考.