小儿特重度烧伤惊厥的原因及救护

目的：探讨小儿特重度烧伤惊厥发生的原因，为临床提供有效的救护措施。方法：回顾分析56例小儿特重度烧伤并发惊厥病人的临床资料。结果：56例患者中入院时发生休克33例，其中发生惊厥15例(占45．5％)，另23例未发生休克患者中无1例出现惊厥。15例惊嗍病人中有13例伴有高热(占86．7％)。结论：小儿特重度烧伤多在合并休克时发生惊厥；惊厥与高热密切相关。镇静、解痉治疗是抢救惊厥的关键措施，针对发生惊厥原因进行治疗护理是抢救成功的有力保证。     

小儿烧伤惊厥病因及发病机制的研究现状

小儿烧伤惊厥是烧伤早期的严重并发症之一，临床上发生率较高，据统计其发病率国外报道为6．6％，国内为5．4％。原因是多方面的，其中高热、低血容量性休克、电解质紊乱、酸碱平衡失调、烧伤脑病以及消化道应激性溃疡出血等是小儿烧伤惊厥的常见病因，其机制尚未明了，一般认为大脑神经元异常放电所致。本文综述了近十年来有关小儿烧伤惊厥的病因及其机制。     

婴幼儿重度烧伤休克期的护理

小儿烧伤后病情重、变化快、休克发生率高[1].小儿烧伤休克期渡过是否平稳,关系着患儿的整个治疗过程、预后和并发症的发生[2].本院自2005年5月～2009年5月共收治婴幼儿重度烧伤142例.现就婴幼儿烧伤休克期的护理体会介绍如下.     

婴幼儿烧伤后惊厥的原因及防治

目的 回顾性分析74例烧伤后惊厥患儿的临床资料,总结婴幼儿烧伤后惊厥的常见原因及处理方法.方法 给予婴幼儿惊厥常规治疗,在烧伤创面使用湿润烧伤膏换药治疗.结果 74例患儿中,73例患儿烧伤创面治愈后出院,1例患儿死亡.结论 婴幼儿烧伤后及时有效地行抗休克复苏、维持水电解质稳定、正确的换药方法、积极清除坏死组织,可以减少烧伤后婴幼儿惊厥的发生,提高婴幼儿烧伤治愈率.     

小儿重度烧伤后惊厥的预防与治疗

1997年10月——2002年3月,第二炮兵总医院烧伤整形外科共收治烧伤患者1194例,其中儿童烧伤患者267例,占22.36％;267例儿童烧伤中,3岁以下188例,占70．41％(188／267),4～12岁79例,占29．59％(79／267)。在188例3岁以下烧伤患儿中,深度烧伤面积在15％以上的重度烧伤患者43例,占22.87％(43／188)。在43例重度烧伤患儿中,6例发生典型的惊厥症状,占     

94例特重度烧伤补液治疗的体会

按照目前国内普遍采用的烧伤严重程度分类标准，该院１９８９年６月￣１９９３年５月共收治重度烧伤９４例，其中小儿４５例，占４７．８７％。在早期补液治疗方面，认识到烧伤局部及远离部位微血管通透性增加，主要发生在伤后８小时，特别是伤后４小时以上提出加快伤后前４小时补液速度对抗休克治疗将起到积极作用。     

小儿特重度烧伤276例治疗经验总结

目的探讨小儿特重度烧伤的治疗方法。方法对1992年—2008年收治的276例特重度烧伤患儿的治疗进行回顾性分析。结果276例中,治愈243例(88%);死亡21例(7.6%);自动出院12例;并发休克116例,因休克导致早期死亡6例,出现与休克有关的严重并发症48例;发生创面脓毒症47例,血培养阳性29例,因感染死亡12例;有吸入性损伤26例中,死亡11例,死亡率57.9%。结论由于小儿特殊的生理和病理特点,特重度烧伤后往往病情变化快,并发吸入性损伤者治疗难度更大,休克、感染、脓毒症及其他严重并发症的发生率高,由此造成的死亡率也较高。因此,在休克防治、吸入性损伤的处理、烧伤感染的治疗、烧伤创面处理、加强营养、积极处理并发症等方面,应及时、准确、有效地进行治疗和干预,有效地减少并发症,提高小儿特重度烧伤的治愈率。     

小儿烧伤休克期出现脑水肿原因及预防

<正>小儿烧伤休克期病情波动大,变化快.而且补液不足与过量之间的范围较小.临床表现难鉴别,补液量及速度不易掌握,补液不当及患儿未入院前饮用大量低渗液体是造成脑水肿的主要原因.     

重度烧伤并发胸腔积液4例

<正>重度烧伤患者,最常见严重并发症是低血容量性休克,主要原因是体液大量丢失,为了及时纠正休克预防多脏器功能衰竭,积极快速补液是一项有效的治疗方案。但是烧伤后血管通透性持续增高,血浆中白蛋白等成分丢失引起毛细血管内胶体渗透压下降^[1],伴随着大量补液导致胸膜腔内漏出液增多,回吸收困难,从而引发胸腔积液,如不及时发现纠正,出现酸碱平衡紊乱及呼吸衰竭,导致救治失败,因此重度烧伤抢救过程中胸腔积液的预防也必须作为早期救治的关注重点。     

小儿烧伤惊厥28例临床分析

作者自1989年1月至1992年1月共收治小儿烧伤472例，发生惊厥者28例（5．9％），年龄最大的为4岁，最小的为9个月。最大烧伤面积为56％，最小的为8％。其中休克者16例占57％。饬后至惊厥时间短者为5小时，最长者为72小时，惊厥伴高热（39C以上）22例占78％，低钠血症占75％，低钾血症7例，高钾血症伴血钙轻度异常3例，代谢性酸中毒22例，本组死亡2例。（一例死于反复抽搐，一例并发早期暴发型败血症），另有2例因惊厥后昏迷未恢复自动出院。作者认为：一、小儿烧伤惊厥并不少见，重者可因脑水肿呼吸衰竭死亡，或出现严重脑功能损害。二、惊…     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.