臀部软组织金属异物取出方法的研究（附916例报告）

目的研究软组织异物的定位方法，探讨解决深部软组织异物摘除的难题。方法采用三维立体异物座位定位器，使异物有正确的定位。再用配套的特制异物钳摘除软组织异物。结果916例软组织异物，通过使用定位器和异物钳后均一次成功取出，平均手术时间为3min，无并发症。结论通过应用新技术使金属异物定位精确、创伤微、痛苦小、成功率高。     

软组织内金属异物取出方法的探讨(附7390例报告)

目的 探讨各部位软组织金属异物的定位及手术方法。方法 1996年6月到2006年6月，采用三维立体异物坐标定位器精确定位异物，再用带磁性的配套特制异物钳、穿刺钳为7390例病人取软组织金属异物。结果 软组织金属异物一次取出成功率99．5％，平均手术时间为5min。结论 该方法定位精确，取出金属异物顺利。具有并发症少、痛苦小、成功率高的优点。     

异物坐标定位器与异物钳在人体软组织异物取出术中的应用

人体软组织金属异物，特别是针状锐性异物，一旦进入体内，随肌肉的收缩，部位较深，移动较快，故定位困难，手术难度大，失败率高，再则，深部软组织异物多具有细小，散在，多发，游动，邻近血管神经区域等特点，处理往往比较棘手，而外科手术切开寻找既费时又难以完全取出。作者从1981年开始研究人体软组织内金属异物，发明了配套的人体异物三维坐标定位器和异物钳（专利号：90207213.7）。     

自制瞄准器探取肢体显影小异物23例体会

目的交流探讨肢体显影小异物的定位与取出方法。方法对23例肢体软组织内X线能显影的小异物,用自制的瞄准定位器定位后,用髓核钳取出异物。结果23例患者共29枚异物均顺利取出,手术时间最短2min,最长32min,平均8min。结论自制的瞄准器能准确定位,髓核钳探取小异物简单、容易,成功率高。     

颈部软组织金属异物取出方法的探讨

颈部是血管神经丰富的重要区域,一旦颈部软组织内异物进入,手术难度较大,容易出血,损伤周围重要器官。作者于１９８９年开始研制了对人体异物三维定位器及配套的异物钳（中国专利号９０２０７２１３－７）取除体内异物５２１２例,特别对颈部５２８例金属异物病人均顺利取出,无一例副损伤。现报告如下。１　资料和方法１－１　临床资料自１９８９年１月至１９９８年１２月,本组共收治颈部软组织异物５２８例。男性４７５例,女性５３例。年龄２～８９（平均２９－５＋１７－７）。异物种类及部位见表１。表１　异物种类及部位（ｎ）颈…     

金属异物体表投影定位的临床应用

目的:分析采用体表投影定位的异物钳取术在临床应用的效果。方法:体表投影定位采用CT扫描检查。我院2012年收治795例,通过体内金属异物体表投影定位异物钳取术,共取出1 008个金属异物。结果:所有病人行CT检查定位后,异物全部被取出,取出率为100%,无并发症出现。治疗效果满意。体表投影定位异物钳取术具有切口小(0.4±0.1)cm、出血量少(1.1±0.5)mL、手术时间短(4.1±2.0)min、术后疼痛轻等优点。结论:异物体表投影定位是一项精确、有效的术前定位方法。     

自制定位膜结合X线透视法在软组织异物取出术中的应用

目的探讨自制定位膜结合X线透视法在软组织内金属异物取出术中的应用价值。方法利用家庭常用物品制作含金属丝定位膜,术前覆盖异物区组织,结合X线透视法精确定位异物位置,指导异物取出手术。结果 34例软组织内金属异物患者,应用自制定位膜结合X线透视法成功取出异物48枚,无其他并发症发生。结论自制定位膜结合X线透视法在软组织金属异物取出术,有较高的应用价值,可以指导异物取出手术。     

CT仿真局部解剖与X线透视双导向的软组织金属异物钳取术

目的探讨CT仿真局部解剖与X线透视双导向软组织金属异物钳取术的临床应用价值。方法 1315例软组织金属异物患者分为平片组、平片加常规CT组和平片加CT仿真局部解剖组。采用体绘制和动态阈值技术以获取CT仿真局部解剖图像,根据影像学资料先行评价、确定异物钳取术的可行性及具体术式,在"C"型臂X线电视透视引导下经皮钳取异物。结果应用动态阈值变化的体绘制技术的CT仿真局部解剖图像成功获得率为100%,基于增强CT源影像的图像层次丰富,且三维显示了基于平扫源影像未能重构出来的动脉与深部静脉。CT仿真局部解剖准确评估了异物的可摘除性、手术风险,并由此确定了具体术式。平片加CT仿真局部解剖组异物介入摘除术的安全性、成功率与治愈率明显高于其他两组(P0.01),手术时间和住院时间短于其他两组(P0.05),并发症发生率和定位器协同使用率低于其他两组(P0.005)。结论 CT仿真局部解剖结合X线透视双导向软组织金属异物钳取术具有良好的临床价值与效果。     

经皮软组织和经皮经血管双介入治疗血管间软组织异物损伤

目的探讨经皮软组织和经皮经血管双介入治疗大血管间软组织异物的可行性。方法对6例经CTA确诊的大血管间金属异物（1例合并创伤性假性动脉瘤）进行双介入治疗。局麻后于电视透视导向下经皮经腔定位异物旁血管后,经皮软组织介入钳取异物。结果异物位于大腿上部3枚、肘窝1枚、前臂2枚,长径3～10mm、短径1～2mm,与毗邻大血管间距0～2mm。成功取出所有异物,术中总透视时间5～9min、总出血量5～10ml,对较小动脉瘤未予治疗,均无严重并发症发生。结论经皮软组织和经皮经血管双介入治疗血管间软组织异物技术可行,为伴血管损伤的血管间软组织异物损伤患者的一站式微创治疗提供了新思路。     

双介入治疗颈部创伤性动脉瘤间异物:动物实验研究

目的通过动物实验探讨双介入治疗颈部创伤性动脉瘤间异物的可行性及效果。方法选取5只2岁健康比格犬,对其右颈部构建创伤性动脉瘤间异物模型(研究侧),左侧颈部采用直接断针刺入、留置方法构建颈动脉旁软组织异物模型(对照侧)。对研究侧,在直接经7F血管鞘颈动脉内植入可降解覆膜支架封堵瘤口的同时,于透视下经皮经软组织钳取动脉瘤间异物;对照侧则采用传统介入方法,在颈动脉内导丝定位透视下经皮经软组织钳取异物。以DSA评价介入治疗效果,并通过CTA或MRA进行随访。结果研究侧直接经鞘法颈动脉内支架植入技术成功率为100%(5/5);异物取出后动脉瘤均有不同程度出血,覆膜支架释放后均有效止血。术后3个月内随访研究侧颈动脉局部均呈轻度或中度狭窄,未见明显内瘘及动脉瘤复发。对照侧传统介入方法取出异物的技术成功率亦为100%(5/5),未见颈动脉狭窄等改变。结论可降解覆膜支架辅助双介入治疗技术可一站式同时微创取出犬颈部创伤性动脉瘤间异物并封闭动脉瘤口;直接经鞘法可作为可供选择的植入血管内支架的动物实验方法。     

手部外伤性异物的治疗体会

目的探讨手部外伤性异物取出术中易忽略的几个问题。方法 10年来对126例手部外伤性异物患者进行了异物取出术。术前、术后均行X线检查,部分患者术前行B超检查。术后随访时间为1~8个月。结果 65例甲下异物患者中,18例行拔甲后,新生指甲欠平整,外形欠佳;47例采用了指甲部分切除,术后指甲生长良好。1例鱼刺伤异物取出(2枚)术后X线复查,仍可见1枚异物残留。1例患者长期(2年以上)针状异物存留,致生锈,取出时断裂。15例仙人掌刺伤异物患者,取出术后有5例局部仍有红肿症状。2例火药爆炸伤患者中,有1例术后经X线复查仍有部分异物残留并导致局部感染。结论甲下异物取出时应尽量避免拔甲,以免甲床长期暴露而变得毛糙,造成指甲畸形;金属异物存留时间较长时间者,取出时应尽可能与周围软组织同时切除,避免异物断裂;对于仙人掌刺存留患者,术中应扩大切除范围;火药爆炸伤应清创彻底。     

A foreign body lodged in the ethmoid sinus 3 years previously: A case report

Introduction and importanceEthmoid sinus foreign body is a rare condition. We describe an unusual case of an intra-ethmoid foreign body that was diagnosed late, we have reported this case to makeover fellow readers aware of the need to carefully examine the patient victim of a road traffic accident and the imaging performed.Case presentationA radio-opaque foreign body was detected at CT- scan of a 70- year-old man, who was the victim of a road traffic accident three years previously. The metallic foreign body was removed from the nasal cavity endoscopically without complications.DiscussionThe presence of foreign bodies in the paranasal sinuses is extremely rare, especially following a road traffic accident, and has a lower incidence compared to facial injuries. The Symptoms are vague, which Paranasal computed tomography is the examination of choice to locate the foreign body. The best ethmoidal sinus surgical approach is endoscopy.ConclusionIt is important to make a diagnosis and include foreign objects with a recurrence of symptoms especially from an accident on a public road and early removal with extensive debridement results in minimal tissue destruction.     

Foreign body in the bladder: A case report

Foreign bodies are occasionally reported in the bladder. In most cases, the foreign body is removed via the transurethral approach. A 57-year-old male patient was referred to our hospital to undergo the retrieval of a foreign body from his bladder. However, the foreign body had become severely calcified and could not be removed transurethrally. Thus, an open bladder wall incision was necessary to remove it. We herein report a case of a foreign body in the bladder that had become calcified and which was successfully removed using a higher bladder incision approach. A careful preoperative examination should be performed to detect the characteristics of the foreign body and avoid the risk of bladder wall perforation.     

Uncommon Foreign Body Reactions Occurring in the Lip: Clinical Misdiagnosis and the Use of Special Techniques of Analysis

This study reports three interesting cases of nodular submucosal lip lesions where foreign-body reactions of unknown origin were detected on hematoxylin and eosin (H&E) analysis. These materials were evaluated under polarized light microscopy, scanning electron microscopy and by energy dispersive X-ray analysis. The results revealed the following materials: an interdental toothbrush bristle, silica, and iron. Unusual mucosal foreign body reaction cases have been reported, but few publications used special techniques to identify the specific foreign material. Clinicians and pathologists might consider these techniques for identifying the precise origin of these foreign bodies.     

Bullet embolus to the heart after gunshot wound to the neck: a case report

A 43-year-old woman presented with gunshot wounds to the neck, chest, and left thigh. Computed tomography of the neck and chest with intravenous contrast revealed a left common carotid pseudoaneurysm and a foreign body in the right atrium. Preoperative chest x-ray and CT scan confirmed a metallic foreign body in the right heart. At median sternotomy, the intracardiac foreign body could not be located using fluoroscopy. The foreign body (bullet) was subsequently removed in the cardiac catheterization laboratory using a percutaneous transvenous basket extraction through a right femoral vein cutdown.     

The intravenous foreign body: a report of 2 cases

Two cases of metallic foreign body injury to the upper limb are described. In both cases the foreign body was clearly visible on x-rays, considered to be lodged in the soft tissues, but migrated to one of the large subcutaneous veins. One subsequently migrated to the heart; the other was removed from the peripheral vein.     

Microscopic metallic wear and tissue response in failed titanium hallux metatarsophalangeal implants: two cases

The membranes present at the implant-bone interface were retrieved from two patients with titanium single stem hallux implants that had failed. Both patients had pain and valgus deformity of the hallux, and radiographs showed a radiolucent shadow around the implant stem, with thinning of the dorsal cortex of the proximal phalanx in one patient. After removal of the implants, arthrodesis of the first metatarsophalangeal (MP) joint was performed. Histologic analysis of the membrane tissue at the implant-bone interface showed a synovial-like appearance. There was a fibrous tissue stroma adjacent to the bone surface, with multiple regions of scalloping covered by mononuclear cells. Fine metallic debris was seen throughout the fibrous tissue. Multinucleated foreign body giant cells were sparsely observed associated with fine particulate metallic wear debris similar to observations from failed total hip arthroplasties. The histologic appearance is evidence that foreign-body granulomatous infiltration associated with metallic wear debris may be a causative factor of peri-implant osteolysis leading to aseptic loosening and failure of titanium single stem hallux implants.     

Migration of a GI Foreign Body into Retro Peritoneum Without Peritonitis

Reporting an unusual case of a GI foreign body migrating to retro peritoneum without peritonitis. A middle aged male patient presented to the outpatient department with low back pain, on evaluation there was long slender radio opaque foreign body present in the pelvis. Explarotary laparotomy done, surprisingly it was found to be a suction canula(metallic) used when undergoing tonsillectomy two years ago.