自体颌下腺游离移植治疗严重干眼病的护理

目的探讨自体颌下腺游离移植治疗严重干眼病的护理措施。方法通过对8例严重干眼病患者行自体颌下腺游离移植术的术前、术后观察和护理。结果8例手术中有7例移植颌下腺成功,1例移植颌下腺萎缩。结论做好术前准备,术后密切观察病情、保护移植的颌下腺、预防并发症发生,正确的出院指导对手术的成功和患者康复有重要的意义。     

自体颌下腺移植治疗角结膜干燥症的护理

自体颌下腺移植治疗角结膜干燥症是一种新的治疗方法。本文总结了自 1999年 8月至 2 0 0 2年 2月我科收治的 3 4例接受自体颌下腺移植术患者的护理经验。术前患者的安全管理 ,协助完善化验检查 ,充分心理护理 ,术后细致的眼部护理 ,严密的病情观察 ,保持引流通畅及详尽的出院指导是促进患者康复的重要保证。     

自体颌下腺移植再造泪腺治疗干眼病的手术配合

干眼病亦称干燥性角结膜炎,是由于眼部或全身多种原因引起的眼部腺细胞分泌减少的常见眼病,会导致视力下降、睑球粘连、纤维瘢痕化、角膜溃疡及新生血管[1].以往的治疗方法主要以对症治疗为主,自体颌下腺移植再造泪腺,重建泪液分泌源,是治疗干眼病泪液缺乏的一种有效的、可选择性的手术治疗方法.自2002年7月至2003年1月,我院采用此方法治疗了8例干眼病,均取得满意疗效,现将手术配合体会报告如下.     

血管化自体下颌下腺移植治疗重症角结膜干燥症患者的护理

总结报道15例血管化自体下颌下腺移植治疗重症角结膜干燥症患者的护理经验,术前做好心理护理,安抚患者的紧张焦虑情绪,完善术前的特殊检查,确保手术的顺利进行,落实术前各项准备,指导患者术后按摩、热敷的方法,重视安全管理,合理摆放物品;术后注重施墨使用和角膜上皮的护理,保持引流管通畅,预防感染,积极预防静脉血管危象、下颌下腺导管阻塞等并发症。本组15例患者全部腺体成活,分泌功能良好,均诉眼干症状明显改善,畏光、惧风症状减轻,可停用人工泪液。     

血管化自体颌下腺移植治疗重症角结膜干燥症的手术配合

我院从 1999年 8月～ 2 0 0 2年 12月开始 ,对 5 1例重症角结膜干燥症患者进行了血管化自体颌下腺移植手术治疗 ,取得了满意疗效。1　资料与方法1.1　一般资料。 1999年 8月～ 2 0 0 2年 12月我院接受治疗的重症角结膜干燥症患者 5 1例。其中男 2 3例 ,女 2 8例 ,年龄 11～ 6 6岁 ,中位年龄 34.7岁 ;患者的发病原因 :药物过敏2 2例 ,慢性角结膜炎 12例 ,角膜类天疱疮 2例 ,Steven -Johnson综合征 1例 ,不明原因 14例。病期 :<6个月 2例 ,6个月～ 1a 7例 ,～ 5a 13例 ,～ 10a 16例 ,>10a 13例。术前的视力情况 :视力 1.0 0～ 1.5 0 2例 ,0 .…     

自体颌下腺游离移植治疗严重干眼症的实验研究

目的:观察兔自体颌下腺游离移植术后的泪液分泌及严重干眼症的治疗效果。方法:摘除兔泪腺制成干眼症模型后,实验组通过显微血管吻合技术将自体颌下腺游离移植于颞侧眶区,导管吻合于外下穹窿结膜,对照组不做其它处理。术后观察泪液分泌、眼荧光素染色、光镜检查等。结果:实验组泪液分泌量持续增加,2～3个月基本稳定,角膜荧光素染色减少或消失,两组有显著性差异(P<0.05)。组织病理学检查见对照组的眼表组织有明显的炎症细胞浸润和结构破坏,而实验组的颌下腺则具有较正常的组织结构。结论:自体颌下腺移植能保持持续的分泌功能,阻止实验性兔眼干眼症的发生。     

兔自体颌下腺部分移植模型的建立

背景:近年来临床上应用血管化自体颌下腺移植治疗重症角结膜干燥症取得了较好的治疗效果,但术后会出现泪溢的并发症,需要再次甚至多次手术切除部分腺体以减轻泪溢的症状.为减少自体颌下腺移植后出现的泪溢并发症,自体颌下腺部分移植是否可行尚待验证.目的:通过建立兔颌下腺部分移植的动物实验模型,探讨兔颌下腺部分移植的可行性.方法:取家兔左侧颌下腺2/3,应用显微外科血管吻合技术移植于颞侧皮下间隙,14 d后取出,苏木精-伊红染色观察其病理变化.结果与结论:15只移植腺体存活兔中7只移植的颌下腺病理切片示正常,腺体正常度在30%以上的6只,腺体正常度在30%以下的2只.结果显示87%兔部分颌下腺移植后,保留了30%以上正常的腺体结构.兔部分颌下腺移植模型构建具可行性,该结果对采用自体颌下腺部分移植治疗干眼症的手术具有参考价值.     

泪液淀粉酶测定在自体颌下腺移植治疗角、结膜干燥症中的应用

目的：探讨自体颌下腺移植治疗角结膜干燥症术后泪液（S－T）中淀粉酶（AMY）含量的变化及意义。方法：采用国际临床化学联合会（IFCC）推荐的亚乙基封闭G7－PNP作底物的酶连续监测法（EPS法）测定移植术后S－T液及30例正常人泪液，颌下腺液AMY含量。结果：移植术后S－T液中AMY呈高分泌状态；术后随时间推移，S－T液中AMY呈现递减趋势，正常人泪液中亦含有高活性的AMY。结论：正常人泪液中含有高活性AMY这一事实证实颌下腺移植术是可行的，S－T液中高分泌水平的AMY提示移植腺体成活并有良好的分泌功能；S－T液中AMY递减趋势可能与眼部微环境变化，适应性变化有关。     

泪液淀粉酶测定在自体颌下腺移植治疗角、结膜干燥症中的应用

目的探讨自体颌下腺移植治疗角结膜干燥症术后泪液(S-T)中淀粉酶(AMY)含量的变化及意义.方法采用国际临床化学联合会(IFCC)推荐的亚乙基封闭G7-PNP作底物的酶连续监测法(EPS法)测定移植术后S-T液及30例正常人泪液、颌下腺液AMY含量.结果移植术后S-T液中AMY呈高分泌状态;术后随时间推移,S-T液中AMY呈现递减趋势;正常人泪液中亦含有高活性AMY.结论正常人泪液中含有高活性AMY这一事实证实颌下腺移植术是可行的;S-T液中高分泌水平的AMY提示移植腺体成活并有良好的分泌功能;S-T液中AMY递减趋势可能与眼部微环境变化、适应性变化有关.     

经体表超声及经口腔内超声联合探查诊断下颌下腺结

诊断涎石病的传统方法主要为X线检查、涎腺造影、MR以及临床口底物理检查等。本研究应用经体表超声及经口腔内高频超声联合探查下颌下腺导管结石27例,现报道如下。1资料与方法1.1一般资料收集2007月12月—2011年7月在我院经体表超声及经口腔内高频超声诊断为单侧下颌     

舌癌行前臂游离肌皮瓣血管化移植舌再造术围手术期护理

目的 探讨舌癌患者围手术期的护理.方法 选择38例舌癌患者加强围手术期护理.结果 本组治愈38例,围术期无并发症.结论 高质量的术前、术后的护理是舌癌患者手术成功及平稳恢复的重要保障,可以预防并发症的发生,促进患者康复.     

彩色多普勒超声在颌下腺导管结石检查治疗中的应用

目的探讨涎石症患者颌下腺导管内结石的分布及其颌下腺超声表现。方法术前对33位患者颌下腺导管进行分区,应用彩色多普勒超声确定颌下腺导管结石位置及颌下腺腺体的超声表现,行手术及内镜术取石治疗,超声诊断结果与手术观察对照分析。结果33例患者中检出颌下腺导管前段结石12例,后段结石19例,分支导管内仅检出结石2例,手术和内镜术取石结果与术前超声提示诊断结果相符。结论颌下腺导管结石好发于导管后段,分支导管结石较少见,超声诊断颌下腺导管结石的准确性高,在确定结石位置、数量,观察导管扩张及颌下腺感染程度均有重要作用,可为涎石病诊断及手术治疗提供重要依据。     

超声诊断双侧颌下腺木村病1例

木村病是一种罕见的良性、慢性浸润性疾病,病因尚不明确,可能与免疫紊乱、过敏反应、非特异性感染等有关[1],临床表现以长期存在并易反复的无痛性头颈部皮下软组织肿物为主,多见于唾液腺,该病可发生于任何年龄,男性发病率远高于女性。木村病呈良性病程,根据既往研究,复发率较高。实验室检查提示,患者外周血嗜酸粒细胞计数增高,血清IgE水平增高[2]。本例特异性超声表现为：双侧颌下腺内低回声病灶,其内见多发小片状低回声区间夹杂“网格状”高回声,内部见丰富血流信号,腺体内及周围淋巴结皮髓质分界不清,可见“门型”血流信号。主要和软组织内血管瘤鉴别,血管瘤超声表现为软组织内梭形、圆形或卵圆形肿物,边界清晰或不清晰,内部回声不均匀,多为低回声,可见典型的蜂窝状结构,内可探及丰富血流信号,探头加压松开后血流信号增多,周围未见淋巴结增大。而木村病探头加压后肿块形变不明显,血流信号变化不大,可与血管瘤鉴别。木村病术前明确诊断较困难,超声是诊断木村和术后随访观察疗效的首选影像学检查方法。     

Sclerosing polycystic adenosis of the submandibular gland: Two case reports

BACKGROUNDSclerosing polycystic adenosis (SPA) is a rare disease of salivary glands, similar to fibrocystic disease of the breast. It occurs over a wide age range and exhibits a slight female preference. Most SPA cases have occurred in the parotid gland. The exact nature of SPA is unclear, but its tumor nature has recently been proposed. Although SPA has a good prognosis after adequate surgery, atypical lesions might occur, ranging from mild dysplasia to carcinoma in situ in some cases. To the best of our knowledge, only five cases of SPA in the submandibular gland have been reported to date. Here, we present two new cases of SPA involving the submandibular gland.CASE SUMMARYA 50-year-old woman and a 52-year-old woman were referred to Tongji Hospital in Wuhan, China, with complaints of moderate pain, recurrent swelling, and a mass in the submandibular area. After admission, the two cases of the submandibular mass were examined physically. The boundary of the submandibular tumor was clear, and the range of motion was good. After preoperative examinations, surgery was performed on a selective basis. Postoperative histopathological examination revealed a well-defined mass with acinar structures, ducts, or cystic dilated glands of various sizes scattered in a large number of proliferative sclerosing stroma. There were flat and cuboidal cells, and eosinophils in the duct epithelium. There was also a eosinophilic substance in the lumen of dilated cysts. No atypical epithelial hyperplasia, invasive growth, or carcinoma in situ was found. Based on the above findings, the mass was diagnosed as SPA. Both patients have remained asymptomatic and no recurrence or distant metastasis had occurred by the 7-mo and 5-year follow-up, respectively.CONCLUSIONSPA is a rare disease of the salivary gland. Even though it has a good prognosis after adequate surgery, atypical lesions may occur from mild dysplasia to carcinoma in situ. However, no recurrence, distant metastasis, or mortality has been reported for submandibular gland SPA. Clinicians and pathologists should be familiar with the characteristics of SPA in the submandibular gland to avoid misdiagnosis and overtreatment.     

Effects of low-intensity focused ultrasound on the mouse submandibular gland

Ultrasound is expected to make a considerable contribution to drug delivery systems (DDSs). We tested the hypothesis that low-intensity focused ultrasound (LIFU) increases vessel permeability in the mouse submandibular gland without causing parenchymal damage. In a preliminary study, LIFU at 3 W/cm2 with a 50% duty cycle for 2 minutes did not cause histologic damage. We therefore applied LIFU to mouse submandibular gland at these conditions before and after injecting horseradish peroxidase. Single labeling laser scanning confocal microscopy revealed positive horseradish peroxidase staining around the excretory ducts in the mucous-producing part of the gland, but absence of staining in control glands. Immunostaining for fibrinogen was positive in the same region. Fibrinogen is an intravascular protein that does not pass through intact vessels. These findings suggest that LIFU increases vessel permeability and disruption without destruction. It is anticipated that this process will be useful in establishing a DDS that uses LIFU.     

接受电脑红外线乳腺透照检查者的焦虑情绪分析与护理

电脑红外线乳腺透照是用于检查、诊断乳腺疾病的方法之一。由于该项检查要求在暗室内进行,被检查者必须暴露胸部和工作人员要对其双侧乳腺进行触诊检查,因此会使被检查者产生不同程度的心理压力,为了解其紧张、焦虑程度,作者采用状态-特质焦虑问卷对被检查者进行心理测评并提出     

Salivary duct carcinoma of the submandibular gland presenting a diagnostic challenge: A case report

BACKGROUNDSalivary duct carcinoma (SDC) is a rare, extremely aggressive malignancy that arises in the submandibular gland. It can metastasize locally early and therefore is an important differential diagnosis of metastatic disease in cervical lymph nodes or specific lymphadenitis such as tuberculous cervical lymphadenitis.CASE SUMMARYWe report a case of SDC in the submandibular gland that presented diagnostic difficulty. The lesion was coincidentally discovered through examination of the radiolucent area of the maxilla. Imaging failed to confirm the possibility of specific inflammation, leading us to execute an open biopsy to verify the diagnosis. The surgical specimen showed that the submandibular gland was primarily replaced with a calcified body. Following histological analysis and confirmation, we performed surgical resection, radiotherapy, and various chemotherapies. CONCLUSIONRadiographic imaging characteristics of lymph node metastases of salivary gland cancer, especially of SDC, may resemble other cervical lymphadenitis; calcification at the submandibular gland is the landmark of SDC occurring at the subman-dibular gland.