海岛渔民胸外伤的治疗（附70例报告）

本院自2005年2月至2007年2月．共收治渔民胸外伤病人70例。今报告外伤原因与种类,探讨救治经验如下。     

胸腹联合伤52例诊治分析

胸腹联合伤是指胸部开放性或闭合性损伤同时合并有腹腔内脏器的损伤．是外科创伤中的严重情况，病情复杂．救治困难，常危及生命。本院白2000年2月至2005年2月．共收治伤情严重的胸腹联合伤52例．现报告如下。     

直肠癌前切除术后吻合口瘘12例分析

1992年2月至2002年12月，我院共行直肠癌前切除78例，术后发生吻合口瘘12例（15．3％）。本文对其作一分析。     

849例重型颅脑损伤的诊治分析

重型颅脑损伤是常见病、多发病．具有高死亡率、高致残率。本院自2004年1月1日至2008年2月29日,共收治重型颅脑损伤患者849例．笔者对此进行总结分析。     

肺隔离症八例

自1991年2月至2007年1月，我们共收治8例肺隔离症患者，均行外科手术治疗，效果良好，现总结其临床经验。1临床资料与方法1．1一般资料本组共8例，男6例，女2例；年龄11～68岁，平均年龄49．6岁。有咯血、咯脓痰病史1例，反复肺部感染史1例；无临床症状6例。     

浮肩损伤治疗的临床评价

1988年10月．2005年2月我院共收治41例浮肩损伤（floating shoulder injury，FSI）患，现就其治疗方法及临床疗效报告如下。[第一段]     

血清IgM检测在儿童泌尿系感染中的意义

本研究主要评价血清IgM检测在儿童泌尿系感染诊断及治疗中的意义。 一、对象和方法 1．对象：选择2000年2月至2007年6月天津市儿童医院收治的肾病综合征（NS）并发泌尿系感染患儿共17例（同期住院NS息儿共500例），非NS患儿发生泌尿系感染257例。     

膈肌损伤修补方式的探讨

胸部闭合性创伤或膈肌受到锐器伤．均可产生膈肌破裂。由于胸腔压力为负压．腹内脏器很容易病人胸腔．产牛膈疝。随着交通事故的增加．膈肌损伤呈现上升趋势．小院1988年2月至2005年10月．共收治了31例膈肌损伤患者．现主要就其修补方式作一探讨。     

严重的闭合性喉气管挫裂伤诊治体会

颈部外伤可致程度不一的喉气管挫裂伤，若处理不当，即可能窒息死亡或致迟发性喉气管狭窄。本院2001年3月至2004年2月．共诊治严重的喉气管挫裂伤病例5例。报告如下。     

老年髋部骨折术后深静脉血栓的防治

下肢静脉血栓（deep vein thrombosis,DVT）可继发致命的肺栓塞和远期深静脉功能不全。自1998年2月～2005年3月骨科手术2812例,发生深静脉血栓41例,其中大于60岁老年人因髋部骨折手术共213例,发生深静脉血栓共19例,发生率8．9％,占同期骨科手术发生深静脉血栓病例的46．3％。现对其相关资料进行总结,了解其高危因素及防治方法。     

Quantification of nerve tension after nerve repair: correlations with nerve defects and nerve regeneration

This study tested the validity of a quantitative in vitro nerve-tension-measuring technique, by correlating the tension measurements with functional and morphologic assessments of nerve regeneration. Initially, harvested nerves were used in vitro to determine a K value for lateral displacement in this tissue. Next, this value was used to calculate the tension of nerve repair, following 0-, 3-, 6-, and 9-mm resections of nerves in groups of rats. After quantifying the nerve tensions following excision and repair, the authors determined a sciatic function index to evaluate functional recovery and axon diameter in the animals. Functional recovery was significantly impaired in animals with elevated measurable tension (9.04 +/- 0.74 g in a 6-mm defect, 27.76 +/- 8.86 g in a 9-mm defect), compared to animals with no or 3-mm excision and measured tension of 3.3 +/- 1.09 g or less. Increased tension was also associated with a significant decrease in axon diameter. This study succeeded, therefore, in quantitatively relating the elements of measured nerve tension, nerve gaps, functional nerve recovery, and morphologic regeneration. Quantification of nerve tension by lateral displacement in vivo offers a possible solution to clinical management of nerve gaps, when the choice between primary repair and nerve grafting is not a clear one.     

内脏神经-体神经端侧吻合后神经纤维再生研究

目的 观察大鼠内脏神经-体神经端侧吻合后神经纤维的再生.方法 24只成年SD大鼠随机分为实验组(n=12)和正常对照组(n=12),实验组大鼠通过内脏神经-体神经端侧吻合建立人工体神经-内脏神经反射弧6个月后,在吻合口近端和远端分别截取10 mm的供体神经(L4VR)和受体神经(L6VR),在L6VR延续的盆副交感神经(PPN)和阴部神经(PN)分别截取10 mm的神经.正常对照组大鼠分别取相应节段的L4VR、L6VR、PPN和PN神经.标本经石蜡包埋切片并行甲苯胺蓝染色,比较实验组和对照组大鼠L6VR、PPN、PN神经纤维数量.结果 实验组大鼠横断面可见新生的有髓神经纤维,L4VR、L6VR、PPN和PN的神经纤维数量分别为1602.2±75.7、1037.9±123.6、817.0 ±52.2、510.4±29.1,吻合口远近端神经纤维通过率为64.8%,实验组和对照组大鼠相应的L6VR、PPN、PN神经纤维数目比率分别为70.2%、68.9%和62.2%.结论 大鼠内脏神经-体神经端侧吻合后体神经能够长入并替代内脏神经.     

跨面神经移植及舌下神经在面瘫中的应用进展

由于感染、外伤、面部肿瘤手术等原因造成的面神经损害,出现面部表情功能丧失和组织营养障碍为主要表现的症候群,引起功能和美学上的并发症,临床称之为面瘫。对于它的治疗,至今还没有统一的治疗方案,各种治疗方法效果不一。而对于神经移植物在国外的研究和使用较多,国内这方面的资料较少,下面就其在面瘫中的应用进展作一综述。     

Use of nerve conduits in peripheral nerve repair

Studies on nerve conduits for peripheral nerve regeneration have concentrated on the manipulation of various conduit materials to avoid sacrificing native nerve in the clinical situation. With the proliferation of available nerve growth-stimulating factors, the focus is shifting experimentally toward molecular biologic manipulation, with the addition of these materials as substrates within the conduit. The clinical use of conduits has concentrated on the use of autogenous tissue, with a few examples of polyglactin (PGA) mesh and silicone. Ultimately, as yet, conduit material does not seem to have a profound effect on outcome. Substrate manipulation has not yet had clinical application. An important problem that remains, both experimentally and clinically, is overriding the size of the maximal gap that can be bridged successfully, as well as obtaining good functional sensory and motor recovery, compared with the use of nerve grafts. Advances in molecular biology may reveal further details about the nerve growth phenomenon, the precise sequencing of the substrate materials that are effective in promoting nerve growth, and when they should be applied. Advances in chemical engineering may provide additional biologically stable materials that have the ability to integrate growth-enhancing agents or factors into the lumen of the conduit.     

Peripheral nerve block with use of nerve stimulator

The authors describe use of the nerve stimulator in conjunction with a percutaneous exploring needle to achieve peripheral blocks accurately and without injuring the nerve. The nerve stimulator allows accurate nerve blocks without causing paresthesiae and the need for additional anesthetic. This technique decreases the possibility of nerve injury.     

面神经的角神经解剖学研究

Objective To study the anatomy of angular nerve (AN), so as to provide safe approach for the denervation surgery of corrugator supercilii, depressor supercilii and proceeas. Methods 10 fresh cadaver (20 sides)were perfused and fixed with formalin. Dissection was performed in the 10 X operating microscope. The plexus of the zygomatic branch and the buccal branch were detected to confirm the AN. The relationship of AN with the surrounding blood vessels was observed. We tracked AN until it entered corrugator supercilii, depressor supercilii and procerus. Results ①AN was classified into Ⅰ, Ⅱ ,Ⅲ type according to its formation pattern. Type Ⅰ (20% , 4/20 sides) AN is single, which is mainly from the plexus of buccal branch plus the zygomatic branch from the orbicularis oculi muscle. In type Ⅱ (20% , 4/20 sides) , the single AN was formed by buccal branch plexus and zygomatic branch plexus in the "Four Muscle Gap". In type Ⅲ (60% , 12/20 sides) , the AN had two branches in the "Four Muscle Gap". ②The three types AN passed inferior to the support ligament at the suborbital part, and then transversed medial to the support ligament at the medial canthus, along the vessels of medial canthus. ③ The branch of AN enters the depressor supercilii or procerus 2. 19 to 4. 28 mm above the medial canthus ligament. The backward branch enters the levator labii superioris alaeque nasi 6. 89 to 9. 38 mm below the medial canthus ligament. Conclusions The approach of denervation surgery for AN should be performed medial to the support ligation, between 2. 19 mm above the medial canthus and 6. 89 mm below the medial canthus.