无张力疝修补术后切口感染处理策略讨论

目的:总结无张力疝修补术后切口感染的治疗方法及效果。方法:对无张力疝修补术后切口感染6例患者进行切口切开清创换药,或并切口补片外置无菌橡胶管引流及抗感染治疗。结果:6例患者均未取出补片,顺利恢复出院,且随访1年无疝复发及切口再感染。结论:无张力疝修补术后切口感染可不取出补片,进行充分清创引流,换药及抗感染治疗,可以治愈并可不取出补片,无复发。     

疝环充填式无张力疝修补术56例报告

目的：探讨疝环充填式无张力疝修补术治疗腹股沟疝的经验，并评价其临床应用价值。方法：回顾总结我院2006年2月～2007年12月疝环充填式无张力疝修补治疗腹股沟疝56例临床资料，其中伴有糖尿病、冠心病、高血压、便秘、前列腺肥大及呼吸系统慢性疾病36例，占64．3％。结果：本组病例均手术治愈。平均手术时间45min，无切口感染，平均住院5d，随访2～22个月，无复发病例。结论：该方法操作简单易行、痛苦少、恢复快、复发率低，是治疗腹股沟疝的理想术式。     

局麻下无张力疝修补术的临床应用

目的 总结应用局麻方式进行无张力疝修补术的方法和特点。方法 应用1%利多卡因进行腹股沟区浸润及阻滞麻醉,对2011年1月-2013年12月410例腹股沟疝患者应用补片进行无张力疝修补术,回顾分析患者的临床资料。结果 本组患者均治愈,麻醉效果满意,手术时间25-90min,平均38min,5例阴囊肿胀,对症保守治疗后痊愈。切口疼痛轻微,无明显异物感,无切口感染等并发症,术后2-3天出院。随访12-38个月,无复发。结论 在腹股沟疝手术治疗中,局部麻醉的方法是安全可行的,镇痛效果良好,易于掌握,对患者干扰小,并发症少,恢复快。     

疝环充填式无张力疝修补术治疗腹股沟疝60分析

目的：观察疝环充填式无张力疝修补术治疗腹股沟疝的疗效。方法：采用聚丙烯锥形充填物及成型补片行疝修补术60例。对手术方法及时间、伤口疼痛、并发症及复发率进行观察。结果：手术时间平均42min;术后平均5h下床活动;伤口轻微疼痛时间2～3d。无切口感染。术后随访1～12个月（中位时间6个月）,除术后4d复发1例外,其余无复发病例。结论：本法是一种更符合人体解剖结构和疝的病理生理的手术方法,操作简便,损伤轻,恢复快,术后复发率低。     

无张力疝修补术治疗老年腹股沟疝89例临床分析

目的：探讨疝环充填式无张力疝修补术治疗老年腹股沟疝的临床疗效。方法：对89例接受疝环充填式无张力疝修补术的老年腹股沟疝患者的临床资料进行回顾性分析。结果：89例手术均获成功,手术时间45～90 min,平均（52.3±7.6）min。术后并发尿潴留3例,阴囊水肿2例,伤口感染3例。随访3月～3年,平均（1.7±0.9）年,2例复发。结论：与传统疝修补术相比,疝环充填式无张力疝修补术具有局部无张力、操作简单、术后恢复快、并发症少、复发率低等优点,是治疗老年腹股沟疝的合理手术方法。     

老年腹股沟直疝采用无张力修补术14例临床观察

目的　观察老年腹股沟直疝无张力修补术的治疗效果。方法　用巴德公司产疝修补材料仿Mcvay法与耻骨结节、耻骨梳韧带缝合并周边固定补片 ,以求彻底关闭肌耻骨裂孔。结果　术后观察最长达 2年 ,腹内压增高疾病依然存在 ,但均无复发。术后伤口出现红肿 9例 ,均在术后 5d内消退 ,无 1例感染。结论　腹股沟直疝用仿Mcvay法无张力修补术是提高治愈率 ,减少复发一种好方法     

无张力疝修补术治疗腹股沟复发疝30例报告

目的：总结无张力疝修补术治疗腹股沟复发疝的经验。方法：回顾性分析无张力疝修补术在治疗30例腹股沟复发疝中的应用。结果：30例患者手术顺利,平均手术时间54 min,平均住院时间7.5 d。术后并发症：尿潴留3例,阴囊积液1例,对症治疗均痊愈,无切口感染及液化。30例患者均随诊1~5年,无再复发。结论：无张力疝修补术应作为治疗成人腹股沟复发疝的首选术式。     

疝环充填式无张力疝修补术后复发原因探讨

目的:总结疝环充填式无张力疝修补术后复发的原因。方法:采用聚丙烯PerFix补片进行疝环充填式无张力疝修补术137例。结果:术后复发4例,复发率为2.9%。结论:疝环充填式无张力疝修补后复发与补片移位及操作不当有密切关系。     

超声在腹壁疝无张力修补术后常见并发症诊断中的应用

目的探讨彩色多普勒超声对腹壁疝无张力修补术后常见并发症的应用价值。方法对103例腹壁无张力疝修补术后出现身体不适或局部异常体征等临床表现的患者进行灰阶、彩色多普勒和频谱多普勒超声检查,观察切口下及其周围组织有何异常。结果切口血肿5例,感染11例,补片弯曲10例,复发2例,术后积液55例,脂肪液化3例,精索水肿10例,超声表现阴性7例,超声检测阳性率93.2%,均经临床或穿刺证实。结论彩色多普勒超声对腹壁疝无张力修补术后并发症的诊断具有较高的应用价值。     

巴德材料疝环充填式无张力疝修补术治疗腹股沟疝56例临床体会

目的总结应用疝环充填式无张力疝修补术治疗腹股沟疝的经验。方法对本院使用美国Bard公司的疝环充填物及网状补片治疗的56例腹股沟疝的手术方法、时间、术后患者疼痛、住院时间、复发率进行回顾分析。结果巴德材料疝环充填式无张力疝修补术手术方法简便,术后疼痛轻,恢复快,复发率低。结论巴德材料疝环充填式无张力疝修补术手术方式更加符合人体解剖结构,效果好,安全可靠。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.