98例腹部肿胀吸脂术临床报告

目的探讨腹部肿胀吸脂术临床效果，分析进一步提高疗效的方法。方法对98例健康女性采用肿胀吸脂技术进行腹部吸脂塑形治疗。结果通过腹部脂肪抽吸，98例临床疗效满意，术区平坦，手感柔软，术后术区皮肤回缩良好，并发症较少。结论腹部肿胀吸脂安全可靠，疗效满意，通过技术改进可进一步提高疗效。     

屈膝半卧位腹部吸脂术

目的：提高腹部吸脂术的塑形效果。方法：采用屈膝半卧位，吸脂范围包括上下腹、两侧髂腰部及乳房下皱襞部分区域。结果：腹部吸脂52例，吸脂总量3000～5200ml，平均3500ml。6例术后早期皮肤有麻木感；4例皮下有轻度瘀斑和硬块。术后腹围缩小6～12cm。结论：采用屈膝半卧位吸脂，方法简便易行，减少吸脂操作时的难度，并有助于确定吸脂范围，增加吸脂量，术后有较好塑形效果。     

环状立体共振吸脂形体雕塑术

目的一次性使吸脂雕塑部位更加完美、轮廓自然、流畅，塑形效果更佳。方法应用共振吸脂减肥技术对腹、髂腰部和／或大腿行一次性环状立体吸脂完成形体塑形。丈中对肿胀液注入量及操作手法进行了探讨。结果278例受术者一次完成腹部、髂腰和／或大腿环形减肥形体雕塑，术后患者疼痛较轻、恢复快，术区皮肤平坦、无反弹迹象，形体曲线自然、流畅，无严重并发症发生。结论环状立体一次性多部位完成吸脂形体雕塑术是安全、可行的，对形体雕塑效果显著，可避免分次手术给患者带来不便及痛苦，同时共振吸脂技术可降低医师的劳动强度。     

超声检测技术在吸脂术中的应用

目的：探讨超声检测技术在吸脂术中的应用价值。方法：以11例腹部多脂患者为对象，采用超声检测技术于术前及术后、术后1个月分别测量腹部的厚度、大血管、神经的走行，加以对比。结果：11例患者均无血肿、血清肿等并发症发生，腹部外形均佳，病人对手术结果均表示满意。结论：超声检测技术具有无创伤性，可重复性，可精确的显示脂肪的厚度和血管、神经的走行，为吸脂术提供良好的指导。     

大腿脂肪抽吸术的护理

随着社会发展和生活水平的提高,肥胖人群在社会生活中的比例不断上升,肿胀吸脂术已成为美容外科的主要手术之一,大腿作为人体脂肪易于堆积的部位,仅次于腹部,居脂肪抽吸手术的第二位。由于大腿组织致密,部位较低,较腹部吸脂更容易出现术中、术后并发症,对患者术中、术后的护理提出了更高的要求。我院2001～2005年应用超声肿胀吸脂法进行大腿脂肪抽吸术86例,取得了良好的疗效。现将护理体会总结报道如下:1临床资料全部患者共86例,全为女性患者,年龄18～56岁,平均年龄为32岁。吸脂部位为单纯大腿内侧6例,外侧12例,其余均为内、外、后面及臀沟…     

肿胀吸脂术的护理

1987年Klein［1］发明并应用了肿胀吸脂术，因其具有安全性高，组织损伤轻微、出血小、麻醉时间短、术后恢复快、并发症小等优点而取代了干性及湿性吸脂术。本文总结了我利于1997年1月～1998年3月间应用肿胀吸脂术治疗22例腹部、馆腰部、臀部等部位的脂肪性堆积病人，取得了良好效果，得到些护理体会.1临床资料本组22例，均为女性，年龄23～53岁，体重52～70kg，平均60kg，均为局部脂肪堆积，影响体形。下腹部吸脂2例，下腹及髂部吸脂5例，上下腹及髂部吸脂12例，臀部吸脂3例。每个病人抽吸总量为450～2700ml，平均1160ml。其中上层脂肪为3…     

肿胀吸脂术在副乳腺切除中的应用

目的探讨肿胀吸脂术在副乳腺切除中的临床价值。方法对43例患者采用肿胀吸脂技术对局部隆起的副乳腺组织进行抽吸,至局部皮肤平坦,术后加压包扎。结果全部患者均I期愈合,术后切口隐蔽,局部隆起外观消失,整个胸壁及腋下曲线流畅,术后无血肿、感染等并发症发生。结论肿胀吸脂术不仅可以小切口切除副乳腺,而且很好地去除了局部增生的脂肪组织,具有更好的美学效果。     

真空负压吸脂术与振动吸脂术对比分析

目的：探讨真空负压吸脂术与振动吸脂术的效果、安全性和并发症。方法：肿胀麻醉下,应用真空负压吸脂器和振动吸脂器对596例1 860个不同部位进行了脂肪抽吸。比较两种方法的效果、出血量及并发症情况。结果：振动吸脂术后效果较好,满意率高;两种方法的出血量差异有显著性。术后22例患者出现并发症（前者16例,后者6例）,经适当治疗后均痊愈。结论：两者相比较,振动吸脂术出血少、安全性更高、并发症少,值得临床推广。     

右美托咪啶在腹部肿胀麻醉吸脂术中的应用

<正>肿胀麻醉吸脂术减肥美体已成为众多肥胖患者乐于接受的减肥手段,但是肿胀麻醉实施时的疼痛不适常常给患者造成不良影响。右美托咪啶具有镇痛镇静的作用,目前广泛用于ICU呼吸机支持的患者[1]。本研究探讨右美托咪啶复合瑞芬太尼可唤醒麻醉在腹部肿胀麻醉吸脂术中应用的可行性和安全性,报告如下。1资料与方法1.1一般资料选取江苏省苏北人民医院2012年11月—2014年11月门诊收治的拟行腹部肿胀麻醉吸脂     

体外超声与体内共振吸脂减肥手术的护理

体外超声与共振吸脂减肥手术是近年来开展较多、简便安全的减肥术式，其优点是不用住院，创伤小，切口隐蔽，出血少，效果好。自2001年10月至2003年7月，我们采用体外超声、体内共振吸脂减肥技术，配合肿胀麻醉方式进行了吸脂减肥手术298例，抽吸均匀、塑形效果好，术后并发症少，现将我们在临床护理配合中的体会总结如下。     

自体纯化冷冻微粒脂肪注射移植修复面部皮肤软组织老化性萎缩凹陷

背景:以少量、反复、多次脂肪注射,是目前提高脂肪移植成活率的理想方法。目的:总结自体纯化冷冻微粒脂肪注射移植在面部年轻化的应用效果。方法:对64例面部皮肤软组织老化萎缩凹陷患者,在其腹部或大腿用肿胀吸脂术抽吸微粒脂肪,经过低速低压离心纯化微粒脂肪,并在-20℃下低温冷冻,37℃下复温培养1h后,检测脂肪组织活力,注射移植填充面部老化凹陷区域。结果与结论:64例(186个部位)中21例接受1次微粒脂肪注射移植,35例接受2次微粒脂肪注射移植,8例接受3次微粒脂肪注射移植。患者脂肪移植后均随访6个月以上,面部老化症状明显改善,效果满意、持久,吸收率低,无感染、脂肪液化等并发症发生。提示自体纯化冷冻脂肪微粒注射移植效果明显、吸收率低、可重复注射、易于患者接受。     

自体纯化冷冻微粒脂肪注射移植修复面部皮肤软组织老化性萎缩凹陷

背景：以少量、反复、多次脂肪注射,是目前提高脂肪移植成活率的理想方法。目的：总结自体纯化冷冻微粒脂肪注射移植在面部年轻化的应用效果。方法：对64例面部皮肤软组织老化萎缩凹陷患者,在其腹部或大腿用肿胀吸脂术抽吸微粒脂肪,经过低速低压离心纯化微粒脂肪,并在-20℃下低温冷冻,37℃下复温培养1h后,检测脂肪组织活力,注射移植填充面部老化凹陷区域。结果与结论：64例（186个部位）中21例接受1次微粒脂肪注射移植,35例接受2次微粒脂肪注射移植,8例接受3次微粒脂肪注射移植。患者脂肪移植后均随访6个月以上,面部老化症状明显改善,效果满意、持久,吸收率低,无感染、脂肪液化等并发症发生。提示自体纯化冷冻脂肪微粒注射移植效果明显、吸收率低、可重复注射、易于患者接受。     

The practical procedure of tumescent technique in burn surgery for excision of burn eschar

The tumescent technique, which involves injection of large volumes of dilute epinephrine solution into subcutaneous fat, has been shown to markedly increase the safety of liposuction surgery, which is associated with risks of blood loss. The authors use this technique during burn surgery and developed a practical method of determining the amount of solution injected. The authors have applied the tumescent technique consisting of subeschar infiltration of dilute epinephrine (1 mg/L) in thermoneutral (37 degrees C) saline. Preoperatively, a 5 x 5 cm square grid pattern is drawn on the burn wound, which facilitates estimation of the amount of infiltrated solution. The authors injected 20 ml of solution per square in the grid. Ten consecutive patients underwent 15 surgical procedures for tangential excision and split-thickness skin grafting. There were no complications during the intraoperative or postoperative period. Their method using a grid pattern drawn on the tissue being treated by the tumescent technique in burn surgery facilitates the excision of burn eschar.     

肥胖症的外科治疗方式与展望

系统复习了各种外科减肥方式的适应证、操作方法、优缺点.负压抽脂减肥术较适合于局部皮下脂肪堆积的肥胖症,内镜胃体缩小减肥术较适合于全身重度肥胖症.不同的肥胖病例应选择合适的方式.     

Reduced blood loss during burn surgery

The purpose of this study was to investigate the use of subcutaneous injection of burn wounds and skin graft donor sites with an adrenaline-saline solution to reduce blood loss during burn surgery. This retrospective study reviewed the requirements of blood products in 30 randomly selected adult patients with more than 10% body area burned, who had at least one burn operation at a university regional burn center, between January 1991 and June 1997. Patients were matched by age and percent body area burned and stratified according to the surgical technique in two groups. In Group 1, 15 patients received the modified tumescent surgical technique: subcutaneous injection of adrenaline (1 part/million in warm saline solution) into the subcutaneous tissue of the donor sites for autologous skin graft and areas of burn eschar to be excised, combined with pneumatic tourniquets in extremities and saline-adrenaline soaked nonadherent pads. In Group 2, 15 patients received the traditional surgical technique: soaked gauze compresses with an adrenaline-thrombin solution (1 ml of 1:1,000 adrenaline, thrombin 10,000 units, and 1 L of normal saline). Outcome measures, transfusion of blood products, operating time and complications between the two patient groups were analyzed using the Wilcoxon 2-sample test. The two patient groups were not different by age (40.4 +/- 19.4 vs 38.9 +/- 17.9), percent total body area burned (27.6 +/- 15.4 vs 32.8 +/- 13.4), or percent full thickness burn (7.0 +/- 8.5 vs 11.5 +/- 8.5). The modified tumescent surgical technique significantly reduced mean total blood units transfused per patient (7.9 +/- 11.5 vs 15.7 +/- 12.9 units; P = .031), and the mean blood units transfused intraoperatively per patient (4.7 +/- 7.8 vs 8.9 +/- 8.0 units; P = .026). The modified tumescent surgical technique significantly reduced the intraoperative and total blood transfusion requirements in our thermally injured patients.     

Tumescent technique in digits: a subcutaneous single-injection digital block

Background

A modified subcutaneous single-injection approach to achieve digital block using a tumescent technique is described.

Method

A convenient sample of patients requiring digital anesthesia for minor surgical procedures on the fingers or thumb in the emergency and plastic departments were enrolled into the study. Digital nerve block was performed by injecting 1% lidocaine into the volar subcutaneous space at the proximal digit to create a firm, turgid feel to the tissue, the so-called tumescent state. The volume of anesthetic was based on the size of the digit. All nerve blocks were performed by 1 surgeon. Successful digital anesthesia was defined as complete loss of pinprick sensation on both the dorsal and volar aspects of the digit and the ability to complete the anticipated minor surgical procedure without pain. All patients were followed for 1 month to assess for adverse events.

Result

Between August 2009 and January 2011, 123 patients (123 digits) requiring digital anesthesia were enrolled into the study. Thirty-nine (32%) were volar lesions, and 84 (68%) were dorsal lesions. The tumescent technique single-injection digital block was successful in all digits. No adverse events were reported.

Conclusion

The tumescent technique in digits to achieve a single-injection digital nerve block is an easy, safe and effective method for digital anesthesia. These data confirm the applicability of the tumescent technique in digits for patients with finger and thumb injuries or tumors that require minor surgical procedures.     

全身麻醉下局部肿胀液注射联合手术切除术治疗体表神经纤维瘤患者的护理

目的探讨全身麻醉下局部肿胀液注射联合手术切除术治疗神经纤维瘤病的有效护理措施。方法回顾性分析2009年9月至2011年5月在哈尔滨医科大学附属第四医院治疗的9例神经纤维瘤病患者的临床资料,总结其护理方法。结果 9例患者术中出血量少,术野清晰,术后无术区血肿等并发症发生,切口均一期愈合,随访3~12个月,肿瘤均未复发,患者自觉外观及肢体运动功能较术前明显改善。结论全身麻醉下局部肿胀液注射联合手术切除术治疗能够提高神经纤维瘤患者治疗效果,减少并发症的发生率。     

腋横纹肌小切口膨胀法副乳乳腺切除术

副乳房为乳腺先天性发育畸形,最常见的发生部位为腋窝前缘。由于副乳房可伴发疼痛,良恶性肿物发生以及影响外貌,多主张手术切除[1,2]。传统上副乳腺切除多需住院治疗,在局麻加强化麻醉下或全麻下进行,且手术多行腋前线纵切口,将皮肤和腺体一并切除后直接缝合,术后瘢痕明显。自2     

电子吸脂结合负压吸脂108例临床分析

目的：探索简单、安全、可靠，吸脂效果好，并发症少的手术方法。方法：首先用皮下超量灌注法使局部组织肿胀，2根针式电极插入去脂部位，同时可配合应用小径吸管抽吸，吸脂后抽吸区以弹力服加压。结果：均取得满意效果，无严重并发症发生。结论：电子吸脂结合负压吸脂可增加吸脂效果，减少并发症发生。