硅胶假体隆乳6个月～8年并发症19例

背景:有很多选择可用于硅胶假体隆乳后并发症的矫治。目的:观察硅胶假体隆乳并发症患者的再次隆乳效果。方法:选择2005-09/2009-09郑州大学第一附属医院整形外科收治的固体硅胶假体隆乳后6个月～8年出现假体移位、乳房下垂、纤维包膜挛缩女性患者19例。行以乳头为圆心,以假体的半径加3cm为半径画圆标记出分离胸大肌后腔隙边缘,采用乳晕缘下半环切口入路,更换硅胶假体,将乳房假体置入胸大肌后间隙,然后将醋酸曲安奈德注射液50mg以及庆大霉素注射液160mg注入囊腔,一期完成并发症的矫治。结果与结论:19例患者再次假体置入后8～10周不良形态消失,均未再出现过假体移位、乳房下垂、纤维包膜挛缩等并发症。19例患者随访时间大于6个月,恢复效果满意。     

腋窝顶部切口硅胶假体隆乳术44例体会

目的探讨腋窝顶部切口隆乳术的效果和安全性。方法44例经腋窝切口将乳房假体置入胸大肌后间隙。结果44例中27例得到随访，随访时间2个月至2年，患者术后乳房及乳头形状位置好，乳头感觉及勃起正常，切口疤痕不显。结论经腋窝切口隆乳术具有创伤小，瘢痕隐蔽，效果稳定可靠。     

应用硅橡胶乳房假体隆乳的并发症

应用硅橡胶乳房假体隆乳的并发症邹景贵，赵扬冰，陈佩珍华西医科大学附一院医学美容中心１９８５～１９９１年７年间，我科应用化工部成都有机硅中心研制的硅橡胶乳房假体增大乳房共８１例、１６１个乳房，经过３个月～３年２个月的追踪随访４４例、８７个乳房，究其隆乳...     

不同类型乳房假体隆乳术后常见并发症发生率比较

目的 比较不同类型乳房假体隆乳术后常见并发症发生率。方法 从2020年1月至2021年2月期间,由同一组手术团队对450例患者（900侧乳房）实施经腋窝入路内窥镜下假体隆乳术,均使用曼托系列硅凝胶假体：光面圆形假体、毛面圆形假体、水滴形假体。随访时间为术后即刻至术后1年,获得有效随访病例400例,统计比较不同类型假体植入后常见并发症发生率。结果 所有患者均未发生气胸、假体感染、假体破裂渗漏、迟发性血清肿;1例患者（1侧）于住院期间发生假体腔隙内血肿,接受手术治疗,为毛面圆形假体;1例患者（1侧）于住院期间发生假体明显移位,接受手术治疗,为毛面圆形假体;5例患者（6侧）于术后1年随访期内发生假体移位,均为光面圆形假体;2例患者（2侧）发生mondor病,其中毛面圆形假体1例,光面圆形假体1例;3例患者（4侧）发生包膜挛缩,均为光面圆形假体,其中2例为Baker Ⅰ-Ⅱ级,1例为Baker Ⅲ-Ⅳ级;84侧乳房发生轻度乳头乳晕感觉障碍,其中光面圆形假体26例（30.95%）,毛面圆形假体28例（33.33%）,水滴形假体30例（35.71%）。结论 光面圆形假体相比于水滴形假体、毛面圆形假...     

硅胶乳房假体的选择与临床应用

硅胶乳房假体一直是乳房美容和乳房重建使用最广泛的生物材料.隆乳术在中国开展起步较晚,且以采用硅胶假体置入为主.硅凝胶充填的硅胶乳房假体历经40余年临床应用实践并不断演变完善,取得良好临床疗效的同时,也暴露了一些相关的问题.其主要的并发症有乳房假体破裂或渗漏,纤维包膜挛缩,假体移位及感染等.对待硅胶乳房假体置入材料,既要重视已明确的并发症,又要重视尚存争议的安全性问题.     

假体隆乳术后并发症的超声诊断价值

目的探讨超声对隆乳术后并发症的诊断价值。方法对20例患者40只乳房假体隆乳术后3d～7年进行超声检查，观察其并发症声像图特征，检查结果均经手术证实。结果隆乳术后并发症36只，其中乳房血肿4只、乳房感染6只、假体破裂8只、假体移位3只、假体包膜挛缩15只；乳房正常4只。并发症的类型和发病率与术后时间长短有明显关系，声像图表现与其类型有关。结论超声显像能清晰、准确显示假体大小、部位、形态及其与周围组织的关系。此方法简便易行，对隆乳术后并发症的诊断有重要价值，可作为术后随访的首选方法之一。     

集束化护理对硅胶假体隆乳术后并发症的影响研究

目的 探究集束化护理对硅胶假体隆乳术后并发症的影响。方法 选择2019年4月至2021年4月在我院行硅胶假体隆乳术的66例患者进行研究,采用随机抽签法将其随机分为对照组和试验组,每组各33例。对照组予以常规护理,试验组予以集束化护理,比较两组患者术后并发症发生率、患者生活质量评分以及患者对乳腺形态的满意度。结果 试验组术后纤维包膜挛缩、血肿、心理障碍发生率显著低于对照组(P<0.05)。术前,两组的乳房整形者生活质量(BREAST-Q)评分比较差异无统计学意义(P>0.05),术后3个月试验组的BREAST-Q评分显著优于对照组(P<0.05)。术后3个月,试验组患者对隆乳术的总满意度显著高于对照组(P<0.05)。结论 集束化护理可减少硅胶假体隆乳术后并发症发生,提高其生活质量,利于提升患者对整形效果的满意度,值得推广应用。     

单侧隆乳术12例报告

我科自 1996年至 2 0 0 1年收治单侧乳房外形不满意患者 12例 ,经单侧硅凝胶假体置入隆乳术后 ,外形、质感有明显改善 ,现报道如下。1　临床资料1 1　一般资料　本组 12例 ,年龄 2 1岁～ 37岁 ,已婚 6例 ,其中 2例无生育史 ,未婚 6例 ;右侧乳房 7例 ,左侧 5 例。 2例婴幼儿时无明显诱因胸部皮肤软组织感染形成脓肿 ,行脓肿切开引流术后瘢痕愈合 ,致单侧乳腺组织发育不全 ;4例因单侧乳房肿瘤行乳腺组织全切术后 ,其中一例同期行硅橡胶假体隆乳术后假体移位 ;6例为隆乳术后 7月～ 8年出现并发症所致 ,其中纤维包膜挛缩 3例 ,盐水假体破裂、渗…     

隆乳术后并发症分析

目的总结隆乳术并发症原因及相应处理方法。方法对2004年3月-2005年10月收治的15例隆乳术并发症患者,采用乳房下皱褶切口或乳晕切口进行处理与治疗。结果 15例均行假体取出术,其中7例一期行再次假体隆胸术。结论隆乳术后并发症依次为纤维包膜挛缩,假体破裂、渗漏,假体移位。聚丙烯酰胺水凝胶注射隆乳术后出现并发症逐渐增多,应引起重视。     

自我按摩预防假体隆乳术后包囊挛缩乳房硬化

对52例隆乳术患者均行腋窝切口，假体置于胸大肌后间隙。于术后3d开始，3次／d行乳房自我按摩，坚持按摩6个月。术后随访6～24个月，探讨假体隆乳术后假体周围纤维组织包膜挛缩的预防治疗。术后乳房位置、形态、手感均满意46例(占88．5％)。假体隆乳术后，自我乳房按摩能够很大程度的减轻假体周围纤维组织包膜挛缩，减少乳房硬化的发生率。     

膨体聚四氟乙烯在硅胶假体隆鼻术后二次修复术中的应用

目的：介绍膨体聚四氟乙烯用于隆鼻修复术中的手术技巧和体会。 方法：选择1998-10／2005-06中日友好医院整形外科收治的隆鼻术后患者85例，均为女性，行硅橡胶假体隆鼻术后3个月-8年。其中属硅橡胶假体隆鼻术后外形不良65例、鼻尖部假体长期支撑局部皮肤变薄11例、光照下鼻梁皮肤透光发亮7例、术后排异反应2例。膨体聚四氟乙烯（美国戈尔公司）加强型补片，规格：1．5cm&;#215;6．5cm&;#215;0．45cm或1.5cm&;#215;6．5cm&;#215;0.7cm。手术取出原来的硅橡胶鼻假体，将膨体聚四氟乙烯加强型补片根据受术者的鼻形雕刻后植入体内。随访时观察患者术后有无感染、排斥现象及假体收缩或松弛情况。 结果：87例患者最短随访3个月，最长随访2年，全部进入结果分析。所有病例均未出现感染及排斥现象，也未曾发现假体有收缩或松弛情况，均取得满意的手术效果。1例因鼻头肥大再次手术外后效果满意。 结论：膨体聚四氟乙烯为较理想的隆鼻材料替代品，尤其适合硅橡胶隆     

膨体聚四氟乙烯在硅胶假体隆鼻术后二次修复术中的应用

目的:介绍膨体聚四氟乙烯用于隆鼻修复术中的手术技巧和体会。方法:选择1998-10/2005-06中日友好医院整形外科收治的隆鼻术后患者85例,均为女性,行硅橡胶假体隆鼻术后3个月～8年。其中属硅橡胶假体隆鼻术后外形不良65例、鼻尖部假体长期支撑局部皮肤变薄11例、光照下鼻梁皮肤透光发亮7例、术后排异反应2例。膨体聚四氟乙烯(美国戈尔公司)加强型补片,规格:1.5cm×6.5cm×0.45cm或1.5cm×6.5cm×0.7cm。手术取出原来的硅橡胶鼻假体,将膨体聚四氟乙烯加强型补片根据受术者的鼻形雕刻后植入体内。随访时观察患者术后有无感染、排斥现象及假体收缩或松弛情况。结果:87例患者最短随访3个月,最长随访2年,全部进入结果分析。所有病例均未出现感染及排斥现象,也未曾发现假体有收缩或松弛情况,均取得满意的手术效果。1例因鼻头肥大再次手术外后效果满意。结论:膨体聚四氟乙烯为较理想的隆鼻材料替代品,尤其适合硅橡胶隆鼻术后外观不佳、鼻尖部张力过大导致鼻尖皮肤变薄的患者。     

A comparison of fatigue and energy levels at 6 weeks and 14 to 19 months postpartum

It has been assumed that women recover from pregnancy and childbirth within 6 weeks. Recent research shows that women's fatigue levels are the same, or higher, at 6 weeks postpartum as at the time of delivery. This study determined the differences in primiparous women's fatigue and energy levels at 6 weeks and 14 to 19 months postpartum. Determinations of how some contributing factors and outcomes of postpartum fatigue relate to each other and to fatigue and energy at 14 to 19 months postpartum were also made. Analyses revealed that women are more fatigued and less energetic at 14 to 19 months than they were at 6 weeks postpartum. Quality of sleep did not correlate with fatigue or energy. At 14 to 19 months postpartum return to full functional status is almost complete, with household and infant care responsibilities being most complete. The women were experiencing mild life crises of various sorts, were somewhat depressed, and were gratified in the mothering role.     

Acute otitis media in children 6 months to 2 years of age

QuestionAcute otitis media (AOM) is one of the most common findings among children in our family medicine office, and we frequently see this illness during seasons with high rates of upper respiratory tract infections. With more widespread pneumococcal immunization, has the rate of AOM declined? What are the current recommendations for antibiotic treatment?AnswerAlthough rates of the infection have declined over time with better uptake of vaccines against Streptococcus pneumoniae, AOM is still prevalent in the pediatric population and may be associated with serious complications that affect hearing and quality of life. Once a diagnosis has been made (based on a combination of acute onset of symptoms, signs of middle ear inflammation, and effusion), treatment of children 6 months to 2 years of age depends on physical examination findings. Children with perforated tympanic membranes and purulent discharge should receive 10 days of systemic antibiotics. For children with more mild symptoms or early AOM, primary care providers should consider either treatment or watchful waiting.     

Quality of life in 650 lung cancer survivors 6 months to 4 years after diagnosis

OBJECTIVE: To present the results of a quality-of-life (QOL) assessment performed with the current version of the Lung Cancer Symptom Scale (LCSS) questionnaire in a large single-institutional data set of 650 patients with lung cancer. PATIENTS AND METHODS: The study group included 650 patients with pathologically confirmed primary lung cancer whose conditions were diagnosed and/or treated at the Mayo Clinic in Rochester, Minn, between January 1, 1997, and December 31, 2001. The QOL assessment was performed using the self-administered LCSS questionnaire (version 2) 6 months to 4 years after the diagnosis of lung cancer. RESULTS: The item response rate for all 9 LCSS questions was 94.2% with a minimum of 92.9%. Significant differences in overall QOL by sex (P=.04), Karnofsky scale (P<.001), weight loss (P<.001), disease stage (P<.001), and histology (P=.001) were found, but no significant differences in overall QOL by age (P=.17) or marital status (P=.06) were observed. CONCLUSION: Our data suggest that QOL in patients with lung cancer at varying times after diagnosis highly correlates with baseline prognostic factors (disease stage, histology, Karnofsky scale, weight loss, and sex).     

Sonographic features with histologic correlation in two cases of palpable breast cancer after breast augmentation by liquid silicone injection

Sonography is rarely used to evaluate the breasts in patients who have undergone liquid silicone injections for breast augmentation because strong acoustic shadowing from the resulting silicone granulomas hampers the examination. We report on 2 patients who underwent silicone injection 18 and 20 years earlier and in whom breast cancers (1 invasive ductal carcinoma and 1 carcinosarcoma) were diagnosed by sonographically guided core-needle biopsy. On sonograms, both cancers had a peripheral hypoechoic rim surrounding an echogenic center. The echogenic center corresponded histologically to a silicone granuloma in 1 patient and to a large area of necrosis in the other; the hypoechoic rims corresponded to areas of cancer in both patients.     

Predictors of exercise behavior in patients with rheumatoid arthritis 6 months following a visit with their rheumatologist

BACKGROUND AND PURPOSE: When factors that influence exercise behavior are known, health care professionals can more likely design and modify patient education materials targeted to promote exercise behavior. This study aimed to identify predictors of exercise behavior in patients with rheumatoid arthritis 6 months after a visit with their rheumatologist. SUBJECTS AND METHODS: Twenty-five rheumatologists and 132 patients with rheumatoid arthritis participated. One hundred thirteen patients (85.6%) completed the 6-month follow-up. Rheumatologists and patients completed baseline questionnaires and were audiotaped during a subsequent visit. Physical function and exercise behavior were ascertained via questionnaire 6 months following the visit. Multivariate logistic regression identified predictors of exercise behavior at 6 months. Eighty-nine patients (79%) were female. The average age was 54.8 years (SD=14.4, range=20-94). The mean duration of illness was 9.8 years (SD=8.7, range= <1-35). Patients were moderately impaired (mean Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] function score=49.3, SD=27.5). Thirty-four patients (27%) were exercising 6 months after visiting their rheumatologist. More than 50% of the rheumatologists had 5 or more years of clinical experience, 18 (72%) were male, and 10 (42%) reported they exercised regularly. RESULTS: Predictors of exercise behavior at 6 months were patients' past history of exercise (odds ratio=6.8, 95% confidence interval=3.1-15) and rheumatologists' current exercise behavior (odds ratio=0.26, 95% confidence interval=0.09-0.77). DISCUSSION AND CONCLUSION: Patients were nearly 7 times more likely to exercise 6 months after visiting their rheumatologist if they participated in exercise in the past. If a patient's rheumatologist was currently performing aerobic exercise, the patient was 26% more likely to be engaged in exercise at follow-up. These data may be useful in understanding patient motivation to participate in exercise.     

南昌市315名8个月～5岁正常儿童气道阻力的研究

目的建立南昌市8个月～5岁正常儿童气道阻力的正常值。方法应用英国Micm MedicalLtd生产的MieroRint肺功能仪测定南昌市315名8个月～5岁正常儿童的气道阻力值,每个测试进行5次阻断,删除有明显偏差的数据,取中值作为测量结果。结果Rint（阻断阻力,即气道阻力）值〈2岁儿童为（0.7±0.6）kPa／L／s,24岁为（0．4±0.3）kPa／L／s,〉4岁为（0．3±0．2）kPa／L／s。流速Flow值〈2岁儿童为（0．2±0.2）L／s,2—4岁为（0．4±0．3）L/s,〉4岁为（0．6±0．3）L/s。结论随年龄增长,气道阻力Rint值逐渐下降,流速Flow值小于2岁者较低,2岁以后变化不大。