扩张皮瓣修复颌颈部瘢痕42例

目的 探讨应用皮肤软组织扩张器扩张皮瓣修复颌颈部瘢痕的临床应用效果.方法 对42例颌颈瘢痕患者Ⅰ期行扩张器埋置术,皮瓣扩张满意后经Ⅱ期行扩张皮瓣转移修复颌颈部瘢痕畸形.结果 42例患者颈部活动受限得到明显改善.所有患者获随访2年,其中3例患者出现轻度瘢痕挛缩,需再次手术;39例效果满意.结论 扩张皮瓣在颌颈部瘢痕修复中取得了满意疗效,且术后效果稳定.     

皮肤扩张术治疗小儿颈胸部烧伤后瘢痕畸形

目的探讨皮肤软组织扩张器治疗小儿颈胸部烧伤后瘢痕畸形的方法及效果。方法对22例颈胸部烧伤后瘢痕形成伴颈部功能受限的患儿,应用皮肤软组织扩张器治疗。结果 22例患儿皮瓣转移后全部成活,其中11例皮瓣尖端部分有水肿、渗液,换药治愈后对功能无明显影响。随访2年,外形及功能均得到改善,颈部活动无明显受限。结论采用皮肤软组织扩张器治疗小儿颈胸部瘢痕畸形,临床效果满意。     

应用超量扩张术修复大面积面颈部瘢痕

目的：探讨延长扩张时间、增大扩张量的皮肤软组织扩张术的临床效果。方法：应用皮肤软组织扩张术修复面颈部瘢痕切除后创面25例,手术分两期进行,Ⅰ期手术：在需要修复的瘢痕组织临近的正常皮肤上设计埋置扩张器的大小、形状及埋置方式,扩张器容量为100～400ml,扩张时间为3～6个月,扩张量为额定容量的2～5倍;Ⅱ期手术：取出扩张器,切除瘢痕,利用扩张皮瓣转移修复创面。结果：全部病例均获得满意效果,随访3个月至10年,皮瓣平整,外观色泽、质地均佳。结论：延长扩张时间,增加扩张量可以产生更多的额外皮肤,修复大面积面颈部瘢痕效果良好。     

皮肤软组织并联扩张术修复面中部瘢痕

目的寻求修复面中部瘢痕的新方法。方法15例面中部瘢痕患者于Ⅰ期手术时,在其颌面、颈、耳后部皮肤软组织下并联埋置2个扩张器,待扩张至有足够的“额外”皮肤软组织后,施行Ⅱ期手术,旋转并推进扩张皮瓣以修复面中部瘢痕。结果本组患者术后切口相对隐蔽,修复部位皮肤颜色、质地等符合要求,面部外观得到明显改善。结论颌面、颈、耳后部皮肤软组织并联扩张术是一种修复面中部瘢痕的较好方法,有一定的临床应用价值。     

皮肤软组织扩张术治疗面颈部瘢痕46例效果观察

目的观察皮肤软组织扩张术治疗面颈部瘢痕的效果。方法采用单个或多个皮肤软组织扩张器置入46例面颈部瘢痕患者的面颈部正常皮肤下,经注水扩张后,再将扩张的皮肤软组织合理转移到要修复的瘢痕区整形缝合。观察术后皮瓣成活率、皮肤色泽、瘢痕恢复情况和治疗过程中的并发症。结果 46例患者术后皮瓣全部成活,2例患者面部扩张器埋置术后感染,3例出现面部皮瓣下血肿,均经对症处理后痊愈,对手术效果无影响,并发症发生率为10.87%。无扩张失败终止治疗病例。术后随访6~12个月,患者面颈部局部皮瓣转移后血运、色泽正常,外形良好,无功能障碍,面颈部为线状瘢痕,较为平整,无增生性瘢痕出现。结论采用皮肤软组织扩张术治疗面颈部瘢痕,操作简单、效果满意,是皮肤烧伤整形外科中修复创面的理想方法。     

应用皮肤软组织扩张器修复头面颈部瘢痕48例体会

目的:探讨皮肤软组织扩张术修复成人头面颈部瘢痕的临床疗效。方法:在瘢痕旁的正常皮肤上行皮肤软组织扩张术,扩张的皮肤面积达到预计量后,切除瘢痕组织,用平行推进法或旋转推进法进行皮瓣转移修复。结果:48例手术顺利完成,1例术后5天扩张器外露,遂行Ⅱ期手术,术后疗效良好;其余病例未发生血肿、感染、扩张器外露、扩张器不扩张、皮瓣坏死等并发症。术后随访8～24个月,皮瓣转移修复区域色泽良好、质感较好、皮色与周围皮肤接近。结论:用皮肤软组织扩张术修复头、面、颈部瘢痕,具有皮肤色泽接近、质感充实、有弹性、手术效果好、容易被患者接受等优点。     

应用多个扩张器扩张皮肤软组织修复颈部挛缩瘢痕的护理

目的 探讨应用多个扩张器皮肤软组织扩张术修复颈部挛缩瘢痕的护理体会。方法 1998年1月～2003年6月应用多个扩张器置入颈部正常皮肤下，扩张皮瓣修复颈部瘢痕切除后创面15例，手术前后制定护理细则，保证病情观察的规范化。结果 13例患者扩张皮瓣转移后无继发畸形，1例皮瓣部分血运障碍，1例扩张器外露、切口感染，经换药后均痊愈。结论 皮肤软组织扩张术是修复较大颈部瘢痕切除后创面的首选方法，规范化的护理，能有效预防术后并发症，提高手术效果。     

皮肤软组织扩张器在烧伤后瘢痕中的应用

皮肤软组织扩张器在烧伤后瘢痕中的应用夏双印，王洁，杨大平，郝立君，蒋海越，徐学武１９９０年１月以来，对供皮困难的大面积烧伤患者，在外观正常皮肤周围的瘢痕皮下埋置扩张器，形成扩张的瘢痕皮瓣，在切取正常皮肤制成全层皮片游离移植修复面、颈部创面时，用此瘢痕...     

微创法超薄皮瓣式皮肤扩张法在面颈部瘢痕治疗中的应用

研究探索一种高效的面颈部皮肤扩张方法。方法：选用长导管薄壁扩张器，经微创切口作潜行超薄皮瓣式皮下间隙剥离并埋入扩张器，术后2～3天进行快速扩张，完成扩张后制作超薄扩张后皮瓣修复瘢痕切除后创面。结果：42例共117个扩张部位均顺利完成注水扩张，Ⅱ期手术的超薄扩张后皮瓣回缩率低、回缩力小，修复术后面部表面平坦，颌颈角正常。发生血肿、炎症．皮瓣部分环死、扩张器外露共9个部位，经治疗全部得到控制，总并发症发生率为7．7％。结论：超薄皮瓣式皮肤扩张法用于面颈部瘢痕治疗效果优良，美学效果好，并发症少。     

皮肤软组织扩张术治疗面颈部瘢痕23例临床分析

目的 总结应用皮肤软组织扩张技术治疗面颈部瘢痕的临床经验.方法 对23例面颈部瘢痕患者分别采用单个或多个皮肤软组织扩张器置入面颈部正常皮肤下,经1～2个月注水扩张后,利用扩张后皮瓣直接推进或形成异位皮瓣修复面颈部瘢痕切除后创面.观察治疗过程中的并发症,术后皮瓣的成活、皮肤的色泽,以及最后面部的瘢痕情况.从而判断治疗的临床效果.结果 本组患者23例,其中1 例术后出现血肿、1例发生扩张器渗漏、2例在扩张过程中出现感染,经处理后正常扩张.扩张后皮瓣均满足修复区所需.术后随访6～12个月患者面颈部皮肤色泽正常,外形良好,无功能障碍,面部为线状瘢痕,较为平整,无增生性瘢痕,治疗效果满意.结论 采用皮肤软组织扩张术治疗面颈部瘢痕方法 简单,效果满意,是一种行之有效的方法.     

杭州健康女性定量骨超声测定原发性骨质疏松

目的 评价杭州健康女性骨超声速度(SOS)值随增龄减少和骨质疏松患病率，建立杭州地区女性骨超声速度值参考数据库。方法 定量超声法测定1208例杭州地区健康女性桡骨远端(RAD)，第3指骨近节(PLX)，第V跖骨(MTR)和胫骨中段(TIB)的超声速度值。结果 RAD、PLX、MTR和TIBSOS峰值(Peak of SOS)均出现在40-45岁，TJB的SOS峰值出现在35—40岁，此后随年龄增长而下降。绝经后妇女在绝经后早期和晚期各有1个SOS快速减少期，前见于桡骨近端，平均年减少率为2．4％，后见于胫骨中段，平均年减少率为1．8％。各部位骨SOS累积减少率随年龄增长而增加，到85岁4部位累积减少为13％-18％。60岁以后骨质疏松性症(OP)检出率为45％-70％，OP检出率以桡骨远端最高，60-70岁平均为67％，第3指骨近端次之约50％，胫骨中段最低为36％；75岁以后分别为70％，65％和45％。结论 全身各部位骨超声速度值到达峰值的年龄不同，峰值也各有差异。绝经后妇女骨超声速度值随年龄增加减少较快，应予激素和补钙治疗，桡骨远端为本地区SOS检测和OP检出的敏感部位。     

Importance of echocardiography in prognosis of surgical outcomes in cholecystitis in elderly patients

The authors propose to use more often echocardiography (EchoCG) in examination of elderly (over 60 years) of age patients with cholecystitis that permits to increase surgical activity to 92.4%. Left ventricular ejection fraction is the most informative. When this fraction is lower than 45% surgery must be recommended on vital indications only. EchoCG was used in 155 patients with cholecystitis, 131 of them were operated. 2 (1.52%) patients died due to acute cardio-vascular insufficiency and pulmonary artery thromboembolism.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

目的 评价脊髓胶质细胞在小鼠骨癌痛形成中的作用.方法 健康雄性C3H/He小鼠40只,周龄8～10周,体重18～22 g,随机分为4组(n=10):假手术组(S组)、骨癌痛组(B组)、PBS组(P组)和米诺环素组(M组).S组跟骨骨髓腔内注射PBS 10 μl;余3组跟骨骨髓腔内注射含2×105个骨纤维肉瘤细胞的PBS 10 μl制备骨癌痛模型,于造模前即刻开始PBS组鞘内注射PBS 5μl,M组鞘内注射米诺环素(用PBS溶解为0.2 mmol/L)5μl,1次/d,连续11 d.于造模前1 d、造模后即刻、3、5、7、9、11 d时测定机械痛阈;于造模后3、7、9、11 d机械痛阈测定结束后测定冷痛阈.痛阈测定结束后处死小鼠,取脊髓组织,测定神经胶质纤维酸性蛋白(GFAP)和CD11b的表达水平.结果 与S组比较,B组和P组造模后3-11 d时、M组造模后3、5 d时机械痛阈升高,B组、P组和M组造模后7～11 d时冷痛阈升高,脊髓CD11b和GFAP表达上调(P<0.05).与B组比较,M组造模后3-11 d时机械痛阈降低,造模后7-11 d时冷痛阈降低,脊髓CD11b和GFAP表达下调(P<0.05).结论 脊髓胶质细胞(星形胶质细胞和小胶质细胞)的激活参与了小鼠骨癌痛的形成.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.