可冲洗负压封闭引流技术在复杂性创面修复中的应用

对复杂性创面21例应用可冲洗VSD技术进行治疗,创面肉芽组织生长良好后予以植皮修复.认为可冲洗VSD技术应用复杂创伤性创面修复,可以促进创面肉芽组织生长,促进创面愈合,减少并发症,是临床上一种治疗复杂性创面的有效方法.     

负压封闭引流(VSD)技术在各类创面的应用研究进展

负压封闭引流(VSD)技术最初设计应用于开放性骨折创面,并取得了良好的治疗效果.随着时代的发展,VSD技术的应用范围不断扩大,并取得了良好的医疗和社会效益.本文综合相关文献,对VSD技术在不同类型创面中的应用进行初步总结,以期进一步拓宽VSD技术的应用领域.     

封闭负压引流结合皮瓣及植皮修复糖尿病患者足部创面

应用负压封闭引流（VSD）技术结合邻近皮瓣转移或植皮修复糖尿病患者足部创面23例。早期扩创后应用VSD覆盖,持续引流7～10d,待创面清洁后手术修复创面。应用VSD引流后,感染控制理想,肉芽生长良好,创面缩小,创面均完全愈合,疗效理想。     

应用负压封闭引流技术治疗多发性Ⅲ-Ⅳ期压疮

对5例多发性Ⅲ-Ⅳ期压疮的患者应用负压封闭引流(VSD)技术治疗,经3~7天治疗后,全身及创面感染均得以控制。其中11个创面经VSD及换药治疗后渐愈合;9个创面经VSD与植皮术后创面愈合;3个创面经VSD后行皮瓣转移修复。     

自体富血小板血浆联合负压封闭引流在糖尿病足溃疡治疗中应用

目的探讨自体富血小板(PRP)血浆在负压封闭引流(VSD)治疗糖尿病足溃疡治疗中应用的方法及疗效。方法回顾性分析赤峰市医院自2013年9月至2017年9月收治的87例糖尿病足溃疡患者的临床资料。将87例患者随机分为VSD组(44例)与VSD+PRP组(43例)。VSD组患者创面持续行VSD治疗,每10 d更换1次敷料。VSD+PRP组患者首先行VSD治疗10 d,然后,应用患者自体PRP外敷创面3 d,再行VSD治疗7 d。两组患者均待创面达到皮瓣移植条件后,行皮瓣移植术。两组患者均行抗感染、控制血糖、改善微循环等处理。治疗2个周期后,记录并比较两组患者创面愈合时间及创面愈合率。结果 VSD组与VSD+PRP组的创面愈合时间分别为(43.0±1.5)d及(36.0±1.1)d,两组比较,差异有统计学意义(P<0.05)。治疗2个周期后,PRP+VSD组创面愈合率为95.3%(41/43),明显高VSD组的45.5%(20/44),两组比较,差异有统计学意义(P<0.05)。结论应用自体PRP可以促进糖尿病足溃疡的创面愈合,缩短VSD治疗的创面愈合时间,提高创面愈合率。     

游离植皮结合负压封闭引流技术治疗糖尿病足溃疡创面

目的 探讨糖尿病足溃疡创面应用负压封闭引流(Vacuum sealing drainage,VSD)技术+植皮手术治疗的临床效果.方法 对16例糖尿病足溃疡创面有效清创,使用VSD技术后,取刃厚皮片或薄中厚皮片,大块邮票状植皮后,再次使用VSD技术治疗.结果 16例患者植皮完全成活.讨论该方法操作简单,术后护理方便,是...     

深二度烧伤创面负压封闭引流效果观察

目的考察负压封闭引流技术（vacuum sealing drainage,VSD）治疗深二度烧伤创面的效果。方法对51例深二度烧伤患者给予分组治疗,VSD组28例,清创后应用VSD技术;常规治疗组23例,两组患者创面新鲜后移植刃厚皮片或者中厚皮片封闭创面。结果 VSD组应用5～10 d后,肉芽新鲜者去除VSD材料装置,手术移植刃厚皮片或者中厚皮片。反之,继续VSD治疗至肉芽新鲜,手术植皮。与常规换药组比较创面愈合时间缩短,疼痛减轻,费用降低。结论负压封闭引流技术对小面积二度烧伤创面愈合有明显促进作用。     

负压封闭引流在急诊四肢严重软组织损伤中的应用

对67例(79个创面)四肢严重软组织损伤患者行手术清创、骨折复位、神经血管肌腱修复后,应用持续负压封闭引流(VSD)敷料覆盖创面,经过1次或多次VSD技术治疗,除2例(4个创面)自动出院外,其余患者创面通过直接缝合、游离植皮或皮瓣转移闭合创面,肢体均获满意外观和功能.     

急诊负压封闭引流术治疗挤压综合征

目的 探讨急诊应用负压封闭引流术(vacuum sealing drainage,VSD)对挤压综合征(crush syndrome,CS)的治疗作用. 方法 随机筛选出我院创伤外科收治的102例挤压伤患者,并分为急诊VSD组(50例),延迟VSD组(22例)和非VSD组(30例),分析各组间VSD术后CS相关指标的变化. 结果 患者术后的生命征、尿量、实验室检查结果、CS发生率、并发症、病死率等评价指标在急诊VSD组均较延迟VSD组和非VSD组显著好转(P<0.05);急诊VSD组和延迟VSD组患者术后并发症、住院时间、病死率等指标较非VSD组显著好转(P<0.05). 结论 早期、急诊应用VSD具有吸附坏死组织和创面渗出物、持续创面主动引流和预防感染等作用,对预防和治疗挤压综合征具有显著效果.     

负压封闭引流技术在小儿损伤中应用的疗效观察

目的探讨负压封闭引流(VSD)技术在小儿损伤中的临床应用效果。方法 2008年10月—2011年6月,采用VSD技术治疗小儿严重损伤共35例,待创面肉芽生成良好,外露的肌腱、骨膜表面有新鲜的肉芽组织覆盖后,给予植皮或者皮瓣转位治疗。结果所有患儿分别经1～3次VSD治疗后,创面均植皮或皮瓣转位成功,创面闭合,外观良好。结论 VSD技术治疗小儿严重损伤,可以促进创面肉芽组织快速生长,缩短病程,减少痛苦,与成人应用VSD相比,临床和社会效果更加明显。     

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,     

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.     

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.     

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.