鱼肝油酸钠、醋酸确炎舒松-A加肾上腺素局部注射治疗瘢痕疙瘩

从本文疗效看对瘢痕疙瘩的治疗是有所提高,但在瘢痕疙瘩内注入鱼肝油酸钠时需谨慎,因为它是一种对血管瘤进行注入疗法的药物,但瘢痕疙瘩组织结构与血管瘤完全不同,它是以胶原堆积为特征,注入鱼肝油酸钠可能引起局部组织坏死!加用肾上腺素引起的副效应也需注意。     

手术切除与注射确炎舒松A治疗瘢痕疙瘩

目的：探讨瘢痕疙瘩的治疗方法及疗效。方法：采用手术切除与局部注射确炎舒松A治疗瘢痕疙瘩87例,其中随访62例。结果：参照朱兆明疗效分类方法,随访62例中优52例（83.87%),良9例（14.52%）,差1例（1.61%）。其中1例注射4例后局部皮肤萎缩。结论：手术切除与注射确炎舒松A是目前治疗瘢痕疙瘩较理想的方法。     

平阳星局部注射治疗小儿颜面部血管瘤56例

皮肤软组织血管瘤是颜面部常见的良性肿瘤，多为先天性错构瘤，其发生率约占全身血管瘤的60％。小儿先天性血管瘤部分可自然消退，但国内一些学者认为颜面部血管瘤可致严重畸形和功能障碍，应采取有效措施，治疗不应等待。我院自1999年12月至2002年12月期间采取平阳星(平阳霉     

确炎舒松-A对断指再植后感觉功能恢复的影响

目的 评价确炎舒松—A对断指再植后感觉功能恢复的影响。方法 选择23例24指因切割伤行断指再植的病例，对照组13例14指，治疗组10例10指。治疗组按指神经走行，于离断平面近端1cm正常组织处的指神经周围注射确炎舒松一A0．3ml和0．5％布比卡因0．2ml，并分别于手术后第3个月、6个月和12个月时进行感觉功能评价。结果 3个月时治疗组和对照组感觉功能恢复无统计学差异(P＞0．05)；6个月和12个月，治疗组优于对照组(P＜0．05)。结论 指神经周围注射确炎舒松一A有利于断指再植后的感觉功能恢复。     

醋酸确炎舒松-A局部注射治疗小儿血管瘤67例

1985年5月至1987年6月,应用醋酸确炎舒松—A(上海第九制药厂生产),局部注射治疗小儿血管瘤取得满意效果。现报道如下。临床资料年龄最小的13天,最大的9岁。皮肤损伤小的0.5×0.3cm,大的7×5cm。67例中毛细血管瘤52例,海绵状血管瘤9例,混合瘤6例。治疗方法:血管瘤局部皮肤常规消毒后,将该药摇匀,用普通消毒注射器和6号针头,直接沿血管瘤     

注射性坐骨神经损伤的手术治疗

目的：提高注射性坐骨神经损伤的疗效。方法：对56例注射性坐骨神经损伤的患儿采用神经卡压松解。神经外膜内注射醋酸确炎舒松-A,神经束膜松解,坐骨神经周围放置醋酸确炎舒松-A,术中对坐骨神经直接电刺激,术后随访2年。结果：神经损伤症状完全恢复18例,部分恢复27例,无明显恢复11例,有效率80.4%。结果：注射性坐骨神经损伤的症状体征,应立即手术,及早的神经外膜松解、生理盐水冲洗及术中对丛骨神经直接电刺激有助于坐骨神经损伤的恢复。醋酸确炎舒松-A的应用能减轻粘连并有效地防止坐骨神经术后的再次疤痕卡压。     

注射性坐骨神经损伤的手术治疗

目的 提高注射性坐骨神经损伤的疗效。方法 对56例注射性坐骨神经损伤的患儿采用神经卡压松解、神经外膜内注射醋酸确炎舒松－A,神经束膜松解,坐骨神经周期放置醋酸确炎舒松－A,术中对坐骨神经直接电刺激等。结果 术后随访2年,神经损伤症状完全恢复18例,部分恢复27例,无明显恢复11例,有效率80．4％。结论注射性坐骨神经损伤一旦有损伤的症状体征,应立即手术,及早神经外膜松解、生理盐水冲洗及术中对坐骨神经直接电刺激有助于坐骨神经损伤的恢复。醋酸确炎舒松－A的应用能减轻粘连并有效地防止坐骨神经术后的再次疤痕卡压。     

5-氟尿嘧啶联合利多卡因及确炎舒松治疗900例瘢痕疙瘩的注射及护理效果分析

目的总结5-FU联合利多卡因及确炎舒松治疗900例瘢痕疙瘩的注射及护理体会,分析注射治疗过程中的注意要点。方法自2002年以来,选择900例瘢痕疙瘩患者,在瘢痕处注射5-FU+利多卡因+确炎舒松,并记录注射前后病灶变化以观察疗效。结果本组中,2例患者因出现药物不良反应而中止治疗,30例患者效果不佳,其余868例患者疗效满意,随访1年均未见复发。结论 5-氟尿嘧啶联合利多卡因及确炎舒松注射治疗瘢痕疙瘩,操作简单,疗效确切,且加强注射前后的护理,有利于提高临床治疗效果。     

A DEVICE FOR THE CONTROLLED VENTILATION OF INFANTS AND CHILDREN

A self-filling ventilator attachment which will deliver presetvolumes from 10 ml to 700 ml is described. It can be operatedby most ventilators or by manual inflation. It is a non-rebreathingsystem and patients can be ventilated with ambient air or anaestheticgases. ^* In receipt of a grant from the Wellcome Trust.     

THE EFFECT OF MUSCLE REPAIR ON POSTOPERATIVE FACIAL SKELETAL GROWTH IN CHILDREN WITH BILATERAL CLEFT LIP AND PALATE

The effect of orbicularis muscle repair on postoperative facial skeletal growth in bilateral cleft lip and palate patients was studied by analysis of cephalometric radiographs and dental casts. Sixty-two patients operated on between 1961-1989 were selected for the study. They were divided into three groups, group 1a (muscle repair; n = 12), group 1b (failed attempt at muscle repair; n = 5), and group 2 (no attempt at muscle repair; n = 45). Comparison of the morphological measurements among these three groups showed that there was a trend towards crossbite in the muscle repair group, but this difference was not significant. Mechanisms by which muscle repair might influence maxillofacial skeletal growth include the possibility that the area around the nasal septum might be the growth centre. The choice of operative technique in bilateral cleft lip and palate should be important.     

A GUIDELINE TO THE MANAGEMENT OF PATENT DUCTUS ARTERIOSUS IN INFANTS AND CHILDREN

Experience with multiple ligation of the patent ductus arteriosus (PDA) at the Hospital for Sick Children, Great Ormond Street, London, is presented. One hundred and sixty-one consecutive cases between January 1971 and December 1974 have been reviewed. Fifty-four children (33%) were less than one year of age. in the majority of cases the diagnosis was made on clinical grounds. Cardiac catheterization and angiography were carried out when associated intracardiac lesions were suspected. The overall mortality was 2.5%. All the deaths occurred in infants less than six months of age who had associated cardiac lesions. There were no deaths in patients who had an uncomplicated PDA or who were more than one year of age. Multiple ligation of the PDA is a simple and safe operation. The risk of operative treatment Is affected more by the presence of associated cardiac lesions and the age of the patient than by the surgical technique employed.     

颞浅动脉组织瓣修复儿童头面部畸形

目的　评价颞浅动脉组织瓣在修复儿童头面部畸形中的作用。方法　1986年10月～1996年12月,采用颞浅动脉组织瓣修复13例儿童头面部畸形,其中先天性畸形9例,烧伤瘢痕3例,感染后瘢痕1例。采用颞部皮瓣1例,颞部毛发皮瓣3例,额部皮瓣1例,耳后浅筋膜瓣与皮瓣8例。组织瓣大小为5.0cm×1.2cm～10.0cm×5.0cm,皮瓣蒂长5～8cm。结果　术后组织瓣均Ⅰ期愈合。术后10例获得随访,时间6个月～12年,皮瓣色泽似邻近皮肤,质地柔软,厚薄适中,毛发瓣毛发生长良好,耳后浅筋膜瓣与皮瓣满足耳再造需要。所有病例术后切口瘢痕隐蔽,外观获明显改善。结论　颞浅动脉组织瓣血供丰富,邻近受区,易操作且形态良好,适用于儿童头面部多种畸形的修复。     

VESICO-URETERIC REFLUX AND SURGICALLY TREATED PELVI-URETERIC JUNCTION OBSTRUCTION IN INFANTS UNDER THE AGE OF 12 MONTHS

Background : Pelvi-ureteric junction obstruction has been increasingly diagnosed in infants, mostly as a consequence of antenatal ultrasound examinations. Methods : Of 55 infants below the age of 12 months who underwent dismembered pyeloplasty over a 7-year period, we aimed to determine the patterns and outcome of associated vesico-ureteric reflux that was present in 15 (28%) of the 53 infants in whom follow-up was available. Results : A total of eight infants had resolution of their reflux with conservative management and the median time to resolution was 15 months. Five infants proceeded to ureteroneocystotomy. Conclusions : Given the association of vesico-ureteric reflux and pelvi-ureteric junction obstruction, routine cystography is recommended when the diagnosis of pelvi-ureteric junction obstruction is made.     

EFFECT OF SURFACE ELECTRODE POSITIONING ON THE COMPOUND ACTION POTENTIAL EVOKED BY ULNAR NERVE STIMULATION IN ANAESTHETIZED INFANTS AND CHILDREN

The effect of surface electrode positioning on the evoked compoundaction potential (ECAP) was studied during inhalation anaesthesiawithout neuromuscular blockade. The ECAP of five fullterm infants(aged 2–20 weeks) and five children (age 1–10 yr)was recorded with a neuromuscular relaxation monitor (Relaxograph,Datex) after supramaximal ulnar nerve stimulation. The fiverecording electrode positions compared were: thenar (adductorpollicis) v. second finger (TD2); thenar v. second dorsal metacarpalinterspace (TM2); hypothenar v. fifth finger (HD5); hypothenarv. fourth dorsal metacarpal interspace (HM4); thenar v. hypothenar(TH). The ECAP was steady at positions TD2 and HD5, but markedvariation and baseline drift was found at TM2, HM4 and TH. TheECAP peak-to-peak amplitudes were twice as great in childrencompared with infants. The hypothenar ECAP was liable to stimulusartefact interference because of the short onset latency atHD5 (2.2(SD 0.4)ms), whereas the adductor pollicis (3.0 (SD0.5)ms) position (TD2) yielded reliable results. Address for Correspondence: Helsinki University, Surgical Hospital,Department of Anaesthesia, SF-00130 Helsinki, Finland.