颈部放射性皮肤损伤修复术的麻醉

介绍了18例颈部放射性皮肤损伤修复术的麻醉。17例为恶性肿瘤,曾接受过综合治疗,全身情况差,局部损伤重。手术以病灶切除皮瓣修复为主,麻醉方法根据病人全身情况、局部损伤及手术方式决定,采用全麻、颈丛阻滞或局麻。麻醉管理强调了术前对张口困难、头颈活动受障病人的术前准备,术中呼吸道的管理及术毕防止呼吸道梗阻并发症的发生。     

用阴囊桥形皮瓣修复阴茎大溃疡一例报告

患者,男性,24岁.包皮环切术后,服扑热息痛2片至使阴茎皮肤大面积溃烂,8天后转入我院.入院时阴茎背部和两侧皮肤缺损.创面宽度占阴茎周径的2/3(6cm),长度约为阴茎的全长,所剩根部皮肤其皮下亦为潜行溃疡.勃起后创面宽长分别为7cm和6cm,肉芽创面新鲜.入院第4天,在硬膜外麻醉下行阴茎溃疡清创、阴囊桥形皮瓣修复术.在阴囊上部设计     

肤生软膏对慢性放射性皮肤损伤的治疗作用和毒性实验

肤生软膏对慢性放射性皮肤损伤的治疗作用和毒性实验吴淑荣陈强纪辉慢性放射性皮肤损伤在肿瘤放疗中常见，多为急性损伤治疗无效或处理不当继发感染所致。损伤形成溃疡，周围组织广泛纤维化，局部微循环障碍致使损伤经久不愈。本研究就肤生软膏对慢性放射性皮肤损伤的疗效...     

复方维生素B12治疗放射性与非放射性皮肤损伤的研究

本文观察了复方维生素例水、油, 霜剂治疗放射性(不同时期)及非放射性皮肤损仿386例。其中采B₁₂水剂治疗急性放射性皮肤损伤49例, 非放射性浅I°烧伤50例, 油剂治疗慢性放射性皮肤损伤37例, 非放射性慢性皮肤溃疡75例复方例霜剂对放射及非放射性皮肤损伤恢复期有保护性治疗作用, 该组观察了175例均收到满意的效果。     

放射性皮肤损伤105例分析

本文报道105咧123个部位,包括急性放射性皮炎10例,慢性放射性皮炎52例,严重溃疡38例及恶变5例的有关皮肤放射性损伤的分析。就这些病例对放射性皮肤损伤的病理、临床表现、诊断 及治疗,尤其对局部手术的有关方而作了较详细阐述和讨论,最后提出了防护意见。     

He-Ne激光照射联合维斯克治疗放射性皮肤损伤的临床疗效观察

放射性皮肤损伤是放射治疗常见的并发症之一, 一旦出现溃疡, 常经久不愈, 患者十分痛苦。作者应用HeNe激光照射联合维斯克治疗放射性皮肤损伤, 取得满意疗效, 现报道如下。     

第4讲 局部放射性损伤的手术治疗

对于局部严重放射性损伤 ,近年来多主张手术修复与功能重建 ,且以局部扩大切除与组织移植修复为主要治疗手段。1　手术适应证主要包括 :( 1 )各部位的急、慢性Ⅲ度损伤 ,坏死、溃疡超过 3ｃｍ以上者 ;( 2 )功能部位 (如手、足、关节 )的急、慢性Ⅱ度损伤 ,早期手术可防止关节畸形 ,保护和促进功能恢复 ;( 3)大面积Ⅱ度局部急性损伤伴有全身放射病、内脏损伤或全身中毒反应明显时 ,早期切除坏死组织、封闭创面 ,有利于减轻复合伤 ,减少并发症 ;( 4)有恶性变者。2　手术时机对于局部严重放射性损伤 ,尤其是急性放射性皮肤损伤的手术时机 ,目前…     

背阔肌肌皮瓣岛状转移修复乳腺癌术后放射性溃疡7例

目的：探讨背阔肌肌皮瓣岛状转移修复乳腺癌术后放射性溃疡的治疗效果。方法：2011—10—2012—10收治乳腺癌术后放射性溃疡7例,女性6例,男性1例,年龄53～67岁,溃疡均位于腋下及侧胸,面积最大的10cm×15cm,最小的7cm×8cm。7例均采用胸背动脉为蒂,背阔肌肌皮瓣岛状转移修复,供皮区中厚皮覆盖。结果：本组7例患者皮瓣全部成活,创面一期修复。结论：背阔肌肌皮瓣岛状转移修复乳腺癌术后放射性溃疡可以获得良好治疗效果。     

皮肤溃疡创面的中西医基础与临床研究近况

皮肤溃疡是临床最常见的慢性损伤之一,其发病机制复杂,至今尚未完全阐明,不同原因所致的皮肤溃疡创面病因学不同,发病机制也各有差异.在临床上,治疗皮肤溃疡的方法很多,局部治疗是主要手段之一,但临床疗效并不尽人意,是临床创面修复的一大难题.促进溃疡创面的修复愈合是治疗慢性皮肤溃疡的基本任务,而寻找安全有效的治疗方法是目前研究的热点问题.近年来,在中西医基础与临床科研人员的努力下,有关慢性皮肤溃疡的基础研究和临床治疗的许多方面已取得长足进步,有力地推动了皮肤创面愈合整体水平的提高.本文旨在对近年来慢性皮肤溃疡创面的中西医基础与临床研究近况作一概述.     

苦豆子总生物碱制剂治疗放射性皮肤损伤的临床观察

放射性皮肤损伤在放射治疗病人中极为常见,它不同于一般皮肤损伤,一旦形成溃疡就不易愈合,重者反复感染,形成久治不愈的顽固性溃疡。对其治疗,至今尚缺少特效药物。因此,研制促进放射性皮肤损伤愈合的新药有其重要意义。本课题从甘肃省丰富的中草药资源中,经过化学...     

中子辐射致骨髓损伤及治疗研究进展

中子相对生物效应较高,能对机体产生十分严重的损伤.骨髓是中子辐射高度敏感的器官,低剂量中子照射即可对骨髓造成严重的辐射损伤,产生骨髓型急性放射病,出现外周血血象改变、造血细胞和骨髓基质细胞损伤等一系列改变.中子辐射致骨髓损伤治疗的难度大,以综合对症治疗为基础,细胞因子的适时应用及对极重度中子骨髓型放射病则实施造血干细胞移植.     

Radiation exposure and dosimetry in transplant patients due to nuclear medicine studies.

Organ transplantation is now an accepted method of therapy for treating patients with end stage failure of kidneys, liver, heart or lung. Nuclear Medicine may provide functional data and semi-quantitative parameters. However, one serious factor that hampers the use of nuclear medicine procedures in transplant patients is the general clinical concern about radiation exposure to the patient. This leads us to discuss the effective doses and radiation dosimetry associated with radionuclide procedures used in the management and follow-up of transplant patients. A simple way to place the risk associated with Nuclear Medicine studies in an appropriate context is to compare the dose with that received from a more familiar source of exposure such as from a diagnostic X-ray procedure. The radiation dose for the different radiopharmaceuticals used to study transplant organ function ranges between 0.1 and 5.3 mSv which is comparable to X-ray procedures with the exception of 201Tl and 111In-antimyosin. Thus Nuclear Medicine studies do not bear a higher radiation risk than the often used X-ray studies in transplant patients.     

骨髓型急性放射病血细胞计数时间动态曲线的定量分析

本文设计了骨髓型急性放射病血细脆计数时间动态曲线的定量分析方法,并通过计算机程序加以实现.由此可获得十几项分析参数,可从不同的角度定量地了解不同处理组的损伤特点,用以判断防治病例的疗效.文中利用狗屏蔽试验白细胞和血小板的计数资料.经本方法分析结果说明,屏蔽骨盆部组效果最好,其次是屏蔽腹部组;屏蔽头颈部组虽然血细胞水平较其它组低,但其恢复速率稳定且最快,应引起重视.     

心阻抗血流图中半胸电极带的应用

心阻抗血流图的操作是将电极围绕颈部与胸部(全胸法)。由于胸部电极可妨碍手术,不能用于术中监测。为此我们将胸部环状电极改为背部半胸电极(半胸法)。并对健康男、女各40名(观察组)及上胸段硬膜外阻滞前后22例(麻醉组)作了两种方法对比,观察到两者图形基本一致。观察组SV、dz/dt max、Zo的相关系数男性分别为0.85、0.95、0.95,女性为0.74、0.94、0.84。麻醉组上述指标的相关系数均大于0.9,STI中指标未见有何差异。因此认为半胸电极是切实可行的。同时提出半胸电极带一定要与皮肤紧贴。     

A cost analysis: general endotracheal versus regional versus monitored anesthesia care

A prospective study was conducted to compare the total cost of all consumable products used to perform a general endotracheal anesthetic (GETA), a regional anesthetic, and a monitored anesthetic (MAC). For 1 month, providers completed a survey for each anesthetic rendered identifying type and quantity of consumables used. The mean cost of each type of anesthetic was identified. Analysis of variance was conducted using SPSS (version 7.5.1) to compare the mean costs of the three groups. Of 936 anesthetics performed, 536 surveys were returned (57%). The breakdown by type was GETA, 60% (N = 319); regional, 35% (N = 189); and MAC, 5% (N = 28). The mean cost per case type was GETA, $61.74; regional, $34.99; and MAC, $26.27. The cost of rendering a GETA was significantly greater (p < 0.0005) than that of either regional or MAC. Clinical practice guidelines were established to address areas in which cost savings could be realized and were provided to all anesthesia practitioners to assist in providing the safest and most cost-effective method of rendering an anesthetic.     

Regional anesthesia for the management of limb injuries in space

Traumatic injuries continue to present a threat to the success of current and future spaceflight missions. The magnitude of this threat will grow as the frequency of extravehicular activities is increased and missions venture beyond low Earth orbit and further away from terrestrial medical support. The capability to render definitive treatment to crewmembers who suffer a serious traumatic injury while in space is relatively limited at present. While some research has focused on the development of specific surgical techniques for the microgravity environment, little attention has been given to how one might practically provide anesthetic care for injured crewmembers expected to undergo these procedures. While many logistical and practical obstacles exist to the provision of general anesthesia in microgravity, regional anesthesia could be used to overcome many of these problems. A regional anesthetic capability for spaceflight missions could be developed with minimal modifications to existing terrestrial techniques and would provide the ability to manage a wide range of potential injuries while in orbit. The capability to provide reliable regional anesthesia could be further augmented and improved using a range of imaging technologies currently in development; it is expected that these devices would have a range of terrestrial applications, including the ability to provide immediate, safe, and reliable anesthetic care to patients in remote locations, or under austere conditions such as the combat environment.     

鼻咽癌放射治疗后染色体畸变率预测放射性脑病的相关研究

目的对染色体畸变率与鼻咽癌放疗后放射性脑病的相关性进行分析，以探讨该指标预测放射性脑病发生及病情严重程度的可行性和可靠性。方法运用分裂中期染色体方法检测17例鼻咽癌放疗后放射性脑病患者和17例鼻咽癌放疗后未发生放射性脑病患者的染色体畸变率，并以多种统计方法分析染色体畸变率与鼻咽癌放疗后放射性脑病发生和病情的相关性。结果染色体畸变以及与自发畸变的累积效应均与放射性脑病的发生和病情严重程度存在相关性，而且累积效应与放射性脑病发生和病情严重程度的相关性更密切。结论染色体畸变具有应用于临床预测放射性脑病发生和病情的价值。     

提高前庭稳定性的简易锻炼方法效果观察

根据电动转椅Coriolis加速度刺激法对半规管系统能产生复合刺激作用的原理,设计了一套提高前庭稳定性的简易锻炼方法。结果表明,Ⅰ组(晕机锻炼组)经锻炼后前庭植物神经反应消失;Ⅱ组(晕机对照组)两次检查的参数无变化;Ⅲ组(正常锻炼组)经锻炼后前庭适应性机能得到进一步巩固。经实际飞行检验,本法具有远期效果。本法无须仪器及锻炼器材,容易掌握,能综合性地提高严重晕机反应的飞行人员及健康飞行人员的前庭系统的适应水平。     

Rectal bleeding after radiation therapy for prostate cancer: endoscopic evaluation

PURPOSE: To analyze the frequency and clinical importance of proctitis and hematochezia after radiation therapy for prostate cancer. MATERIALS AND METHODS: Of 63 patients with prostate cancer treated with curative intent by a single radiation oncologist between July 1, 1993, and December 31, 1997, 30 were asymptomatic, but 33 had heme-positive digital rectal examination (DRE) results or hematochezia at routine follow-up. Twenty-six of these patients underwent endoscopy of the sigmoid colon or colon for evaluation of these symptoms. Median doses of 60.0 Gy at postoperative radiation therapy and 68.4 Gy at definitive radiation therapy were delivered to four fields daily by using blocking customized on the basis of computed tomographically documented evidence of disease. The Fisher exact test and the Kaplan-Meier method were used to analyze the results. RESULTS: The frequency of rectal bleeding approached 80% at 3 years after radiation therapy in definitively treated patients. Only 14 patients had proctitis: eight as the only sign, and six in association with other disease. Six patients had other disease without proctitis, and four patients had normal examination findings. The frequency of rectal bleeding in the presence of proctitis was similar to that in the presence of other disease (Fisher exact test, P =.68). CONCLUSION: Hematochezia or positive DRE findings are frequent sequelae of definitive radiation therapy for prostate cancer; however, causes other than proctitis are often documented at endoscopy. Symptomatic individuals warrant rigorous evaluation to rule out serious coexistent disease.     

骨髓型放射病犬的血清生物发光动态特征

本文采用18只成年雄性犬,分为三组,分别以~(60)Coγ线照射2、5、8Gy。照后每天同时测一次血清生物发光强度和体温,并作出光热各动态曲线,在两种曲线的特征进行相互比较的基础上,作者首次提出光热竞争论、峰谷位移定则、位移常数(0.333……)、放射热等新概念,并探讨峰谷位移定则可用来在核事故中快速剂量分类的可行性。