Millard法修复单侧唇裂的临床观察及手术方法改进

目的对Miuard法修复单侧唇裂的临床效果进行分析总结，探讨个体化修复单侧唇裂术式。以进一步改善单侧唇裂修复术后的效果。方法根据健、患侧唇高差分别选择MillardⅠ、MiUardⅡ及改良的MiUardⅡ术式(即MillardⅡ加沟状线上方的微小三角辩法)，评判临床效果。结果208例单侧唇裂患者根据个体差异选择术式。手术效果满意，双侧唇高一致，唇弓饱满，红唇圆滑，外形好。结论根据单侧唇裂健、患侧唇高盖灵活应用Millard术式可达满意手术修复效果，改良Millaid术式足以修复严重的Ⅲ度单侧唇裂患者。     

旋转交叉推进瓣整复单侧不完全性唇裂鼻唇畸形的疗效

目的 探讨应用旋转交叉推进瓣整复同时伴有鼻唇畸形的单侧不完全性唇裂患儿的疗效。方法 回顾性研究2018年1月—2021年12月就诊福建医科大学附属协和医院12例伴有鼻唇畸形的不完全性唇裂患儿,均采用旋转交叉推进瓣进行首次鼻唇修复;采用照片分析法,通过数码照片测量术前、术后即刻及术后1年患儿唇高、唇长、鼻孔高度、鼻孔宽度及鼻孔面积,以此判定该术式在不完全性唇裂整复中的临床疗效。结果12例患儿术前裂隙侧比非裂隙侧唇高约7∶10;唇长比约8∶10;鼻孔高度比值约7∶10;鼻孔宽度比约13∶10;鼻孔面积比约12∶10;经治疗后患儿术后即刻健患侧唇高、唇长、鼻孔高度、鼻孔宽度及鼻孔面积基本一致;术后1年复查,唇高、唇长、鼻孔高度、鼻孔宽度具有一定反弹,但与术后即刻比较,差异无统计学意义（P> 0.05）。鼻孔大小基本对称,疗效满意。结论 旋转交叉推进瓣在整复单侧不完全性唇裂患儿的鼻唇畸形中疗效稳定,有望为后期唇腭裂治疗指南提供参考依据。     

120例唇裂修复术的体会

目的探讨唇裂修复术式的选择及如何避免可能发生的缺陷。方法 120例唇裂应用三角瓣法、矩形瓣法、旋转推进法、前唇全长修复术、Z形修复术。结果基本达到唇裂修复目标的要求者96例,占80%;24例有不同程度的缺陷,有的兼有2种以上缺陷,占20%。结论术前充分的准备,精心设计,术中精心操作,术后精心护理,调动医患双方一切积极因素,才能达到修复的最佳效果。     

双侧推进错位皮瓣修复红唇哨唇畸形

目的观察应用双侧推进错位皮瓣修复红唇口哨唇畸形的可行性和效果。方法自2005年12月—2009年8月选择年龄为6～32岁的红唇口哨唇畸形的患者52例,行双侧推进错位皮瓣修复。结果 52例患者术后7d,手术切口均甲级愈合,黏膜瓣存活良好,形态外形满意,随访4个月～4a,形态无明显变化。结论应用双侧推进错位皮瓣修复红唇口哨唇畸形是可行的且较理想的手术方法 。     

唇腭裂一期整复术初步体会

后腭裂治疗的成功与否主要取决于是否获得满意的面部外形与良好的功能。多数学者主张小年龄组唇腭裂整复效果较好,一般行分期整复唇裂与腭裂[1]。然而,由于种种原因,临床上仍可见到年龄偏大但仍未及时修复的唇腭裂患者。我科对这类患者施行一期整复术,效果满意。1一般资料本组10例。年龄范围为4．5～12岁,性别：男3例,女7例,按邱蔚六主编《口腔颌面外科学》临床分类标难予分类：双侧唇腭裂Ⅲ度2例,双侧跨裂深Ⅱ度伴上唇正中裂Ⅱ度1例,单侧完全性唇裂见度5例,单侧腭裂Ⅱ度作唇裂Ⅱ度1例,单侧腭裂深Ⅱ度伴唇裂Ⅱ度1例。2治疗方法经…     

侧唇黏膜瓣在Ⅲ度唇裂手术鼻底重建中的应用

目的：分析探讨不同方法修复单双侧完全性唇裂患者鼻底的临床效果。方法：选取2005年3月-2011年3月在笔者所在医院治疗的完全性唇裂患者300例,将患者分为对照组和观察组,对照组87例患者采用瓦合式修复鼻底,观察组213例患者采用侧唇黏膜瓣修复鼻底,分析比较两组患者临床效果。结果：与对照组相比,观察组侧唇黏膜未加抛弃得以充分利用,患者满意度明显升高,比较差异有统计学意义（P〈0.05）。结论：侧唇黏膜瓣重建鼻底优于瓦合式重建鼻底,值得推广。     

局部真皮瓣重建鼻槛修复唇裂术后继发畸形

目的:探讨唇裂术后继发畸形鼻槛的重建方法。方法:该文对20例唇裂术后无鼻槛或鼻槛不显的患者,利用白唇瘢痕修复时局部真皮瓣填充修复重建鼻槛。结果:20例患者经随访3~6个月效果满意,重建鼻槛形态逼真。结论:利用局部真皮瓣重建鼻槛,可使鼻槛显现、饱满,外形自然、生动、逼真,值得推广。     

邻近组织瓣即刻修复唇癌术后缺损的临床研究

目的 探讨应用邻近组织瓣修复唇癌术后缺损的方法 及效果.方法 选取唇癌切除手术23例患者,对其缺损即刻修复,其中采用直接拉拢缝合或附加对偶三角瓣法7例,鼻唇沟组织瓣转移法3例,Abbe-Estlander法9例,Bemard法2例,矩形旋转组织瓣法2例.结果 所有病例术后组织瓣均成活,随访1～5年,肿瘤无复发或转移,供瓣区无明显继发畸形.结论 应用邻近组织瓣即刻修复唇癌术后缺损,手术简单、安全,为实用而有效的方法 .     

邻近组织瓣即刻修复唇癌术后缺损的临床研究

目的探讨应用邻近组织瓣修复唇癌术后缺损的方法及效果。方法选取唇癌切除手术23例患者，对其缺损即刻修复，其中采用直接拉拢缝合或附加对偶三角瓣法7例，鼻唇沟组织瓣转移法3例，Abbe—Estlander法9例，Bernard法2例，矩形旋转组织瓣法2例。结果所有病例术后组织瓣均成活，随访1～5年，肿瘤无复发或转移，供瓣区无明显继发畸形。结论应用邻近组织瓣即刻修复唇癌术后缺损，手术简单、安全，为实用而有效的方法。     

Abbe瓣、Estlaader瓣和Bernard瓣修复唇癌术后缺损的临床疗效

目的探讨Abbe瓣、Estlaader瓣和Bernard瓣修复唇癌术后缺损的临床疗效。方法选取我院收治的唇癌患者20例,根据患者缺损部位及缺损大小选择不同的修复方法,分别采取Abbe瓣、Estlaader瓣和Bernard瓣修复唇癌术后缺损,并对其临床资料进行回顾性分析。结果术后1个月总分41分,术后3个月总分57分,术后6个月总分70分,术后1个月总分明显低于术后3个月及术后6个月,差异有统计学意义（P〈0．05）。术后3个月总分明显低于术后6个月,差异有统计学意义（P〈0．05）。结论Abbe瓣、Estlaader瓣和Bernard瓣修复唇癌术后缺损均有自身的优点,需根据患者缺损部位、缺损大小等因素进行选择适合的方法,可达到理想的效果。     

Roentgenologic evaluation of indrawn parietal pleura

Among linear densities extending out from the lateral margin of a peripheral mass to the pleural surface, a thin line with a small triangular density at the pleural surface is considered to be contiguous layers of indrawn visceral pleura with a small amount of fluid between layers. We agree that the thin line represents contiguous layers of indrawn visceral pleura, but we believe that the triangular density at the pleural surface is not formed by a small amount of pleural effusion, but by indrawn parietal pleura accompanying extrapleural soft tissue of the chest wall. A trapezoid or a belt shaped soft tissue density between a peripheral mass contiguous to the visceral pleura and the chest wall are also signs of indrawn both visceral and parietal pleurae in the presence of adhesion of the pleura over the mass.     

Human echinococcosis (hydatidosis) in Uruguay: a comparison of indices of morbidity and mortality, 1962-71

The number of hospital cases of hydatid disease diagnosed in Uruguay during the 10 years 1962-1971 was determined by retrospective survey of all medical and surgical centres on three occasions. The annual index of hospital cases was compared with the estimated real prevalence of infection in man determined by extrapolation from the rates of intrathoracic hydatid cysts detected by mass miniature radiography. The highest rates of infection, as determined by these methods, were observed in the interior departments, particularly among rural populations, although some infections were apparently acquired in the capital department of Montevideo. The national index of hospital cases was the highest yet reported for any country but comparison with indices of estimated prevalence indicated that diagnosed cases were only a small proportion of existing infections. The different indices of human prevalence, particularly in the younger age groups, are expected to serve as baseline data to measure future changes in infection pressure achieved as a result of the control measures recently initiated.     

关节镜辅助下综合方法治疗髌骨软化症48例疗效分析

目的探讨治疗中重度髌骨软化症的最优方法。方法髌骨软化症患者48例56膝分为2组，分别以单纯传统外科手术方法（A组：胫骨结节抬高手术组，n=26）及关节镜下外侧支持带松解、内侧支持带紧缩加关节面打孔减压综合治疗方法（B组：关节镜综合手术组，n=30）进行治疗，随访比较疗效。结果胫骨结节抬高手术组疗效优良率61.5%，有效率69.2%；关节镜综合手术组疗效优良率86.7%，有效率93.3%。关节镜综合手术组疗效明显优于胫骨结节抬高手术组（P〈0.05）。结论关节镜辅助下综合治疗是一种较为理想的治疗髌骨软化症的方法。     

The Culture of Tubercle Bacilli from Laryngeal Swabs: (Section of Comparative Medicine)

In a considerable proportion of cases of pulmonary tuberculosis there is no spontaneous expectoration, especially in female patients and patients under collapse treatment. A simple and efficient method is described to obtain suitable material for bacteriological examination in these cases. A laryngeal swab, made up from a piece of wire with cotton-wool wrapped round its end, is passed down the larynx and the patient asked to cough. Two swabs are taken from each patient. The swabs are passed through sterile test tubes containing 10% sulphuric acid and 2% sodium hydroxide solutions for five minutes in each and 2 Petragnani media inoculated with each swab. The cultures are examined after five days for contamination, and after twenty-eight days for macroscopical colonies of tubercle bacilli. The results obtained in two groups of cases of 166 and 107 patients were: 37.95% and 54.20% positive cultures respectively. The highest positive figures were obtained in female patients. Thus tubercle bacilli were demonstrated in a considerable proportion of cases previously regarded as sputum-negative or having no sputum. Apart from diagnosis the method gives valuable help in judging the efficiency of treatment. The finding of bacilli in early infiltrative lesions is of considerable practical as well as theoretical importance.     

结核病患者呼吸机管路清洗消毒效果的临床观察

目的观察全自动清洗消毒机集中处理结核病患者呼吸机管路的消毒效果。方法对结核病患者使用后的呼吸机管路采用全自动清洗消毒机进行集中清洗消毒,消毒前、后对呼吸机管路及其配件进行细菌培养及结核菌检测。结果消毒前,所有样本的结核菌阳性率为100%;经全自动清洗消毒机集中清洗消毒后,采样监测均无菌生长,结核菌检测阳性率为0%。结论全自动清洗消毒机对结核病患者呼吸机管路进行集中清洗消毒能保证消毒效果。     

改良单骨道双束重建内侧髌股韧带治疗复发性髌骨脱位的临床研究

目的：探讨改良单骨道双束重建内侧髌股韧带治疗复发性髌骨脱的临床应用价值。方法：对33例复发性髌骨脱位患者行改良单骨道技术双束重建内侧髌股韧带联合关节镜下髌骨外侧支持带松解加胫骨结节内移治疗。术后观察切口愈合情况,髌骨稳定性,膝关节X片检查测量对比术前、术后髌骨适配角、髌骨倾斜角、外侧髌股角,采用Lysholm和Kujala评分评估膝关节功能。结果：33例均获随访,时间8-15个月,平均（12±3.1）月。切口按期愈合,无感染,髌骨稳定,运动能力恢复,33例病例均无髌骨再脱位,两组患者的术前、术后髌骨适配角为（21.8±5.9）°、（-2.5±4.0）°,髌骨倾斜角（24.9±5.8）°、（14.8±4.2）°,外侧髌股角（-6.1±2.3）°、（5.4±1.6）°。Lysholm评分术前、术后分别为（35.10±9.31）分和（89.11±5.21）分, Kujala评分术前、术后分别为（36.26±13.36）分和（90.45±4.55）分,比较差异有统计学意义（P〈0.05）。结论：改良单骨道双束重建技术重建内侧髌股韧带具有操作简单,牢固可靠、并发症少、住院费用低的优点,联合关节镜下髌骨外侧支持带松解加胫骨结节内移,可取的良好的治疗效果。     

成人肺结核不典型影像学表现分析

目的研究成人肺结核不典型的影像学表现,探讨诊断中存在的问题。方法回顾性研究分析了32例成人肺结核的X线、CT表现,其中6例做CT增强扫描,8例做纤维支气管镜检查,全部经临床或病理确诊。结果肿块型8例,表现为叶、段实变型6例,粟粒结节型5例,支气管内膜结核6例,空洞型4例,下叶结核3例。共误诊14例,其中误诊为肺癌7例,误诊为肺炎6例,1例误诊为转移癌。结论肺结核的发病出现上升趋势,发病率升高,老年结核增多,X线、CT表现各有特点,检查要全面,切勿单纯依赖一种检查,要密切结合临床,才能减少误诊。     

Computed tomography of thymic hyperplasia in older children

Computed tomography (CT) findings of 8 cases of thymic hyperplasia in children aged 7 to 15 years were retrospectively analyzed in comparison to 8 cases of tumors of anterior mediastinum. All cases of thymic hyperplasia retained a somewhat triangular or arrowhead-like shape at least on one side while tumors showed bilateral globular contour with lobulated border. No compression of the air way or pleural fluid was observed in thymic hyperplasia. These CT features are useful for making a diagnosis of thymic hyperplasia when an older child is presented with an anterior mediastinal mass on chest X-ray.     

荧光判读仪快速培养结核分枝杆菌方法的应用效果评价

目的评价荧光判读仪对结核分枝杆菌快速培养法在结核病诊断中的应用价值。探讨建立一种经济、快速、有效的结核菌的培养方法。方法对43例活动性肺结核确诊病人的痰液进行快速结核分枝杆菌培养,同时以改良的罗氏培养基对其进行结核分杆杆菌慢速培养作对照。对这2种方法所用时间、培养阳性率进行比较。结果采用荧光判读仪快速培养法比罗氏培养法出结果提前15d左右,培养阳性率高8.7%。结论荧光判读仪测定法比常规结核分支杆菌培养方法用时短,阳性率高,相对于其他快速培养经济实用,适合基层结核病院使用推广,应用。