腓动脉穿支腓肠神经营养血管游离皮瓣修复手足软组织缺损

Objective To report the operative techniques and clinical results of the free psroneal artery perforator sural neurecutanecus flaps. Methods Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomozed with a branch of a nearby artery, and the small saphenoas vein was anastomosed with the cephalic vein or the great sapheneous vein to establish the flap's circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap. Results From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 crux7 cm to 18 cm× 11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 ～ 12 mm. Conclusions The flap has all the advantages of the h'ee flap, the perforator flap and the neurocutaneous flap. It is easily performed with reliable blood supply. It's a good choice for repairing the skin defects of hands and feet.     

腓动脉穿支腓肠神经营养血管游离皮瓣修复手足软组织缺损

Objective To report the operative techniques and clinical results of the free psroneal artery perforator sural neurecutanecus flaps. Methods Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomozed with a branch of a nearby artery, and the small saphenoas vein was anastomosed with the cephalic vein or the great sapheneous vein to establish the flap's circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap. Results From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 crux7 cm to 18 cm× 11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 ～ 12 mm. Conclusions The flap has all the advantages of the h'ee flap, the perforator flap and the neurocutaneous flap. It is easily performed with reliable blood supply. It's a good choice for repairing the skin defects of hands and feet.     

腓动脉穿支腓肠神经营养血管游离皮瓣修复手足软组织缺损

Objective To report the operative techniques and clinical results of the free psroneal artery perforator sural neurecutanecus flaps. Methods Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomozed with a branch of a nearby artery, and the small saphenoas vein was anastomosed with the cephalic vein or the great sapheneous vein to establish the flap's circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap. Results From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 crux7 cm to 18 cm× 11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 ～ 12 mm. Conclusions The flap has all the advantages of the h'ee flap, the perforator flap and the neurocutaneous flap. It is easily performed with reliable blood supply. It's a good choice for repairing the skin defects of hands and feet.     

缬沙坦联合卡托普利治疗慢性心力衰竭的疗效观察

目的探讨缬沙坦联合卡托普利治疗慢性心力衰竭(CHF)的临床疗效。方法将我院收治的78例CHF患者随机分为对照组和观察组,各38例。对照组在基础治疗上给予卡托普利口服治疗,观察组在对照组治疗的基础上联合应用缬沙坦治疗,治疗前后对两组患者分别进行心功能指标(NYHA分级)评估,行血常规、肾功能、肝功能、心电图、超声心动图检查及计算左室射血分数(LVEE),比较两组治疗效果和不良反应发生情况。结果观察组总有效率为92.1%,对照组总有效率为81.6%,两组疗效比较,差异有统计学意义(P<0.05);治疗后观察组心率及LVEE改善情况优于对照组,差异有统计学意义(P<0.05)。两组治疗期间不良反应较轻微,且均可耐受。结论卡托普利联合缬沙坦治疗心力衰竭疗效显著,安全可靠,可作为治疗CHF的一线药物进行临床推广应用。     

肋间置细硅胶管低负压闭式引流治疗气胸临床观察

<正> 气胸常见多发,治疗方法的不断改进。自1995年10月至96年6月我们对20例气胸用细径硅胶管胸腔留置,低负压持续引流治疗,并对照了单纯抽气法及粗管闭式引流法,结果此法优点明显,现报告如下: 临床资料 自发性气胸20例,男性14例,女性6例,年龄21—74岁,其左侧气胸12例,右侧气胸8例,高压性气胸5例,闭合性气胸15例。气胸量在60—90％,发病时间1—7天,平均2.5天,上述病例均系住院病人,除临床症状体征外,均具备胸片,胸腔测压资料。     

超声波检查脂餐与蛋黄餐后胆囊收缩功能比较

应用超声诊断胆囊疾患,以往用脂餐(素油一两油煎两个荷包蛋)了解胆囊收缩与排空功能。由于脂餐使用不便,加之油腻不易被患者接受,因此,我们改用两个煮熟之蛋黄代替脂餐,获得与脂餐同样的结果。采用常规检查方法,首先对125例青年大学生(男81例女44例)用蛋黄餐进行检查并对其中57例于蛋黄餐检查之次日进行脂餐测定胆囊功能。两组之结果基     

超声诊断易漏诊的髂动脉狭窄1例

患者男,82岁,主因"眩晕"就诊。既往有高血压史10年,查体未见异常。超声:腹主动脉、髂总动脉、左侧髂外动脉、双侧股总动脉未见明显狭窄。右侧髂外动脉起始处狭窄段由相距约1cm的两段组成,每段各长约0.5cm;狭窄段收缩期峰值流速(peaksystolic velocity,PSV)为400cm/s,右髂总动脉PSV为123cm/s,二者比值     

快速减压后大鼠模型视网膜电生理的变化

目的 观察快速减压(RD)后大鼠视网膜电图(ERG)的变化,并探讨减压病造成视网膜早期功能损伤的特点。方法 20只大鼠按数字表法随机分为4组,分别为正常对照(NC)组、安全减压(SD)组、快速减压处理后0 h(RD0)组和6 h(RD6)组,SD组、快速减压处理各组大鼠暴露于加压舱内,舱内气压在30 s内升至1.0 MPa,维持5.5 min,快速减压各组打开放气阀用55 s减至常压,SD组采用动物安全减压方案减到常压。按照国际临床视觉电生理学会的标准化方案,采用国特医疗系统和银-氯化银角膜电极以及银针电极对大鼠进行暗视视网膜电图(Scot-ERG)、振荡电位(OPs)、明视视网膜电图(L-ERG)记录。结果 快速减压后大鼠ERGa、b波以及OPs O2波幅值降低,潜伏期明显延长。快速减压后6h,Scot-ERG b波和OPs O2波幅值增加,RD6组[b波(134.5±27.9) μV,O2波(27.1±9.2)μV]较RD0组[b波(56.5±21.1) μV,O2波(8.1±1.9) μV]高(P＜0.05)。SD组比RD0组和RD6组视网膜电活动受抑制程度轻,SD组Scot-ERG b波和OPs O2波幅值[b波(266.5±25.2) μV,02波(44.1±5.6) μV]高于快速减压后RD0组和RD6组(P＜0.05)。结论 快速减压会造成大鼠视网膜电生理异常,安全减压可有助于减轻这种功能损伤。     

温度对冰冻红细胞保存的影响

目的观察不同温度条件下红细胞在冰冻、融化、洗涤后的质控指标,分析不同的保存、融化温度对红细胞的影响.方法各取20袋保养液为输血用复方枸橼酸钠抗凝剂(ACD-B)的全血,于采血后6 d内离心制成红细胞悬液,直接滴入(红细胞表面温度在5℃～10℃)红细胞低温保护剂或将红细胞和保护剂在37℃水浴后(红细胞表面温度20℃～22℃)再保存,-80℃冰冻保存数日后取出融化、洗涤.分别于融化后以及洗涤后立即取样测定红细胞回收率、游离血红蛋白.结果与未经加温而直接保存的红细胞相比,37℃水浴后的冰冻红细胞,融化洗涤后的红细胞回收率明显升高,游离血红蛋白明显减少.结论红细胞及低温保护剂经过37℃水浴后能更好地冰冻保存红细胞.但由于操作条件的限制,红细胞融化、洗涤后必须24 h内输注.