颅脑损伤促进的坐骨神经再生

BACKGROUND:Studies have shown that craniocerebral injury can promote the repair of sciatic nerve injury in rats, but its precise mechanism remains unclear. OBJECTIVE:To further explore the action mechanism of craniocerebral injury on the repair of sciatic nerve injury using morphology and histology. METHODS:Sixty specific-pathogen-free healthy male Sprague-Dawley rats were randomly divided into two groups. Rats with craniocerebral injury and sciatic nerve injury were considered as the experimental group. Rats with simple sciatic nerve injury were considered as the control group. Classical Feeney method was used in models of craniocerebral injury and SunderlandV sciatic nerve injury. At 8 and 12 weeks after modeling, sciatic nerve index was detected. Masson staining and NF200 immunofluorescence staining were used to observe the nerve regeneration at the anstomotic site. Transmission electron microscope was used to observe the number of regenerative axons. RESULTS AND CONCLUSION:At 8 and 12 weeks after modeling, compared with the control group, gait and sciatic nerve index recovered better in the experimental group. In the experimental group, Masson staining showed fewer nerve membrane collagen fibers, and the axon arranged neatly. NF200 immunohistochemistry showed that in the experimental group, the density of regenerated nerves was high, and nerves were regularly distributed. Transmission electron microscopy showed that in the experimental group, regenerative axons were regularly arranged, collagen scar was less, and myelin layer arranged regularly. Results suggested that the craniocerebral injury in rats may promote the repair of peripheral nerve injury by reducing scar collagen in nerve endings.     

VSD治疗糖尿病足感染的责任制整体护理体会

目的：：研究封闭负压引流术(VSD）治疗糖尿病足感染的责任制整体护理效果。方法：足感染(DFU)患者114例,随机分为2组,观察组给予VSD责任制整体护理,对照组给予一般护理。比较2组术后焦虑自评量表(SAS)和抑郁自评量表(SDS)评分、血糖水平、创面愈合时间和患者对护理的满意度。结果：观察组患者SDS、SAS评分明显低于对照组(P＜0.01),血糖水平控制、创面愈合时间、患者对护理的满意度均明显优于对照组。结论：VSD的责任制整体护理可以减少糖尿病足感染患者的焦虑心理状态,有利于血糖控制,提高患者对护理工作的满意度。     

20例脑出血患者压疮的封闭负压引流治疗效果研究

目的：探讨封闭负压引流（VSD）治疗脑出血患者压疮的效果。方法选取2011年1月至2014年2月承德医学院附属医院神经外科住院的20例脑出血长期卧床导致并发压疮的患者作为研究对象,分为试验组和对照组。对照组10例,用常规方法治疗;试验组10例,在对照组的基础上结合VSD技术进行治疗,对比两组治疗后的临床效果。结果试验组有效率为95．2％,对照组有效率78．0％;试验组与对照组创面细菌感染率分别为10．0％和30．0％;创面平均换药次数分别为2．1次和8．2次,两组疗效差异具有统计学意义（P＜0．05）,以上指标试验组明显优于对照组。结论应用VSD技术治疗脑出血并发压疮患者疗效满意,值得临床借鉴和应用。     

数字减影血管造影联合Fogarty球囊导管取栓术在动脉联合血栓中的应用

目的 比较数字减影血管造影(digital subtraction angiography,DSA)引导下Fogarty球囊导管取栓术、切开探查术在动脉危象联合血栓中应用的效果。方法 回顾性分析2012年9月～2020年5月承德医学院附属医院收治的35例在断肢再植术后出现血管危象,经高频超声诊断为联合血栓的患者临床数据。依据手术方式分为微创组(即DSA引导下Fogarty球囊导管取栓术,12例),开放组(即切开探查术,23例),对手术前、中、后各项指标进行比较研究。结果 入院时两组一般资料差异均无统计学意义(P>0.05),具有可比性;对血管再通畅时间、术中手术时间、术中出血量进行比较,微创组显著低于开放组(P<0.05);对术后再次栓塞率、术后截肢率进行比较,微创组显著低于开放组(P<0.05);术后9个月随访患肢功能优良率二组间比较,差异无统计学意义(P>0.05);对住院医疗费进行比较,开放组显著低于微创组(P<0.05)。结论 DSA引导下Fogarty球囊导管取栓术处理动脉危象联合血栓,可避免断端修复区域二次损伤,并发症发生率低,早期疗效确切,但...     

周围神经损伤的修复

1985年11月～1988年12月,应用显微外科技术修复周围神经损伤40例,45条神经。其中臂丛神经3例,胸背神经1条,肌皮神经1条,桡神经10条,正中神经12条,尺神经7条,指神经3条,坐骨神经2条,腓总神经4条,胫神经2条。     

腔内可吸收线打结技术在腹腔镜胆囊切除术中的应用体会

目的：探讨腔内可吸收线打结技术在腹腔镜胆囊切除术（lapamscplc cholecysteetomy，LC）中的效果。方法：应用腔内可吸收线打结技术行腹腔镜胆囊切除术36例。结果：患者均于腹腔镜下行胆囊切除术，无中转开腹，无胆管损伤及胆漏等并发症发生，手术平均时间40min，平均住院4天。结论：无钛夹腔内可吸收线打结法腹腔镜胆囊切除术具有结扎可靠牢固，患者对其无发应，术后无疼痛，手术费用低，并可消除因钛夹留置体内造成的反应或夹闭不全造成脱落、胆漏等并发症。