闭式引流在甲状腺外科的临床应用

甲状腺手术虽不断改进和提高,但手术并发症仍较多,国内报告约5.7～9.7%,其中术后出血和血肿达0.6～1%。而且因术后血肿压迫导致急性窒息死亡者时有报告。预防术后出血和血肿的发生除术中妥善止血外,非常重要的是术后充分引流。只要充分引流就绝无血肿发生,更不会     

多巴胺外渗致局部坏死的护理

2002年5月,我院收治1例肺心病患者,因应用多巴胺外渗致局部坏死,经精心治疗护理,30天后好转出院.……     

名老中医张天健治疗脊髓型颈椎病的经验

脊髓型颈椎病是骨伤科疑难病之一，由于非手术治疗一般收效徽且疗程长，牵引和按摩还有可能使症状加重，临床上常采用手术治疗。但又由于手术难度大，危险性高，患者不宜接受。张天健老师是著名的中医骨科专家，作者师承学习，受益非浅，从师2年期间，张老运用中药辨证治疗了23例症状尚轻或手术后效果不明显的脊髓型颈椎患者，收到较好疗效。现整理介绍如下。     

127例海军飞行员血液流变学指标及其与冠心病危险因素的相关分析

近年来冠心病等心血管疾病对飞行的影响特别突出，飞行员因冠心病的停飞率有增加趋势[1]。研究飞行员血液流变学指标及其与冠心病危险因素的关系，对探讨飞行员冠心病的防治及降低停飞率有重要的指导意义。现将2001年5月至2004年5月来我科疗养的127名海军飞行员的调查情况报告如下。     

重组2型腺相关病毒-转化生长因子β3对实验性肝纤维化大鼠肝脏组织病理学和Ⅰ型胶原表达的影响

Objective To investgate the effects of TGF β 3 on rat hepatic fibrosis. Methods The TGF β 3 cDNA was cloned into rAAV2 vector. Rats were randomly divided into four groups: normal control group, model group, negative control group and TGF β 3 group. Hepatic fibrosis was induced by hypodermic injection of 40% CCI4. Recombinant AAV2-TGF β 3 viral particles were injected via the vena caudalis one week before CCh treatment. Rats were executed 8 weeks after CCI4 treatment, global histological change was observed after HE staining, the distribution of the collagen fibers was observed after masson staining, his-tochemistry was done to observe the expression of collagen Ⅰ; The positive area rate of the collagen fibers and the average optical rate of collagen Ⅰ were quantified. Results HE staining indicated that collagen fibers were reduced in the TGF β 3 group. Masson staining shown that the collagen fibers were distributed around the blood vessel, in the portal area and disse space. Compared to the model group (13.2%±2.2%) and negative control group (12.3%±1.5%), the collagen fibers in liver tissues of TGF β3 group (7.7% ± 1.5%) were significantly decreased (q = 9.456, P < 0.01; q = 8.217, P < 0.01). Histochemistry indicated that the collagen fibers of liver tissues of TGF 15 3 group (0.185±0.033) were significantly higher than those in the model group (0.252±0.042) and the negative control group (0.230±0.029), (q = 6.228, P < 0.01; q = 4.346, P < 0.01). Conclusion TGF β 3 alleviates the damage to hepatic cell and the level offibrosis in CCI4 treated rats and inhibits the expression of collagen Ⅰ.     

卡文在老年人围手术期应用的初步观察

胃肠外营养自20世纪70年代以来广泛应用于临床，它是通过静脉途径供给患者所需的营养物质，经历了从营养素分瓶输注到倡导混合输注的过程。临床在输注方式上目前仍以分瓶输注为多，但这并不合理，以往的三升袋是将氨基酸、葡萄糖、脂肪酸等营养制剂在配制室混合后输注，由于其营养输入的合理性而受到营养专家多年倡导，但在实际应用上并不如分瓶输注普遍，主要是其存在诸多不便，如渗透压高、保存时间短、要有专用的配制室、输注时间长等，另外在混合输注过程中出现患者不适的比例也较高。     

漏斗胸闭合修补术对患儿心肺功能影响的中期评估

背景/目的:自从引入漏斗胸闭合修补术后,越来越多的患者愿意接受该手术治疗。然而对于该手术对心肺功能的长期影响一直存在争论。本研究旨在对闭合修补术对漏斗胸患儿的肺功能、心功能、运动耐量,以及患儿对其胸部外观的认可和主观运动能力的长期影响进行观察评估。方法:对所有接受漏斗胸闭合修补术的患儿进行前瞻性评估。患儿接受的检查包括术前CT检查、肺功能检查、运动耐量检测以及评估心功能的ECG。在植入支杠后3个月和21个月以及取出支杠后3个月时分别对患儿进行检查。结果:共有48例患儿有术前和术后检查资料,其中有11例在支杠取出后…