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目的:采用改进的掌板紧缩手术方法,以矫正手的爪状畸形,间接增强手指背伸肌力和指屈肌力。方法:在掌指关节处将掌板“H”形切开,远侧舌状瓣向近侧牵拉屈掌指关节与近侧瓣重叠缝合在人为制造的掌骨颈部的粗糙面上。结果:196例施行矫正手术,随访1~11年,除4例失败外,均矫正成功,外形良好,增强了手的抓握与夹捏力,无1例发生屈肌腱粘连。结论:本术式有效地矫正了爪状手的畸形 相似文献
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遇到髌骨部分骨折,胫骨髁间隆突撕脱骨折,膝关节交叉韧带断裂后重建,部分骨折块复位后固定需要在骨折复位后或韧带固定时用钻孔穿钢丝或丝线肌腱固定,因钢丝、丝线、肌腱柔软,经过骨孔或用其它引导物时常不便,我们采用自制的骨孔引导器,经临床应用效果满意。 1 结构与制作 (1)针套用100mm×1.6mm或100mm×1.8mm金属穿刺针外套。(2)针芯为双根,针芯前端连接呈圈套形,采用长200mm,直径0.4mm不锈钢丝。 相似文献
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Objective To investigate the therapeutic effect of fibular head composite flap for bone and skin defect at medial malleolus in children. Methods From Aug. 2005 to Apr. 2009, 4 children cases(2 male, 2 famale, from 3 to 11 year) with bone and skin defect at medial malleolus were reconstructed with fibular head composite flaps pedicled with lateral inferior genicular vascular bundle. The skin defect was 3- 6 cm × 8-10 cm in size. Results All the 4 compostie flaps survived completely. The patients were followed up for 4 months to 4 years with good bony healing. Both esthetic and functional results were satisfactory in ankle joint. Conclusions The fibular head composite tissue flap has a good therapeutic effect for bone and skin defect at medial malleolus in children. 相似文献
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Objective To provide an anatomical basis for repairing the medial malleolus with bone-severed vascularized fibular head epiphysis, and to explore the effect of clinical application with this method. Methods Figures of fibular head and medial malleolus were measured on 20 fresh lower limbs specimens of child age from 2 to 12 years old, then bone-severed formula was deduced. The bone-severed composite fibular head epiphysis to repair the defect of medial malleolus were carried for 6 child patients of emergency or post-poned cases on one stage. Obersved the clinical effect by following-up. Results The angle between fibular head and stem (M) was(170±8)°, angle of fibular head sadacc(N) was (145 ±6)°, length(1.5±0.2)cm and width (1.4±0.2)cm; angle between medial malleolus and stem(1) was(152±8)°, length of the articular surface of medial malholus was(1.25 ± 0.2)cm and width (1.25 ± 0.2)cm. Angle between defect surface and tibia was(Q). Formula: angle of bone-severing X = L-N-Q, and apex at the upper 1/6 of the reversed articular surface of fibular. 6 cases with this method was completed, all healed at stage one, following-up 1 to 3 years, medial malleolos developed well and no epiphysis ossification anticipation, and the ankle joint has no inversion with its loadind and walking function good. Conclusion The fibular head epiphysis and the medial malleolus differ in shape to some extent, but good donor can be got by bone-severing, can repair the epiphysis and soft tissue defect of the medial malleolus at one stage with additional flap, developing with the child at the same time, it is a perfect method to reconstruct the traumatic defect of child medial malleohs. 相似文献
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车辆撞、轧致下肢毁损伤82例救治体会 总被引:1,自引:0,他引:1
载重、高速车辆撞、轧致下肢创伤 ,常造成肢体断离并复合组织缺损 ,或复杂开放性骨折合并皮肤软组织大面积缺损、血管神经断离与缺损 ,足部虽完整但严重缺乏血供等毁损伤。对这种创伤不宜行局部或远位带蒂皮 (肌 )瓣或复合组织瓣转移修复 ,用吻合血管组织瓣转移修复颇困难。 1985~ 2 0 0 0年 ,我们应用显微外科技术修复与重建下肢创伤 4 988例 ,其中车辆撞、轧致下肢毁损 82例 ,经急诊救治保存了肢体 ,并恢复功能。1 临床资料1 1 一般情况 男 71例 ,女 11例 ;年龄 19~ 2 8岁 ,平均 2 2 5岁。撞伤 5 2例 ,轧伤 2 8例 ,摔伤 2例。受伤部… 相似文献
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Objective To study the clinical effect of iliac flap straddled donor area to primary repair large defect of bone and soft tissue. Methods Through the anatomical study about iliac flap, the new oper-ation method about iliac flap was designed, which straddled donor area and used one blood vessel stem (deep iliae circumflex artery) and two branch blood vessel(deep iliac circumflex artery and superficial iliac circum-flex artery compounding in series) for blood supply. Blood supply area of the analogical operation was stud-ied by irrigating fresh cadaver with Indian ink. Thirty-two patients with large defect of bone and soft tissue (20 males, 12 females, 17-68 years old, average 36 years old) were repaired by this method, and the hemo-dynamics was studied by laser Doppler flowmetry. Results It was feasible to connect superficial iliac cir-cumflex artery with the branch of deep iliac circumflex artery. Indian ink irrigating fresh cadaver simulate operation showed that area scope dyed by Indian ink: in ilium, Indian ink was found in the bone which was (15.8±3.2) cm away from anterior superior iliac spine. In skin flap, Indian ink was found (8.6±2.4) cm superi-or, (5.4±2.6) cm inferior, (5.8±2.6) cm internal and (24.6±5.8) cm external from the anterior superior iliac spine. Laser Doppler flowmetry showed that the peripheral blood flow of skin flap increased as time passed, the increase speed began to tardy at the third day, then ingress the platform stage. Thirty-two cases were all succeed with functional rehabilitation and perfect shape. Thirty-one cases got completely bone healing; bone healing time ranged from 9 to 19 months, with an average of 12 months. One case turned to chronic os-teomyelitis, and had to suffer operation again, the bone healing time was 22 months. Conclusion As the ili-ae flap straddled donor area has sufficient blood supply, it can repair large defect of bone and soft tissue in one stage. 相似文献
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