延期植皮术治疗功能部位烧伤后慢性溃疡的价值

延期植皮术由于皮片成活率高，近几年在创面修复中的应用逐渐受到重视。1998～2003年，我们用延期植皮术治疗功能部位烧伤后慢性溃疡20例，效果良好。现报告如下。     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.     

两种方法保存人体透明软骨行异种移植的实验研究

目的　探讨不同方法保存的人体透明软骨 ,异种移植后软骨存活的动态变化及在整形外科应用的可行性。　方法　选择 4 8只新西兰种成年白兔 ,随机分为两组 ,每组 2 4只 ,分别接受 - 198℃液氮冷冻和 75 %酒精灭活法保存的人体透明软骨移植 ,观察一年。术后每 3个月比较两组血清IgG、IgM、IgA、C3、C4 、PFB(补体B因子 )含量 ,每月随机抽取两组各两只兔子取移植软骨块观察其外形、色泽 ,测重量。比较光学显微镜和透射电镜下的组织学变化。　结果　两实验组各时间点IgG、IgM、IgA、C3、C4 、PFB含量与术前相比无显著性差异 ,P >0 0 5。深低温保存法软骨移植后 1- 2个月内重量略有增加 ,3个月重量开始减少 ,至 1年达最低点。光学显微镜下观察 ,2个月可见新生不成熟软骨细胞。 3个月时软骨开始出现退行性变 ,至 6个月时明显加重。酒精灭活移植软骨重量无明显变化 ,仅在 6个月时开始出现轻度退行性变。透射电镜下观察的变化规律基本与光学显微镜下的观察结果相一致。结论酒精灭活法保存的人体透明软骨用于异种移植后 ,外型变化小 ,提示其临床应用可行性优于液氮冷冻保存法。     

人工气道417例的应用体会

应用人工气道救治重危病人在国内已逐渐普及。本文分析了我们两家医院1992年1月-1994年12月在抢救危重病人时建立人工气道的417例临床资料，以供参考。1一般资料男性241例，女性176例。年龄5-89岁（58．6±11．3岁）。417例中，329例进行了机械通气。原发病见表1。2人工气道建立的方式见表2。注：。采用两种方式者，以应用时间长的一种作统计，2例永久带管者除外2．1经鼻气管插管适于自主呼吸存在者。插管前增大吸氧流量，鼻孔内滴入1％利多卡因和1％麻黄素。清醒者部分病人咽部和经环甲膜穿刺用利多卡因麻醉。检查气囊是否漏气。塑料导管在…     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.     

利用负压封闭引流治疗糖尿病坏疽并坏死性筋膜炎1例

糖尿病坏疽是由于下肢中小血管病变及微循环障碍,周围神经病变等因素导致的严重感染,由于感染等因素破坏组织严重,糖尿病肢端坏疽截肢率高达38.1%～75.0%.1,2 近年来兴起的负压封闭引流术VSD技术,具有促进坏死组织、细菌清除,促进肉芽组织生长的作用,我们将此技术试用于1例强烈要求保肢的糖尿病坏疽患者,现报道如下.     

磨痂术在深Ⅱ度烧伤创面早期处理中的应用研究进展

深Ⅱ度烧伤一直是烧伤外科学领域研究与治疗的重点和难点[1].尽早去除坏死组织,可有效减轻烧伤创面过度炎症反应,避免创面加深,促进创面较好愈合,减轻瘢痕形成.临床上,去除深Ⅱ度烧伤坏死组织的方法有多种,如:削痂、酶或中药溶痂、激光或超声物理清创等.近年来,磨痂术在深Ⅱ度烧伤创面中的应用越来越受到重视.本文就磨痂术在烧伤创面早期处理中的应用进展进行综述.     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.     

多层真皮-脂肪重叠移植在进行性单侧面萎缩整形术中的应用

进行性单侧面萎缩(progressive facial hemiatrophy,PFHA),是一种病因尚不明、少见的以单侧面部皮肤、皮下组织及骨结构萎缩为特征命名的疾病,其中皮下组织受影响最为严重,极少波及双侧.首先由Parry于1825年报道,其后Romberg在1846年又详细描述了本病的典型特征,故又称为Parry-Romberg综合征[1].     

皮肤扩张器治疗回状颅皮

回状颅皮又称皱褶性厚皮病 ,临床上较为少见 ,特点为惯发于头顶及枕部 ,类似皮肤松垂 ,在头皮上折叠 ,形成状若脑回的嵴和沟。嵴可以有 2～ 2 0条 ,约 0 .5～ 2ｃｍ宽 ,沟深 1ｃｍ。我科自 1989～ 1998年 ,共收治回状颅皮 12例 ,应用皮肤扩张器治疗 ,取得良好效果 ,报告如下。一、临床资料 :本组男性 10例 ,女性 2例 ,年龄最大 5 4岁 ,最小 16岁 ,头枕部 9例 ,头顶部 3例 ,最小面积 3ｃｍ× 8ｃｍ ,最大面积 9ｃｍ× 15ｃｍ。注入生理盐水量最多为 760ｍｌ ,最少为2 2 0ｍｌ ,扩张时间最长为 3个月 ,最短为 1个月。二、讨论 :回状颅皮根据头…