颈总动脉损伤致呼吸心跳骤停1例急救与护理体会

<正> 我院于1993年底治左颈总动脉损伤致失血性休克、呼吸心跳骤停患者一例。抢求成功。现将救治体会总结如下。1 临床资料     

指背皮支链皮瓣修复手指背侧组织缺损的临床应用

目的　探讨指背皮支链皮瓣修复手指背侧组织缺损的手术方法和疗效。 方法　应用指背皮支链皮瓣修复手指背侧组织缺损10例,切取皮瓣面积 1.0 cm×1.5 cm~2.0 cm×3.0 cm。 结果　术后仅1例远端出现表皮积液,经相应处理,皮瓣均成活,术后随访3~12 月。皮瓣修复后手指外形美观,转移皮瓣外观良好,色泽自然,质地柔软,不臃肿,手指各关节活动功能优良。 结论　指背皮支链皮瓣血供恒定,不牺牲指动脉,皮瓣设计简易,切取方便,是修复手指背侧组织缺损的简单、安全、有效的方法。     

上、下坡跑台训练膝骨关节炎模型大鼠关节软骨及炎症因子的变化

BACKGROUND: Different training methods have different effects on primary knee osteoarthritis. OBJECTIVE: To compare the effects of uphill or downhill running on articular cartilage degeneration and inflammatory responses of knee osteoarthritis rats.   METHODS: 108 female Sprague-Dawley rats were randomly divided into six groups: normal control group, ovariectomized group, uphill running group (run & up), downhill running group (run & down), uphill running model group (model & up), downhill running model group (model & down). The rats in the normal control group were raised routinely with no treatment; rats in the ovariectomized group were ovarientomized and raised in routine way; rats in the run & up group and run & down group were subjected to uphill running training on the slop +15° or downhill running training on the slop -15°; rats in the model & up group and model & down group were subjected to uphill running training on the slop +15°or downhill running training on the slop -15° after ovarientomized. Training programs were as follows: 28 m/min, 60 minutes per day, 6 days per week. RESULTS AND CONCLUSION: Compared with the other five groups, in the model & up group, the Mankin’s score was significantly increased, indicating that articular cartilage degeneration occurred, and the peak of carboxy-terminal telopeptide of type II collagen contained in the urine had passed, at 4 weeks after modeling. At 6 weeks, the Mankin’s score of the model & down group was increased to reach the degeneration standard, but it was still lower than that of the model & up group; the expression levels of tumor necrosis factor-α and interleukin-1β in the synovial fluid were significantly higher in the model & up and model & down groups than the other four groups. At 8 weeks, the Mankin’s score and the expression levels of tumor necrosis factor-α and interleukin-1β were further increased in the model & up and model & down groups, especially in the model & up group. These results indicate that treadmill running exercise after ovariectomized can result in articular cartilage injury and local inflammatory responses; compared with the downhill running training, the uphill running training can cause cartilage injury earlier and more efficiently.      

延期烧伤创面实施MEBT/MEBO治疗100例

目的：探讨MEBO对延期烧伤创面的治疗效果。方法：回顾性分析1997-2005年100例延期烧伤创面治疗效果。结果：全部达到临床治愈,未出现任何并发症。结论：延期烧伤创面实行MEBT／MEBO治疗同样可产生良好的治疗作用。     

一期前路病灶清除、钛网融合器植入内固定术治疗脊柱结核

目的 探讨脊柱结核一期前路病灶清除、钛网融合器植入加内固定手术对胸腰椎结核的治疗效果.方法 2005年10月～2009年10月行脊柱一期前路病灶清除、钛网融合器植入加内固定治疗胸腰椎结核患者131例,观察手术后椎体融合情况、结核复发情况、神经症状恢复情况、纠正畸形情况及术后并发症.结果 本组随访6～24个月(平均12个月),重建后的椎体稳定,无内植物的移位,1例内固定松动;后凸畸形较术前平均改进17°;3例结核复发;神经功能改善率为94.26%,神经功能完全恢复率为75.41%;3例出现下肢静脉血栓形成,其中1例出现肺栓塞,经积极治疗症状消除.结论 脊柱前路结核病灶清除、钛网融合器植入内固定手术具有矫正畸形、加速骨融合、预防结核复发、内固定确切和减少术后并发症的优点,疗效满意.     

分化型甲状腺癌应用全甲状腺切除术与次全甲状腺切除术的疗效及安全性比较

目的 探讨分化型甲状腺癌(DTC)应用全甲状腺切除术与次全甲状腺切除术的疗效及安全性.方法 选取我院2017年8月至2018年8月收纳的确诊为DTC患者200例,其中100例患者进行全甲状腺切除术,即全切组,此外100例患者进行患侧峡部以及腺叶切除,即次切组,依据手术方法 的不同将其分为全切组与次切组各100例,比较两...     

刻意再植术治疗难治性根尖周炎的预后及相关因素分析

目的：评价刻意再植术治疗难治性根尖周炎的疗效以及影响再植预后的相关因素。方法：回顾分析2001年因难治性根尖周炎,临床建议拔除患者5例7个患牙,经即刻拔除再植术＋根管充填治疗5年后的临床资料。其中,5例患者均为45岁以上,年龄最大56岁,女性3例,5个患牙,3个磨牙,2个前磨牙;男性2例,前磨牙和磨牙各1个。上述患牙均在局麻下拔除术、牙齿离体后30min内完成根尖周变性组织湿法刮除术、根管充填术、牙体缺损即刻解剖性外形修复术,再植复位术。结果：术后5年复查,所有患牙均存留,牙龈附着正常,牙体活动度在Ⅰ度内,咀嚼功能良好,X光检查均达到牙周膜或骨性愈合。结论：根尖生物膜与难治性根尖周炎的发生密切相关,牙齿再植术能有效地清除病灶区的整个生物膜,彻底根治生物膜引起的难治性和慢性感染,为临床降低医源性牙齿缺失提供了一种新途径。     

疾病预防控制中心疫苗管理模式探讨

2005年6月1日国务院《疫苗流通和预防接种管理条例》(下简称《条例》)的正式颁布执行,改变了疾病预防控制机构对疫苗使用的统一管理模式.但疫苗不是普通药品,更不是一般商品,一旦在采购、选择及使用过程中出现任何差错,都将造成严重后果.为重新建立一套适合相关法律法规的新的管理模式.我们对相关情况进行了探讨.1条例生效后面临的问题1.1管理部门控制力下降2005年6月1日《条例》正式生效.     

锥颅单孔双管冲洗引流治疗慢性硬膜下血肿(附26例报告)

慢性硬膜下血肿（ＣＳＤＨ）采用骨瓣开颅等手术治疗有诸多不利之处［１］。１９９６年１０月～１９９８年１０月,我们对手术方式进行了改进,采用锥颅单孔双管冲洗引流术治疗２６例,取得了满意效果。报告如下。１　临床资料１．１　一般资料　２６例中男１９例,女７例,年龄１８～８８岁,平均４９．２岁。有头部外伤史２１例,原因不明５例。从发病至入院时间最长６个月,最短１５ｄ,平均５９．５ｄ。１．２　发病形式　以头痛起病２３例,其中２例卧床２个月;轻偏瘫１４例,反应迟钝、记忆力下降６例,均为６０岁以上患者;伴视神经…