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991.
目的:为了减少唇裂修复术中出血,便于手术操作,缩短手术时间,相对地减少手术的危险性。方法:利用压迫止血及滑杆的原理,自行设计制作了唇裂术止血减张固定器,经过动物实验证实,在2h以内不会对组织有任何不可逆损伤,并成功地应用于唇裂修复术中。结果:临床应用68例,与传统止血方法比较,术中出血明显减少,便于手术操作,而且安全可靠,在2h以内不会对上唇组织有任何不可逆损伤,手术的危险性相对地减少。结论:应用唇裂术止血减张固定器进行唇裂修复术,术中出血明显减少.手术时间明显缩短,手术的危险性相对地减少,对减轻术后切口瘢痕有利,值得临床推广应用。 相似文献
992.
Hiroomi Murayama Masanobu Meda Ken Miyahara Yoshimasa Sakai Hajime Sakurai Hiroki Hasegawa Akemi Kawamura 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(3):91-97
Objective: We assessed the current role of preoperative and intraoperative autologous blood donation in pediatric open-heart surgery.
Methods: Group 1 consisted of 51 patients between 5 and 10 years old who underwent preoperative autologous blood donation. Group
2 consisted of 50 age-matched patients without preoperative donation as controls. Intraoperative donation was conducted in
both groups prior to cardiopulmonary bypass. We evaluated perioperative blood cell count, blood loss, and the need for homologous
blood products. Results: No serious complications occurred in preoperative or intraoperative donation. Total preoperative donation storage was 17.5±3.4
mL/kg. Intraoperative donation was 21.7 ±6.1 mL/kg in Group 1 and 12.8±4.0 mL/kg in Group 2 (p<0.001). On admission, serum
hemoglobin was lower in Group 1 (12.2±1.0 g/dL versus 13.6±1.6 g/dL, p<0.001) but returned postoperatively to the preoperative
value. It hovered at a depressed level in Group 2 (12.2±1.4 versus 10.2±1.1 g/dL, p<0.001). The homologous blood requirement
was significantly less in Group 1 than in Group 2 (0% versus 10%, p<0.05). Postoperative platelet counts showed similar curves,
and blood loss was not statistically significantly different between groups. Conclusion: Preoperative and intraoperative donations are safe and continue to contribute uniquely to blood conservation, providing
important options in comprehensive blood conservation programs in current pediatric open-heart surgery. 相似文献
993.
Whole-cell patch-clamp recordings (WCR) were made from sympathetic preganglionic neurons (SPN) in neonate rat spinal cord slices. SPN were identified histologically by filling them with the fluorescent dye Lucifer Yellow contained within the patch pipette solution. Current clamp recordings were obtained from SPN with a potassium based pipette solution. The cells exhibited many of the characteristic properties of SPN seen previously with intracellular recordings in both the rat and the cat. However, we found an order of magnitude increase in both cell input resistance (950 MΩ) and time constant (118 ms) over those seen with conventional recordings. We believe these values approximate better the situation in intact cells, and will have a vital bearing upon how SPN integrate inputs. We conclude that WCR in spinal cord slices provides a powerful tool for investigating the cellular properties of SPN. 相似文献
994.
Diagnosis of somatisation: effect of an educational intervention in a cluster randomised controlled trial. 下载免费PDF全文
Marianne Rosendal Flemming Bro Per Fink Kaj Sparle Christensen Frede Olesen 《The British journal of general practice》2003,53(497):917-922
BACKGROUND: Somatisation is highly prevalent in primary care (present in 25% of visiting patients) but often goes unrecognised. Non-recognition may lead to ineffective treatment, risk of iatrogenic harm, and excessive use of healthcare services. AIM: To examine the effect of training on diagnosis of somatisation in routine clinical practice by general practitioners (GPs). DESIGN OF STUDY: Cluster randomised controlled trial, with practices as the randomisation unit. SETTING: Twenty-seven general practices (with a total of 43 GPs) in Vejle County, Denmark. METHOD: Intervention consisted of a multifaceted training programme (the TERM [The Extended Reattribution and Management] model). Patients were enrolled consecutively over a period of 13 working days. Psychiatric morbidity was assessed by means of a screening questionnaire. GPs categorised their diagnoses in another questionnaire. The primary outcome was GP diagnosis of somatisation and agreement with the screening questionnaire. RESULTS: GPs diagnosed somatisation less frequently than had previously been observed, but there was substantial variation between GPs. The difference between groups in the number of diagnoses of somatisation failed to reach the 5% significance (P = 0.094). However, the rate of diagnoses of medically unexplained physical symptoms was twice as high in the intervention group as in the control group (7.7% and 3.9%, respectively, P = 0.007). Examination of the agreement between GPs' diagnoses and the screening questionnaire revealed no significant difference between groups. CONCLUSION: Brief training increased GPs' awareness of medically unexplained physical symptoms. Diagnostic accuracy according to a screening questionnaire remained unaffected but was difficult to evaluate, as there is no agreement on a gold standard for somatisation in general practice. 相似文献
995.
老年性骨质疏松脊柱良性骨折与转移瘤性骨折的MRI鉴别 总被引:13,自引:0,他引:13
目的探讨脊椎骨质疏松性压缩骨折的MRI表现及其与转移性压缩骨折的鉴别诊断.资料与方法回顾性分析53例老年性骨质疏松伴压缩性骨折和20例转移性椎体压缩骨折患者的MRI资料.全部病例均行常规MRI检查(矢状位、横轴位).分析两者引起的压缩骨折MRI征象,包括椎体和椎弓根的形态及信号改变、椎间盘增厚、椎体内真空现象和椎旁软组织形态.探讨两者之间的差别.结果两者在椎体和椎弓根形态及信号、椎体内真空现象、椎旁软组织形态上存在非常显著性差异(P<0.01).结论 MRI能准确显示骨质疏松性压缩骨折的形态及信号,与转移瘤之间有显著差异,大多能对二者做出鉴别诊断. 相似文献
996.
997.
Nitin Gupta Saurabh Varshney S. S. Bist Pratima Gupta Rajat Bhatia 《Indian journal of otolaryngology and head and neck surgery》2007,59(4):309-312
Retropharyngeal abscesses were fairly common in preantibiotic era but the advent of antibiotics has reduced the overall incidence
of these abscesses. They still continue to occur specially in developing world and carry significant morbidity and even mortality
if not managed properly. The prevalence of this abscess in the young children pose a bigger challenge, as the examination
of oral cavity is difficult. Emphasis is placed on the age, sex, type, and duration of symptoms, bacteriology, methodology
of diagnosis, therapy and complications. With proper antibiotic cover and surgical management, majority of patients today
survive without major residual squeal. Hereby we present a series of 15 cases of retropharyngeal abscess. 相似文献
998.
999.
1000.
宫颈癌合并妊娠的发生率较低,但却是妊娠期最常见恶性肿瘤。妊娠期胎儿取舍问题的考虑会影响医患双方对宫颈癌治疗时间和治疗方案的选择,而宫颈癌也会影响到分娩方式的选择,从而影响围产儿的预后。近年来宫颈癌发病逐渐年轻化,如何处理两者的关系具有重要的临床意义。现综述近年来在宫颈癌合并妊娠的诊断及治疗等方面的研究进展。 相似文献