Hemispheric cerebrovascular venous thrombosis due to closed head injury

Case report We present the case of an 8-month-old infant who was admitted to our Neurosurgery Department with venous infarction related to sagittal sinus thrombosis. The infarction was radiologically detected 5 days after the baby had undergone surgery for acute subdural hematoma due to a closed head injury.Results and conclusions Cerebrovascular venous thrombosis is a rare clinical entity that has multiple causes and variable presenting symptoms. There is no consensus on overall strategy concerning surgical, radiosurgical, or medical therapy (anti-coagulation, thrombolytic, and anti-edema treatment), and exactly how, when, or in which cases these should be applied. The treatment planning should be based on clinical findings, and should be modified according to the clinical course. In this case, the clinical and radiological findings regressed with symptomatic treatment alone.     

Clinical study of biocompatibility between open and closed heparin-coated cardiopulmonary bypass circuits

The objective of this study was to investigate the difference between the closed circuit system and the open circuit system in clinical heparin-coated cardiopulmonary bypass (CPB) circuits with a centrifugal pump. We evaluated the coagulation, fibrinolysis, and inflammatory response in valvular heart surgery. Nineteen patients were assigned at random to a group for the closed circuit system or the open circuit system. This is the first report on the effect of a closed circuit in valvular surgery. We measured the platelet count, white blood cell count, plasma fibrinogen concentration, thrombin–antithrombin III complex, plasmin-2 plasmin inhibitor complex, D-dimer, interleukin-6, polymorphic neutrophil-elastase, and the plasma free hemoglobin. Blood samples were collected before the start of perfusion, 15 and 60min after the start of perfusion, 60min after the administration of protamine, and 1 day after the operation. During the perfusion, coagulation, fibrinolysis, and inflammatory responses were activated; however, no significant differences between the two groups were noted. In this clinical investigation with suction and the cell saving system, the closed circuit was not found to be superior to the open circuit with regard to biocompatibility.     

Comparison of effectiveness of two urinary drainage systems in intensive care unit: a prospective,randomized clinical trial

Objective In a previous nonrandomized study we observed no difference in the rate of acquisition of bacteriuria between a complex closed drainage system (CCDS) and a two-chamber drainage system (TCDS) in ICU patients. To confirm this result we performed a statistically powerful study assessing the effectiveness of the CCDS and the TCDS in ICU patients.Design and setting Randomized, prospective, and controlled study in the medicosurgical intensive care unit (16 beds) in a teaching hospital.Patients and interventions We assigned 311 patients requiring indwelling urinary catheter for longer than 48 h to TCDS or CCDS to compare the rate of acquisition of bacteriuria.Measurements and results Patients did not receive prophylactic antibiotics during placement management or catheter withdrawal. Urine samples were obtained weekly for the duration of catheterization and within 24 h after catheter removal, and each time symptoms of urinary infection were suspected. There was no statistical difference in the rate of bacteriuria between the two groups: 8% with TCDS and 8.5% with CCDS. Rates of urinary tract infection were 12.1 episodes with TCDS and 12.8 episodes with CCDS per 1000 days of catheter.Conclusions This randomized study on the effectiveness of TCDS and CCDS in ICU patients confirms the findings of our previous study. No differences were noted between the two systems. The higher cost of CCDS is not justified for ICU patients.An erratum to this article can be found at     

Five-Year Experience on Ultrasonic Treatment of Breast Contractures

The authors report their experience in five years of treating breast implant capsular contractures with an external ultrasonic device that facilitates the closed capsulotomy technique. A set of 52 patients have been treated with a 82.6% of improvement at a year follow up. Methods of application and results are discussed.     

闭合性胰腺损伤26例临床分析

胰腺因其位置深居腹膜后，闭合性胰腺损伤早期症状和体征轻微，且无特征性，易误诊；近几年在胰腺损伤的诊治方法上，已有了很大的进步，但保守治疗和手术治疗上仍存在着争议。为探讨闭合性胰腺损伤的临床诊断方法和治疗措施，减少病死率，现总结大连中山区人民医院收治的闭合性胰腺损伤26例，报道如下。     

早期高压氧治疗闭合性脑损伤的观察及护理干预

目的探讨早期高压氧治疗闭合性脑损伤的疗效。方法将120例闭合性脑损伤患者随机分为2组各60例,对照组给予常规治疗,观察组在此基础上给予高压氧治疗。结果观察组有效率97%,伤残率3%,对照组分别为76.7%、25%,两组比较有显著性差异（P〈0.05）。结论早期应用高压氧治疗闭合性脑损伤患者,可明显提高疗效,降低伤残率,改善预后。     

撬拨复位克氏针内固定治疗Sanders Ⅱ型跟骨舌形骨折

目的:探讨采用闭合撬拨复位,克氏针内固定治疗Sanders Ⅱ型跟骨舌形骨折的方法和疗效.方法:在术中透视及CT监测下,采用闭合撬拨复位,克氏针内固定治疗Sanders Ⅱ型跟骨舌形骨折22例,复位后经术中影像学检查,要求后跟距关节面解剖复位,恢复跟骨的长度、宽度、高度和B hler角、Gissane角,克氏针内固定结合石膏外固定.术后6周去除石膏,8周拔除克氏针,逐步负重.术后6月内每月进行随访1次.结果:22例均获得随访,时间18～24月,平均16.8月.骨折全部愈合,术前Bhler角平均8.1度,术后平均35.4度;术前Gissane角平均108.4度,术后平均114.5度.术后1年的AOFAS评分平均83.5分.结论:采用闭合撬拨复位,克氏针内固定的方法治疗Sanders Ⅱ型跟骨舌形骨折,能有效保证跟距关节后关节面的解剖复位,恢复跟骨的解剖形态,手术损伤小,术后外观、功能恢复满意.     

心房间隔缺损闭式修补术

总结２１８例心房间隔缺损闭式修补术的经验。方法手术方法有三种：埋藏内褥式，外褥式带垫片缝合和埋藏内“８”字缝合。房间隔缺损直径为０．８－４．５ｃｍ，其中２例伴有右上肺静脉畸形引流。结果本组病例无死亡，术后随访发现房间 通者４例，其余病例均恢复良好。     

闭合复位空心加压钉固定治疗老年股骨转子间骨折

目的探讨闭合复位空心加压钉固定治疗老年股骨转子间骨折的效果。方法2002年4月～2006年7月对58例老年股骨转子间骨折手术在C形臂X线机定位下采用骨折闭合复位空心加压钉固定。结果手术时间40～70min,平均55min。术中出血量30～40ml,平均35ml。术后住院时间3～10d,平均6.5d。58例骨折端全部愈合。参照股骨转子间骨折疗效评定标准：优28例,良25例,可3例,差2例,优良率91.4%（53/58）。结论闭合复位空心加压钉固定手术治疗老年股骨转子间骨折疗效满意。     

闭合性肝破裂临床诊治资料分析

目的探索未来战争中闭合性肝脏破裂的早期诊断方法 ,为及时分级救治、挽救生命、减少并发症、降低病死率提供依据。方法回顾分析笔者所在医院136例闭合性肝破裂。其中术前明确诊断为肝脏破裂109例中CT检查97例,超声检查116例,分别确诊94、93例;其余均为手术探查确诊。未确诊者,及时行腹腔穿刺抽出不凝性血液后术中探查确诊。结果痊愈出院135例,1例死于多脏器功能障碍综合征。17例出现并发症者均经治愈出院。结论外伤性肝破裂的临床表现易被合并其它伤的症状掩盖,早期诊断较困难;CT、超声检查及腹腔穿刺有助于早期诊断。重视肝破裂的早期确诊,及时合理治疗有利于减少并发症和降低病死率。