Medpor骨板在眼眶爆裂性骨折修复术中的应用

目的探讨应用Medpor骨板修复眼眶爆裂性骨折的手术方法及疗效。方法应用Medpor骨板作为充填材料施眼眶爆裂性骨折修复术28例,术后观察3个月~3年。结果 28例眼眶爆裂性骨折患者,其中单纯眶内壁骨折12例,单纯眶下壁骨折6例,眶内壁及下壁复合骨折10例。手术治愈19例(70%),好转9例(30%)。结论应用Medpor骨板作为充填材料治疗眼眶爆裂性骨折临床效果满意,安全可靠。     

经鼻内镜联合额窦前壁开窗双径路手术治疗额窦疾病

目的 探讨经鼻内镜联合额窦前壁开窗双径路治疗额窦疾病的手术指征.方法 回顾性分析24例经鼻内镜联合额窦前壁开窗双径路手术治疗额窦疾病的临床资料,其中额窦后壁粉碎性骨折并脑脊液漏16例、额窦骨瘤5例、额窦内翻性乳头状瘤2例、额窦内翻性乳头状瘤癌变1例.结果 16例额窦脑脊液漏均一次修补成功,5例额窦骨瘤、2例内翻性乳头状瘤和1例内翻性乳头状瘤癌变者均一次手术切除,术后完全恢复,无术中、术后并发症发生.手术后额窦脑脊液漏患者随访3～132个月;额窦骨瘤患者随访8～38个月;额窦内翻性乳头状瘤及癌变患者随访7～42个月,中位随访时间36个月,病变均元复发,额窦引流通畅,额部无影响容貌的缺陷.结论病变主体位于额窦后壁、有复发倾向或恶性病变,以及病变范围或手术部位的外侧界限超越眶纸板平面是经鼻内镜联合额窦前壁开窗双径路的手术指征.     

计算机辅助鼻额区域影像解剖学研究

OBJECTIVE: To evaluate the value of Advantage Windows 3.1 (AW 3.1) software for anatomical study of nasofrontal region, and to study the CT characteristics of nasofrontal region which related to the frontal sinus surgery. METHODS: Eighty patients underwent axial consecutive computed tomography scans and these data were studied with AW 3.1 software which provided reconstructional imaging of continuous coronal, sagittal, axial sections. Some related structures of nasofrontal region were studied and measured. RESULTS: AW 3.1 software could identify and measure the following structures accurately: The diameter of frontal sinus was (22.5 +/- 8.6) mm in height, (16.3 +/- 6.8) mm in depth, (23.8 +/- 9.8) mm in breadth. The diameter of frontal sinus ostium: the anterior-posterior diameter was (7.3 +/- 1.7) mm, the transverse diameter was (8.5 +/- 1.9) mm. The width of nasal beak of frontal bone(5.9 +/- 1.4 ) mm. The distance of frontal sinus ostium to the floor of columella nasi and the corresponding angle to the nasal floor were (60.8 +/- 4.2) mm and (70.1 +/- 4.7) degrees. The superior attachment sites of the uncinate process were as follows: lamina papyracea 41%, posteromedial wall of agger nasi cell 11%, middle turbinate 19%, anterior skull base 16%, superior bifurcation 13%. The cells could impinge on the frontal recess to cause obstruction (terminal recess 38.8%, anterior ethmoid cell 27.6%, agger nasi cells 24.5%). The accessory cells could impinge on the frontal sinus (perifrontal cells 32.7%, superaorbital cells 38.8%, intersinus septal cells 32.0%). There was significant difference between two groups of characteristics of nasofrontal region. CONCLUSIONS: AW 3.1 software is a helpful and powerful new tool for anatomical study of nasofrontal region and for preoperative evaluation. The structures of nasofrontal region are complex and various, frontal sinusitis almost always results from the obstruction of frontal sinus outflow tract. These results of anatomical study of nasofrontal region are helpful in directing the functional endoscopic surgery in frontal sinus.     

慢性鼻及鼻窦炎并眶内炎性假瘤1例

1临床资料患者,男性,51岁,因右眼突出、睁眼困难伴视力下降2个月余入院。患者缘于2个月前无明显诱因出现右眼胀痛并突出、睁眼困难、复视,视力轻度下降,到当地医院就诊诊断为右眼动眼神经麻痹,入院并给予营养神经、改善微循环治疗2周,2周后右眼突出加重并固定,视力下降为光感,为求进一步诊治来我院,既往13年前有车祸致鼻部及右眼外伤史。     

前路开眶治疗眼眶肿瘤26例临床观察

眼眶肿瘤是眼科常见病,其患病率占眼眶病的第二位^[1]。对位于眼球后的肿瘤既往常采用侧壁开眶的方法摘除肿瘤,但侧壁开眶对病人损伤大,术后恢复较慢。近年来,我们采用前路开眶的方法对26例肿瘤位于球后及球周的患者行肿瘤摘除,取得了较好的效果,现报告如下。     

皮层下动脉硬化性脑病120例临床表现与CT分析

目的探讨皮层下动脉硬化性脑病（SAE）的临床表现及头颅CT特点,旨在提高对皮层下动脉硬化性脑病的诊断,以便及早治疗。方法对120例经临床和头颅CT诊断为SAE患者的临床资料进行回顾性分析。结果常发病于50岁以上;高血压为其主要病因;脑CT均表现为不同的白质疏松及脑梗死;临床表现为进行性智力障碍,可有不同程度局灶神经系统缺损体征。结论 SAE的直接病因是高血压,对有长期高血压和进展性痴呆伴多发腔隙性卒中者,结合头颅CT白质疏松改变可考虑诊断本病,给予及时治疗可提高患者生存质量,减少病死率。     

Effects of electroacupuncture on hippocampal and cortical apoptosis in a mouse model of cerebral ischemia-reperfusion injury

Objective: To observe the effects of electroacupuncture on hippocampal and cortical apoptosis in a mouse model of cerebral ischemia-reperfusion injury.Methods: Mouse models established by repeated cerebral ischemia-reperfusion,followed by electroacupuncture at Shenshu,Geshu,and Baihui points.The control group mice were intragastrically administered Hydergine.On day 1 and 7 post-treatment,hippocampal and cortical apoptosis was detected by terminal-deoxynucleotidyl transferase mediated dUTP nick-end labeling (TUNEL),and apoptosis images in the hippocampal CA1 zone and cortical area were analyzed.Results: In the model group,apoptotic cells were detected one day after treatment and some cellular fibers were disarrayed.By day 7 post-treatment,there was an increase in the number of apoptotic cells in the hippocampal CA1 region.In addition,there were apoptotic cells in the cortical area,the cortical Jayers were thinner with localized neuronal loss and sieve-like lymphocyte infiltration,as well as glial cell proliferation and visible infarct lesions.However,in the Hydergine and electroacupuncture groups,there was a small number of apoptotic cells.At 7 days post-treatment in the model group,field number,numerical density on area,and surface density were increased.However,in the Hydergine and electroacupuncture groups these parameters were decreased (P＜0.01),with a significant difference between the two treatment groups (P＜0.01).Conclusion: Electroacupuncture treatment inhibited apoptosis and provided neuroprotection.     

眼眶前额皮层在执行功能中的作用

近年来,关于大脑前额叶执行功能及其发展的研究成为国内外认知神经科学研究的新热点。因为执行功能的障碍会导致患者产生认知、情绪和社会功能等方面的异常,因此,对大脑执行功能的研究既具有重大的理论意义,也具有重要的现实意义。在理论上,研究执行功能使我们能够了解大脑亿万神经元的分布活动如何产生协调有序、具有目的性的行为,从而为揭示大脑一心灵或身心关系问题开辟广阔的前景;在实践中,研究前额叶的执行功能有助于我们对脑损伤病人和精神病人的诊断和治疗,对多动症儿童和行为问题儿童的了解和帮助,对一些社会现象和心理健康问题的理解和懈释．     

经鼻填充鼻中隔软骨修复眶内侧壁骨折

目的：探讨应用鼻内镜填充鼻中隔软骨,修复眶内侧壁骨折,经鼻做眼部手术的可能性。方法：选取眶内侧壁骨折患者11例（11眼）,术前检查均有不同程度的眼球内陷、复视、视力减退症状,行眼眶CT诊有眶内容物疝入筛窦并伴积液,其中6例内直肌肿胀。手术开始在内镜直视指引下,经鼻腔开放筛窦,摘除筛房,暴露骨折的纸板,将疝入物回纳眶内,鼻中隔软骨覆盖骨折区。结果：患者手术后全部治愈。双眼突出度相差≤1mm,平均0.11mm。视力较术前不改变或者略有改善。鼻内镜检查见筛窦术腔上皮化,填充的鼻中隔软骨无移动,无感染及排斥现象。结论：经鼻填充鼻中隔软骨修复眶内侧壁骨折方法简便,成功率高。自体鼻中隔软骨无排斥反应。     

额颞部美学分区联合高密度脂肪移植的面部美化年轻化治疗的效果

目的使自体脂肪面部移植的年轻化治疗更加符合面部美学形态, 提高治疗效果。方法 2017年12月至2020年5月, 郑州美莱医疗美容医院要求面部年轻化女性患者425例, 年龄18～55(33±6)岁。按额颞部美学分区指导行自体高密度脂肪面部移植治疗。结果 425例患者术后3个月评估效果, 填充1次外观形态满意376例(88.5%), 49例不满意, 其中45例行2次补充注射。2次填充后满意420例, 占98.8%。未出现严重术后并发症。结论按照额颞部美学分区结合自体高密度脂肪移植行面部年轻化治疗, 术后形态自然, 满意度较高。