可吸收线连续缝合在无张力腹外疝修补术中的应用

目的探讨可吸收线连续缝合在腹外疝无张力修补术中应用的安全性及效果。方法使用可吸收线连续缝合无张力疝修补术治疗腹股沟疝79例、切口疝4例,观察术后疼痛、切口感染、慢性疼痛及复发等并发症。结果83例术后随访6个月～5年,1例右下肢高位截肢后同侧巨大斜疝病人发生术后疝囊残腔积液,无复发;其余病例无因局部疼痛用止痛剂者,无切口感染、浆液肿、阴囊血肿、疝复发、睾丸萎缩等并发症。结论可吸收线连续缝合在腹外疝无张力修补术中的使用可减少复发、疼痛、感染等并发症,安全有效。     

Propagation of Tears in Pericardium From Young Bulls: Influence of the Suture

The tearing of the collagen fibers of biological materials utilized in implants or bioprostheses is an important, and sometimes early cause of the failure of these devices. We studied the force necessary to propagate a tear in a biomaterial, pericardium from young bulls, and the influence of the suture. An Elmendorf pendulum capable of measuring the force necessary to tear a given length of tissue was employed. We analyzed 112 trials (70%) that proved valid after achieving the homogeneity of the samples according to their thickness, thus making the results comparable. Mean forces ranging between 19.87 and 150 N were required to propagate tears measuring from 0.25 to 2.0 cm. In the samples with a 1‐cm‐long suture, sewn using an edge‐to‐edge technique, the propagation of the tear required a mean force of 15.75 N when the suture was made of nylon and 28.73 N when Prolene was utilized. When these results were compared with the mean recorded in an unsutured control series (56.76 N), the loss of resistance was significant in both sutured series (P = 0.000 and P = 0.011, respectively). Finally, the equation that relates the force (y) with the length of the tear made in unsutured tissue (x) was also obtained: y = 58.14 + 9.62x² (R² = 0.924). The force necessary to produce a microtear, thus estimated, can be utilized as a parameter for comparison.     

腭咽环扎线在组织中的变化

将临床使用的3种环扎材料分别植入64只家兔肌肉及皮下组织中,动态观察术后4d至24W中的拉力变化和组织反应。结果表明,各种环扎线的拉力均在一定时间后丧失;线本身也逐渐被坚实致密的纤维结缔组织疤痕取代。组织对环扎线的反应顺序为肠线>丝线>阔筋膜。丝线组织反应比肠线轻,拉力保持性能较阔筋膜好,且来源方便,应为腭咽环扎术首选。     

Vascular anastomoses with absorbable suture material: An experimental study

A synthetic, monofilament, absorbable suture material, polytrimethylene carbonate, was tested to determine its suitability for use in arterial anastomoses. The material studied is a copolymer made of trimethylene carbonate and polyglycolic acid, with a retention time in the tissue of up to six months. In an experimental group of 12 mongrel dogs, using simple end-to-end anastomoses, aortic and femoral patch grafts of bovine heterograft material and iliofemoral bypass implants of 5 mm of expanded polytetrafluoroethylene prostheses were performed and arteriographically and histologically documented. Direct intraindividual comparisons were made with the absorbable (polytrimethylene carbonate) and nonabsorbable (polypropylene, expanded polytetrafluoroethylene suture) materials, a total of 108 anastomoses. No suture material-related complications such as ruptures or suture line aneurysms occurred. Polytrimethylene carbonate sutures led to less inflammation and scar tissue formation than polypropylene sutures. Complete absorption of the suture material by hydrolytic decomposition was followed by an almost complete regeneration in all layers of the vessel wall. Regeneration of the connective tissue structures of the media was noted. Initial associated reactions in the intima eventually disappeared. Both suture materials were equivalent histologically in the early months of the study, but after 10 month follow-up differences were observed, especially in the structure of the media, apart from the fact that polytrimethylene carbonate is absorbed completely after four to seven months.     

周围神经粘合与缝合的比较研究

报告用三种不同的粘合剂吻接周围神经的修复效果，并与缝合法进行了比较。将６０只大白鼠随机分为４组，每组１５只。切断左侧坐骨神经。Ⅰ组用纤维蛋白粘合剂吻接神经，Ⅱ组用酶粘合剂粘接神经，Ⅲ组用ＺＴ胶行神经外膜对合，Ⅳ组用９－１０缝合针线行常规神经外膜缝合。术后１、２、３月时将每组动物各取５只检测。动态观测诱发肌电图、光镜及电镜下超微结构的变化以评价其修复效果。结果表明，粘合法是一种修复周围神经损伤的有效     

针刺颅骨缝治疗脑血管疾病的应用解剖

目的：为针刺颅骨缝治疗脑血管疾　病提供临床实用表面解剖数据。方法：用等分规、量角规、卷尺、卡尺　等测量器对２９颗成年正常完整干燥颅骨标本的矢状缝（Ｌ１）、冠状缝（Ｌ２）、人字缝（Ｌ３）　、翼颞部骨缝（Ｌ４～Ｌ６）骨性固定标志间距离、夹角（峤恰⑩角）进行观测。　结果：Ｌ１为１０．４６±０．９０ｃｍ，Ｌ２为１２．０３±０．９１ｃｍ　，Ｌ３为６．７３±０．７２ｃｍ，Ｌ４为２．７１±０．４１　ｃｍ，Ｌ５为６．０９±０　．４２　ｃｍ，Ｌ６为９．６６±０．９９　ｃｍ，峤亲１８．９３±４．０２度，右１７．４１±４．０６度；　饨１１１．１０±９．９２度。结论：观测颅骨缝所得数据的同身寸简化法，　准确、实用，可供临床头针治疗参考。     

倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术中的应用

目的探讨单向倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术中应用的安全性及有效性。方法将2014年6月至2016年6月期间60例行腹腔镜胃十二指肠溃疡穿孔修补术的患者分为两组,其中32例采用传统可吸收线缝合为传统缝线组,28例采用倒刺线缝合为倒刺线组,采用SPSS 17.0统计软件分析两组资料,缝合时间、手术时间、术中出血、术后住院时间采用均数±标准差表示,采用t检验;术后并发症计数资料采用χ~2检验;P0.05为差异具有统计学意义。结果所有患者均成功完成手术,无中转开腹,围手术期无并发症发生。两组患者术前一般资料、术中出血、术后住院时间差异均无统计学意义(均P0.05),但倒刺线组缝合时间[(6.4±2.8)min比(41.8±6.5)min]、手术时间[(18.6±4.5)min比(65.8±8.3)min]均明显少于传统缝线组(均P0.05)。60例均获得随访。随访时间3~22个月,平均随访11.5个月。所有患者出院1~3个月返院行胃镜检查,无幽门狭窄、溃疡出血等。结论倒刺缝线在腹腔镜胃十二指肠溃疡穿孔修补术的应用是安全有效,能够缩短缝合时间及手术时间,降低腹腔镜下缝合难度,缩短学习曲线,值得在临床上广泛应用。     

Expression of In Vivo Mechanical Strain upon Different Wave Forms of Exogenous Forces in Rabbit Craniofacial Sutures

Sutures are fibrous joints between craniofacial bones, providing an interesting model for studying the biomechanics of the interface between soft and mineralized tissues. To explore whether different wave forms of exogenous forces induce corresponding sutural strain wave forms, sutural strain of the premaxillomaxillary suture (PMS) and nasofrontal suture (NFS) of New Zealand White rabbits (N=8) was recorded upon application of static, sine- and square-wave forces against the maxilla from 1 N to 5 N in 1 N increments. The PMS demonstrated compressive strain, whereas the NFS tensile strain. Despite a tenfold difference in peak PMS strain (-1451 ± 512 ) and NFS strain (141 ± 39 ) in response to 5 N cyclic forces, wave forms of exogenous forces were expressed as corresponding wave forms of sutural strain in both the PMS and NFS. Peak sutural strain was similar upon static and sine-wave cyclic loading. Thus, cells and matrix components of fibrous sutural tissue experience different wave forms of exogenous forces as corresponding wave forms of tissue-borne mechanical strain. Current craniofacial orthopedic therapies exclusively utilize static forces to change the shape of craniofacial bones via mechanically induced bone apposition and resorption. The present data provide room for exploring whether cyclic forces capable of inducing different sutural strain wave forms may accelerate sutural anabolic or catabolic responses. © 2003 Biomedical Engineering Society. PAC2003: 8719Rr     

快微乔线皮内缝合法在会阴缝合术中的应用

目的：探讨快微乔线皮内缝合法在会阴缝合术中的临床应用价值。方法;用１个零的快微乔线,阴道粘膜连续缝合,会阴部肌层和皮下脂肪层间断缝合。皮肤行内缝处理,紧贴皮下褥式穿行,线结打在皮内,术后不用拆线。结果;会阴部切口愈合佳,无水肿,硬结,疼痛轻,不留疤痕。     

关节镜下规避骺板“8”字法缝线固定治疗急性儿童前交叉韧带胫骨止点撕脱性骨折

目的：选取该院探讨关节镜下实施规避骺板“8”字法缝线固定术治疗急性儿童前交叉韧带胫骨止点撕脱性骨折的临床疗效。方法2011年3月-2015年3月收治的关节镜下膝关节前内、外侧及辅助正中入路,采用“8”字法缝线固定治疗急性儿童膝关节前交叉韧带胫骨止点撕脱性骨折的22例患者进行回顾性分析,术后随访2年(14~32个月,平均26个月),对其进行临床评价,包括前抽屉试验、Lachman试验评价膝关节稳定性,根据Lysholm评分、IKDC评分及Tegner评分来术后评价膝关节功能,术后骨折部位X线及CT评价骨折复位愈合情况。结果术后3个月 X线及CT片示骨折均为解剖复位或近解剖复位,均达到骨性愈合。患者前抽屉试验Lachman试验及均为阴性,术后膝关节Lysholm评分(86~96分)(94.7±3.3)分、IKDC评分为(72.2~94.1分)(84.6±3.2)分,Tegner评分7~9分(8.35±1.4)分,较术前差异有统计学意义(P<0.01)。体检步态均正常,测量双小腿长度差异无统计学意义。结论关节镜下规避骺板“8”字法缝线固定术治疗急性儿童前交叉韧带胫骨止点撕脱性骨折疗效确切、创伤小、固定可靠、膝关节活动度及功能好,不影响儿童生长发育。