色素痣分次切除的手术适应证研究

目的探讨分次切除治疗较大色素痣的手术适应证。方法对46例不同部位先天性色素痣(面部22例,躯干部13例,四肢11例)采用部分切除治疗,比较术前、术后近期、术后远期病变大小及局部情况的差异。结果术后近期病变面积较术前明显缩小(P0.05),术后远期较近期病变面积有不同程度增大(P0.05),但与术前相比仍存在统计学差异(P0.05)。1例面部色素痣患者存在轻度变形,2例四肢色素痣患者存在轻度活动受限。结论先天性色素痣应首选一次性切除病变,但不同部位色素痣具有不同的手术适应证。面部及四肢跨关节的色素痣更适宜采用分次切除进行治疗,而躯干部及四肢非关节部位应力求一次性切除病变。     

某部特种兵心理健康状况的调查研究

本文应用SCI-90量表对特种兵的心理健康水平进行追踪调研,了解特种兵心理健康水平的发展变化趋势,并利用统计软件SPSS对数据进行幂入的研究,提出了一些干预策略,对于提高特种部队官兵心理素质,培养和提高其在特种作战中适应能力和战斗力等均有重要意义.     

Lateral crus graft with autologous rib cartilage for cleft lip nostril asymmetry: a report of 35 cases

Summary： A surgical technique of lateral crus strut graft to correct the deformity of nostril contour and improve asymmetric nostril shape by autologous rib cartilage was reported. Thirty-five patients （20 males and 15 females）, with a mean age of 19 years （range of 16-26 years） were included in this study. All of the patients suffered moderate to severe unilateral cleft lip nostril deformity and underwent surgical technique of lateral crus strut graft by autologous rib cartilage to correct the asymmetric nostril contour from 2010 to 2012. The views of the nostril contour on both sides were reviewed and some parameters were measured at different time points （preoperatively, and 3 months and one year postoperatively） including the long axis and short axis of the nostrils. The differences in nostrils including long axis, short axis, elliptical area and eccentricity on the both sides were compared at different time points. The differences in the long axis and eccentricity of the nostrils on the two sides were decreased significantly between the preoperative view and postoperative view （P〈0.05）. The surgical technique of lateral crus graft with autologous rib cartilage is effective to correct the abnormal nostril contour and improve the asymmetry for unilateral cleft clip patients.     

单侧唇裂术后继发鼻畸形伴鼻中隔高位偏曲的同期整复

目的 观察并探讨单侧唇裂继发鼻畸形伴鼻中隔高位(筛骨垂直板)偏曲同期整复术的临床效果.方法 采取跨鼻小柱鼻翼软骨边缘切口,充分游离移位的组织并将其复位,同时行鼻中隔偏曲矫正术.在传统切除鼻中隔软骨偏曲部分及矫正犁骨沟偏斜的基础上,凿除偏曲的筛骨垂直板部分,并利用所取鼻中隔软骨重建鼻尖支架.结果 本组共30例患者.经1～12个月随访,所有患者鼻外形明显改善,鼻小柱居中,两侧鼻孔大小基本相等,偏曲鼻中隔软骨得到矫正,鼻塞、头痛等症状均得到明显改善.结论 单侧唇裂术后继发鼻畸形伴鼻中隔高位偏曲同期整复术,即通过矫正鼻中隔软骨与硬骨偏曲,从而较彻底地解决了鼻中隔偏曲问题;又通过合理利用所取鼻中隔软骨重建鼻尖支架,改善了鼻尖美学形态,是一种值得推广的手术方式.