目的 探讨应用微型骨锚钉结合克氏针急诊一期修复指间关节侧副韧带断裂的临床效果.方法 2015年1月——2017年5月,我科对11例指间关节侧副韧带断裂的患者进行一期急诊手术治疗.术中应用微型带线骨锚钉重建断裂的指间关节侧副韧带的起点或止点,应用一枚克氏针固定受损的指间关节.克氏针术后3周拔除,逐渐进行功能锻炼.结果 术后11名患者创口Ⅰ期愈合,无血肿、感染、皮肤坏死,植入物外露等并发症发生,11名患者随访时间1个月到18个月,平均8个月.定期拍片检查,无关节脱位及植入物脱位,松动,断裂等并发症发生.再采用seatta功能评定标准评估疗效.评价优良率达到82％.结论 应用微型骨锚钉结合克氏针治疗急诊指间关节侧副韧带断裂技术容易掌握,疗效可靠,值得临床推广.

目的 探究手部先天畸形患儿采用保留骨骺关节融合术矫正的治疗效果.方法 12例手部先天畸形患儿,采用保留骨骺关节融合术矫正治疗,观察患儿的治疗效果.结果 手术后患儿伤口均为一期愈合,没有针道感染,将克氏针拔除后,融合关节较为稳定,且关节的屈曲畸形和侧偏都得到有效纠正,大大增强了关节稳定性,外观得到了明显的改善,患指的捏持力和可用性也有明显改善,效果显著.结论 手部先天畸形患儿采用保留骨骺关节融合术矫正,能够明显改善患指功能,外形美观,对患指的生长发育没有不良影响.

目的:探讨复拇指畸形的临床手术治疗体会.方法:对2013年1月～ 2015年3月收治的复拇指畸形患者39例,手术方法及恢复其正常的解剖结构.结果:经治疗手术矫治后优20例,良13例,差6例,术后随访0.5 ～2年,拇指外形满意,骨轴线正常,发育良好,屈伸、外展、对掌功能良好.结论:术中正确处理切除赘生拇指,保留近似正常的存留拇指.

在人们日常生活和学习工作中,手部的作用是非常重要的。一但因意外发生烧伤状况时,由于经常处于裸露状态,手部出现烧烧的概率相对是较高的。本文对手足部深度烧伤的整形修复进行深入探讨。

在潮湿、寒冷或有风的环境下,机体长时间地暴露,就可能因低温作用使人体局部或全部温度下降,进而发生机体损伤即为冻伤,这是低温环境或严寒地区作业人员较为常见的急症之一。由于手、足、耳、鼻表面温度较低,且位于身体的远端,加之血液循环较差,所以极易发生局部冻伤。本文就对冻伤的危害及局部冻伤的临床治疗展开探讨。

烧伤最为突出的特征是局部的操作会致使体内稳态失衡,进而对全身多个系统产生严重影响。可以说,烧伤是以应激、免疫为核心的全身性复杂病理过程。做为烧伤患者最为主要且常见的并发症,烧伤感染会对患者的诊疗过程产生不利影响,严重的感染还可能使患者体内多脏器出现功能衰竭,进而对患者生命构成危胁。因此,正确处理烧伤创面,预防和避免烧伤创面感染是烧伤病症临床治疗的重要课题之一。

在临床实践中,因手部外伤而致多元组织大范围毁损较为常见。毁损性手外伤的治疗应以重建手部功能为目的,即最大限度地重建和恢复伤手的功能与外观。下面对目前临床处理毁损性手外伤的主要方法,如利用"废指"重建毁损手部分功能和利用"异位再植"重建毁损手的手部功能的具体措施展开深入探讨。

目的探讨负压封闭引流(VSD)技术治疗糖尿病手部外伤后手指感染的应用效果。方法对22例糖尿病患者外伤后手指感染行切开排脓、扩创、VSD冲洗术,VSD冲洗1-2个疗程后,严格控制血糖,胰岛素(诺和锐30R)皮下注射联合二甲双胍糖适平一日三次口服,血糖控制平稳后创口直接缝合或残端皮瓣修复。结果 22例糖尿病患部外伤后手指感染患者,创口均一期愈合,平均随访1.2年(6个月～2年),术后效果好,住院时间平均25.6d。结论使用VSD负压封闭引流治疗糖尿病手部外伤后手指感染效果好,痛苦小,手指截指率低,缩短疗程,值得推广。

在人们日常工作生活当中手是使用频率最高的肢体,所以也就更容易受到伤害。一但发生手部外伤,临床早期处理对手部外伤的诊疗效果影响极大。该文从手部外伤早期处理中产生失误的原因,手部外伤临床早期处理的基本方法,以及最大限度做好手部外伤临床处理及康复治疗的有效措施等几方面展开深入探讨。以期通过不断地研究与探讨,提升手外伤临床早期处理效果,推动手外伤临床早期处理取得预期的疗效。

在人们生活中手部功能是最为常用,这也使得手部外伤较为多见,特别是手指外伤后导致皮肤缺损,或是关节、骨、血管和神经外露在医学临床上更是常见。手部组织受伤缺损,尤其是骨关节、伴肌腱等复合组织的缺损临床处理相对更为困难。伴随着医学技术的发展,手外伤带蒂皮瓣修复成有效医治此类伤病的重要手段。该文对手外伤带蒂皮瓣修复术展开深入探讨。

<正>2010年9月—2012年8月本科采用严格清创联合负压封闭引流技术(vaccum sealing drainage,VSD)治疗手部高压注射伤患者6例,取得良好效果,现报道如下。1临床资料1.1一般资料本组6例患者均为男性,年龄22～65岁,平均年龄29岁。高压注射物分类:油漆伤2例,采油工程作业

OBJECTIVE:To explore the approach and methods for clinical pharmacists to take part in judgment and treatment of adverse drug events.METHODS:One typical cases of Clebopride malate tablets induced torsion spasm or dysmyotonia in which the clinical pharmacists had participated were reported and analyzed.RESULTS:The patient was given anticholinergic anisodamine(654-2),and adverse drug reactions were reported.CONCLUSION:Clinical pharmacists should strengthen their clinical thinking ability in the practice of adverse drug events diagnosis and treatment so as to be able to assist the physicians in providing high-quality pharmaceutical care.By using evidence-based medicine,clinical problems can be resolved through optimal clinical evidence is closely combined with clinical experience and patient's condition to find and collect optimal clinical evidence,pay attention to the accuracy of clinical evidence and Meta-analysis.

Objective To assess sodium deoxy-ribonucleotide injection in the treatment of burn wound healing time and side effects.Methods 82 cases of such patients,according to the odd or even number of admission number were randomly divided into the observation group and the control group,the former were given sodium deoxy-ribonucleotide injection,the latter of Lu gua polypeptide injection.Results In treatment group,the average healing time was significantly shortened than in the control group(P0.05),the rate of adverse reactions is zero.Conclusion Sodium deoxy-ribonucleotide injection could significantly shorten wound healing time,reduce the occurrence of adverse reactions for burn patients.It is a kind of good drug in the treatment of middle and small area burn.

目的:观察黄药子对人甲状腺癌细胞株SW579细胞凋亡抑制蛋白Survivin的诱导作用,探讨黄药子抑制甲状腺癌细胞增殖的作用机制。方法:48只成年雄性Wistar大鼠分为空白对照组和药物高、中、低剂量组,空白对照组给予生理盐水,药物组给予不同剂量的黄药子(100、200、400mg/kg),15天后,分别提取其血清,对SW579细胞进行处理,采用RT-PCR和Western blotting方法分别检测Survivin mRNA和蛋白的表达。结果:中、高剂量药物组细胞Survivin mRNA表达明显低于空白对照组(P<0.01);中、高剂量药物组细胞Survivin的蛋白表达明显低于空白对照组(P<0.01)。结论:黄药子能明显下调人甲状腺癌细胞株SW579 Survivin mRNA和蛋白的表达,诱导其细胞凋亡。

Objective To study the treatment results of scar around chin,neck and chest scars with expanded flap from cervical,humeral and thoracic flap.Methods From March 2008 to March 2011,we used expanded skin flap from the cervical,humeral and thoracic to repair severe soft tissue defects of the chin,neck and chest on 27 patients.Results Most of the patients have good results.Complications happened including hematoma 2 cases,3 cases of ischemic necrosis is genesis at the distal side of the flap.Post-operation follow-up of to18 months flap,there is no contraction.Conclusion The cervical,humeral and thoracic flap of expanded skin can be satisfactorily applied to repair the severe chin,neck and chest scars.

<正>注射用棓丙酯粉针是中药赤芍中的活性成分-没食子酸酯的衍生物,是在没食子酸酯的结构上进行修饰而得到的具有更强生物效应的药物[1]。临床上主要用于治疗缺血性脑血管病(如急性脑梗死、慢性脑血栓、腔隙性脑梗死、脑供血不足、脑昏迷后遗症、脑外伤、脑震荡)。

Objective To analyze the numerous scholar's research results,summarizes the treatment optimum condition of the VSD technology in the treatment of deep burn injured area.Methods 21 patients with vacuum sealing drainage(VSD) technology for the treatment of superficial wounds and deep drainage.Results 21 patients by continuous negative pressure wound drainage,replacement of at least 1 wound drainage devices,up to 4 times the fresh wounds underwent autologous skin graft or skin flap surgery,postoperative a closed wound.Conclusion VSD treatment of deep burn wounds is simple,easy to master,far superior to conventional therapy.

Objective To study skills and effect of AO mini titanium plate fixation in the treatment of metacarpal and phalangeal intraarticular fracture.Methods The patients with metacarpal and phalangeal intraarticular fractures were treated by early open reduction and AO pure titanium mini plate and nail.Early rehabilitation was carried out postoperatively.Totle 42 cases of metacarpal fractures were observed.Among them,26 cases were metacarpal fractures,with the metacarpal head fracture in 9 cases,with basilar part fractures in 4 cases,with phalange fracture in 16 cases.Results All cases were followed up for 3 months to 1 year after operation.The fractures were healed completely.Functional evaluation were achieved good rate by the hand surgery standard.Conclusion The method of AO mini titanium plate and nail fixation could have good effect in the treatment of Metacarpal and phalangeal intraarticular fractures.

Objective To summarize the clinical experience on treatment of hand hot crush injury.Methods 38 cases of such patient were used relative treatment methods according to varied situation.Results The function of 33 cases of hand flaps were complete or partial recovered and 5 cases had no function.Conclusion The proper method according to vareid degree and location should be key point and might improve the hand function as well as possiple.

Objective Our aim is evaluate the Quality-of-life influence of immediate or delayed autologous breast reconstructions.Methods The retrospective analysis of psychosocial outcomes for seventy-two cases of mastectomy with autologous breast reconstructions,including thirty-one immediate cases and forty-one delayed cases through survey questionnaires,which were mailed or inquired by phone at least 6 months after breast reconstruction operation.All patients were evaluated using the European Organization for Research and Treatment of ance(EORTC).Results For the immediate autologous breast reconstruction cohort,significant improvements were observed in symmetry,role function,emotional function,social function and arm symptoms scores(P0.05 and P0.001),compared with delayed reconstruction.Conclusion Immediate autologous breast reconstruction seems to significantly improve psychosocial status for breast cancer patients.Therefore,it should be perfered to women undergoing breast mastectomy.