To investigate the osseointegration condition of ITI and Osstem-SS implants by measuring the implant stability quotient (ISQ) so as to provide guidance for proper restoration time.Method:Ninety-three patients were selected as subjects.179 implants were implanted.According to bone quantity of edentulous area,all the subjects were divided into two groups.62 patients with sufficient bone quantity were in group A,while 31patients with insufficient bone quantity who needed bone-added surgery were in group B.125 implants were implanted in group A,including 64 ITI implants and 61Osstem-SS implants.54 implants were implanted in group B,including 28 ITI implants and 26 Osstem-SS implants.Implant stability quotient (ISQ) was measured immediately after surgery as well as at the 4,6,8,12,16,24 weeks after surgery.Clinical and imaging examination was taken at the same time.Results:In group A,final restoration of ITI implants was completed 8 weeks after surgery when the ISQ was 74.17± 1.85,while 12 weeks with ISQ was 72.00± 2.59 for Osstem-SS implants.In group B,16 weeks with ISQ was 65.09± 3.42 for ITI implants and 24 weeks with ISQ was 62.09± 6.16for Osstem-SS implants.In the following period of 3 to 24 months after restoration,no failure case was observed.Conclusion:Implant stability quotient (ISQ) can represent the osseointegration condition of implants,which will help to choose the proper restoration time.

目的观察平台转移设计的Ankylos种植系统种植体颈部骨吸收情况,评价其临床效果。方法 196例患者共植入Ankylos种植体344颗,并行种植修复。观察随访3～48个月,进行临床及X线检查,并对其进行评价。结果 344颗种植体骨结合良好,种植体成功率100%,患者均对种植体功能及修复效果感到满意。结论 Ankylos种植体基台莫氏锥度的连接设计可以取得满意的临床修复效果。

PURPOSE:To evaluate and compare the dynamic changes in functional loading or non-functional loading with platform-switching (PLS) implants and butt-joint implants,and to refine the factors leading to marginal bone loss around PLS.METHODS:Six adult dogs were selected and numbered randomly.The second,third and fourth premolars in bilateral mandible of each dog were extracted. After 3 months, the implantation operation was carried out. There were 3 kinds of implants, 36 implants in total, which were divided in to 3 groups: Group A,Group G and Group U. In particular order, A, G and U were placed on each side of every dog. Three months later, the 2nd surgery was begun. At the 4th month from the 1st surgery, for each dog, on the right side only, the abutments were installed and impression was taken. Then, after 2 weeks, the dental prostheses were put on. All dogs were executed at the end of the 12th month. X-ray film was taken at the 3rd, 6th, 9th and 12th month and the moment of the 1st surgery (baseline). Measurements were made between the implant shoulder (IS),the most coronal level of bone in contact with implant (CLB), and the level of alveolar bone crest (BC). According to the different groups of implants (A, G, U), all records were analyzed with paired and Wilcoxon's signed rank test using SPSS11.5 software package.RESULTS:The mean IS-CLB and IS-BC values of group A, G were significantly different with those of group U at the 6th, 9th and 12th month, while there was no significant difference between group A and G. No matter they were loading or not, the self-comparison of each kind of implant presented no significant difference. There was no significant difference between every kind of implant on their self-comparison during the first three months; while, the differences were significant during the next 9 months.CONCLUSIONS:The most significant changes in the absorption of marginal bone around two stage submerged implant can be observed after 3 months of implanting. The bone absorption was not related to functional loading or not.

目的:探讨系统性出院指导对腭裂整复术患儿语音治疗依从性的影响。方法:将110例腭裂整复术患儿按手术时间分为对照组50例和实验组60例,对照组给予常规出院指导,实验组患儿及家属给予系统性出院指导,语音治疗6个月后,比较两组语音治疗依从性和效果。结果:实验组语音治疗依从性高于对照组(P<0.01),实验组语音治疗效果优于对照组(P<0.01)。结论:系统性出院指导可增强腭裂整复术患儿及家属对疾病知识的理解,提高语音治疗依从性,明显改善腭裂患儿的语音功能。

Objective To observe the influence of different manipulations on the homogenicity of insulin solution.Methods Mixture of Humulin-R was made as follow: adding Humulin-R into bottling saline directly(Group A),or reverting the bottle for 8-10 times after adding Humulin-R(Group B),adding 4 U of Humulin-R into packed saline using 1 mL injector(Group C),or injecting 5 mL of saline into the plastic bag after adding Humulin-R(Group D).Same transfusion speed was kept.Results The initial concentration of insulin in the bottling was higher than those of the middle and later period.The different manipulations of adding and mixing insulin in packed or bottling saline did not effect its homogenicity. Conclusion Different methods of mixing and adding drug do not affect the homogenicity of insulin solution.

<正>血管瘤是口腔颌面外科治疗的一种常见病,多发于儿童,其发病率为8%～12%,其中60%的血管瘤发生于面部[1],随着生长发育逐渐增大,如不及时治疗可影响美观及引起功能障碍。虽然传统的治疗方法很多,但各有其局限性。因此笔

2004年1月～2005年12月,我院收治糖尿病合并冠心病患者526例,给予精心护理效果满意.现报告如下. 1临床资料 本组男236例,女290例,50～80岁,平均62岁,病程5～25年,平均16年.均有不同程度的心慌、气促,活动后胸闷、憋气、心绞痛等症状.心电图检查:陈旧性心肌梗死47例,急性心肌梗死3例,其余病例均有不同程度的ST-T改变.

目的 探讨颌面部间隙感染伴糖尿病患者的护理措施,预防和减少并发症的发生.方法 对31例颌面间隙感染伴糖尿病患者进行抗感染、控制血糖、脓肿切开引流等处理,同时加强饮食护理、并发症护理、病情观察、舒适护理和健康教育.结果 31例住院8～47 d痊愈出院.结论 及时、正确、有效的综合治疗是康复的关键,个体化、全方位的护理是患者康复的保障.

腭裂是口腔颌面部常见的一种先天性畸形,不仅影响上颌骨的正常发育,还可引起咀嚼、发音等功能障碍,只有通过手术才能达到恢复功能的目的.腭裂术后由于各种原因易引起呼吸道梗阻、出血、感染、穿孔、复裂等多种并发症.并发症的发生不仅增加了患者的痛苦,而且还影响手术效果,重者可导致手术失败,甚至危及生命.本文对我院1990～2004年收治的660例腭裂手术治疗后发生并发症的52例患儿进行临床分析,探讨并发症发生的原因及相关的护理对策。

下颌骨及其周围软组织肿瘤切除术后缺损的即刻修复,一直是口腔颌面外科的重要研究课题之一.尽管已有许多不同的游离骨瓣、骨肌皮瓣成功地运用于下颌骨及其软组织缺损的修复重建,但其难以修复大型的下颌骨缺损,日后义齿修复也有困难.1989年Hidalgo首先应用游离腓骨瓣修复下颌骨缺损,因其有足够的长度和坚实的骨密质,有利于种植体恢复牙列和咀嚼功能而愈来愈受到重视,我科于1996～2002年应用游离腓骨肌皮复合组织瓣一期修复下颌骨及软组织缺损24例,效果满意.现将护理体会介绍如下.

静脉穿刺输液是临床常用的抢救和治疗的重要措施之一,文献[1,2]对头皮针针尖刺入皮下后如何进入静脉,以及持针手法无明确规定,临床上也不一致,有的持针柄的上下面,有的则持针柄的前后面.为了比较不同持针手法患者疼痛的程度,我们进行了观察对比,现将结果报告如下.

全麻手术患者手术时间估计超过3～4h,或术中可能需大量输液者,术前常需留置导尿管,防止发生尿潴留,而术后拔管时间却无明确规定,临床上多在术后第1天拔管.根据观察,留置尿管期间,患者因尿管刺激,尿意感较强,甚至有的患者感觉尿道灼痛,且拔管后有尿潴留等并发症发生.为了减轻患者的痛苦,降低并发症的发生率,我们将拔管时间提前至术后6h,取得较好效果,现将结果报告如下.

口腔癌联合根治术后可致局部组织缺损,引起患者语言、吞咽、张口及进食等功能障碍,使术后生存质量明显下降.一期游离皮瓣移植修复缺损,可恢复组织形态及器官功能,提高患者的生存质量.但由于显微外科手术的特殊性,有一定的失败率,失败的主要原因是疼痛、情绪激动、烦躁和固定不充分所引起的血管痉挛、血栓形成、感染、压迫等所致的血循环障碍,以术后72h内多发.如予以积极的生理、心理、社会舒适护理,能使患者身心处于最佳状态,提高治疗的耐受性及依从性,减少并发症的发生.具体舒适护理措施如下.

腭裂术后能清晰发音、准确地表达语言是病人求治的迫切愿望.临床实践表明,虽然腭裂手术后病人可以获得满意的解剖形态,但仍有很多病人存在不同程度的语音障碍,这主要是由术后腭咽闭合不全以及不良的发音习惯所引起的口腔共鸣失衡,逐渐形成的代偿性语音.手术后通过对病人积极正规的语音训练可以纠正不良发音习惯,提高语音清晰度[1].但语音的训练是一项长期的工作,单靠手术后住院短时间训练是难以完成的,因此,病人在出院后应继续进行系统的训练.