目的：探討電擊傷的臨床特征，手術治療及療效。方法：對78例電擊傷患者的臨床資料進行分析。結果：電擊傷多為工傷，病情重，常常多次手術，住院時間長，致殘率高。結論：早期積極、延遲的手術，功能可得到最大的恢復，截肢率降低，預后較好；電擊傷創面修復以皮瓣、肌皮瓣轉移的手術方式效果為佳。
ObjectiveTo investigate the effectiveness of double buried suture method for correction of secondary mild unilateral cleft lip nose deformity. MethodsBetween June 2010 and June 2012, 20 patients with secondary mild unilateral cleft lip nose deformity were treated with double buried suture method. Among 20 patients, 12 were male and 8 were female, with an average age of 21 years (range, 14-44 years). All patients had unilateral cleft lip nose deformity after unilateral cleft lip repair, including 9 cases of left deformity and 11 cases of right deformity. The time between first repair and double buried suture was 11-42 years (mean, 19 years). ResultsIncisions healed by first intention, and no related complication occurred. The patients were followed up 6-12 months (mean, 8 months). All patients were satisfied with the nasal contour, symmetrical projection of the alar dome, a central columella, symmetry of nasal floor, and no obvious scar. No recurrence was observed during follow-up. ConclusionDouble buried suture method not only can correct secondary mild unilateral cleft lip nose deformity completely, but also can avoid obvious scarring and recurrence of nose deformity.
Objective To summarize the treatment of chronic osteomyel itis of the skull and its effectiveness. Methods Between January 2004 and February 2009, 24 patients with chronic osteomyel itis of skull were diagnosed and treated, including 16 males and 8 females with an average age of 45.6 years (range, 18-56 years). The mean disease duration was 5.8 years (range, 3-11 years). The causes included infection after craniotomy in 3 cases, burn in 15 cases, and electrical injury in 6 cases, and the leision was located at the frontal and parietal of the skull in 10 cases, at the temporal and parietal of skull in 8 cases, and at the occipital of the skull in 6 cases. The soft tissue defects ranged from 7 cm × 6 cm to 19 cm × 12 cm, and the skull defects ranged from 5 cm × 4 cm to 10 cm × 7 cm. After wide thorough debridement of necrotic tissue, soft tissue defects were repaired with adjacent scalp flap in 12 cases, trapezius myocutaneous flap in 6 cases, and free anterolateral thigh flap in 6 cases; the flap size ranged from 8 cm × 7cm to 20 cm × 13 cm. The donor sites were sutured directly or covered with spl itthickness skin. Results All pathological examinations showed pyogenic osteomyel itis of the skull, and local ized squamous carcinoma was found in 1 case. One patient had sub-flap infection at 2 weeks after operation, and heal ing was achieved after surgical removal of residual tissue; the remaining flaps survived, and incision healed by first intention. All patients were followed up 10 months to 4 years with an average of 2 years after operation. The color and texture of the flaps were good. No recurrence of osteomyel itis happened during follow-up. The patient diagnosed as having local ized squamous carcinoma was followed up 4 years without recurrence. At 3 to 6 months after operation, 8 patients had headache or felt dizzy, and the skull was reconstructed by the titanium meshes. Conclusion In patients with chronic osteomyel itis of skull, the infected foci should be cleaned out thoroughly as early as possible, and the skin flap or myocutaneous flap is used to repair the wounds, thus the good results can be achieved.
目的：探討N-乙酰半胱氨酸對燙傷大鼠炎癥反應的影響。方法：48只Wistar大鼠隨機分為實驗組和對照組，制作燙傷休克模型，傷后1小時腹腔注射生理鹽水40ml/kg抗休克，實驗組于抗休克鹽水中加入N-乙酰半胱氨酸160mg/kg，其后足量飲水。分別于燙傷前、燙傷后8小時、16小時及24小時，處死每組各6只大鼠并立即心臟取血，采用ELISA法檢測大鼠血清中TNF-a含量，于創周近頭側 0.5cm處取皮膚全層組織，在顯微鏡下進行中性粒細胞計數。 結果：兩組大鼠血清TNF-a含量傷后顯著升高，8小時達到高峰，其后逐漸下降，兩組各時點比較有顯著差異（P＜0.05）；創周組織中性粒細胞計數于傷后隨時間延長逐漸增多，兩組比較有顯著性差異（P＜0.05）。 結論：N-乙酰半胱氨酸有助于降低燙傷大鼠血漿中TNF-a含量及創周組織中的中性粒細胞計數量，減輕燙傷大鼠的全身及局部炎癥反應。
目的:回顧性分析臀會陰及下肢大面積皮膚軟組織撕脫傷的治療體會。方法:2005年1月至2007年6月,對8例臀會陰及下肢大面積皮膚軟組織撕脫傷患者進行綜合治療。男4例,女4例,年齡4～48歲,平均26歲,病程1天～1月,平均2周。皮膚撕脫達體表總面積8%～20%。致傷原因:車禍傷7例,高墜傷1例。其中7例成人均上翻身床治療,1例小孩床上自行翻身,6例由于創面距肛門較近或脊髓損傷不能控制大便而行結腸造瘺,通過造瘺口排便,創面愈合3月后行造瘺還納術。所有患者均通過積極創面處理、肉芽新鮮后行刃厚植皮術而痊愈。結果:8例患者經過我們的綜合治療后傷口均愈合,隨訪6月后皮膚愈合良好。6例行結腸造瘺的患者中3例因骨盆骨折穩定于出院后3月左右行結腸造瘺還納術,恢復肛門排便,3例伴有脊髓損傷患者而不能自行控制排便的患者在隨訪期間未行結腸造瘺還納術。結論:臀會陰及下肢大面積皮膚軟組織撕脫傷患者通過上翻身床,必要時行結腸造瘺,積極的創面處理及對癥支持治療能取得較好效果。