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        find Author "李正勇" 13 results
        • 高強度聚焦超聲致Ⅲ度燒傷的治療探討

          目的 探討高強度聚焦超聲治療并發癥的臨床治療。 方法 2001年4月~2005年11月,收治6例高強度聚焦超聲Ⅲ度燒傷患者,應用局部皮瓣治療。男5例,女1例;年齡45~78歲。燒傷均位于右季肋部。皮膚壞死范圍3 cm×3 cm~6 cm×4 cm。手術清創后創面范圍為9 cm×5 cm~12 cm×7 cm,切取局部皮瓣范圍10 cm×6 cm~13 cm×8 cm。 結果 術后1例皮瓣發生紅腫,經紅外儀局部照射理療后痊愈,余皮瓣均成活,創面Ⅰ期愈合。供區植皮成活,Ⅰ期愈合。術后隨訪3個月,皮瓣外觀質地佳,無感染、積液。結論 應用局部皮瓣治療高強度聚焦超聲燒傷創面效果滿意。

          Release date:2016-09-01 09:23 Export PDF Favorites Scan
        • MODIFIED TRANSCRANIAL APPROACH TO RESECT TUMOR AROUND THE ANTERIOR SKULL BASE AND DOUBLE TISSUE FLAP TO RECONSTRUCT THE ANTERIOR SKULL BASE

          Objective To explore better approach of resecting tumoraround the anterior skull base and reconstructing the anterior skull base.Methods In November 2004, a 49-years-old male patient with intracranial recrudescent adenoid cystic carcinoma in the anterior cranial fossa was treated using modified transcranial approach. Neurosurgeon and rhinolaryngologist cooperated to excise the tumour completely, and to reconstruct anterior skull base using the pedicle periosteum temproal musculofascial flap(15 cm×10 cm) andthe pedicle flap of aponeurosis of occipitofron talis muscle and muscular fasciae(10 cm×6 cm).Results After operation, the wound healed by first intention. Complication, such as infection and cerebrospinal rhinorrhea, did not occur. The patient was discharged 10 days after operation, and was followed up for 8 months, no local recurrence were investigated and no scar formed over the face.Conclusion The modified transcranial approachis a relatively novel exposure that enables the skilled cranial base surgeon tosafely resect many malignant lesions previously and to reconstruct the defect of anterior skull base together. 

          Release date:2016-09-01 09:26 Export PDF Favorites Scan
        • Filling injection in facial danger area and related vascular complications

          Facial filling injection is one of the technologies to achieve facial rejuvenation in a non-surgical way. With the application of emerging cosmetic filler preparations and the development of new technologies, there are more and more options to achieve facial rejuvenation. Complications may result from the use of new materials whose safety has not been proven in studies. This article describes common facial filler choices, facial risk areas and vascular complications, and discusses how to improve the safety of facial injections. The purpose is to enable operators to fully understand the facial risk area, select the appropriate filling injection, and be able to identify the symptoms of vascular complications as early as possible, thereby improving the safety of facial filling injection.

          Release date:2022-07-28 02:02 Export PDF Favorites Scan
        • MENTOCERVICAL RECONSTRUCTION AND EFFECTIVENESS EVALUATION IN TREATMENT OF MENTOCERVICAL CICATRICIAL CONTRACTURE DEFORMITY

          Objective To investigate the procedures and effectiveness of platysma scar flap for reconstructing mentocervical appearance in patients with mentocervical cicatricial contracture deformity. Methods Between April 2004 and August 2011, 26 patients with mentocervical cicatricial contracture deformities were admitted. There were 15 males and 11 females, aged 12-31 years (mean, 18 years). The causes included scald injury in 19 cases and flame injury in 7 cases, including 23 cases of deep second degree burn and 3 cases of third degree burn. The time between injury and scar formation was 6-27 months (mean, 10 months). The mentocervical angle was (117.10 ± 14.46)°, and the cervicomental angle was (143.38 ± 15.68)°. The platysma scar flap transfer (8 cm × 7 cm to 10 cm × 8 cm in size) and skin grafting were performed to reconstruct mentocervical appearance. Results The flap and skin graft all survived and the incisions healed by first intention. All the patients were followed up 6 months-3 years (mean, 16 months). The mentocervical and cervicomental angles were significantly reduced to (89.31 ± 6.30)° and (117.83 ± 10.65)° respectively at 2 weeks after operation (P lt; 0.05), showing no significant difference when compared with normal mentocervical angle (90°) and cervicomental angle (120°) (P gt; 0.05). The satisfactory results of the mentocervical appearance and cervical extension function were obtained in 21 patients whose mentocervical and cervicomental angles were restored to normal. Conclusion Platysma scar flap transfer is an effective method to reconstruct mentocervical appearance and reduce mentocervical and cervicomental angles in patients with mentocervical cicatricial contracture deformity.

          Release date:2016-08-31 04:22 Export PDF Favorites Scan
        • Influence of N-Acetylcysteine on Burned Rats’ Inflammatory Effect

          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。

          Release date:2016-09-08 10:14 Export PDF Favorites Scan
        • THERAPEUTIC RESULT OF OPERATION COMBINED WITH LARGEDOSE OF ROFERONA FOR CUTANEOUS MALIGNANT MELANOMA

          Objective To observe the effects of operation with large-dose of RoferonA for cutaneous malignant melanoma. Methods From January 1998 to December 2005, thirtythree patients with cutaneous malignant melanoma were treated. There were 20 males and 13 females, aging 17-79 years. The disease course was 2 months to 7 years. In 33 patients, nine patients identified as clinical-stage Ⅰ received singly enlargedresection to the primary lesion and performed split-thickness skin graft dermoplasty or adjacent skin flap repair; twenty-three patients identified as clinicalstage Ⅱ received enlargedresection to the primarylesion and performed proximal lymphaden scavenge as well as received split-thickness skin graft dermoplasty; and one patient identified as clinical-stage Ⅲ received palliative resection to the primary lesion. All patients received large dose of Roferon-A after operation. Results There are no recidivation in the 9 patients of clinicalstage Ⅰ. There are 1 recidivation and 1 quit in all the 23 patientsof clinicalstage Ⅱ. One patient of clinicalstage Ⅲ died after 18 months of operation. Conclusion The operation combined with large-dose of RoferonA after operation was a more effective way to treat cutaneous malignant melanoma.

          Release date:2016-09-01 09:19 Export PDF Favorites Scan
        • 顳淺動脈筋膜瓣聯合皮片修復全耳再造術后耳軟骨支架外露

          目的總結采用顳淺動脈筋膜瓣聯合皮片修復全耳再造術后軟骨支架外露的療效。 方法2011年1月-2013年12月,收治5例組織擴張法行全耳再造術后1周內發生皮瓣壞死、軟骨支架外露患者。男3例,女2例;年齡7~19歲,平均13.4歲。左耳1例,右耳4例。術中徹底清創后,軟組織缺損范圍達1 cm×1 cm~3 cm×2 cm;取顳淺動脈筋膜瓣聯合全厚皮片覆蓋軟骨支架。 結果手術均順利完成,術后創面Ⅰ期愈合,皮片成活。患者均獲隨訪,隨訪時間1~3年,平均1.6年。再造耳外形、大小、位置與健側相似,相關耳結構清晰。患者對再造耳外形滿意。 結論全耳再造術后發生皮瓣壞死、軟骨支架外露需及時行清創手術,應用顳淺動脈筋膜瓣聯合皮片修復支架外露效果良好。

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        • Progress in modern medical treatment of hemifacial microsomia

          Hemifacial microsomia (HFM) is a developmental hypoplasia of one side of face and ear due to congenital hypoplasia. At present, the causes of HFM have not been completely clarified, the classification methods are diverse, and the diagnosis and treatment methods are complex. Through reviewing the relevant study on the treatment of HFM domestic and overseas in recent years, the possible etiology and corresponding clinical manifestations of the disease are analyzed, and the existing clinical classification methods, treatment strategies and latest research results are summarized.

          Release date:2021-03-19 01:22 Export PDF Favorites Scan
        • TREATMENT OBSERVATION OF NASAL TIP DEFECTS RECONSTRUCTED BY BILOBED FLAPS AFTER GAINT NEVI EXCISION

          ObjectiveTo discuss a reliable and aesthetic surgery method for the reconstruction of large defects on the top of nose after giant nevi resection. MethodsBetween January 2011 and June 2015, 46 cases of nasal tip defects caused by giant nevi resection were treated. Of 46 cases, 22 were male and 24 were female, aged 15-59 years (median, 28 years). The right ala nasi was involved in 28 cases, the apex nasi in 8 cases, and the left ala nasi in 10 cases. The diameters of nevi were from 8 to 12 mm (mean, 9.75 mm); no alar cartilage was invaded. Hair growth was seen in 14 cases. The duration of nasal nevi was from 3 years to 49 years (mean, 9.8 years). There were 9 recurrent patients who received laser therapy before surgery. The defects sizes after excision were from 10 mm×10 mm to 14 mm×14 mm. The bilobed flaps were used for one-stage reconstruction, which sizes were from 11 mm×10 mm to 15 mm×14 mm and from 10 mm×10 mm to 15 mm×14 mm. ResultsAll the incisions healed by first intention, and the flaps survived. No complication of intracranial hemorrhage or subdural hemorrhage occurred. The patients were followed up 6 months to 5 years (mean, 18 months). The appearance of nasal tip and nasolabial fold was satisfactory, and no recurrence was found during follow-up. ConclusionOne-stage bilobed flap reconstruction for nasal tip defects after giant nevus resection is one of the effective, safe, and aesthetic surgery methods.

          Release date:2016-11-14 11:23 Export PDF Favorites Scan
        • 皮下蒂皮瓣在面部腫瘤切除術后創面修復中的應用

          目的探討采用皮下蒂皮瓣修復面部腫瘤切除術后創面的臨床經驗。 方法回顧性分析 2008 年1 月-2013 年 1 月收治的 60 例面部皮膚腫瘤患者,其中脂溢性角化癥 12 例,角化棘皮瘤 6 例,色素痣 10 例,基底細胞癌 30 例,鱗狀細胞癌 2 例。切除術后創面面積最小者為 0.5 cm×0.5 cm,位于右鼻翼,為色素痣切除術后創面;最大者為 6 cm×5 cm,位于鼻背部,為基底細胞癌切除術后創面。采用皮下蒂皮瓣修復面部皮膚腫瘤切除術后創面。 結果60 例患者均順利完成手術,術中出血少。術后未發生感染。除 1 例患者術后皮瓣遠端輕度缺血,形成薄痂,術后 10 d 痂殼脫落后傷口愈合,其余患者的傷口均獲一期愈合。術后隨訪 3 個月~5 年,無腫瘤復發,皮瓣形態良好,無明顯瘢痕。 結論徹底切除、及時修復、獲得良好外觀是面部腫瘤切除術后創面修復的關鍵。由于面部血循環豐富,皮下蒂皮瓣為面部腫瘤切除術后創面修復的首選。

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