31例眼睑恶性肿瘤切除后Ⅰ期修复的总结

眼睑恶性肿瘤切除术后,眼睑修复时机的选择,对保持眼睑功能和美容的效果起着十分重要的作用,术式的选择是决定手术成功关键。采用眼睑全层缺损行异体巩膜片移植,替代睑板、滑行球结膜瓣前徙替代睑结膜的眼睑再造术,对31例眼睑恶性肿瘤切除,同时进行眼睑再造术。术后无排斥反应,眼睑闭合良好,外形满意。结论认为,较大范围的眼睑恶性肿瘤切除的患者,采用异体巩膜片移植、滑行结膜瓣前徙眼睑再造术能达到保持眼睑功能和美容的效果,是理想的眼睑恶性肿瘤切除后Ⅰ期修复临床决策。     

应用烧伤整形外科技术治疗大面积皮肤撕脱伤

探讨大面积皮肤撕脱伤的治疗方法。分析总结大面积皮肤撕脱伤及合并损伤17例,根据伤情综合应用清创撕脱皮肤缝合、带蒂真皮下血管网皮瓣回植、撕脱皮肤反取皮回植、组织瓣转移修复、游离皮片移植、头皮取皮术、异体／异种皮移植、创面持续负压吸引VSD等治疗方法,观察创面修复、肢体外观及功能恢复情况。结果17例患者经综合治疗后创面均愈合。功能部位均予全层皮片或皮瓣修复;19处创面有深部组织外露,予皮瓣或肌瓣修复;随访6个月～3年,所有肢体功能良好。根据皮肤软组织损伤情况而综合运用多种烧伤整形外科技术修复大面积撕脱伤可缩短疗程,并最大可能保留受伤区域的功能与外观,改善患者生活质量。     

带腓肠神经腓骨复合组织瓣移植修复前臂尺侧缺损

观察以带腓肠神经的腓骨复合组织瓣移植修复前臂尺侧缺损的临床效果.时15例前臂尺侧复合组织缺损的患者实行带腓肠神经的腓骨复合组织瓣移植修复术.结果15例组织瓣全部成活,前臂功能恢复良好.应用带腓肠神经的腓骨复合组织瓣移植修复前臂尺侧缺损,是一种治疗复合组织缺损的有效手术方法.     

带腓肠神经腓骨复合组织瓣移植修复前臂尺侧缺损

观察以带腓肠神经的腓骨复合组织瓣移植修复前臂尺侧缺损的临床效果。对15例前臂尺侧复合组织缺损的患者实行带腓肠神经的腓骨复合组织瓣移植修复术。结果15例组织瓣全部成活,前臂功能恢复良好。应用带腓肠神经的腓骨复合组织瓣移植修复前臂尺侧缺损,是一种治疗复合组织缺损的有效手术方法。     

国内同行关于异体颜面移植的讨论

换脸术为严重毁容患者重获美容带来了新希望.但是就像很多新生事物一样,在国内引起了激烈的争论.我们以丁香园上的帖子为基础,对国内同行的争论进行了总结,以期对异体颜面移植这一成果有一深入的认识.通过初步分析可以看出,虽然对于这一课题争论比较大,但是广大医护人员还是认可此次手术,并认为这是创新.     

乳晕月牙状切口与传统切口手术治疗男性乳房发育症的比较研究

探讨乳晕月牙状切口切除男性乳房发育症的手术方法及美容效果.回顾性分析5年来在局麻或全麻下,分别采用乳晕月牙状切口(46例)和传统沿乳晕弧形切口或放射状切口(32例)保留乳头乳晕手术治疗男性乳腺发育症,比较两种术式的手术时间、术中出血量、切口隐蔽程度、患者满意度及住院费用等临床资料的差异.乳晕月牙状切口潜行切除增生的乳腺腺体与传统切口相比,切口更小而隐蔽,术后外观美容效果更好,是治疗男性乳房发育症的一种理想术式.     

国内同行关于异体颜面移植的讨论

换脸术为严重毁容患者重获美容带来了新希望。但是就像很多新生事物一样,在国内引起了激烈的争论。我们以丁香园上的帖子为基础,对国内同行的争论进行了总结,以期对异体颜面移植这一成果有一深入的认识。通过初步分析可以看出,虽然对于这一课题争论比较大,但是广大医护人员还是认可此次手术,并认为这是创新。     

胸腔镜肺切除术治疗肺部恶性肿瘤的合理性

通过回顾近年电视胸腔镜手术(VATS)在治疗非小细胞肺癌的进展,得出以下结论:在有经验的胸外科医师手中,VATS肺叶切除术是一种安全有效、死亡率和并发症发生率很低的术式.VATS肺叶切除是一种完全的肺部肿瘤切除手术,在有选择的早期病例可以达到与开胸手术一样的生存率.但这种术式并不适用于全部肺部恶性肿瘤和所有胸外科医师.     

以中节指动脉弓为蒂逆行指动脉岛状皮瓣修复指端缺损

观察以中节指动脉弓为蒂逆行指动脉岛状皮瓣修复指端缺损的临床效果.对24例指端缺损的患者实行以中节指动脉弓为蒂逆行指动脉岛状皮瓣修复术.结果24例患者皮瓣全部成活.术后随访3个月～6个月.手指功能恢复良好.该手术操作简便,术后功能外观好,是修复指端特别是指腹皮肤软组织缺损的首选手术方法.     

风湿性心脏病瓣膜置换术后抗凝治疗中"度"的把握

风湿性心脏瓣膜病在世界范围内发病率极高,瓣膜置换术是目前治疗该病的主要方法,根据不同的病情及需要可置换机械辩或生物瓣,我国患者更常选择机械瓣置换,术后生物瓣置换需抗凝3个月～6个月,而机械瓣置换者需终身抗凝,故抗凝治疗非常关键.本文从辨证思维的角度分析如何在瓣膜置换术后把握好抗凝治疗.     

Reinforcement and Inhibition of Eyelid Reflexes

Taste preferences, as measured in 48-hour, Richter-type drinking tests (test solution opposite distilled water), were determined for northern grasshopper mice (Onychomys leucogaster, ssp. breviauritus). The Ss were nine males and nine females which were individually housed within an environmental chamber. The test solutions were prepared from five sugars (fructose, glucose, lactose, maltose, sucrose), three salts (magnesium sulfate, potassium chloride, sodium chloride), and two acids (citric acid and hydrochloric acid). In randomly assigned order, each sugar and each salt solution was presented at five molar concentrations, and each acid was paired with distilled water at six levels of pH. Strong drinking preferences were shown for all concentrations of the sugars above .05?.10 M, and sugars ranked in order of preference as follows: Maltose = sucrose > glucose = fructose > lactose. Preferences were also shown for hypotonic concentrations of NaCl. The other salts and both acids, however, were indifferently preferred at low concentrations and were rejected at the higher concentrations. Taste preferences by grasshopper mice for these chemicals were similar to those exhibited by Mongolian gerbils tested with the same items. The similar patterns of preference shown by New World cricetid rodents (grasshopper mice) and Old World cricetid rodents (gerbils) suggest that conclusions concerning disparity in taste sensibilities among animal forms may be premature.     

Eyelid conditioning and concomitant GSR activity

The purpose of these experiments was to investigate an aspect of autonomic activity (namely, skin resistance) during the course of eyelid conditioning, as a check on those theories which postulate that ‘arousal’ or ‘emotionality’, as measured by autonomic activity, is related to the level of conditioning.

Although many measures of skin resistance were obtained (including both basal levels and responses), the results were with one exception entirely negative in showing no significant correlations between the autonomic variables and eyelid conditioning. The exception was a significant correlation between skin resistance change to a test-trial puff of air (the UCS) and the level of eyelid conditioning reached by the subject; this result supports predictions made by Spence about the role of a hypothetical emotional response in conditioning, but was obtained in only one of the two studies.

The generally non-significant relationship between skin resistance and eyelid conditioning is discussed with respect to response specificity, and also to a postulated specificity in conditioning such that a subject who conditions well in one modality does not necessarily condition well in another modality. This specificity is considered in the light of the physiological mechanisms involved in each response system.     

上睑凹陷临床治疗方法的进展述评

上睑凹陷指的是上睑区眶下缘处出现的凹陷,常常与眼睑皮肤松弛下垂同时发生,为上睑老化的临床表现之一。随着人们对眶区年轻化的日渐重视,整形美容医师对纠正上睑凹陷研究出多种治疗方法。我们搜集了关于上睑凹陷临床治疗方法的国内外文献,并综合比较,分析进展趋势。目前的国内外研究中可将治疗方法概括分为三大类：组织的重新定位;注射及填充;以及两种方法的联合应用。而两种方法的联合应用正逐渐成为当今临床的主要治疗趋势。