The comparative study of local application of magnetic piece dressings of different intensities (Gs) on the effect of survival of 48 skin flaps (2×5cm in size) and the healing of the incisional wornds was reported. Twelve Japanese long ear white rabbits were used for this study. It was noted that the magnetic field intensity of 200or 400 Gs showed remarkable increase of the area of survival of the skin flaps and enhancement of the healing of the incisional wounds.
ObjectiveTo investigate the effectiveness of retroperitoneal laparoscopic approach combined with anterolateral mini-incision for lumbar spine tuberculosis. MethodsA retrospective analysis was made on the cl inical data of 22 patients with lumbar spine tuberculosis undergoing focus clearance, fusion, and internal fixation by retroperitoneal laparoscopic approach combined with anterolateral mini-incision between June 2006 and June 2012. There were 14 males and 8 females, with an average age of 42.6 years (range, 26-57 years) and with a mean disease duration of 7.3 months (range, 3-10 months). There were 17 patients with single-level spinal tuberculosis (L1, 2 in 3, L2, 3 in 6, L3, 4 in 4, L4, 5 in 2, and L5 in 2) and 5 patients with double-level spinal tuberculosis (L1-3 in 2 and L2-4 in 3). The preoperative Cobb's angle of lumbar spine was 5-28° (mean, 20°). In 6 patients having compression symptom, 4 cases were rated as grade D and 2 as grade C according to Frankel classification. The operative time, intraoperative blood loss, and postoperative complications were recorded. At last follow-up, the neurologic function was assessed according to Frankel grade, the Cobb's angle after operation was measured on lumbar lateral X-ray film; the efficacy was evaluated according to Nakai criteria, and the fusion was evaluated according to Suk criteria. ResultsAll operations were successfully completed. The operation time was 110-250 minutes (mean, 140 minutes), and intraoperative blood loss was 120-280 mL (mean, 180 mL). The symptoms of femoral nerve injury and sympathetic nerve injury occurred in 1 case respectively and was relieved at 1-3 weeks after operation. All incisions healed by first intention. The patients were followed up 16-50 months (mean, 21 months). During the follow-up period, no loosening or breakage of implants and no tuberculosis recurrence were found. At last follow-up, the nerve function was recovered to grade E in the others except 1 case at grade D. The Cobb's angle was 2-16° (mean, 7.8°). According to Nakai criteria for efficacy evaluation, the results were excellent in 9 cases, good in 10 cases, and fair in 3 cases, with an excellent and good rate of 86.4%. The bony fusion rate was 95.5% (21/22) according to Suk criteria. ConclusionRetroperitoneal laparoscopic approach combined with anterolateral mini-incision for lumbar spine tuberculosis is a safe and effective approach with minimal invasion and less complications.
目的探讨小切口胆总管末端结石的治疗。方法对110例胆总管末端结石患者采用小切口术中胆道镜、气囊导管等治疗的临床资料进行回顾性总结。结果术中采用胆道镜、气囊导管等清除末端结石86例（78.2%）。术后用胆道镜取出结石10例（9.1%），胆道镜联合内镜乳头括约肌切开技术清除结石14例（12.7%）。术中18例(16.4%）并发胆总管末端医源性损伤，其中1例术后并发消化道大出血死亡，其余病例经2~20年随访无远期并发症。结论胆总管末端结石采用小切口术中胆道镜、气囊导管等相结合能清除多数结石，难以取出的末端结石于术后经内镜处理为妥。
目的 总结840例小切口胆囊切除术的经验体会。方法 我院应用新器械行小切口胆囊切除术840例，男302例，女538例，年龄16～64岁； 胆囊结石832例，胆囊息肉8例。其手术指征与大切口胆囊切除术相同。术中应用小切口自动伸开架、深部送结器、小切口带灯拉钩、缝合胆囊肝床之外科扣锁钳、肝脏直角灯钩以及为防止在小切口内手术时遗失纱布而特制的气囊纱布； 同时，确保手术能在小切口内完成，术前进行了周密检查以排除肝、胆、胃之肿瘤，并于术前行动态胆囊底B超定位检查，以确定小切口之位置和了解手术难易。结果 840例中行择期手术737例，急诊手术103例； 手术历时平均30分钟； 住院时间3～4天。术后全部患者均获随访，其满意度为98.5%(827/840)。因照明障碍误伤右肝管1例，因胆囊颈结石嵌顿误伤胆总管1例。结论 应用小切口及自制手术器械行胆囊切除术，避免了LC及传统开腹术的一些弊端，效果确切，便于患者接受。
目的 探讨急性化脓穿孔性阑尾炎术后切口感染的相关因素。方法 回顾性分析2009年1月至2011年6月期间我院普外科手术治疗的化脓穿孔性阑尾炎161例患者的临床资料。结果 161例患者中35例（21.7%）发生了切口感染。单因素分析结果表明，肥胖（体质指数＞30kg/m2）、手术时间超过1h、术前未预防性应用抗生素及术后首次切口换药时间＞3d者切口感染发生率高（P＜0.05）；多因素分析结果表明，手术时间超过1h及术前未预防性应用抗生素是急性化脓穿孔性阑尾炎术后切口感染的独立危险因素（P＜0.05）。结论 早期诊治、降低手术时间、术前合理预防性应用抗生素有助于减少切口感染机会。