摘要:目的: 探讨在阑尾切除术中应用抗菌薇乔缝线以减少阑尾切口感染的可能性。 方法 : 将我院2007年4月至2009年3月所有阑尾切除术病例1425例随机分为抗菌薇乔缝线组和丝线组,比较其切口感染发生率。 结果 : 统计中按阑尾未穿孔、阑尾穿孔以及总计分别计算切口感染率,在抗菌微乔线组感染率分别为017%、072%、028%,丝线组分别为154%、781%、267%,两组间分别予以X2检验,其〖WTBX〗P 值均小于001,具有显著性差异。 结论 : 缝线是辅助产生切口感染的一个危险因素,在阑尾切除术中使用抗菌薇乔缝线可以显著降低切口感染率。Abstract: Objective: To investigate the application of Coated VICRYL Plus Antibacterial suture in order to reduce the possibility of infection of appendectomy incision. Methods : Hospital from April 2007 to March 2009 appendectomy patients in all 1425 cases were randomly divided into Coated VICRYL Plus Antibacterial suture group and silk group,compared to the incidence of incision infection. Results : The statistics are not in accordance with perforated appendicitis, perforated appendicitis, as well as calculation of the total, respectively, incision infection, the infection rate in the Coated VICRYL Plus Antibacterial suture group were 017%, 072%, 028%, silk group were 154%, 781%, 267% between the two groups separately X2 test, the P value of less than 001, with a significant difference. Conclusion : The suture is to assist the incision produced a risk factor for infection in appendectomy,Coated VICRYL Plus Antibacterial suture can be used in a significant reduction in incision infection rates.
Objective To investigate the method and the curative effect of postauricular muscular fasciae-periosteal flap and modified unwrinkle incision in parotidectomy. Methods From January 2006 to August 2008, 28 patients with benign lesions of parotid gland were treated. There were 17 males and 11 females aged 19 to 79 years old (average 50 years old),including 20 cases of mixed tumor, 5 cases of adenolymphoma, 1 case of branchial cleft cyst, 1 case of eosinophil ic hyperplastic lymphogranuloma, and 1 case of myoepithel ioma. Tumor masses were all prominent, with the diameter of 2.4-3.8 cm and partial-tough texture. The course of disease was 3-18 months (average 9.5 months). Parotid gland and tumor mass were resected with postauricular incision hidden within the hairl ine, introcession defect (3.0 cm × 2.0 cm × 1.0 cm-3.5 cm × 2.5 cm × 1.5 cm) were repaired with simultaneouly adopting postauricular muscular fasciae-periosteal flap (4.0 cm × 3.0 cm × 1.0 cm-5.0 cm × 4.0 cm × 1.5 cm) by turning the pedicle flap 180°. Results All incision healed by first intention and no necrosis of postauricular muscular fasciae-periosteal flap occurred. All patients were followed up for 6-24 months (average 12 months). The incision was hidden within postauricular hairl ine and shape of parotid realm was good. No sal ivary fistula, facial paralysis, and earlobe numbness occurred. No Frey syndrome were found by local iodine-starch tests. Conclusion Because of hidden incision, good repair effect of region introcession deformity, and fewer postoperative compl ications, the modified parotidectomy with postauricular muscular fasciae-periosteal flap and modified unwrinkle incision is a better method in parotidectomy.
目的探讨多发性肋骨骨折合理治疗方法。 方法回顾性分析山东省日照市岚山区人民医院心胸外科2010年1月至2013年10月115例胸部闭合性损伤患者的临床资料，其中男81例、女34例，年龄19～75岁，平均36.2岁。 结果CT三维重建能够准确判断肋骨骨折情况及胸廓变形情况，然后设置小切口选择性手术内固定肋骨骨折，患者经过手术治疗后全部痊愈，无死亡病例，患者术后疼痛明显减轻，胸廓形状基本恢复，呼吸功能及咳嗽功能基本恢复，住ICU时间8～72（10± 2）h，住院时间9～21（12± 1）d。随访6～18个月，随访率88.7%（102/115）；患者对手术治疗效果满意度为95.1%（97/102）。 结论多发性肋骨骨折患者利用螺旋CT三维重建立体定位后采用小切口手术内固定治疗是一种安全且符合微创原则的治疗方法。
目的 探讨带记忆弹簧圈（MK）补片在无张力修补中、小切口疝中的应用。方法 回顾性分析2005年1月至2007年1月期间我院实施MK补片下置术修补腹壁中、小切口疝25例患者的临床资料，其中初发21例，复发4例。结果 22例一期愈合，3例发生切口皮下积液，经穿刺抽吸处理后治愈。住院7～15 d，均痊愈出院。随访10个月至2年，无复发病例。结论 用MK补片下置术修补腹壁中、小切口疝经济、安全、有效、感染风险降低。
Objective To compare the outcome of uterine exteriorisation repair with in situ in caesarean section. Methods A randomized controlled trial with 220 cases were recruited. Woman with term singleton pregnancy underwent caesarean section and without severe complication were randomly allocated to the two groups (112 cases in exteriorisation group and 108 cases in situ group). Women in treatment group received exteriorisation when the uterus was sutured, While others had the uterus repaired in situ as control. Main outcome measures included perioperative haemodynamic parameters, loss of blood, changes in haemoglobin concentration, duration of operation, postoperative pain score and febrile days, gastrointestinal discomforts and function recovery as well as postoperative maternal morbidity.Data were analyzed by SPSS 11.0. Results Haemoglobin concentration dropped in both groups after caesarean section, and the drops in control group was significantly higher than that of treatment group (t=-2.902, P=0.004). In both groups, pulse before operation was markedly higher than when suturing the uterus and postoperation (Plt;0.05), but no difference was observed between the two groups. Systolic blood pressure of treatment group was lower than that of control group before operation, when suturing the uterus and after operation (F=5.246, P=0.022), but there was no difference among these 3 time points within the group. Onset of flatus was earlier in control group than in treatment group (t=5.567, P=0.000). No difference was identified between the two groups when receiving the different suturing methods. No severe maternal morbidity was observed.Conclusions Uterine exteriorisation and in situ repair have similar effects on intra- and postoperative outcomes. In routine process.