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find Author "卢建国" 4 results
  • 改良第一趾蹼皮瓣游离移植术后供区创面的修复

    目的总结应用穿支血管蒂足内侧隐神经营养血管皮瓣修复改良第1趾蹼皮瓣游离移植后供区创面的疗效。 方法2009年5月-2012年8月,对9例手部皮肤缺损患者应用改良第1趾蹼皮瓣游离移植修复后,供区遗留3.8 cm × 3.3 cm~5.2 cm × 3.6 cm大小创面,均不能通过直接缝合或植皮修复。男7例,女2例;年龄28~56岁,平均36.2岁。创面合并第1、2趾趾伸肌腱或第1、2趾跖骨外露。手部皮肤缺损修复后一期采用大小为4.2 cm × 3.6 cm~6.0 cm × 4.0 cm的穿支血管蒂足内侧隐神经营养血管皮瓣移位修复供区创面。 结果术后9例皮瓣均顺利成活,创面Ⅰ期愈合。患者均获随访,随访时间6~13个月,平均7个月。皮瓣颜色、质地与受区周围皮肤相似。第1趾蹼夹持、伸展等功能恢复良好。术后6个月,皮瓣静态两点辨别觉达4~9 mm,平均4.8 mm;皮瓣感觉功能恢复至S3 3例,S3+ 4例,S4 2例。 结论应用穿支血管蒂足内侧隐神经营养血管皮瓣修复改良第1趾蹼皮瓣移植后供区创面可获满意疗效。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 改良第一趾蹼皮瓣游离移植修复拇指指腹缺损

    目的 总结吻合血管改良第1 趾蹼皮瓣游离移植修复拇指指腹缺损的疗效。 方法 2008 年2 月-2011 年2 月,收治拇指指腹缺损12 例。男8 例,女4 例;年龄20 ~ 57 岁,平均32.9 岁。机器绞伤7 例,电刨伤3 例,压砸伤2 例。新鲜创面10 例,受伤至入院时间为2 ~ 6 h;陈旧性创面2 例,均为拇指再植术后指腹坏死,于伤后13 d 及15 d 入院。创面范围3.0 cm × 2.0 cm ~ 3.6 cm × 2.8 cm,采用吻合血管改良第1 趾蹼皮瓣游离移植修复,切取的改良皮瓣保留了趾蹼原有功能结构,皮瓣切取范围3.4 cm × 2.3 cm ~ 4.4 cm × 3.0 cm;供区游离植皮或用穿支血管蒂足内侧隐神经营养血管皮瓣修复。 结果 术后供、受区皮瓣和植皮均完全成活,切口Ⅰ期愈合。术后患者均获随访,随访时间8 ~24 个月,平均10 个月。修复后拇指外形美观,伸屈、对掌功能正常,感觉恢复至S3 4 例,S3+ 6 例,S4 2 例。 结论 吻合血管改良第1 趾蹼皮瓣游离移植修复拇指指腹缺损,外形、功能恢复好,供区损伤小,是较好的修复方法之一。

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • Effectiveness of intercostal nerve block and analgesia with bupivacaine liposomes in single-pore thoracoscopic lung surgery: A prospective study

    Objective To compare the analgesic effect, duration and incidence of adverse reactions of liposome bupivacaine and bupivacaine hydrochloride after intercostal nerve block in single-pore thoracoscopic lung surgery. Methods A total of 228 patients in our hospital who needed to undergo thoracoscopic lung surgery were selected and divided into two groups by random number table method: a group B with bupivacaine hydrochloride (n=128) and a group LB with liposome bupivacaine (n=110). Intraoperative intercostal nerve block was performed under endoscopy, and the time of first use of analgesic drugs after surgery, cumulative use of opioids 72 h after surgery, incidence of postoperative nausea and vomiting, length of stay and other indicators were evaluated and recorded. Results Visual analogue scale (VAS) scores at 4 h, 8 h, 12 h, 24 h, 48 h and 72 h in the LB group were significantly lower than those in the group B (P<0.05). The total number of activities within 48 h after surgery in the group B was significantly lower than that in the LB group (P<0.05), and the postoperative hospitalization days in the LB group was shorter than that in the group B, but the difference was not statistically significant.There was no statistical difference between the two groups in postoperative adverse reactions Conclusion Intercostal nerve block with liposome bupivacaine during single-pore thoracoscopic lung surgery can significantly reduce postoperative pain, improve quality of life, and promote recovery. It is worthy of clinical promotion.

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  • (足母)趾底内侧动脉皮穿支血管蒂隐神经营养血管逆行皮瓣修复前足皮肤缺损

    目的 探讨(足母)趾底内侧动脉皮穿支血管蒂隐神经营养血管逆行皮瓣修复前足皮肤缺损的疗效。 方 法 2007 年2 月- 2010 年3 月,收治前足皮肤缺损患者16 例。男11 例,女5 例;年龄22 ~ 53 岁,平均37.5岁。致伤原因:交通事故伤4 例,压榨伤12 例。缺损部位:(足母)趾5 例,前足跖侧8 例、背侧3 例。新鲜创面12 例,陈旧创面4 例。创面范围为5.0 cm × 3.5 cm ~ 10.0 cm × 6.0 cm。术中切取大小为8 cm × 6 cm ~ 12 cm × 7 cm、以(足母)趾底内侧动脉皮穿支为血管蒂的隐神经营养血管逆行皮瓣修复缺损。供区游离植皮修复。 结果 术后6 d 1 例皮瓣出现远端浅表坏死,经换药1 周后愈合;其余皮瓣及供区植皮均顺利成活,创面Ⅰ期愈合。患者术后均获随访,随访时间7 ~ 18 个月,平均8 个月。皮瓣外观、质地良好;感觉功能恢复至S1 1 例,S2 3 例,S3 12 例;两点辨别觉2 ~ 4 mm,平均2.6 mm。足趾及踝关节活动范围正常。 结论 (足母)趾底内侧动脉皮穿支蒂隐神经营养血管逆行皮瓣为多源性供血,手术切取简便、安全,术后外形良好,可恢复受区感觉,是修复前足皮肤缺损的有效方法之一。

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
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