目的：探讨覆膜支架治疗外伤性颈内动脉海绵窦瘘（TCCF）的临床治疗经验。方法：11例TCCF经血管内介入治疗，1例外伤性颈内动脉海绵窦瘘患者复发，压迫颈总动脉无效，行球囊闭塞颈内动脉及瘘口。结果：术后杂音立即消失，数天后结膜水肿消退，造影见瘘口完全闭塞，10例TCCF患者颈内动脉保持通畅。1例患者颈内动脉闭塞。无操作所产生的并发症出现。结论：覆膜支架是处理TCCF的有效手段；瘘口再通可能与支架移位、贴壁不良有关。压迫颈总动脉对再通瘘口的治疗无效。
In order to preserve more normal tissue in situ in case of severe traumatic rupture of spleen, simultaneous ligation of splenic artery and vein was performed successfully on animals and then was applied for clinic use. The preserved splenic tissue all survivied and functioned well. Patients with severe traumatic rupture of spleen grade Ⅳ-Ⅴ were all cured by ligation of both the splenic artery and vein at the same time.
To comprehend the present situation in diagnosis and treatment of traunatic hepatorrhexis in this country,693 patients with traumatic rupture of the liver in 31 hospitals where to be located in Sichuan,Zhejiang,Guizhou,Yunnan,Fujian,Heilongjiang,Gguangxi and Hebei province in this country were collected through questionnaire and analysed.The data showed that male to female ratio was 4.17 to 1,with an average of 39.3 years.Closed injury accounted for 74.5% and 53.9 percent of them were injured in traffic accident.47.4% of the patients were admitted to the hospital within 4 hours after injury.Hemorrhagic shock was present high up to 61.9%.During exploratory laparotomy,hematoperitoneum was greater than 1000ml accounted for 61.5%,injury to the right lobe of liver 70.0%,and hepatorrexis associated with other organs and tissues injuries were 19.8%.45.5% of the patients was in third degree or more according to the AAST classificatino.All of the patients were treated by surgery,83.7% percent of them with debridement and suture and omentum packing for hemostasis,49 patients undergone partial hepatectomy.The postoperative complication rate was 22.2% and mortality was 8.7%.The authors consider that to perfect the emergency treatment system,enrich the knowlege and skill of the basic personnel so that the injured can be properly treated is cruical to improve the cure rate and reduce the mortality.
目的 探讨自制封闭式负压引流冲洗治疗四肢难愈性创面的护理要点。 方法 对2011年8月－2012年9月收治的38例使用自制封闭式负压引流冲洗+Ⅰ期植皮修复四肢难愈性创面的患者进行护理观察。 结果 34例四肢难愈性创面Ⅰ期成功修复创面，减轻了患者住院期间痛苦，缩短患者治疗时间，住院费用明显下降，4例创面因感染植皮大部分融解，经2次冲洗引流，培养肉芽后再植皮痊愈，无护理并发症发生。 结论 术后患者维持在适应的体位、间歇式冲洗，持续恒定的负压吸引、密切的护理观察和引流管的管理是护理的关键环节。