目的 探讨乳房肿物体表定位膜对乳腺彩超结果的影响。方法 回顾性分析2010年12月至2011年1月期间，笔者所在医院乳腺门诊检查触诊阴性的180例患者共236个乳房肿物贴膜前后的彩超检查结果，分析其血运、边界、钙化及分级情况的变化。结果 贴膜后，236个肿物中有2个血运情况有变化，7个边界有变化，5个钙化情况有变化，5个分级有变化，但贴膜前后乳房肿物的血运（P=0.500）、边界（P=0.136）、钙化（P=0.082）及分级（P=0.172）变化情况比较差异均无统计学意义。结论 乳房肿物体表定位膜不影响乳房肿物的彩超检查结果。
ObjectiveTo investigate the clinical value of cervical vascular color Doppler ultrasound for dignosis of nonrecurrent laryngeal nerve before thyroid surgery. MethodsThere were 1931 cases of thyroid patients treated between January 2010 to Jule 2014, group these patients according to the results of preoperative chest radiograph examination, the chest radiograph shows abnormal vessels image were group A (45 cases), no abnormalities were group B (1886 cases). Before operaton, made patients of group A to have routine carotid duplex ultrasound to identify whether the right subclavian artery abnormalities. All patients were exposed to conventional methods of recurrent laryngeal nerve during surgery. ResultsThe 45 patients of group A, chest angiography showed 17 cases with right subclavian artery abnormalities, they were confirmed that all the 17 patients were nonrecurrent laryngeal nerve by surgery, no damage cases. The other 28 cases showed a normal right subclavian artery and no cases of nonrecurrent laryngeal nerve. The 1886 patients in group B, surgical exploration found four cases with nonrecurrent laryngeal nerve, injury in 1 case. The 21 patients whose nonrecurrent laryngeal nerve were on the right side, there were no left side with nonrecurrent laryngeal nerve and no co-exist cases of nonrecurrent and recurrent laryngeal nerve. The average exposure time of nonrecurrent laryngeal nerve in patients of group A (17 cases) was significantly shorter than that group B[(4.28±1.08) min vs. (15.50±2.08) min, t=-15.978, P=0.000]. ConclusionsThe cervical vascular color Doppler ultrasound examination before thyroid surgery can be adjuvant used, if there is the right subclavian artery abnormalities, it showes that there is the right side nonrecurrent laryngeal nerve. So as to effectively prevent the damage of nonrecurrent laryngeal nerve during thyroid surgery.
Objective To compare the effectiveness of poly ether ether ketone (PEEK) positioning devices combined with mixed reality technology versus color doppler ultrasound guidance for the localization of vessels in anterolateral thigh perforator flap. Methods A retrospective analysis was conducted on 40 patients with tissue defects after oral cancer resection who underwent repair using the anterolateral thigh perforator flap between January 2022 and June 2023. According to the different intraoperative positioning methods of the anterolateral thigh perforator flap, they were randomly divided into PEEK group (mixed reality technology positioning with PEEK positioning device combined with CTA data) and color ultrasound group (using color ultrasound guided positioning), with 20 cases in each group. There was no significant difference in gender, age, etiology, and disease duration in the two groups (P>0.05). The number of perforator vessels actually detected in the two groups of regions of interest was recorded, and compared them with the intraoperative identified number to calculate the success rate of perforator vessels; the distance between the perforating point and the actual puncture point was measured, the operation time of the two groups of flaps was recorded. ResultsP In the PEEK group, 32 perforator vessels were identified, 34 were found by intraoperative exploration, and the success rate was 94.1% (32/34); in the color ultrasound group, 29 perforator vessels were identified, 33 were found by intraoperative exploration, and the success rate was 87.8% (29/33); there was a significant difference in the success rate of identifying perforator vessels between the two groups (P<0.05). The distance between the perforating point and the actual puncture point and the operation time in PEEK group were significantly shorter than those in color ultrasound group (P<0.05). Patients in both groups were followed up 6-30 months, with a median of 17 months; there was no significant difference in the follow-up time between the two groups (P>0.05). In the PEEK group, there was 1 case of flap necrosis at the distal edge and delayed healing after trimming and dressing change. In the color ultrasound group, there was 1 case of flap necrosis at 7 days after operation and pectoralis major myocutaneous flap was selected for repair after removal of the necrotic flap. In the rest, the flap survived and the incision healed by first intention. Donor site infection occurred in 1 case in PEEK group and healed after anti-inflammatory treatment. The maxillofacial appearance of the two groups was good, the flap was not obviously bloated, and the patients were satisfied with the repair effect. Conclusion Compared with the traditional color ultrasound positioning, the positioning marker made of PEEK combined with CTA data to locate the vessels in anterolateral thigh perforator flap has higher success rate and positioning accuracy, and the flap production time is short, which has high clinical application value.