【摘要】 目的 探讨青海玉树地震伤员损伤影像学表现及其诊断价值。 方法 2010年4月15-16日，对83例玉树地震伤员进行影像学表现分析。 结果 胸部损伤33例，四肢损伤32例，脊柱损伤22例，骨盆损伤15例，头颅及颌面部损伤12例，腹部损伤7例，仅软组织挫伤13例。 结论 影像学检查结合患者临床表现能快速、准确、有效对地震性损伤进行临床诊治。【Abstract】 Objective To observe and investigate the manifestations and diagnostic value of radiological features for the injured in Yushu earthquake. Methods From 15th to 16th April, 2010, 83 patients who were injured in Yushu Earthquake underwent CT or DR examinations. Results In 83 patients, chest injury was found in 33, limb injury was in 32, spinal injury was in 22, pelvic injury was in 15, head and maxillofacial injuries were in 12, abdominal injury was in seven,and single soft tissue injury was in 13. Conclusion Radiological examination can exactly, quickly and effectually diagnose the injuries caused by the earthquake.
目的:分析四川汶川地震颅脑损伤患者CT表现及其价值。方法:对地震发生后近2个月内陆续送至四川大学华西医院治疗，因地震致有颅脑损伤史的140名伤员进行颅脑CT分析总结。结果:在本组伤员中，头皮损伤97例（69％）；颅骨骨折68例（49%）；脑挫裂伤66例（47%）；硬膜外和（或）硬膜下积血、积液44例（31％）；蛛网膜下腔出血36例（26％）；脑水肿、软化灶29例（21％）；其他43例（31％）。结论:CT扫描能准确、快速、有效地对地震颅脑损伤患者进行判断，可为临床治疗方案起指导作用。
【摘要】 目的 探讨汶川大地震伤员颌面损伤CT表现及其诊断价值。 方法 对2008年5月12日-7月23日就诊的汶川大地震颌面部伤员51例的CT资料进行回顾性研究。 结果 颌面部骨折21例，多发骨折12例。眼部外伤性改变9例，鼻面部外伤性改变38例。 结论 地震颌面部损伤发生部位主要在鼻面部。CT扫描结合临床检查，能对地震性颌面部外伤的诊断提供帮助。【Abstract】 Objective To observe the features and diagnostic value of CT for maxillofacial injury in Wenchuan Earthquake. Methods The clinical data and CT images of 51 patients with maxillofacial injury in Wenchuan Earthquake from 12th May to 23rd July, 2008 were retrospectively analyzed. Results There were 21 patients (41.2%) with maxillofacial fracture, 12 with multiple fracture, 9 (17.6%) with eye injury, and 38 (74.5%) with facial and nasal injury. Conclusion The facial and nasal injury is the main injury in the maxillofacial trauma caused by the earthquake. CT is helpful to diagnose this kind of injury.
目的：分析四川汶川地震脊柱损伤患者CT表现及其价值。方法：对地震发生后近2个月内先后送至四川大学华西医院治疗的148名脊柱外伤伤员，进行脊柱骨折特点CT分析。结果：148例伤员共有341个椎骨骨折，其中颈椎骨折49个，胸椎骨折110个，腰椎骨折179个，骶椎骨折3个。压缩骨折43个，爆裂骨折41个，后柱断裂149个，压缩骨折合并后柱断裂6个，爆裂骨折合并后柱断裂102个，骨折脱位18个。148例脊柱伤员有84例伴发椎管狭窄。结论：CT能准确、快速地对地震脊柱损伤患者进行诊断，为临床治疗起到指导作用。
目的:着重分析汶川地震中伤员下肢骨折的发生部位、类型及其产生机制和临床意义。方法:对5·12汶川大地震发生后近2个月内先后送至四川大学华西医院治疗的496例下肢骨折伤员,按X线检查结果对骨折部位及类型进行分析。结果:下肢多部位粉碎性骨折而截肢者29例(5.8％),其余467例伤员共584个部位发生骨折。按骨折部位分类:股骨162个(27.7％),胫腓骨275个(47.1％),髌骨19个(3.3％)以及足骨128个(21.9％)。按骨折类型分类:粉碎性骨折244个(41.8％),斜行骨折194个(33.2％),横行骨折53个(9.1％),线性骨折35个(6.0％),螺旋形骨折33个(5.7％),嵌插骨折17个(2.9％),凹陷性骨折2个(0.3％),同一部位(胫腓骨骨干)的多种类型骨折6个(1.0％)。结论:本组汶川地震造成的下肢骨折,部位以胫腓骨为主;类型以粉碎性骨折为主。常规X线检查对下肢骨折伤员具有简便、快速和准确的诊断价值。
摘要:目的:分析汶川大地震伤员中上肢骨折的发生部位、类型及其产生机制和临床意义。方法:对地震发生后近2个月内先后送至四川大学华西医院治疗的140例上肢骨折伤员,按X线检查结果对骨折部位及类型进行分析。结果:140例伤员共183个部位发生骨折。按骨折部位分类:即肱骨60个(32.8％),桡骨51个(27.9％),尺骨41个(22.4％)及手骨骨折31个(16.9％)。按骨折类型分类:横行骨折46个(251％),斜行骨折31个(16.9％),螺旋形骨折11个(6.0％),粉碎性骨折64个(35.0％),嵌插骨折8个(4.4％),线行骨折13个(7.1％),撕脱骨折10个(5.5％)。结论:本组汶川大地震性的上肢骨折,部位以肱骨骨折为主;类型以粉碎性骨折为主。常规X线检查对上肢骨折伤员具有简便、快速和准确的诊断价值。
目的:分析汶川大地震中伤员骨盆骨折的发生部位及骨折类型。方法:对地震发生后近2个月内先后送至四川大学华西医院治疗的95例骨盆骨折伤员,按放射学检查结果进行骨折部位及类型分析。结果:95例伤员共发生133个部位的骨折。按骨折部位分类:髂骨22个(16.6％),坐骨10个(7.5％),耻骨81个(60.9％),髋臼18个(13.5％),骶尾骨2个(1.5％)。按骨折类型分类:斜行骨折71个(53.4％),粉碎性骨折43个(32.3％),线性骨折11个(8.3％),横行骨折5个(3.7％),嵌插骨折3个(2.3％)。结论:地震造成骨盆骨折部位以耻骨为主,类型以斜行骨折为主。对骨盆骨折伤员,X线及CT检查相结合能为临床提供更好的影像诊断价值。
目的:分析四川汶川大地震胸部损伤患者影像学表现及其价值。方法:对地震发生后近2个月余陆续送至四川大学华西医院治疗,因地震致有胸部损伤史的155名伤员进行影像学分析总结。结果:在本组伤员中,胸廓骨折139例,胸膜损伤160例,肺损伤55例,纵隔损伤28例,肺部慢性感染39例,肺部肿块2例。其中部分伤员为多处复合性损伤。结论:影像学检查能准确、快速、有效地对地震胸部损伤患者进行判断,可为临床治疗方案起指导作用。
ObjectiveTo explore the feasibility to restore pronunciation function by repairing partial suprahyoid epiglottis-preserved circumferential defect in near total laryngectomy with anterior medial thigh flap in advanced laryngeal cancer. Methods A retrospective study of 5 male patients with advanced laryngeal cancer between August 2019 and October 2022, aged 56-73 years, with an average age of 65 years were reviewed. The disease duration ranged from 3 to 24 months, with an average of 8 months. Tumor classification by location: 2 cases of glottic type, 2 cases of supraglottic type, and 1 case of subglottic type; TNM staging: 3 cases of T4N0M0 stage, 1 case of T4N1M0 stage, and 1 case of T4N2M0 stage; American Joint Committee on Cancer (AJCC) staging (2017): stage Ⅳ. Near total laryngectomy with partial suprahyoid epiglottis-preserved and selective bilateral neck dissection were performed before the anterior medial thigh flap was used to repair the circumferential defects. The flap size ranged from 6 cm×5 cm to 8 cm×6 cm. Four patients underwent adjuvant radiotherapy and chemotherapy after operation, while 1 patient did not receive any other adjuvant treatment such as radiochemotherapy. Results The flaps of all 5 patients survived without obvious neck infection. One patient developed a slight pharyngeal fistula after oral feeding at 1 month after operation, which healed after another week of gastric feeding. Primary healing also achieved in the thigh donor area. One patient had bilateral cervical lymph node metastasis, and 1 patient had lymph node metastasis on one side. The remaining 3 patients had no cervical nodes metastasis on both sides. All 5 patients were followed up 12-36 months, with an average of 27.6 months. Four patients had clear, audible, and hoarse voice while 1 patient (case 3) had pronunciation similar to whispering. Laryngoscopy showed that the reconstructed laryngeal inlet was fissure-shape and the reconstructed laryngo-trachea canal below the laryngeal inlet was gradually enlarged. At 1 month after operation, the gastric tube was withdrawn and the food was taken orally. There was no obvious aspiration pneumonia. The tracheostomy tube could be blocked in 4 patients for from 30 seconds to 3 minutes. Among them, 3 patients were able to make a noticeable pronunciation even when the tube was not blocked, and they were able to engage in barrier-free language communication; the tracheostomy tube could not be blocked in 1 patient who had a pronunciation similar to whispering. Preliminary voice analysis showed that the patients have a relaxed and natural pronunciation, without obvious breath-holding or air-swallowing movement, compared to patients with esophageal pronunciation. Decannulation did not achieved until the last follow-up in all 5 patients. ConclusionThe anterior medial thigh flap can repair circumferential defects after near total laryngectomy in advanced laryngeal cancer patients and achieve satisfactory pronunciation, thus can serve as an effective pronunciation rehabilitation method. The preserved part of epiglottis may play a role to prevent postoperative aspiration.
Objective To summarize the research progress of controlled release of angiogenic factors and osteogenic factors in bone tissue engineering. Methods The domestic and abroad literature on the controlled release structure of growth factors during bone regeneration in recent years was extensively reviewed and summarized. Results The sustained-release structure includes direct binding, microsphere-three-dimensional scaffold structure, core-shell structure, layer self-assembly, hydrogel, and gene carrier. A sustained-release system composed of different sustained-release structures combined with different growth factors can promote bone regeneration and angiogenesis. Conclusion Due to its controllability and persistence, the growth factor sustained-release system has become a research hotspot in bone tissue engineering and has broad application prospects.