【摘要】 目的 观察综合治疗体表血管瘤及脉管畸形的临床疗效。 方法 2008年1月-2010年9月，收治体表血管瘤和脉管畸形患者共205例。手术治疗156例，其中单纯手术治疗103例，合并介入治疗9例，硬化剂治疗44例；非手术治疗49例，其中介入治疗1例，硬化剂治疗38例，介入合并硬化剂治疗10例。术后随访6个月～3年。 结果 15例手术治疗患者于术后6个月～2年复发，其中单纯手术治疗患者10例（复发率9.71%），合并介入治疗患者2例（复发率22.22%），合并硬化剂治疗患者3例（复发率6.82%），均再次手术治疗后痊愈。9例非手术治疗患者于治疗后3个月～2年复发，其中8例硬化剂治疗患者，1例介入合并硬化剂治疗患者，均经手术治疗后痊愈。余患者未见复发。 结论 以手术治疗为主的综合治疗，是体表血管瘤和脉管畸形治疗的良好方法。【Abstract】 Objective To observe the clinical therapeutic efficacy of comprehensive treatment on body surface hemangioma and vascular malformations. Methods Between January 2008 and September 2010, 205 pateints with surface hemangioma and vascular malformation were treated. A total of 156 patients received surgical treatment, in whom 103 received surgery alone, 9 underwent combined interventional treatment, and 44 received combined sclerotherapy. There were 49 patients underwent non-surgical treatment, including intervention in 1, sclerotherapy in 38 involving 10 had combined sclerotherapy. The patients were followed up for 6 months to 3 years. Results A total of 15 patients who had received surgical treatment recurred 6 months to 2 years after the treatment, including 10 who had been treated with surgery alone (with the recurrence rate of 9.71%), 2 combined with interventional treatment (with the recurrence rate of 22.22%), and 3 combined with sclerotherapy (with the recurrence rate of 6.82%). They were all cured after reoperation. Nine cases of non-surgical treatment recurred 3 months to 2 years after the treatment, including 8 who had received sclerotherapy, and 1 combined with interventional treatment and sclerotherapy. Patients were all cured after surgery. The other patients had no recurrence. Conclusion Applying mainly on surgical treatment, the combined therapy is a good way for body surface hemangioma and vascular malformations.
【摘要】 目的 建立兔耳中期瘢痕动物模型，寻找兔耳瘢痕形成的最佳位点。 方法 选用日本大耳白兔20只，在兔耳腹侧选定6个位点，作直径1 cm直达软骨表面的皮肤全层及软组织缺损240个。创面暴露，于伤后7 d去除软骨上面的肉芽及血浆痂壳一次。术后连续3个月观察创面自然愈合及瘢痕增生情况;用HE及苦味酸-天狼星红染色观察瘢痕形成及胶原分布情况;用计算机图像分析系统测定胶原含量。 结果 兔耳腹侧可制作类似人的增生性瘢痕模型，瘢痕的发生率42.5%~56.7%，瘢痕增生的高峰在造创后30~50 d。不同位点瘢痕增生程度不同，胶原含量也不同。 结论 兔耳腹侧可建立中期瘢痕动物模型，兔耳腹侧的中分和耳尖外侧部分是制作兔耳增生性瘢痕的理想位点。【Abstract】 Objective To establish an animal model of intermediate stage hypertrophic scar on the rabbit ears and to find out the best sites of scar formation. Methods A total of 240 full-thickness skin and tissue defect directing access to the cartilage surface was created on the ventral side in 20 Japan white rabbits and each ear contain 6 defect sites.The wound was treated by exposure method.On the 7th day after operation, the granulation tissue and plasma shell were removed on the cartilage.Wound healing and scar proliferation under natural condition were observed continuously for 3 months.The scar formation and collagen distribution were observed by HE and Sirius red staining, and the collagen content was analyzed by using computer image analysis system. Results The ventral wound of rabbit’s ears produced hypertrophic scar similar to human hypertrophic scar, the incidence of scar was between 42.5% to 56.7%.The peak of scar proliferation was in 30 days to 50 days after operation.The degree of scar proliferation and collagen content varied at different sites. Conclusion The ventral wound of rabbit’s ears can produce intermediate stage hypertrophic scar model, the middle sites and the lateral ear tip are ideal site for madding animal model of hypertrophic scar on the rabbit ears.
Objective To develop an evaluation tool for the screening of high risk population for oral complications in critically ill patients, which can be performed accurately and scientifically. Methods Basing on the related foreign oral assessment scale, combined with the method of brainstorming, expert consultation, method of clinical status and so on, the item pool of the assessment scale was determined. Five nursing experts and two oral experts assessed the content validity and 50 ICU nurses were tested. Then, the screening accuracy of the assessment scale was proved by application in 100 critically ill patients selected randomly. Results The Cronbach’s a coefficient of final version of the High Risk Assessment Scale for Oral Complications in Critically Ill Patients (including seven parts contents of oral health assessment and oral pH value test) was 0.815, the content validity index (Sr-CVI/Ave) was 0.932. The results of 50 nurses to the 91.2% assessment items of the assessment scale were very important and important. For screening related indicators of oral complications in high-risk patients, the sensitivity of the assessment scale was 97.53%, the specificity was 94.11%, the positive predictive value was 98.75%, the negative predictive value was 88.89%, and the crude agreement was 95%. Conclusion There are good reliability, validity and a high accuracy of screening test in the High Risk Assessment Scale for Oral Complications in Critically Ill Patients. It can be used for screening patients at high risk for oral complications in critically ill patients, and help clinical nurses to complete the oral health status of the critically ill patients quickly.
Objective To investigate and analyze the clinical features of primary pulmonary malignant melanoma. Methods The medical records, imaging examinations, pathological results, treatment and prognosis of four primary pulmonary malignant melanoma (PMML) patients were retrospectively collected. In combination with 96 cases reported in the literature, a total of 100 patients with PMML were analyzed. Results Among the 100 PMML patients, there were 60 males (60.0%) and 40 females (40.0%), with an average age of 56.9±10.3 years. Common clinical symptoms were cough (60.0%), chest tightness or pain (18.0%), hemoptysis (16.0%), and dyspnea (11.0%). Distant metastasis was found in 30 cases (30.0%) at the time of consultation. The clinical stage of the first diagnosis and evaluation of the patients was stage Ⅰ in 7 cases (7.0%), stage Ⅱ in 24 cases (24.0%), stage Ⅲ in 13 cases (13.0%), stage Ⅳ in 39 cases (39.0%), and 17 cases (17.0%) did not mention a clear tumor stage. Thirty patients (30.0%) received comprehensive anti-tumor therapy, 53 patients (53.0%) received surgical resection, and 17 patients among them (17.0%) received postoperative adjuvant comprehensive therapy. The overall median survival time of PMML patients was 8.0 (2.0 - 14.4) months. The median survival time of stage Ⅳ PMML patients was 5.0 (3.1 - 6.9) months, which was significantly lower than 24.0 (6.0 - 32.0) months of stage Ⅱ patients (P<0.05) and 15.0 (0.6 - 29.4) months of stage Ⅲ patients (P<0.05). Further analysis showed that different treatment regimens had no significant effect on the median survival time of patients with stage Ⅳ PMML (P>0.05). Conclusions PMML has a high degree of malignancy and no specific clinical symptoms. It is mainly diagnosed by pathology. Surgical resection, postoperative adjuvant chemoradiotherapy or immunotherapy are the main treatment methods, but its overall prognosis is poor.