摘要:目的:分析汶川大地震傷員中上肢骨折的發生部位、類型及其產生機制和臨床意義。方法:對地震發生后近2個月內先后送至四川大學華西醫院治療的140例上肢骨折傷員,按X線檢查結果對骨折部位及類型進行分析。結果:140例傷員共183個部位發生骨折。按骨折部位分類:即肱骨60個(32.8％),橈骨51個(27.9％),尺骨41個(22.4％)及手骨骨折31個(16.9％)。按骨折類型分類:橫行骨折46個(251％),斜行骨折31個(16.9％),螺旋形骨折11個(6.0％),粉碎性骨折64個(35.0％),嵌插骨折8個(4.4％),線行骨折13個(7.1％),撕脫骨折10個(5.5％)。結論:本組汶川大地震性的上肢骨折,部位以肱骨骨折為主;類型以粉碎性骨折為主。常規X線檢查對上肢骨折傷員具有簡便、快速和準確的診斷價值。
【摘要】 目的 探討青海玉樹地震傷員損傷影像學表現及其診斷價值。 方法 2010年4月15-16日，對83例玉樹地震傷員進行影像學表現分析。 結果 胸部損傷33例，四肢損傷32例，脊柱損傷22例，骨盆損傷15例，頭顱及頜面部損傷12例，腹部損傷7例，僅軟組織挫傷13例。 結論 影像學檢查結合患者臨床表現能快速、準確、有效對地震性損傷進行臨床診治。【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:分析汶川大地震中傷員骨盆骨折的發生部位及骨折類型。方法:對地震發生后近2個月內先后送至四川大學華西醫院治療的95例骨盆骨折傷員,按放射學檢查結果進行骨折部位及類型分析。結果:95例傷員共發生133個部位的骨折。按骨折部位分類:髂骨22個(16.6％),坐骨10個(7.5％),恥骨81個(60.9％),髖臼18個(13.5％),骶尾骨2個(1.5％)。按骨折類型分類:斜行骨折71個(53.4％),粉碎性骨折43個(32.3％),線性骨折11個(8.3％),橫行骨折5個(3.7％),嵌插骨折3個(2.3％)。結論:地震造成骨盆骨折部位以恥骨為主,類型以斜行骨折為主。對骨盆骨折傷員,X線及CT檢查相結合能為臨床提供更好的影像診斷價值。
目的:分析四川汶川大地震胸部損傷患者影像學表現及其價值。方法:對地震發生后近2個月余陸續送至四川大學華西醫院治療,因地震致有胸部損傷史的155名傷員進行影像學分析總結。結果:在本組傷員中,胸廓骨折139例,胸膜損傷160例,肺損傷55例,縱隔損傷28例,肺部慢性感染39例,肺部腫塊2例。其中部分傷員為多處復合性損傷。結論:影像學檢查能準確、快速、有效地對地震胸部損傷患者進行判斷,可為臨床治療方案起指導作用。
目的:分析四川汶川地震顱腦損傷患者CT表現及其價值。方法:對地震發生后近2個月內陸續送至四川大學華西醫院治療，因地震致有顱腦損傷史的140名傷員進行顱腦CT分析總結。結果:在本組傷員中，頭皮損傷97例（69％）；顱骨骨折68例（49%）；腦挫裂傷66例（47%）；硬膜外和（或）硬膜下積血、積液44例（31％）；蛛網膜下腔出血36例（26％）；腦水腫、軟化灶29例（21％）；其他43例（31％）。結論:CT掃描能準確、快速、有效地對地震顱腦損傷患者進行判斷，可為臨床治療方案起指導作用。
目的:著重分析汶川地震中傷員下肢骨折的發生部位、類型及其產生機制和臨床意義。方法:對5·12汶川大地震發生后近2個月內先后送至四川大學華西醫院治療的496例下肢骨折傷員,按X線檢查結果對骨折部位及類型進行分析。結果:下肢多部位粉碎性骨折而截肢者29例(5.8％),其余467例傷員共584個部位發生骨折。按骨折部位分類:股骨162個(27.7％),脛腓骨275個(47.1％),髕骨19個(3.3％)以及足骨128個(21.9％)。按骨折類型分類:粉碎性骨折244個(41.8％),斜行骨折194個(33.2％),橫行骨折53個(9.1％),線性骨折35個(6.0％),螺旋形骨折33個(5.7％),嵌插骨折17個(2.9％),凹陷性骨折2個(0.3％),同一部位(脛腓骨骨干)的多種類型骨折6個(1.0％)。結論:本組汶川地震造成的下肢骨折,部位以脛腓骨為主;類型以粉碎性骨折為主。常規X線檢查對下肢骨折傷員具有簡便、快速和準確的診斷價值。
目的：分析四川汶川地震脊柱損傷患者CT表現及其價值。方法：對地震發生后近2個月內先后送至四川大學華西醫院治療的148名脊柱外傷傷員，進行脊柱骨折特點CT分析。結果：148例傷員共有341個椎骨骨折，其中頸椎骨折49個，胸椎骨折110個，腰椎骨折179個，骶椎骨折3個。壓縮骨折43個，爆裂骨折41個，后柱斷裂149個，壓縮骨折合并后柱斷裂6個，爆裂骨折合并后柱斷裂102個，骨折脫位18個。148例脊柱傷員有84例伴發椎管狹窄。結論：CT能準確、快速地對地震脊柱損傷患者進行診斷，為臨床治療起到指導作用。
【摘要】 目的 探討汶川大地震傷員頜面損傷CT表現及其診斷價值。 方法 對2008年5月12日-7月23日就診的汶川大地震頜面部傷員51例的CT資料進行回顧性研究。 結果 頜面部骨折21例，多發骨折12例。眼部外傷性改變9例，鼻面部外傷性改變38例。 結論 地震頜面部損傷發生部位主要在鼻面部。CT掃描結合臨床檢查，能對地震性頜面部外傷的診斷提供幫助。【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.
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.