目的 回顾性分析2008年5月12日汶川地震及2013年4月20日芦山地震中，笔者所在医院收治的8例地震肝外伤住院伤员情况，为地震肝外伤的诊治提供参考。方法 于笔者所在医院病案科查询因地震伤入院且诊断为肝外伤的伤员，收集其相关临床资料并分析。结果 笔者所在医院在汶川及芦山地震后共收治地震肝外伤患者8例，其中7例患者伴随有其他合并伤。入院后2例患者接受了肝脏手术治疗，其余6例患者行保守治疗。所有患者均治愈出院。结论 早期明确诊断，选择恰当的治疗方式，及时处理合并伤，可以使地震肝外伤患者获得良好的预后。
目的：研究外伤性脑梗死患者血小板P选择素动态变化的临床意义。方法：用流式细胞仪测定42例外伤性脑梗死患者，50例无脑梗死外伤患者及40例正常对照者外周血血小板P选择素。结果：急性期(1周内)外伤性脑梗死患者P选择素明显高于无梗死脑外伤患者和健康对照组(Plt;0.01)。14 d时，外伤性脑梗死患者血小板P选择素表达，与无梗死脑外伤患者和健康对照组无显著差异(Pgt;0.005)。结论：P选择素参与外伤性脑梗死的病理过程，测定它们有利于外伤性脑梗死的早期诊治，改善预后。
目的探讨腹腔镜在腹部外伤诊断与治疗中的应用价值。方法 对36例腹部外伤患者行腹腔镜探查术，首先明确诊断，根据不同的损伤脏器和类型，进行腹腔镜下处理，处理困难或无效时及时中转开腹。结果本组病例术中均明确诊断。10例开放性腹部外伤中，胃破裂伤2例，肝裂伤2例，脾破裂1例，小肠破裂伤2例，大网膜损伤1例，肠系膜血管破裂1例，单纯腹壁裂伤1例。26例闭合性腹部外伤中，胃破裂2例，肝破裂7例，脾破裂12例，小肠破裂2例，肠系膜血管破裂1例，单纯腹膜后血肿2例。于腹腔镜下行缝合、修补、电凝、明胶海绵止血等治疗20例（55.6%），10例（27.8%）未做特殊处理，6例（16.6%）中转开腹。本组病例术中出血量为55~1 800 ml（平均520 ml），手术时间为60~186 min（平均128 min）。 所有病例均放置腹腔引流2~5 d（平均3 d），住院时间3~16 d（平均9 d）。全组均无气腹相关并发症和死亡病例。结论腹腔镜诊治腹部外伤具有创伤小、诊断率高、恢复快等优点，大部分病例还可在腹腔镜下达到诊治一体化的目的。
目的：分析地震灾害中颅脑外伤合并眼伤的临床特点和诊治难点，为制定合理的对策提供参考。方法：统计分析2008年5月12日汶川地震中绵阳地区颅脑外伤合并眼伤96例的疾病资料，以及早期处理方案和效果。结果：颅脑外伤合并的眼伤中钝挫伤比例高(99.5%)，昏迷患者容易忽视眼部损伤。结论：在生命抢救后的功能抢救阶段及时检查眼部情况有利于早期发现和挽救视功能；根据灾情整合眼科医疗资源，利用原有团队建制，有利于提高医院对大规模灾情的紧急应对效率。
ObjectiveTo investigate the safety, feasibility, and efficacy of fast track surgery (FTS) in gastrointestinal tract injury. MethodsThe data of 61 patients with gastrointestinal tract injury from July 2007 to July 2013 were retrospectively analyzed, among whom 29 patients were received FTS (FTS group) and 32 patients were received conventional care (control group). The first flatus and defecation time, hospital stay, rates of wound infection and lung infection, and the mortality were compared between these two groups. ResultsThe average first flatus and defecation time and the average hospital stay in the FTS group were significantly shorter than those in the control group (2.21 d versus 3.16 d, P=0.000; 7.45 d versus 9.78 d, P=0.000). The rate of lung infection in the FTS group were significantly lower than that in the control group[3.4% (1/29) versus 21.9% (7/32), P=0.033]. The rate of wound infection and the mortality had no significant differences between the FST group and the control group[3.4% (1/29) versus 15.6% (5/32), P=0.111; 0(0/29) versus 3.1% (1/32), P=0.337]. ConclusionsFTS is safe and effective among those gastrointestinal tract injury patients who visited the hospital in time and injury limited. FTS could promote defecate, shorter the hospital stay, and don't increase the complications and mortality.
目的 探讨外伤性脾破裂手术适应证和方法。方法 对77例外伤性脾破裂进行保脾手术治疗，按姜洪池脾损伤四级分类法： Ⅰ级8例，Ⅱ级41例，Ⅲ级18例，Ⅳ级10例。附加脾动脉结扎术6例。结果 死亡4例； 2例并粘连性肠梗阻。获随访45例，随访时间3个月至3年，仅4例儿童有反复上呼吸道感染，无1例发生脾切除后凶险感染(OPSI)。结论 根据脾损伤的部位和程度，可采用两种以上的联合保脾术式，对控制伤脾出血及保留脾脏功能有重要价值。
Objective To investigate the changes in the expression level of PDGF in the bone callus of rats with femoral fracture and brain injury to explore the effect of brain injury on the fracture heal ing and the related mechanism. Methods Sixty-four 12-week-old SD rats weighing (356 ± 25) g were randomly divided into 8 groups with 8 rats in each. The rats in groups A1, B1, C1 and D1 had a femoral fracture and a brain injury for 1, 2, 3 and 4 weeks, respectively; the rats in groups A2, B2, C2 and D2 had a mere fracture without a brain injury for 1, 2, 3 and 4 weeks, respectively. After the CR films were taken, the bone callus was obtained 1, 2, 3 and 4 weeks after operation, respectively. Then, the bone callus and its histology were examined by HE staining, the expressions and changes in the level of PDGF were examined by the immunohistochemical staining, and the level of PDGF mRNA was measured by in situ hybridization. Results The CR films showed that the callus formation in the A1-D1 groups was earl ier and greater than that in the A2-D2 groups at the same time point. The HE staining indicated that more fibroblasts and early-stage chondrocytes were found in group A1; some fibroblasts in the fracture interspace and few early-stage chondrocytes were found in group A2; some newly-formed trabecular bones were found at the end of the fracture in group B1; but no trabecular bone formation was found in group B2; woven bone formation and a few chondrocytes between trabecular bones in the fracture interspace were found in group C1; only a few trabecular bones in the fracture interspace were found in group C2；woven bones turned to lamellar bones in group D1；and more immature trabecular bones in the fracture interspace were found in group D2. The positive expression of PDGF and PDGF mRNA was b in the cytoplasms of fibroblasts, mesenchymal cells, vascular endothel ial cells, early-stage chondrocytes, osteoblasts and osteoclasts. The percentage of the positive cells for PDGF and PDGF mRNA in the callus was significantly higher in groups A1-D1 than in groups A2-D2 at the same time point (P lt; 0.05). Conclusion Brain injury can promote the fracture heal ing process, which is probably related to an increase in the expression level of PDGF after the brain injury.