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find Author "岑瑛" 109 results
  • 与时俱进不断创新,提高我省创面治疗的医疗水平

    创面及创面治疗是外科领域永恒的主题。一个多世纪以来,围绕创面的处理,特别是难愈性创面的治疗,众多的研究和方法源源不断地问世,但其中绝大多数是大同小异,治疗效果无明显差别。  在上个世纪90年代,一种创面治疗的新方法——负压封闭引流技术(vacuum sealing drainage,VSD)问世,该方法堪称创面治疗的一次革命,一次飞跃。该方法变开放式创面治疗为封闭式,既减少了换药的痛苦,为创面制造了一个封闭的符合组织修复需要的环境,同时负压吸引也有利于创面分泌物的引流,适当的负压对创面组织及血管的再生起到了促进作用。通过此方法,复杂的难治性创面的治疗取得了很大的进展,特别对糖尿病性溃疡、烧伤创面、起搏器植入术创面、植皮术后、电击伤扩创后创面等。2008年“5?12”汶川大地震发生后,该项技术由以色列友人托马士引入我省,在我省整形烧伤学界同仁的努力学习下,经不断研讨摸索、总结与交流,这一革命性的技术迅速被推广和应用。德阳市中心医院李永忠主任和成都医学院马兵主任,分别举办了多期VSD学习班,对该项技术在我省的全面推广起到了很大的促进作用。  通过对VSD临床应用、经验总结,针对不同病种、不同情况的使用得到了不断改进,如VSD对传统的褥疮、糖尿病创面、电击伤创面的常规治疗,以及对植皮后或皮瓣转移后创面的改进治疗,均取得了良好的效果。川北医学院的向小燕应用VSD对15例患者共19处褥疮进行治疗,总结出扩创后应用VSD 5~18 d后创面即可准备充分,可进一步手术,并能极大提高手术成功率。配合VSD的临床应用,马红等从护理角度探讨了该方法的治疗体会,认识到应用该法时,从体位、皮肤清洁、功能锻炼、冲洗及观察、消毒、心理、营养等方面的护理对治疗的成功也十分关键。而马兵等则对VSD的研究进展作了较详尽的综述,对VSD的作用机制、适应证、禁忌证、影响因素及发展方向分别进行了探讨,罗江蓉则从动物实验角度对VSD应用于全厚皮移植术的加压固定作了较深入的研究,从其所做动物实验结果,观察到应用VSD后,可提高所植皮片的成活率。  总之,VSD对各种创面的处理治疗是非常简便、有效、省时,减少患者痛苦,减轻医护人员工作量的一个好方法。  四川省整形烧伤学界的同仁们,长江后浪推前浪,一浪更比一浪高,愿我们大家不断努力,不断学习,与时俱进,不断创新,为进一步提高我省创面治疗的医疗水平共同努力。                                                              二〇一一年九月五日

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
  • 不断努力进一步提高我省创面处理的水平

      创面的处理,是外科大夫永恒的工作主题之一,对于难以覆盖或修复的创面处理,更成为了摆在所有整形外科医师面前的一道难题。  通过不断努力,我省的整形烧伤外科医疗队伍在创面处理方面有了长足的进步。目前对于创面的处理,从基础研究到生物组织工程材料的应用,从新技术应用于创面到各种组织瓣覆盖创面,以及护理队伍对创面护理体会的总结等,无不显示了我省烧伤整形医务工作者在这个领域取得的喜人成绩。  创面的基础研究,应立足于解决临床难题方面。但要做到贴近临床,并将基础研究的成果应用于临床,必须具备丰富的临床经验并有扎实的科研素质才能得以实现。在这方面,成都医学院的李晨阳医师及四川大学华西医院的于蓉医师均作了可喜的尝试,他们在创面愈合后的瘢痕或瘢痕疙瘩形成的机制研究方面做了初步的有效的工作;将生物材料作为组织修复的替代物或填充物,运用先进的科学技术和方法实现组织材料的“工厂化”,是科技应用于人类的一大福音;四川大学制革系的林海等人跨学科结合自身的优势在脱细胞真皮基质的研究方面取得了可喜的成绩,他们研究成功的医用生物皮片现已能作为填充材料应用临床实验;对于创面或难以覆盖的创面的处理,我省的同行们在这方面也作出了显著的成绩。将生长因子用于创面促进创面愈合;使用各种组织瓣覆盖创面;运用封闭式负压引流装置治疗皮肤缺损,均取得了良好的治疗效果。同时,护理人员也对各种创面加强了护理,并总结出了一些有实际指导经验的护理体会,通过医护之间的良好合作,共同提高对创面患者的诊治水平。  总之,在创面的处理方面,我省各级医院的医务工作者均做了大量的工作,取得了可喜的成绩,省市级重点医院,在这方面起到了引领和带头人的作用。但与其他兄弟省市相比,无论是基础研究还是临床实际均还存在一定差距,还需不断努力,进一步提高我省创面处理的水平,造福于四川的父老乡亲。二○一○年一月十三日

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  • 重视烧伤感染,提高烧伤患者救治率

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
  • 深化医护一体化,提高创面治疗水平

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  • Progress in clinical manifestations and treatment of Poland syndrome

    Poland syndrome is a congenital anomaly characterized by unilateral underdeveloped or absent chest wall, accompanied by varying degrees of ipsilateral limb defects. In clinical practice, Poland syndrome is prone to misdiagnosis and missed diagnosis, which delays treatment timing and affects treatment effectiveness, as the current etiology is not yet clear and there is no unified and standardized clinical classification and treatment plan. This article summarizes and elaborates on the etiology, clinical manifestations, classification, diagnosis, and treatment of Poland syndrome by reviewing relevant literature on the diagnosis and treatment of Poland syndrome both domestically and internationally in recent years, in order to enhance understanding of Poland syndrome, provide reference for standardized clinical diagnosis and treatment, and improve the efficiency of diagnosis and treatment.

    Release date:2023-09-28 02:17 Export PDF Favorites Scan
  • Progress in clinical application of V-Y advancement flaps

    Based on skin elasticity and mobility, V-Y advancement flaps are designed to repair wounds. Traditional V-Y flaps have been limited due to short advancing distance. With the development of perforator flaps and the application of microsurgical techniques, V-Y advancement flaps are gradually transiting from traditional random flaps to axial flaps containing well-known vessels or perforator arteries. The advancing distance of V-Y advancement flaps is significantly increased, and the design forms are gradually flexible and diversified. V-Y advancement flaps are widely used in clinical practice and can be used to repair wounds in almost all parts of the body. This article reviews the clinical application progress of V-Y advancement flaps to further promote its clinical application.

    Release date:2019-08-15 01:20 Export PDF Favorites Scan
  • 精氨酸对创伤后机体影响的研究进展

    Release date:2016-09-01 11:08 Export PDF Favorites Scan
  • Abdominoplasty for Patients with Obesity after Weight Loss

    【摘要】 目的 探讨肥胖人群减肥后体重急剧下降导致腹壁松弛行腹壁整形手术的疗效。 方法 2003年4月-2009年10月,24例减肥后体重下降导致腹壁松弛患者中男3例,女21例,年龄28~44岁,平均36岁。其中1例合并甲状腺功能亢进,1例合并糖尿病病史;20例均通过运动、控制饮食等方式致体重下降,4例接受胃减容手术后体重下降。体重下降稳定后至腹壁整形手术时间间隔2~4年,平均2.5年;减肥前至腹壁整形手术前体重下降37~67 kg,平均下降45 kg。手术采用屈髋位,切除松弛皮肤组织,收紧腹壁及腰部松弛组织,耻骨上沿皮瓣远端去表皮后与耻骨上沿骨膜缝合固定。所有患者随访5个月~2年。 结果 23例术后2周皮瓣完全成活,切口愈合良好,无切口感染;1例术后出现耻骨上切口约2 cm表皮裂开,换药2周后切口愈合,术后腹壁平整、对称,无皮下血肿发生。随访期间切口疤痕隐蔽,阴阜无上移,腹壁平坦、对称。 结论 该腹壁整形手术方式效果良好,术后并发症少,值得推广。From April 2003 to October 2009, 24 obese patients, including three males and 21 females, developed abdominal chalastodermia caused by weight loss. Their age ranged from 28 to 44 years old with an average age of 36 years. Among them, one had hyperthyroidism and one had a medical history of diabetes. Twenty patients lost weight by exercise and diet, while the other four lost weight through stomach reduction surgery. Time span from weight loss to abdominal plastic surgery was two to four years, averaging at 2.5 years. During the time from before weight loss until the surgery, weight loss ranged from 37-67 kg, averaging at 45 kg. The surgery adopted the position of bending hip. The loose skin was removed; abdominal wall and loose waist tissues were tightened; and the far end of flap without skin along the upper edge of pubis was sutured with the periosteum. All patients were followed up for a time ranged from five months to two years. Results Flaps survived within two weeks after the surgery, incision healed perfectly, and no infection occurred to the incision for all the patients except in one case, there was a 2 cm of skin fissure in the upper incision which was cured after two weeks of dressing. After the surgery, the abdominal wall was flat and symmetrical without subcutaneous hematoma. During the follow-up, scars were well hidden, mons pubis was not shifted upward, and the abdominal wall was flat and symmetrical. Conclusion The abdominal wall plastic surgery has a good clinical outcome with few complications, which is worth being popularized.

    Release date:2016-09-08 09:25 Export PDF Favorites Scan
  • Clinical application of advancement flaps in repairing mandibular scars

    Objective To explore the clinical application effects of cervical advancement flaps in repairing mandibular scars. Methods A retrospective analysis was performed on the clinical data of patients with mandibular scars admitted to the Department of Plastic and Burn Surgery of West China Hospital of Sichuan University between January 2018 and July 2020. The lateral X-ray images of the patients were analyzed before and 2 weeks after surgery, and the differences in the mento-cervical angles and the cervico-mental angles before and after surgery were compared. Results A total of 21 patients were included, including 7 males and 14 females. At admission, all patients had a mandibular scar area of (3-7) cm × (3-6) cm, and underwent primary repair with cervical advancement flaps. All patients had good postoperative skin flaps survival, primary wound healing, and obvious mento-cervical angle and cervico-mental angle. The preoperative mento-cervical angle was (110.24±9.47)°, and at 2 weeks post surgery, the mento-cervical angle was (98.39±4.95)°, with a statistically significant difference (P<0.05). The preoperative cervico-mental angle was (134.15±6.00)°, and at 2 weeks post surgery, the cervico-mental angle was (126.44±3.60)°, with a statistically significant difference (P<0.05). Conclusion The neck advancement flap is an effective surgical method for treating simple mandibular scar, which is simple and can improve the appearance of the jaw and neck.

    Release date:2024-04-25 02:18 Export PDF Favorites Scan
  • Application of compound Huangbai liquid coating agent in burn treatment

    Compound Huangbai liquid coating agent is a preparation that combines multiple traditional Chinese medicinal herbs and has shown significant efficacy in burn treatment. In recent years, the application of this coating agent in burn treatment has received widespread attention, and it plays a role in promoting wound healing, preventing infection, and reducing patient pain. This article reviews the research progress of compound Huangbai liquid coating agent in burn treatment, explores its mechanism of promoting wound healing, evaluates its current advantages and limitations in burn treatment, and provides scientific basis and theoretical support for its better use in burn treatment.

    Release date:2024-09-23 01:22 Export PDF Favorites Scan
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