间甲酚化学烧伤实验性治疗

目的开展间甲酚化学烧伤动物实验研究,为临床治疗提供理论依据。方法将间甲酚原液涂在家兔背部,并随机分为对照、手术切痂、SD-Ag 涂药、饱和硫酸钠湿敷及自来水冲洗组。检测血液中 BUN、ALT、AST、GGT、AKP 5种生化指标。观察心、肝、脑、肺、肾的病理变化及超微结构变化。结果间甲酚不仅可对皮肤造成深度烧伤,而且经过皮肤渗透还可引起全身主要脏器的损害。结果显示:血液中5种生化指标均出现异常,光镜和电镜观察组织细胞均有异常变化。结论4种不同治疗方法均有效,其中以手术切痂、外涂 SD-Ag 最好,饱和硫酸钠湿敷次之,用自来水冲洗可减轻间甲酚对皮肤的直接损伤。由于间甲酚对内脏器官影响较大时间较长,因此在治疗烧伤创面的同时,应用保护心脏、肝脏、肾脏药物的时间也要适当延长。     

间甲酚化学烧伤实验性治疗

目的开展间甲酚化学烧伤动物实验研究，为临床治疗提供理论依据。方法将间甲酚原液涂在家兔背部，并随机分为对照、手术切痂、ＳＤＡｇ涂药、饱和硫酸钠湿敷及自来水冲洗组。检测血液中ＢＵＮ、ＡＬＴ、ＡＳＴ、ＧＧＴ、ＡＫＰ５种生化指标。观察心、肝、脑、肺、肾的病理变化及超微结构变化。结果间甲酚不仅可对皮肤造成深度烧伤，而且经过皮肤渗透还可引起全身主要脏器的损害。结果显示：血液中５种生化指标均出现异常，光镜和电镜观察组织细胞均有异常变化。结论４种不同治疗方法均有效，其中以手术切痂、外涂ＳＤＡｇ最好，饱和硫酸钠湿敷次之，用自来水冲洗可减轻间甲酚对皮肤的直接损伤。由于间甲酚对内脏器官影响较大时间较长，因此在治疗烧伤创面的同时，应用保护心脏、肝脏、肾脏药物的时间也要适当延长。     

16例消化道化学烧伤的临床救治

一般资料：本组男６例，女１０例，年龄３－５３岁。误服强酸５例、强碱７例、石炭酸２例、松香水２例。伤后入院时间＜１５ ｍｉｎ者４例，２０－３０ ｍｉｎ者７例，４０ ｍｉｎ－１ｈ者４例，＞２ｈ者１例。患者均有烦躁、急腹症表现，大部分患者口周皮肤被烧伤呈黄褐色，多数患者表现为呼吸困难。 治疗：根据入院时患者伤后时间的长短分别采用常规洗胃和手术切开、暴露胃腔反复清水冲洗方法。手术切开胃体的患者必须确诊为化学烧伤并且伤后时间＜３０ ｍｉｎ。切开胃体之前，应妥善隔离腹腔，避免其它脏器遭受化学溶液的污染，减少术后…     

食管化学烧伤后狭窄的手术治疗

目的 探讨食管化学烧伤后狭窄的外科治疗及横结肠代食管手术的应用价值。方法 106例食管化学烧伤后狭窄的病人均采用横结肠代食管手术、保留结肠左动脉升支、胸骨后顺蠕动吻合，除横结肠咽腔吻合32例外，均横结肠食管颈部吻合。结果 无手术死亡。手术后发生颈部吻合口瘘12例、吻合口狭窄8例、气管切开3例，经治疗后均痊愈。结论 食管化学烧伤后应积极采取胸骨后横结肠代食管术，行横结肠食管颈部吻合或结肠咽腔吻合都是适宜的。     

氢氟酸烧伤患者的治疗

1991～ 2 0 0 0年 10年间我科共收治 2 1例氢氟酸烧伤患者 ,深感氢氟酸烧伤的治疗有其特殊性。典型病例 :患者男 ,2 0岁 ,浓度 5 5 %氢氟酸泄漏致双下肢、右眼灼伤 ,伤后 3ｈ入院。诊断 :(1)氢氟酸烧伤总面积 9% ,Ⅲ度 4 %ＴＢＳＡ ;(2 )右眼烧伤。急诊检测血钙 1.5 3ｍｍｏｌ/     

消化道化学烧伤的早期救治分析

目的研究探讨消化道化学烧伤的早期治疗方案。方法回顾性介绍2000年至2012年本院消化道化学烧伤患者19例，分别观察分析其致病原因、住院时间、预后和并发症发生情况，并详细介绍3例典型病例。结果19例因不同化学物质造成的消化道烧伤患者均得到治愈，平均住院时间15．6±13．5天，发生并发症者10例。结论消化道化学烧伤治疗的关键在于早期诊断、根据化学物质特性尽早给予针对性处理，同时予抗炎、补液、营养、对症、支持、促愈等综合辅助治疗。     

电烧伤临床治疗33例

电烧伤对深部组织破坏性大 ,致残率高 ,给患者家庭和社会带来较大负担。其治疗较一般热烧伤难度大 ,往往需多次手术治愈。笔者单位于 1999年 9月～ 2 0 0 1年 9月共收治电烧伤患者 115例 ,其中 33例 (2 8.7% )经 3～ 7次手术治愈。现将治疗体会介绍如下。临床资料 :本组 33例 ,其中男性 31例 ,女性 2例 ,年龄 8～ 5 2岁 ,平均 (31.7± 11.7)岁 ,烧伤面积 1%～ 70 % ,平均(15 .7± 18.3) %TBSA ,均为深Ⅱ度和Ⅲ度创面。其中头、面、颈烧伤 16例次 (48.5 % )、胸部 13例次 (39.4 % ) ,上肢 33例次 (10 0 .0 % )、下肢 19例次 (5 7.6 % )。同…     

An experimental study for diagnosis of burn depth

The histopathological findings in 42 experimental and 8 clinical burns are reported. The percentage clinical diagnostic error was determined for each type of burn. The current literature on the subject is reviewed.     

An experimental study of mitogen-stimulated blastogenic transformation and interleukin-2 in mice after burn injury]

In this study, mitogen-stimulated blastogenic transformation (MSBT) and interleukin 2 (IL-2) production by splenic lymphocytes in mice were measured at various time intervals after unanesthetized burn injury. The results showed that both MSBT and IL-2 production were suppressed after burn injury. There was a significant positive correlation between these two parameters. The postburn serum showed in vitro suppressive activity upon MSBT, IL-2 production and IL-2-IL-2R interaction of normal control. The results indicated that burn injury had a significant effect on lymphocytes.     

犬烧伤休克延迟复苏的实验研究

目的探讨应用林格液进行烧伤休克延迟复苏的效果.方法12只犬随机分为对照组(S组,6只)和治疗组(LR组,6只).LR组采用35%TBSAⅢ度烧伤模型,伤后6h以乳酸林格液进行复苏,并以尿量为1.0ml@kg-1@h-1及心输出量为伤前值的70%～80%来调整输液速度及输入量,观察其在伤后第一个24h复苏中的容量负荷、平均动脉压(MAP)、左心室收缩压(LVSP)、左室内压最大上升/下降速率(±dp/dtmax)、心脏排血指数(CI)、氧供给(DO2)及氧消耗(VO2)等的变化.结果乳酸林格液在烧伤休克延迟复苏后第一个24h的复苏中,每1%烧伤面积的输液量为(887±1.02)ml/kg,比采用Parkland公式复苏多1.2倍,其中在复苏后4h内的输液量为(3.63±0.99)ml/kg,为总入量的41%;MAP、LVSP、±dp/dtmax、CI、DO2及VO2等指标在复苏后2h即达到或接近对照组水平.结论乳酸林格液在烧伤休克延迟复苏中,比早期复苏需要更多的液体量才能满足需求,而血流动力学、心肌功能及氧动力学等在复苏后2h即有明显改善.     

家兔氢氟酸烧伤心肌损害的实验研究

目的　研究氢氟酸烧伤对心肌的影响 ,提高对氢氟酸导致氟中毒的认识。　方法　采用新西兰白兔 2 %TBSAⅢ度氢氟酸烧伤模型 ,观察各时相点心肌和相关酶谱指标的改变 ,以及病理形态学变化。　结果　 ( 1)伤后心肌各项酶含量较伤前明显增高 (P <0 .0 1)。 ( 2 )血清心肌酶含量增高峰值均在 48h以内出现。各时相点心肌酶谱含量的差异均有非常显著性意义 (P <0 0 1)。( 3)血清心肌酶含量以CPK增幅最大 ,增加了 97.5 %。而LDH、AST、CK -MB分别增加了 81.9%、76 .1%和 6 0 .3%。 ( 4)病理形态学检查发现 ,光镜下见心肌纤维颗粒变性、灶性坏死 ,心肌间质出血 ,并伴有中性粒细胞、淋巴细胞浸润。电镜观察心肌细胞内肌原纤维减少或消失 ,细胞水肿严重 ,线粒体肿胀、嵴消失 ,血管内皮细胞肿胀 ,电子密度极低 ,呈大泡状 ,肌细胞核变形。　结论　氢氟酸烧伤后对心肌有一定程度损害 ,心肌和心肌相关酶谱含量的改变 ,反映了氢氟酸致伤后的心肌损伤程度 ,在抢救氢氟酸烧伤、氟中毒时应监测心肌酶谱及心电图等指标 ,注意保护心脏的功能     

An experimental study of excimer laser angioplasty]

An excimer laser, which is a pulsed ultraviolet laser and ablates tissue precisely with no thermal injury, is expected to coronary laser angioplasty. We transmitted XeCl excimer laser (308 nm) via a 400 microns fused silica fiber. In the first experiment, we studied about excimer laser ablative effects to normal canine arteries and atherosclerotic rabbit aortas, and about healing responses following excimer laser irradiation in both models. Surfaces after excimer laser ablation were slightly rough but no thermal injury was found in the media. And for healing process of normal canine arteries, endothelial cells appeared at 3 weeks and completely covered surfaces with fibrointimal ingrowth at 3 months. In the rabbit aortas, at 3 weeks there was reconstruction of the surface. At 2 months no accelerated atherosclerotic or aneurysmal changes were observed. In the second, with this excimer laser (short pulse) and 400 microns fused silica fibers (distal fiber-end power: 3-6 mJ/pulse), we performed transluminal laser angioplasty to recanalize totally occluded canine femoral arteries under an angioscopic guidance. We cold recanalize 8 of 9 totally occluded arteries with no thermal injury of adjacent tissue, though perforations were observed in 7 of 9 arteries. In the third, we used a newly-developed long pulse excimer laser, with which distal fiber-end energy was about 3 to 4 times as much as the short pulse one, to recanalize totally occluded canine arteries. In result, recanalization was performed in 6 of 8 arteries rapidly with little thermal injury. However, we observed perforations in 6 of 8 arteries like the short pulse one. Multifiber catheter ("over the wire system") coupled with this long-pulse excimer laser was used to reconstruct stenotic iliac arteries of atherosclerotic rabbit models. The procedure was successful in all the 5 rabbits. In conclusion, our preliminary results suggested that further developments of a more powerful and longer pulse-duration excimer laser, optic delivery system and guidance system would make excimer laser angioplasty safer and more effective method in the near future.     

An experimental study of chemical debridement of full-thickness burn in rabbits by N-acetylcysteine

N-acetylcysteine, a mucolytic expectorant, was used for debridement of a full-thickness burn in rabbits. The drug was applied 24h postburn and repeated once a day. Debridement was completed in an average of 2.25 days with bloodless separation of any remaining eschar from the underlying healthy deep fascia layer by blunt dissection with a forceps. In the wounds treated with 25% N-acetylcysteine(pH 2.5), debridement was faster than those treated with glacial acetic acid mixture at the same pH. The debriding action of the drug is probably depolymerization of heat-denatured extracellular proteins (mainly denatured collagen and proteoglycans), disrupting specific linkage and lowering the molecular weight of eschar molecules. Acidity of the drug also promotes debriding process.     

大鼠严重烫伤后睾丸的病理变化

对大鼠严重体表烫伤后睾丸组织的病理变化进行了动态观察。大鼠体表３０％ＩＩ度烫伤后睾丸出现明显病变，其病理变化出现早、程度较重、形态变化多样，生精细胞、支持细胞、曲细精管界膜、间质细胞及血管内皮细胞均有不同程度的损伤性改变。生精细胞的病变以精母细胞及精细胞为重，精原细胞无明显损伤，伤后３０天生精上皮基本恢复正常。曲细精管界膜内纤维连接蛋白（Ｆｎ）于伤后早期减少。认为曲细精管界膜及支持细胞的损伤，特别是后者的损伤，改变了生精细胞生长、发育的微环境而可能导致或加重生精细胞的损伤。