闭合伤腹膜后血肿的诊断和处理

本文报告闭合性腹部创伤所致腹膜后血种44例，重点讨论血肿探查指征。本组根据血肿部位，邻近脏器，血管分布情况和血肿的形态决定是否探查。盆腔腹膜后血肿多与骨盆骨折有关，手术止血难以奏效，血肿探查应慎重。     

急性乳突炎69例分析

自应用抗生素以来,急性乳突炎的临床表现和经过有很大改变,现虽少见,但仍为一严重可致死的疾病。作者于1974～1983年间治疗69例,约2/3采用保守疗法,1/3手术治疗。64例儿童共发作急性乳突炎69次,复发者4例,其中1例反复发作3次。男34,女30;年龄2月～18岁,平均3.9岁。诊断根据临床表现:     

颅面联合切除筛窦癌瘤10例报告

颅面联合中切除筛窦癌瘤１０例，取额部冠状开口、跨越上矢状窦开颅，切除前颅凹底骨板及肿瘤，面部取鼻侧切开进路。剥离肿瘤与颅内贯通，将肿瘤与侵犯的组织整块切除，提出了手术适应证。禁忌证，主张综合治疗。     

人胚神经干细胞移植对大鼠脑液压冲击伤的影响

目的　通过人胚神经干细胞 (HNSCs)移植大鼠脑液压冲击伤 (FPI)探讨HNSCs对脑损伤修复的影响。方法　体外培养HNSCs并用 5 溴脱氧尿嘧啶 (BrdU)标记 ,液压冲击大鼠右侧大脑皮质运动感觉区制作脑外伤模型 ,脑外伤后 2 4h移植HNSCs ,分别于脑外伤前、脑外伤后 2 4h、4周行神经运动行为学评分 (NMFE)和检测左下肢的短潜伏期体感诱发电位 (SLSEP)及免疫组织化学染色检测BrdU、巢蛋白 (nestin)、微管相关蛋白 2 (MAP2 )、胶质纤维酸性蛋白 (GFAP)和半乳糖脑苷 (GalC)蛋白表达。结果　大鼠液压冲击伤后 2 4h ,左下肢功能障碍明显 ,运动评分14 .3 75 0± 2 .13 3 9,SLSEP潜伏期 3 0 .463± 4.64 0与损伤前相比均差异有显著性 (P <0 .0 1) ,但移植HNSCs组与对照组差异无显著性 ;HNSCs移植后 1周 ,BrdU阳性细胞从移植区域向周围扩散 ,邻片nestin、MAP2和GFAP均为阳性 ,但MAP2阳性细胞较多 ;HNSCs移植后 4周 ,未见nestin阳性细胞 ,液压冲击区域聚集GFAP/BrdU双阳性细胞和MAP2 /BrdU双阳性细胞 ,且GFAP/BrdU阳性细胞较多。结论　HNSCs移植对大鼠脑液压冲击伤的功能恢复无影响 ,但早期HNSCs多数分化为神经细胞 ,晚期多数分化为神经胶质细胞。     

一种测量鼻通气道简易方法的临床应用

自上世纪末以来,为客观测试鼻呼吸功能,曾介绍过多种鼻测压法,但迄今尚无一种满意的测量方法。因此,本课题亟待进一步研究。理想的鼻测压法应具备下列条件:①对鼻腔解剖结构无影响;②能保持鼻腔生理的气流和压力;③操作简便,病人无痛苦;④测试结果准确可靠,临床实用。根据上述条件作者介绍一种测试鼻呼吸     

老年性滑动性巨疝嵌顿二例

例1.男,68岁。自幼患有右侧腹股沟部可复性肿物,渐如成人手拳大降入阴囊内。近2日因劳累后此肿物还纳受阻,伴恶心、呕吐,包块肿痛而就诊。入院后以“右侧腹股沟斜疝嵌顿”行急诊手术。术中在寻找疝囊时,见有很多脂肪组织,始疑为滑动性疝。切开疝囊,露出盲肠、阑尾和部分回肠,均已绞窄坏死。松解内环,在内环上方约2.5cm处,按照肌纤维的方向切开内斜肌和腹横肌,并横形切开腹膜,使疝内容物充分暴露,将坏死的盲肠、阑尾和回肠一并切除,行升结肠与回肠端侧一期吻合术,完成肠道重建。按滑疝腹腔内修补法,缝闭腹膜切口,将游     

TUMORAL CALCINOSIS A CASE REPORT

Tumoral calcinosis is a rare disease. Recent- ]y we found a typical case and thereby report it in the following. The patient was a 62-year old male admitted to this hospital on July l, 1982. Five months be- fore admission he found a mass of about half an egg size on the lateral side of the left knee. The mass was painful and the pain increased when the knee was flexed and decreased when it was stretched. The patient had been diagnosed as a case of "chondroma", "synovial chondromatosis", etc. by several other hospitals. Physical examination found a protrusion in the lateral side of the left knee and a hard pal- pable mass of about 3.5 X 4 cm. No distinct bor- derline between the mass and the surrounding tissue was seen. Radiographs showed a multi-nodular, calci- fied mass within the soft tissue of the lateral side of the left knee, which measured 3.5 x 4 cm and had a sharp margin. Bony structure of the knee joint was normal. An operation performed on July 10, 1982 found a mass with intact capsule which was re- moved from between the biceps femoris and vas- tus lateralis. It was a firm, rubbery tumor and covered by grayish-white to grayish-yellow fibrous tissue. Sectioning of the tumor revealed a multi- lobular structure with a fibrous connective tissue band separating the pasty, calcarenous deposits. Microscopically, multiple cystlike cavities were filled with blue-colored materials. The fibrous walls of the cysts consisted of numerous fibrous tissue in which there were multinucleated giant cells and histiocytes. Pathologic diagnosis was tumoral calcinosis.