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find Author "潘振宇" 4 results
  • 拇指末节软组织缺损的修复

    目的 总结拇指末节软组织缺损的修复方法及临床效果。 方法 2002 年1 月- 2008 年1 月,收治37 例拇指末节软组织缺损。男24 例,女13 例;年龄17 ~ 52 岁,平均27.4 岁。电锯伤5 例,冲压伤24 例,撕脱伤8 例。其中末节指尖组织缺损6 例,指腹12 例,指背9 例,指侧方5 例,脱套伤5 例。缺损范围1.5 cm × 1.0 cm ~ 6.0 cm ×3.0 cm。受伤至入院时间1 h ~ 7 d,平均36 h。根据拇指末节软组织缺损情况,采用第1 掌骨背侧逆行筋膜皮瓣8 例,拇指尺背侧逆行岛状皮瓣9 例,示指背侧岛状皮瓣13 例,中指动脉侧方岛状皮瓣2 例, 甲瓣3 例,第1 掌骨背侧逆行筋膜皮瓣联合示指背侧岛状皮瓣2 例。皮瓣切取范围1.5 cm × 1.0 cm ~ 6.0 cm × 3.0 cm。供区植皮修复。 结果 术后1 例甲瓣修复者拇指伤口感染,1 例示指背侧岛状皮瓣血供不良,1 例第1 掌骨背侧逆行筋膜皮瓣远端表皮坏死,均经对症处理后愈合。其余皮瓣及供区植皮均顺利成活,切口Ⅰ期愈合。患者术后均获随访,随访时间6 ~ 24 个月,平均15 个月。皮瓣血运、质地、弹性良好。指间关节活动范围15 ~ 70°,平均56°;掌指关节活动范围正常。根据1954 年英国医学研究会感觉功能恢复评定标准:感觉功能恢复为S1 ~ S3+。两点辨别觉为5 ~ 12 mm。 结论 对拇指末节软组织缺损选择适当的皮瓣进行修复,可获得满意的临床效果。

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • 封闭式负压引流联合前臂皮神经营养血管皮瓣修复手掌皮肤缺损

    总结封闭式负压引流(vacuum sealing drainage,VSD)联合前臂皮神经营养血管皮瓣修复手掌皮肤缺损的临床疗效。 方法 2005 年6 月- 2006 年5 月,收治12 例手掌皮肤缺损患者。男7 例,女5 例;年龄17 ~ 45 岁。挤伤3 例,电锯伤2 例,绞伤4 例,电烧伤1 例,爆炸伤2 例。缺损范围5 cm × 4 cm ~ 7 cm × 7 cm。采用VSD 待创面肉芽组织新鲜、感染控制后,用前臂内、外侧皮神经营养血管皮瓣移位修复手掌皮肤缺损,皮瓣范围6 cm ×5 cm ~ 8 cm × 8 cm。 结果 术后1 例皮瓣远端部分坏死,1 例因血肿压迫出现静脉危象,经对症处理后愈合。余患者皮瓣Ⅰ期愈合。供区成活良好。患者获随访4 ~ 15 个月。根据中华医学会手外科学会功能评定标准:腕关节、掌指关节功能均为优;1 例肌腱功能评分为良,其余为优;感觉评定S1 1 例,S2 2 例,S3 5 例,S3+ 2 例,S4 2 例。 结论 VSD 能减少创面感染机会,为皮瓣修复提供良好组织床。前臂皮神经营养血管皮瓣移位修复手掌部组织缺损,具有耐磨、无挛缩、重建感觉以及色泽与原皮肤相近等优点,是修复手掌部皮肤缺损的良好方法之一。

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • Evidence-based Guidelines on Medication for Children with Pneumocystosis: A Systematic Review

    ObjectiveTo systematically review quality of evidence-based pneumocystosis guidelines for children, compare the differences and similarities among recommendations, and to provide references for clinical application. MethodsDatabases such as TRIP, PubMed, CNKI, VIP, WanFang Data, CBM, U.S National Guideline Clearinghouse (NGC), and Guidelines International Network (GIN) were searched to collect evidence-based guidelines on medication therapy for children with pneumocystosis. Methodological quality of included guidelines was evaluated according to the AGREE Ⅲ instrument, and the differences and similarities among recommendations were compared. ResultsA total of 3 evidence-based guidelines concerning children with pneumocystosis were included, of which, 2 were made by the USA and 1 by international academic organizations. Only 1 guideline was especially suitable for children, while others were for children of different ages and adults. The results of AGREE Ⅲ scoring showed that, among 6 domains which were rated using the AGREE Ⅲ instrument, "scope and purpose", "stakeholder involvement", "rigor of development", "clarity and presentation" and "editorial independence" were scored more than 60%; while "applicability" was only scored 46%, 25% and 31%. Besides, the grading of evidence and grading of recommendations were different. The medication recommendations of different guidelines were not the same. ConclusionThe quality of 3 guidelines is not high, and the grading of evidence and the strength of recommendation are still needed to be unified. The target population and the recommendations in the guidelines are different.

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  • Development and preliminary validation of questionnaire for infection process and prevention of 2019 novel coronavirus infection in medical staffs

    ObjectiveTo develop the questionnaire and test its reliability for investigating route, prevention, and control of SARS-CoV-2 infection in medical staffs.MethodsThis questionnaire was development based on the COVID-19 relevant guidelines, official documents issued by the National Health Committee of the People's Republic of China, and published studies. The development group performed repeated discussions and drafted the first questionnaire, then performed expert consultation and revised the draft according to their suggestions. Eventually, some frontline medical staffs were invited to carry out pre-test investigation of the questionnaire and test its reliability.ResultsThe first draft included 48 items; 18 experts were invited in the first round questionnaire and 10 experts in the second round questionnaire. The positive coefficient of experts in these two rounds was both greater than 75%, and the authority coefficient of experts' opinions was greater than 0.70. The variation coefficient of these items was between 0.00 and 0.35, the coordination coefficient of experts was 0.193 (P<0.05). The experts of above two rounds put forward 14 suggestions for text modification or adjustment options of some items; after the development group held repeatedly discussions, a total of 8 items were performed secondary consultation and finally reached consensus. The final questionnaire included two domains of questionnaire before and after confirmed diagnosis. The domain "before confirmed diagnosis" covered 4 sections and 29 items involving infectious cause, plan and knowledge of prevention and control, and psychological symptoms. The domain "after confirmed diagnosis" covered 5 sections and 21 items, included symptoms, treatment, and psychological status after diagnosis; impact on the surrounding environment and people, and awareness of protection after infection. The pre-test results showed that the total items were considerably numerous, some items were difficult to understand, some laboratory results and treatment conditions were ambiguous, etc. After modification and re-testing, the test-re-test reliability of each domain was between 0.74 and 0.93, and the overall re-test reliability of the questionnaire content was 0.82.ConclusionsThis research has developed a questionnaire for investigating infection process, prevention and control of SARS-CoV-2 infection in medical staff, and the items considered two domains prior to and after confirmed diagnosis. The reliability and practicability of the questionnaire are acceptable.

    Release date:2020-07-02 09:18 Export PDF Favorites Scan
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