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        west china medical publishers
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        find Author "徐巍" 14 results
        • 腹部帶蒂皮瓣修復前臂大面積皮膚缺損一例

          Release date:2016-09-01 11:38 Export PDF Favorites Scan
        • Analysis and Management of the Suspected Outbreak of Nosocomial Infection in Newborn Babies Infected by Rotavirus in the Hospital

          ObjectiveTo sum up experiences of precaution and provide evidence to prevent such accidents in the future via analyzing the nosocomial infection in newborn babies who were infected by rotavirus. MethodsWe investigated and monitored the 8 cases of nosocomial infection occurred between July 7th and July 14th, 2012 by epidemiologic and environmental hygienic methods, and analyzed the existing risk factors and took measures to control. ResultsThere were 8 nosocomial infected cases among the 45 newborn babies who were hospitalized. The infection rate was 17.8% and the accident lasted for 7 days. The distribution of space, time and population was clustered. Environment and hands were the main media to spread the virus. ConclusionThe accident was a suspected nosocomial infection caused by rotavirus in the hospital. It can be controlled effectively through intensive cleaning and sterilizing, isolated touching, and improving the medical staff's compliance and accuracy rate of hand sanitation.

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        • Application of High-quality Nursing Services and Its Effects in Gynecologic Clinical Nursing Pathway Implementation

          目的 探討優質護理服務在婦科臨床護理路徑(CNP)實施中的應用效果。 方法 2010年4月-2011年4月納入婦科CNP的住院患者中隨機抽取150例,并選擇同期病區全部17名護士作為對照組;在2011年5月-12月納入婦科CNP并實施優質護理服務的住院患者中隨機抽取150例,并選擇同期病區全部22名護士作為試驗組。比較兩組患者疾病相關知識知曉率、患者及護士工作滿意率、平均住院日的差異。 結果 試驗組患者疾病相關知識知曉率、患者及護士滿意率優于對照組,且平均住院日明顯縮短。 結論 優質護理服務應用于改進CNP管理質量,可提高患者疾病相關知識知曉率和護患滿意率,縮短住院時間,減輕醫療負擔,有利于CNP的實施。

          Release date:2016-09-08 09:16 Export PDF Favorites Scan
        • 股四頭肌癱瘓多肌聯合的功能重建

          Release date:2016-09-01 10:20 Export PDF Favorites Scan
        • Epidemiology Analysis of the Distribution of People with Trauma due to Traffic Accidents in Deyang City

          目的 探討德陽市道路交通傷中人員分布的流行病學特點。 方法 回顧性統計分析德陽市2003年-2005年發生的5 300例道路交通傷資料,總結其中的規律和特點。 結果 在5 300例交通傷中,傷亡人員以男性居多(男︰女= 2.58︰1),其中16~55歲的青壯年占了全部傷亡人員的75.72%;工人、農林牧漁業人員和學生占交通傷的比例最高,達52.73%。步行、二輪摩托車和自行車是造成人員傷亡的最主要三個原因,三者比例達到了59.34%。 結論 加強交通安全意識的教育,加大交通法規的宣傳和貫徹力度,加強部門間協作是減少交通傷發生的有效措施。Objective To investigate the epidemiological characteristics of the distrubution of people with trauma due to traffic accidents in Deyang City. Methods The data of 5 300 road traffic accidents from 2003 to 2005 in Deyang were retrospectively analyzed. The rules and characters were summarized. Results More males were injured or dead than females in the 5 300 road traffic accidents (male : female = 2.58︰1 ). The young adults aged from 16 to 55 accounted for 75.72% of all the casualties. The workers, agriculture employees and students had the largest percentage (52.73%) of the injuries. Walking and riding motorcycles and bicycles were the main causes leading to the injury, which occupied 59.34%. Conclusion The effective measures to reduce trauma due to traffic accidents will attribute to enhance the personnel awareness of road safety education, improve the publicity work and enforcement of traffic laws, and strengthen collaboration of different epartments.

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        • Different Internal Fixation for Intertrochanteric Fractures in Elderly Patients

          目的 回顧分析不同內固定方式對老年股骨粗隆間骨折的臨床療效。 方法 1999年3月-2009年5月采用內固定手術治療121例股骨粗隆間骨折患者,根據內固定方式不同分為4組:動力髖螺釘(DHS;A組43例)、經皮加壓鋼板(PCCP;B組19例)、股骨近端髓內釘(PFN;C組27例)、Gamma釘(D組32例)。4組患者年齡、骨折類型(Tronzo-Evans分型)等一般資料比較差異無統計學意義(P>0.05),具有可比性。記錄手術時間、術中出血量及術后引流量、術中術后并發癥、骨折臨床愈合時間、術后髖關節功能恢復程度,比較評價各組臨床療效。 結果 術后各組患者切口均Ⅰ期愈合,無傷口感染等早期并發癥發生。患者均獲隨訪,隨訪時間18~108個月,平均56.4個月。與A組比較,B、C、D組手術時間明顯縮短,術中出血量及術后引流量減少,骨折愈合時間縮短,差異均有統計學意義(P<0.01),A組較差;B、C、D各組間兩兩比較差異無統計學意義(P>0.05)。術后并發癥發生率A組較高,與其余各組比較差異有統計學意義(P<0.05)。末次隨訪時各組髖關節功能Harris評分比較差異無統計學意義(P>0.05)。 結論 B、D組及C組3種手術方法在治療老年患者股骨粗隆間骨折具有創傷小、并發癥少等優勢,與A組法比較更有利于老年患者術后康復,但應注意骨折的良好復位及內固定物位置。

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        • 前后路聯合復位固定術治療嚴重下頸椎骨折脫位

          目的 觀察頸椎前后路聯合手術復位固定治療嚴重下頸椎骨折脫位的臨床效果。方法 2003年4月~2006年8月,采用前后路聯合手術復位減壓固定治療嚴重下頸椎骨折脫位合并不同程度脊髓損傷者7例。男5例,女2例;年齡27~42歲。致傷原因:車禍傷5例,高處墜落傷2例,受傷部位C4、54例,C5、63例。Allen分類:屈曲壓縮型Ⅴ度4例,牽張屈曲型Ⅲ度3例。完全性癱瘓1例;不完全性癱瘓6例,其中上肢肌力1~2級3例,3~4級3例。脊髓損傷按Frankel分級:A級1例,B級4例,D級2例。于傷后1~8 d手術。前路固定采用Orion帶鎖鋼板(頸椎帶鎖鋼板)7例,后路側塊鋼板螺釘固定2例,后路釘棒系統固定5例。結果 本組術后傷口均Ⅰ期愈合,獲隨訪4~24個月,平均6個月。X線片檢查示損傷節段固定穩定,未見內植物松動、脫落及斷裂。植骨于3~4個月內均融合。術后4個月脊髓功能按Frankel分級,術前1例A級,術后無恢復;術前4例B級,術后恢復至C級2例可行走,恢復至B級2例可扶拐行走,2例D級恢復至E級,能正常行走。術后4例行CT及MRI檢查,頸椎序列均恢復,椎管矢狀徑達到正常,脊髓受壓解除。結論 頸椎前后路聯合手術復位固定嚴重下頸椎骨折脫位可使損傷節段獲得早期穩定,方便術后護理和早期功能鍛煉,有利于脊髓功能恢復。

          Release date:2016-09-01 09:23 Export PDF Favorites Scan
        • BIOMECHANICAL COMPARATIVE STUDY ON PROXIMAL FEMORAL LOCKING PLATE AND Gamma3 FOR TREATMENT OF STABLE INTERTROCHANTERIC FRACTURE

          ObjectiveTo compare the biomechanical properties between the proximal femoral locking plate and Gamma3 for fixing stable intertrochanteric fracture so as to provide a theoretical basis for selecting internal fixation in the clinical application. MethodsFive pairs of antiseptic femur specimens were selected. Specimens of each pair of matching were randomly divided into groups A and B (n=5). All specimens were made the intertrochanteric fracture of 31A1.1 type according to AO/Association for the Study of Internal Fixation (AO/ASIF) classification. Fracture was fixed with Gamma3 in group A and with proximal femoral locking plate in group B. The axial compression, destruction, and torsion tests were carried out on the mechanical testing machine. ResultsAxial compression test:The load-displacement curve of groups A and B was basically a straight line; axial stiffness of groups A and B was (621.00±36.48) N/mm and (542.55±46.94) N/mm respectively, showing significant difference (t=3.648, P=0.036). Destruction test:The maximum yield load of groups A and B was (4 394.82±450.37) N and (2 987.54±112.14) N respectively, showing significant difference (t=5.433, P=0.032). After loading maximum yield load, femoral fracture occurred again, and internal fixation and bone interface loosening were observed in group A; bending and breaking of proximal locking screw for internal fixation were found in group B, but loosening of internal fixation and bone interface was more obvious in group A than in group B. Torsion test:The torque of specimens in 2 groups increased with the increase of torsion angle (P < 0.05), the torque corresponding to the torsion angle in group B was larger than that in group A, but the difference was not significant (P > 0.05). The torsional stiffness of groups A and B was (1.78±0.16) N·mm/deg and (2.01±0.08) N·mm/deg respectively, showing no significant difference (t=-3.833, P=0.162). ConclusionProximal femoral locking plate and Gamma3 in the treatment of stable intertrochanteric fracture have good biomechanical properties, which can meet the requirements of minimal invasion, strong internal fixation, and early activity.

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        • OPERATIVE TREATMENT OF SACROILIAC JOINT FRACTURE AND DISLOCATION IN Tile C PELVIC FRACTURE WITH Colorado 2TM SYSTEM

          Objective To explore the effectiveness of Colorado 2TM system in the stabil ity reconstruction of sacroil iac joint fracture and dislocation in Tile C pelvic fracture. Methods Between February 2009 and January 2011,8 cases of Tile C pelvic fracture were treated with Colorado 2TM system. There were 3 males and 5 females with an average age of 34.4years (range,22-52 years). Fractures were caused by traffic accident in 3 cases, by fall ing from height in 3 cases,and by crash of heavy object in 2 cases. According to Tile classification, 5 cases were classified as C1-2, 2 cases as C1-3,and 1 case as C2. The time between injury and operation was 5-10 days (mean, 7 days). After skeletal traction reduction, Colorado 2TM system was used to fix sacroil iac joint, and reconstruction plate or external fixation was selectively adopted. Results The postoperative X-ray films showed that the reduction of vertical and rotatory dislocation was satisfactory, posterior pelvic ring achieved effective stabil ity. All the incisions healed by first intention, and no blood vessel or nerve injury occurred. Eight patients were followed up 6-24 months (mean, 12 months). No loosening or breakage of internal fixation was observed and no re-dislocation of sacroil iac joint occurred. The bone heal ing time was 6-12 months (mean, 9 months). According to Majeed’s functional criterion, the results were excellent in 5 cases, good in 2 cases, and fair in 1 case at last follow-up. Conclusion Colorado 2TM system could provide immediate stabil ity of pelvic posterior ring and good maintenance of reduction effect, which is an effective method in the therapy of sacroil iac joint fracture and dislocation in Tile C pelvic fracture.

          Release date:2016-08-31 05:42 Export PDF Favorites Scan
        • CLINICAL FEATURES AND EARLY TREATMENT FOR 596 PATIENTS WITH FRACTURE IN WENCHUAN EARTHQUAKE

          Objective To summarize the cl inical characteristics of 596 patients with fracture in Wenchuan earthquake and to investigate the therapeutic methods and effects of early treatment. Methods From May 12th 2008 to May 21st 2008, 596 patients with fracture caused by Wenchuan earthquake were treated, including 283 males and 313 females aged1.9-102 years (median 43 years). The time from injury to hospital ization varied from 12 minutes to 4 days. There were 132 cases of upper extremity fracture, 496 cases lower extremity fracture, 10 cases clavicular fracture, 16 cases scapular fracture, 23 cases pelvis fracture, and 59 cases spinal fracture. Among them, 183 cases were open fracture and 413 cases were closed fracture. And 214 cases had multiple fracture (35.9%) and 68 cases had crush injury in l imbs which scored (6.84 ± 2.48) points according to the mangled extremity severity score (MESS). Thirty-six cases were combined with neurovascular injury. The wound of the open fracture was contaminated at different degrees, but no gas gangrene was observed. Open fracture was treated with suturing or no suturing after debridement, open reduction and internal or external fixation. Closed fracture was fixed with spl ints, cast and traction. Forty-nine patients whom were highly suspected as osseous fascia compartment syndrome received incision decompression timely, and 34 patients whose MESS were above 7.0 points or suffering from crush injury of l ifethreatening systemic symptoms received amputation. Results Apart from 34 patients receiving amputation, 460 patients achieved functional reduction of fracture after manipulative reduction and 102 cases got satisfactory reduction after surgery. Postoperatively, 289 patients were transferred to other hospitals. Among the rest 307 patients, 34 with severe wound infection were healed after multiple debridement, anti-infection, and skin flap transplantation (16 cases healed by first intention and 18 cases healed by second intention), 42 cases with crush syndrome were treated with open decompression and amputation, and nodeep venous thrombosis of lower l imb, stress ulcer and death were observed after operation (29 cases healed by first intention and 13 cases healed by second intention). Conclusion By aiming at the features of fracture caused by earthquake, the prompt and professional treatment can achieve good therapeutic effects.

          Release date:2016-09-01 09:05 Export PDF Favorites Scan
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