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"手外科" 3 results
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自1987年以來，采用四種不同血管蒂的前臂逆行島狀皮瓣修復手部各種創面共45例，其中以橈動脈為蒂的14例，尺動脈為蒂的6例，骨間背側動脈為蒂的16例，尺動脈腕上皮支為蒂的9例。除1例失敗外均全部成活。修復效果滿意。此四種前臂島狀皮瓣在手外科修復術中各有其臨床應用價值。對這四種前臂島狀皮瓣的解剖特點，切取后對手部血供的影響以及手術適應證進行了討論。
Release date：2016-09-01 11:14
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目的總結完全清醒無止血帶局部麻醉技術（wide awake local anesthesia no tourniquet，WALANT）在手外科手術中的應用效果。方法 2021年4月—10月，采用WALANT為28例手外傷患者實施麻醉并手術。男18例，女10例，年齡15～55歲，平均35歲。急診手術22例，擇期手術6例。骨折切開復位內固定術5例，骨折內固定物取出術l例，肌腱探查斷裂修復術18例，肌腱粘連松解術4例。采用疼痛視覺模擬評分（VAS）評估疼痛情況，術中觀察出血情況，術后觀察麻醉維持時間、手指血供變化及有無并發癥發生，采用主動運動總和法（TAM）評定手部功能。結果 術中麻醉與止血效果滿意，患者未訴疼痛。第1針刺入皮膚時VAS評分為2～4分；術中操作未引起明顯疼痛，VAS評分為0～1分；麻醉效果可持續6～8 h，VAS評分為2～6分。術后手術區域麻醉效果逐漸消失后，所有患者口服或靜脈滴注非甾體止痛藥能有效緩解疼痛。術后24 h內患者無頭痛、頭暈、惡心、嘔吐、乏力、皮疹等藥物不良反應，術后8 h手指皮溫及毛細血管反應同正常手指。術后未出現血運障礙等麻醉不良反應。28例患者均獲隨訪，隨訪時間6～12個月，平均8個月。末次隨訪時TAM評定獲優20例、良8例。結論手外科手術中應用WALANT止痛和止血效果良好、操作簡單、安全有效，術中能即刻觀察手術效果。
Release date：2023-01-10 08:44
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A series of 28 cases of fractures of the small tubular bones of the hand, including Bennetts fracture, were treated with the minor unilateral multifunctional external fixator. After manipulation, a hole was drilled on the proximal and distal parts of the fractured bone. Hand in functional position, the external fixator was set in place. Functional exercises were begun after the fixation. The patients were follwed up for two to six months. The average healing time was thirtyfive days. The average healing time for Bennett’s fractures was twentyeight days, and for the fractures of metacarpal bone was forty-two days. There were no deformity and complication of infection following external fixation.The functional recovery of the hands was satisfactory. The fixator had the following advantages: It was simple and had tight fixation; fractures with infection, was still indicated and could be adjusted according to the clinical purpose.
Release date：2016-09-01 11:16
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