veoexrmpzt
Dołączył: 21 Lut 2011
Posty: 371
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Skąd: England
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 Wysłany: Pią 11:16, 18 Mar 2011 Temat postu: MBTシューズ $ |
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,[link widoczny dla zalogowanych]
Anterior interosseous nerve and radial nerve superficial branch of the United shifting fix defects in high ulnar nerve injury
More common in abdominal trauma in about 25% [mortality is also high. Our hospital from August 1991 to August 1999 were treated 92 cases of traumatic rupture of liver. Reported below. Clinical data 1 1.1 General Information 92 cases 68 cases of male, female, 24 cases in 5 years of age the youngest, largest of 67 years, average 32.6 years old. Traffic accident in 63 cases fall injury in 8 cases, 9 cases of blunt trauma, stab wounds in 12 cases. By American Society of Trauma Surgery, classification, this group of 24 cases of grade Ⅲ injury, I injured a grade Ⅱ 68 cases. 6 cases were associated with craniocerebral trauma, thoracic trauma in 8 cases, fractures in 6 cases, 3 cases of renal contusion, colon injury in 1. Surgical treatment of sub-1.2 treatment group and non-surgical group, 14 cases of non-surgery group, injured in I a Ⅱ. Operation group, 78 cases including 56 cases of simple suture,[link widoczny dla zalogowanych], gauze packing to stop bleeding in 9 cases, omental packing and suture repair in 5 cases,[link widoczny dla zalogowanych], liver resection debridement in 4 cases, 4 cases of hepatic artery ligation. 8 cases of which help control bleeding portal triad clamping completion of surgery, a block of time in the 1O 25min, an average of 19min. 1.3 Results The 78 cases of liver trauma patients, 7 died, accounting for 8.97% of surgical cases. Non-surgical group 14 patients were cured. Department of surgery group died of severe liver injury thereof, of which 3 patients with severe brain trauma, and 1 with chest trauma, and 1 with post-hepatic inferior vena cava and hepatic vein injury patients died in the right. 1 case of the first operation failed to stop the bleeding line deterministic operation, after the DIC second surgery to death, 1 case of death can not control the bleeding. 2 to discuss non-surgical treatment of 2.1 and the B-CT and other imaging technology to monitor the progress and the means of constant improvement of traumatic rupture of the liver provided a guarantee of non-surgical treatment. 3 years in our hospital cases of non-surgical treatment increased significantly than before. But the non-surgical treatment should be strictly controlled. We believe that the basis of non-surgical treatment should include: ① I Ⅱ level of a mild liver injury. ② no active bleeding. ③ hemodynamic stability. ④ no peritoneal irritation. ⑤ no other internal organs need surgery combined abdominal injuries. ⑥ should be closely monitoring. ⑦ ready to do any surgery,[link widoczny dla zalogowanych], if patients continue to hemorrhage, pulse rate, blood pressure, increased peritoneal irritation should be surgery. 2.2 Surgical treatment of surgical treatment should be based on the active implementation of anti-shock. Severe liver injury should be established on the vena cava of two or more distribution channels, and corrective shock. 2.2.1 General use of abdominal median incision through the right rectus abdominis and the right costal margin of the incision. Incision should be large enough to facilitate exposure. For some close to the diaphragm and chest wall side of a serious injury, is difficult to expose the operative field, the operation even difficult. Such cases should be determined line of the right thoracoabdominal approach. 2.2.2 simple suture of the group of 56 patients. For some mild liver damage, surface cracking and more frustrated with the law. Suture the wound should not stay dead space at the bottom to prevent accumulation of blood infection. 2.2.3 debridement of liver resection for some of the more severe liver injury, liver damage a large, bleeding ferocious. We have 4 cases to give the first hepatic portal blocking at room temperature, the loss of blood supply have been only part of the liver associated with the inactivation of liver tissue and liver tissue with poor blood supply to give debridement resection, ligation or ligation pipe joints to give bar should not be large suture to avoid deactivation, inactivation of liver tissue is conducive to bacterial growth j. Erzhi infection. The first portal vein occlusion for non-hepatic inferior vena cava after liver hemorrhage can control bleeding, reduce bleeding, to detect hepatic vein and inferior vena cava bleeding,[link widoczny dla zalogowanych], bleeding in time for certainty. Less surgical trauma, to maximize the retention of the survival of liver tissue. 2.2.4 hemostatic gauze tamping extensive fragmentation of some liver and bleeding in patients with ferocious, because the injury does not allow line of heavy bleeding into uncertainty, but also often lead to ulnar nerve ulcer; so we believe that reconstruction of sensory function in the same subject attention. Superficial branch of radial nerve sensory area of non-dominated important parts, often as a clinical cut transplant donor, in the dorsal radial wrist flat and superficial branch of ulnar nerve sensory nerve fibers are pure, we believe that the same group felt satisfied with the results of functional reconstruction .
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