骨科
词汇介绍
拓展阅读
解析
Amputation 英 /ˌæmpjuˈteɪʃn/ 美 /ˌæmpjuˈteɪʃn/
释义 n. 截肢;切断(术)
复数 amputations
例句 Until now, how amputation is translated into gene activation has been like magic. 迄今为止,截肢是如何被解释为基因活化仍像魔法一样。
概述
概述
截肢术是指经骨或关节将已丧失生存能力、危害病人生命和没有生理功能的肢体截除的外科手段,是一项破坏性的手术。
术前局部处理
1.1 切开引流 必须充分暴露脓腔,将坏死组织包括肌腱清理干净。
1.2 局部换药 (1)干性坏疽宜暂时用无菌敷料 (或酒精纱布)包扎。(2)湿性坏疽应先切开并用凡士林油纱填塞引流。(3)创面选择敏感的抗生素纱布湿敷。
截骨平面的确定
截骨平面判定应考虑:(1)营养状况。若出现皮色苍白、皮温降低、肌肉软组织萎缩菲薄、汗毛脱落等征象,说明组织营养差,愈合不良。(2)经皮氧分压测定。经皮氧分压测定能密切反映动脉实际灌注压的变化并可以预测截肢面伤口的愈合能力。一般认为PGCO2>6.7 kPa,切口愈合良好;PGCO2<5.3 kPa,切口愈合不良。
适应征
小腿坏疽达中段1/3水平或膝关节以下挛缩,屈曲功能丧失;经X线摄片证实小腿骨有骨髓炎;血管造影显示腘动脉以下血流信号微弱或消失,侧支循环未建立。
手术方法
取股骨中下段(股骨大转子向远心端13~15 cm 处)做截骨平面并测量周径、直径。于大腿前、后正中线分别距截骨平面远心端2/3和1/3直径处,对称性向后弧形切至大腿内外侧中线与截骨平面交汇点。处理创面组织,常规断骨处理,断缘上端向后上方斜面磨平,勿使肌肉与皮瓣分离。修剪皮瓣、肌肉残端,放置引流条或负压引流管、缝合。
SPECT/CT骨显像在冻伤评估和治疗中的应用
发表时间:2019-02-10
影响指数:1.9
作者: Manganaro MS
期刊:Br J Radiol
Frostbite is a localized cold-induced tissue injury resulting from prolonged exposure of flesh to freezing (0°C) and near freezing (2°C) temperatures.1,2 Frostbite typically affects adults between 30–49 years of age with a strong male predominance (10:1) and most commonly involves the hands and feet (>90% cases), although the face, cheeks, ears and nose may also be affected. Vasospasm and arteriovenous shunting leading to ischemia and infarction is central to the pathogenesis of frostbite and occurs on a spectrum ranging from minor exposure and pernio (chilblains), to necrosis and gangrene. The severity of frostbite is dependent on the duration of exposure. Frostbite has a predilection for those who are unable to protect themselves from adverse environments such as wilderness hikers, alcoholics and substance abusers, psychiatric patients, and the poor.
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