ABSTRACT
Objective:To investigate the clinical effect of Flow-through perforator flap of posterior interosseous artery in repair of dorsal digital soft tissue defect with disorder of blood supply in digital tip.Methods:From January 2018 to June 2020, 12 patients who had digital dorsum soft tissue defect with digital tip blood supply disorder were treated with Flow-through perforator flap of posterior interosseous artery. The size of flaps was 2.0 cm× 2.0 cm-5.5 cm×3.0 cm. The posterior interosseous artery in the flap was bridged with the proper palmar artery of digit, 1 subcutaneous vein in the flap was anastomosed with the dorsal subcutaneous vein, and 1 subcutaneous vein in the posterior interosseous artery with the palmar subcutaneous vein. The donor sites were sutured directly. The wound healing, blood supply of digit and flap survival were observed after operation. The quality of flap survival and digital joint function were observed in the follow-up reviews at outpatient clinic.Results:All the 12 Flow-through perforator flaps of posterior interosseous artery survived, the blood supply of digit was good, and the wounds healed in the first stage. The follow-up period was 6-24 months. The appearance and texture of the flaps were good without obvious bloating. Only linear scar was left in the forearm donor site. According to the Trial Standard of Upper Limb Function Evaluation of Chinese Society of Hand Surgery, the results were excellent in 11 cases and good in 1 case.Conclusion:The perforator flap of posterior interosseous artery has constant anatomy, and the diameter of blood vessel matches the blood vessels of digits. It is suitable for Flow-through technique. It has less subcutaneous tissue, no secondary thinning, and the donor site can be closed directly. It is a good method to repair the dorsal soft tissue defect with disorder of digital end blood circulation.
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Objective:To explore the clinical effect and nursing experience of papaverine intramuscular injection after finger replantation with self-designed hip intramuscular injection positioning device.Methods:Totally 216 cases of patients treated with palavering for anti-vasospasm after of severed fingers from January 2018 to December 2019 were randomly divided into control group (108 cases) and observation group (108 cases) by random number table method. The control group received intramuscular injection of buttock muscle according to the conventional method, and the observation group used the auxiliary intramuscular injection with self-designed glutei muscle positioning device. The incidence of postoperative hip indurations and ecchymosed, survival rate of and buttock were analyzed Pain scores were compared.Results:Totally 76 cases (70.37%) and 62 cases (48.15%) in the control group, 12 cases (11.11%) and 6 cases (5.56%) in the observation group. The difference between the two groups was statistically significant ( χ2 values were 78.545, 67.307, P<0.01). 78 cases (72.22%) survived in the control group and 96 cases (88.89%) survived in the observation group ( χ2 value was 11.416, P<0.01). After papaverine intramuscular injection, there was no significant difference in hip pain score between the two groups on the first and second day ( P>0.05), but there was significant difference between the two groups on the third to seventh day ( t values were 17.17 to 45.97, P<0.05). Conclusion:Palavering intramuscular injection can reduce the incidence of hip indurations and ecchymosed, relieve buttock pain and improve the survival rate of amputated finger, which is worthy of clinical application.
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Objective] To study six-meridians’exopathy syndromes,to analyze the characteristics of six-meridians’exopathy,and to improve formulas concerned.[Method] Based on ZhangZhongJing’s works,to collect clauses concerned and to improve formulas,which would be compared with each other for analyzing the pathogenesis of six-meridians syndromes. [Result] Wind pathogen is hot ,so that clearing heat with pungent and cool-natured drugs should be used,while exopathy in Yang-meridians‘prognosis is better than Yin-meridians’.The formulas should refer to ZhangZhongJing,YeTianShi and WuJuTong’s works.Exopathy in Tai-yang meridian’s formula is GuiZhi decoction,exopathy in Yang-ming meridian’s formula is MaHuangGancaoXingRen decoction,exopathy in Shao-yang meridian’s formula is XiaoChaiHu decoction,while exopathy in Tai-yin meridian’s formula is GuiZhiRenShen decoction,exopathy in Shao-yin meridian’s formula is MaHuangFuZiXiXin decoction,exopathy in Jue-yin meridian’s formula is MaHuangShengMa decoction.[Conclusion] Formulas were improved,which suite to the pathogenesis of six-meridians’exopathy. Classical formulas and pungent and cool-natured drugs should be compared with each other,which provided an initial foundation to the discussion of hot and cold diseases.
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Objective]To introduce Professor Lian’s experience of recuperating tumor with Chinese medicine. [Method]To analyze the col ection of Professor Lian’s clinical experience. [Result]Based on pulse and syndrome, using famous descriptions,which is the key of the effectiveness. [Conclusion] Professor Lian is ful of clinical experience, whose descriptions are common and worth studying.