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asbryobvrz · Wysłany: Czw 7:16, 17 Mar 2011

Oligohydramnios clinical analysis of 206 cases

B-monitoring Qingdao Oligohydramnios is the medical and health guidance 37, 2005 No. 4 of the necessary means to deal with such cases. Palace of pregnant women with high clinical observation, abdominal circumference, body weight increase, or even less; have a sense of who the uterus wrap a carcass, and should be suspected oligohydramnios, parallel B-ultrasound. More than 39 weeks pregnant should be routine B-mode ultrasound diagnosis of oligohydramnios upon,[link widoczny dla zalogowanych], in addition to aggressive treatment of concurrent (combined) disease, but other than fetal malformations in the case of termination of pregnancy during cesarean section as soon as possible to improve the prognosis of perinatal children the key. Modified radical mastectomy skin flap necrosis prevention week of wide-Tak Sun Minghui radical mastectomy skin flap necrosis is a common complication, which not only increases the patient's hospital stay, but also to patients with a certain degree of suffering and economic difficulties, it is Breast Cancer Radical prevention of flap necrosis is very important. Our hospital since 2000 on 196 cases of breast cancer patients I ~ Ⅱ implementation of the modified radical mastectomy, satisfactory results are summarized below. The clinical data of 1 196 cases in this group, are women. Aged 27 to 65 years, mean age 45 years. Tumor is located in the upper outer quadrant in 92 patients, 67 cases within the upper quadrant, the central and outer side 37 cases of inferior quadrant. Tumor diameter is less than 6cm, and the pectoralis major non-invasive. 2 Methods 2.1 Design of the incision in the sternum from the transverse incision in the medial edge of the third intercostal space, lateral beyond the anterior axillary line axillary 3cm. Cut from the edge of the tumor 4 ~ 5cm. Curvature of the flap as the location of the tumor, down, left and right can be properly adjusted to ensure good co-operation on the skin without tension. Free flap, on up to the subclavian, issued costal arch level, the edge of the sternum and outside of the latissimus dorsi level. Free flap, flap processing is modified radical mastectomy in breast cancer prevention an important part of flap necrosis. In the free flap, by the assistant flap with forceps to pull tension level, the surgeon electric knife in the skin and superficial fascia (superficial fat tissue) within the flap edge of the adipose tissue is not retained in the free even after 4 ~ 5cm thin layer of fatty tissue retention. So we think that as far as possible in the free flap vascular network under the protection of leather. 2.2 thoroughly cleaned and the subclavian axillary lymph nodes from the chest wall edge of the pectoralis major skills will free up, stretched out on the limb to move the upper arm, forearm, buckling to the opposite side, so pectoralis major muscle was completely relaxed state. Chest with a retractor to pull to the opposite side can be fully exposed to the armpit in the surgical field. Clear surgical field, the possibility of injury is small, can be fully cleared subclavian, axillary perivascular and central group, the lateral group, before and after the group's lymphatic and fat tissue. Chest injury that is not the case, completely clear of the business unit staff hospital of Qingdao 26601l subclavian and axillary lymph and tissues. Anatomy of the long thoracic nerve and thoracodorsal nerve to be protected. 2.3 Protection of pectoral nerves to take the approach fully reveal the armpit, pulled pectoralis major, pectoralis minor muscle revealed superficial, attention to the protection from the brachial plexus lateral light beam in the pectoralis minor muscle on the top of the chest into the pectoralis major nerves. Do not damage the brachial plexus from the lateral beam, the small muscles in the chest after the chest before the oblique medial nerve and brachial plexus from the medial beam line in the pectoralis minor muscle behind the lateral thoracic nerve. Pectoralis major muscle to ensure a good blood supply and nerve supply. 2.4 The careful operation to prevent the subcutaneous fluid,[link widoczny dla zalogowanych], wound thoroughly bleeding, subcutaneous hematoma fluid is an important cause of skin flap necrosis. The flap on the chest wound fixed number of pins, to prevent the flap and wound seroma shift-type friction. In the joint paper, we put two porous silica conventional drainage. A drainage tube placed in the armpit area, and another drainage pipe along the inner edge of the wound (sternal lateral) from the incision outside the abdominal wall below the first place the leads. This has been fully wound drainage. After the operation,[link widoczny dla zalogowanych], while continuing with the suction aspiration pneumoperitoneum created cavity fluid, then vacuum tank, while a small piece of gauze with a soft chest wall depression oppression, particularly under the armpit and collarbone area, so that negative pressure . 5 to 7 days after drainage tube pulled. 3 to discuss the requirements of radical mastectomy revealed good axillary lymph node dissection satisfaction. Under this premise, take damage, a small incision and beautiful, little effect on limb function, anatomy and function of the pectoral muscles to retain the integrity of the surgical method. The method described in this paper to achieve the above requirements. Conducive to wound healing, axillary dissection and good quality of life for women,[link widoczny dla zalogowanych], transverse incision is superior oblique incision. The scar is small,[link widoczny dla zalogowanych], only 15 ~ 20cm. Flap necrosis is the most common complication after breast cancer. Our hospital since 2000, with transverse incision flap range, above, below the main lateral skin defect, the skin on the dominant nerve damage, more importantly, healing the largest part of the longitudinal tension are buffered, reducing tension small, is conducive to the blood supply skin flap and skin flap supply. Therefore, no flap necrosis. As we adopt a transverse incision, preserves the normal pectoralis major