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双语推荐：藏毛窦

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藏毛窦是一种临床常见病。目前我国肛肠外科医生对藏毛窦的临床表现和治疗方法尚缺乏足够的了解，误诊率和复发率高。本文结合2013年美国结直肠外科医师学会发布的藏毛窦临床诊疗指南，从藏毛窦的病因、诊断及非手术治疗和手术治疗4个方面进行论述。
Pilonidal disease is a common clinical condition which is not sufficiently recognized with regard to the clinical manifestation and treatment by colorectal surgeons in China, resulting in high misdiagnosis rate and recurrent rate. With reference to the Practice Parameters for the Management of Pilonidal Disease published in 2013 by The American Society of Colon and Rectal Surgeons , we discuss the management of pilonidal disease in four aspects , including etiology, diagnoses, nonoperative and operative management.

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目的：探讨改良菱形皮瓣成型术在藏毛窦治疗中的效果。方法：2000年1月-2014年2月收治藏毛窦患者52例，采用此种术式治疗，观察疗效。结果：52例患者均取得一期愈合。所有患者均未出现切口血肿、切口裂开及积液感染等情况。术后随访1～4年，均无复发。结论：改良菱形皮瓣成型术在藏毛窦的治疗上较其他术式有明显优势，值得推崇为藏毛窦治疗的优选手术术式。
Objective:To explore the effect of modified rhomboid flap molding technique in the treatment of pilonidal sinus. Methods:52 patients with pilonidal sinus were selected from January 2000 to February 2014.They were given this kind of operation treatment.The curative effect was observed.Results:52 patients all achieved primary healing.All patients had no incision hematoma,incision dehiscence and effusion infection.Followed up from 1 year to 4 years after operation,they had no recurrence. Conclusion:The modified rhomboid flap molding technique in the treatment of pilonidal sinus has obvious advantages when compared with other operation.It is worthy of praise for the optimal operation method in the treatment of pilonidal sinus.

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目的：评价引流配合德赛恩换药治疗骶尾部藏毛窦的疗效。方法：10例骶尾部藏毛窦患者均行切开窦道和脓腔，彻底清除窦道内坏死组织，创面敞开充分引流，术后采用德赛恩纱条换药。结果：10例均一期愈合，平均住院时间17d，平均换药时间35d，随访3个月~1年无复发。结论：充分引流并德赛恩换药治疗骶尾部藏毛窦，疗效确切，疗程短，换药方便，一期治愈率高。
Objective To evaluate the efficacy of draining combined with Dermacyn soaked gauze dressing on sacrococcygeal pilonidal sinus. Methods The opening the sinus up, draining away the pus and removal of necrotic tissue was performed for ten sacrococcygeal pilonidal sinus patients. Dermacyn soaked gauze dressing was applied to the incision qod. Results 10 cases were diagnosed as sacrococcygeal pilonidal sinus pathologicaly and obtained one-stage healing. The mean length of stay and dressing was 17 days and 33 days respectively. During a folow-up period of 3 months to 1 year, there was no recurrence. Conclusion Complete draining combined with Dermacyn soaked gauze dressing was proved to be in short treatment course, convenient dressing and high rate of one-stage healing.

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目的：探讨骶尾部藏毛窦患者的护理体会。方法做好术前护理和术前准备，术后早期避免下床活动，以防伤口出血，注意保持伤口清洁干燥，预防因感染而延期愈合，做好伤口换药，预防尿潴留。结果本组均行手术切除病灶，无一例复发。结论骶尾部藏毛窦的主要治疗手段是手术切除，术前术后护理及伤口换药对于手术成功率至关重要。
Objective To investigate Nursing sacrococcygeal pilonidal sinus patients.Methods Good care and preoperative preparation before surgery, to avoid getting out of bed early, to prevent bleeding wound, keep the wound clean and dry to prevent infection and delayed healing due, good wound care, prevention of urinary retention. Results The group underwent surgical excision of the lesion, with no recurrence.Conclusion The main treatment for sacrococcygeal pilonidal sinus is surgical resection, preoperative and postoperative care and wound dressing for success rate of surgery is essential.

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目的探讨不溶性藻酸钙泡沫型一次性医用敷料在藏毛窦术开放性切口换药中的临床疗效。方法对23例藏毛窦患者在术后开放性切口换药中,根据创面大小剪取条形状不溶性藻酸钙泡沫型一次性医用敷料放置创口,外加无菌纱布覆盖,1~2次·d-1。术后使用抗生素5~7 d。结果 23例患者术后48~96 h局部皮肤红肿、疼痛等症状消失,换药时患者疼痛减轻,创面渗液明显减少,住院20~25 d,均康复出院。结论在藏毛窦术开放性切口换药中应用不溶性藻酸钙泡沫型一次性医用敷料,可明显缩短创面愈合时间,且无明显的不良反应,是一种疗效好、安全性高的创口敷料。
Objective To investigate the clinical efficacy of insoluble calcium alginate foam wound dressing in open wound dressing change in patients undergoing surgery for pilonidal sinus. Methods According to wound size, strip-type insoluble calcium alginate foam wound dressing was placed on the wound and sterile gauze was used to cover the wound once or twice per day in 23 patients with pilonidal sinus. After operation, patients were treated with antibiotics for 5-7 days. Results Local redness, swelling, pain and other symptoms disappeared 48-96 hours after operation in all patients. In addition, the pain was relieved and wound exudate was reduced during dressing changes. All patients were discharged from hospital after hospitalization for 20-25 days. Conclusion The insoluble calcium alginate foam wound dressing is an effective and safe wound dressing, which can shorten wound healing time without obvious adverse reactions in patients undergoing surgery for pilonidal sinus.

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目的：探讨Limberg菱形转移皮瓣在骶尾部藏毛窦手术中的应用。方法采用Lim-berg菱形转移皮瓣技术治疗骶尾部藏毛窦患者18例。结果手术时间45～135 min，平均（86±20）min，住院时间8～26 d，平均（15．5±4．5）d。随访16例，失访2例，平均随访时间15．7个月（3～74个月），随访期内未见复发。其中3例发生术后缝合切口底端部分裂开，1例出现皮下积液，1例皮下血肿，1例出现Limberg皮瓣尖端表皮坏死，均经常规换药引流后愈合，无切口感染。结论 Limberg菱形转移皮瓣技术治疗骶尾藏毛窦，治愈率高，术后恢复快，复发率低，推荐用于复发性或者病灶范围广泛的患者。
Objective To evaluate the efficacy of Limberg rhombic flap for the management of sacrococcygeal pilonidal sinus.Method A total of 18 patients with sacrococcygeal pilonidal sinus were treated by Limberg rhomboid flap.Results The operative time ranged from 45 to 135 minutes,with an av-erage of(86 ±20 )minutes.The postoperative hospital stay ranged from 8 to 26 days,with an average of (15.5 ±4.5)days.A total of 16 patients were followed up for 3 to 74 months,with an average of 15.7 months,and 2 cases were lost.No recurrence was observed during the follow-up period.There were 3 cases of wound dehiscence at the lower end,1 case of subcutaneous hydrops,1 case of subcutaneous hemotoma and 1 case of flap necrosis.After regular dressing change and drainage,these patients were all healed with-out wound infection.Conclusion Limberg rhombic flap has the advantages of high success rate,fast post-operative recovery and low reccurence rate in the treatment of sacrococcygeal pilonidal sinu

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目的：探讨骶尾部藏毛窦两种不同切口处理方法的临床效果，为其临床诊治提供理论依据。方法：回顾性分析我院自2008年1月至2014年1月期间收治并得到完整随访的68例骶尾部藏毛窦，将其分为一期缝合组和创口敞开组，观察2组患者的性别、年龄、体质量指数（BMI）、囊肿大小（最大径×最小径）、窦道长度、囊肿距肛缘距离、外窦口数量、既往手术次数、手术创口大小（横径×纵径）、创口愈合时间和术后并发症的差异。结果：一期缝合组30例，其中男26例，女4例；创口敞开组38例，其中男31例，女7例。全组平均BMI为25.02 kg/m2。一期缝合组创口愈合时间为14～29 d；创口敞开组创口愈合时间为16～67 d。一期缝合组和创口敞开组分别有1例于术后1年内复发。一期缝合组有1例切口感染，发生率为3.33%；创口敞开组有2例患者出现创口感染，发生率为5.26%。2组患者性别、年龄、病程长短、距肛缘距离、外窦口数量及既往手术次数差异均无统计学意义（P＞0.05）；而囊肿大小、窦道长度、皮肤创口大小及创口愈合时间差异均有统计学意义（P＜0.05)。结论：藏毛窦窦道切除一期缝合术后恢复快、痛苦小，是理想的手术方式。但对于那些囊肿较大、窦道较长、创口张力较大及组织缺损较多的患者，
Objective: To summarize the methods of diagnosis and treatment for sacrococcygeal pilonidal sinus.Methods: The processes of diagnosis and treatment for 68 patients with sacrococcygeal pilonidal sinus were analyzed retrospectively. They were divided into the sinus resection and primary suture group, and the sinus resection and incision open group. The difference of two groups was observed in gender, age, body mass index (BMI), the cyst size, the sinus length, the distance from the anal verge cyst, the number of external ports, the number of previous surgery, the surgical wound size, the wound healing time and the postoperative compli-cations.Results: The primary suture group of 30 patients included 26 males and 4 females. The incision open group of 38 patients included 31 males and 7 females. The average BMI (BMI) was 25.02 kg/ m2 in total. The wound healing time of the primary suture group was 14~29 d. The other group was 16~67 d. One case of the pri-mary suture group develop

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目的 :比较胺碘酮和毛花甙C(西地兰)静脉用药治疗院前急救中快速心房纤颤的疗效。方法 :随机抽取2010年1月-2011年1月上海市医疗急救中心随车急救中用毛花甙C治疗心房纤颤的110例病例为Ⅰ组;2011年2月-2013年2月用胺碘酮治疗心房纤颤的110例病例为Ⅱ组。Ⅰ组静脉注射毛花甙C 0.4~0.8 mg。Ⅱ组静脉注射胺碘酮150 mg,如未转复为窦性心律者,重复给予75~150 mg,后改为静脉滴注150~450 mg。结果 :胺碘酮组治疗效果优于毛花甙C组,两组差异有统计学意义。结论 :静脉注射胺碘酮治疗心房纤颤的作用迅速、安全,其疗效优于毛花甙C。
Objective:To compare the efifcacy of amiodarone and lanatoside C(cedilanid) in the intravenous treatment of rapid atrial fibrillation at the pre-hospital emergency center. Methods: One hundred and ten cases of patients with atrial ifbrillation treated with lanatoside C were randomly selected as group I in Shanghai Medical Emergency Center ambulance during Jan. 2010-Jan. 2011 while another 110 cases treated with amiodarone as group II during Feb. 2011-Feb. 2013. 0.4~0.8 mg of lanatoside C was intravenously given in group I and 150 mg of amiodarone in group II, and 75~150 mg of amiodarone were repeatedly given and then 150~450 mg of amiodarone if the patients did not convert to sinus rhythm. Results:The efifcacy of amiodarone was better than that of lanatoside C, and the difference was statistically signiifcant. Conclusion:Amiodarone in the treatment of atrial ifbrillation possesses quick action and good safety and its efifcacy is much better than lanatoside C. So it is recommended as th

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目的 探讨瘢痕性脱发的临床、组织病理与皮肤镜特点,以及治疗和预后的特征.方法 回顾性分析53例瘢痕性脱发患者的临床资料,分析其组织病理、皮肤镜征象、治疗和预后的特点.结果 瘢痕性脱发以脱发、毛囊开口消失、毛囊皮脂腺单位数目减少或消失为共同特征.基底细胞局灶液化变性、毛囊角栓、毛细血管分支状扩张、免疫荧光阳性提示盘状红斑狼疮；界面皮炎提示毛发扁平苔藓；炎症和弹力纤维轻微破坏提示假性斑秃；毛囊间黏蛋白沉积及毛囊口下陷为黏蛋白性脱发的特点；脓疱可见于脱发性毛囊炎和分割性蜂窝织炎或毛囊炎,前者多伴有簇状发,窦道形成则仅见于后者.治疗对淋巴细胞性患者使用免疫抑制剂,对中性粒细胞性患者使用抗生素和维A酸.结论 组织病理检查对诊断起决定性作用.瘢痕性脱发造成不可逆的毛囊损害,治疗周期长.早期诊断及早期合理用药可控制疾病发展,减少永久性脱发损害.
Objective To investigate the clinical,histopathological and dermoscopic features as well as treatment and prognosis of cicatricial alopecia.Methods Clinical data on 53 patients with cicatricial alopecia were retrospectively collected and studied.Pathological and dermoscopic characteristics,as well as treatment modality and prognosis of cicatricial alopecia were analyzed.Results Cicatricial alopecia was characterized by alopecia,disappearance of follicular ostia,and absence or decrease in the number of polisebaceous gland units.Pathologically,focal liquefactive degeneration of basal cells,follicular keratotic plugs,arborising telangiectasia together with a positive immunofluorescence test were usually suggestive of discoid lupus erythematosus,interface dermatitis suggestive of lichen planopilaris,inflammation and mild disruption of elastic fibers suggestive of classic pseudopelade of Brocq.Mucin deposition between hair follicles and sinking of follicular ostia were pathological and derm

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目的：分析探讨鼻内镜手术治疗真菌性鼻窦炎的临床疗效。方法：对30例真菌性鼻窦炎患者施行鼻内镜手术，标本进行病理学研究，术后采用抗生素辅助治疗。结果：30例患者经手术治疗，均治愈出院，鼻腔通气良好，症状消失，上颌窦口通畅。术后随诊回访6个月～1年，无1例复发，无并发症发生。病理学诊断感染真菌为：白色念珠菌5例，毛霉菌12例，曲霉菌13例。结论：鼻内窥镜手术治疗真菌性鼻窦炎具有创伤小，治愈效果良好，缩短诊疗时间，是诊断和治疗真菌性鼻窦炎的理想方法。
AIM:To investigate the clinical efficacy of endo-scopic sinus surgery for fungal sinusitis.METHODS:30 cases of fungal sinusitis were undergone endoscopic sinus surgery,pa-thology specimens were studied.After surgery,antibiotics were used as adjuvant therapy.RESULTS:30 patients were treated by surgery,and they were all cured.Nasal ventilation is good,and the symptoms disappeared,what''s more,maxillary sinuses were smooth.The patients were followed up for 6 to 1 2 mouths.No case was recurred and had complications.fungal infection was di-agnosed by pathological that Candida albicans had five cases,mu-cous had 1 2 cases,and aspergillosis had 1 3 cases.CONCLU-SION:Treating fungal sinusitis by endoscopic surgery has many characteristics,such as less invasive,good effect,shorten treat-ment time.This is an ideal way to diagnose and treat fungal sinus-itis.

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