RESUMO
Objective To explore the effects of small incision in situ release on surgical indications,nerve conduction velocity and upper limb function in patients with carpal tunnel syndrome(CTS).Methods A total of 100 CTS patients admitted to our hospital from January 2018 to January 2022 were selected,they were randomly divided into the control group(50 cases,treated with traditional carpal tunnel release)and the observation group(50 cases,treated with small incision in situ release),the clinical data of CTS patients were collected and surgical indications,nerve conduction velocity,upper limb function and the incidence of complications were compared between the two groups.Results The total effective rate was 98.00％in the observation group and 84.00％in the control group(P＜0.05).In the observation group,the length of incision was(1.65±0.29)cm,the time of opening and closing incision was(4.85±1.02)min,the hospitalization time was(3.24±0.62)d,the intraoperative blood loss was(17.88±3.53)mL,and the VAS score was(3.03±0.56)points one day after operation.The control group were(4.02±0.81)cm,(10.06±2.28)min,(7.11±1.34)d,(24.37±5.27)ml,(4.04± 0.89)points,the differences were statistically significant(P＜0.05).After treatment,The thumle-wrist sensory conduction velocity of CTS patients in the study group was(46.05±8.39)m/s,the middle finger-wrist sensory conduction velocity was(45.05±8.95)m/s,the thenar muscles-wrist motor conduction velocity was(53.94±11.47)m/s,the FIM ADL score was(34.38±7.22)points,and FMA The upper limb score was(34.23±7.25)points,and the control group was(41.86±8.22)m/s,(40.88±8.28)m/s,(49.05±10.01)m/s,(27.81±6.01)points,(41.05±9.19)points.The difference between the two groups was statistically significant(P＜0.05).The total incidence of complications was 4.00％in the observation group and 20.00％in the control group(P＜0.05).Conclusion Small incision in situ release is effective in the treatment of CTS patients,which can improve the surgical indications and nerve conduction velocity,help patients recover upper limb function,and reduce the incidence of postoperative complications.
RESUMO
Objective To explore the effects of VEGF/bFGF sustained release microspheres combined with hyperbaric oxygen therapy on survival rates of uhralong random pattern flaps in rats.Methods Modified McFarlane flap rat models were randomly divided into 4 groups,VEGF/bFGF microspheres + hyperbaric oxygen group,VEGF/bFGF microspheres group,hyperbaric oxygen group and control group.At the end of 7 days,survival rates of flaps were calculated (Survival rate =Survival area/total area × 100％).The tissue samples were taken from middle portion of flaps to detect the neovascularization.Immunohistochemistry was used to detect the differential expression of VEGF.Results Seven days after the random pattern flap operation in rats,the survival rates of VEGF/bFGF microspheres combined with hyperbaric oxygen therapy experimental group,VEGF/bFGF microspheres experimental group,hyperbaric oxygen therapy experimental group,and control group were (89.54 ± 3.23) ％,(73.54 ± 4.57) ％,(71.89 ± 2.26) ％,(50.36 ± 2.37) ％ respectively.The neovascularization counts of each group in part Ⅱ were (35.14 ± 4.21)/mm2,(23.34 ± 2.53)/mm2,(25.22 ±2.73)/mm2 and (17.37 ± 5.73)/mm2 respectively.VEGF cumulative absorbance in VEGF/bFGF microspheres + hyperbaric oxygen group,VEGF/bFGF microspheres group,hyperbaric oxygen group and control group were 78.39 ± 9.12,52.42 ± 13.59,49.84 ± 12.93,29.24 ± 10.35 respectively.In each experimental result group,there were significant difference between the combination group and the other groups (F =189.956,P ＜ 0.05),but there was no significant difference between VEGF/bFGF microspheres experimental group and hyperbaric oxygen therapy experimental group.Conclusion VEGF/bFGF sustained release microspheres combined with hyperbaric oxygen therapy can promote flap neovascularization,increase the flap blood supply and then improve the survival of random pattern skin flaps.