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1.
Objective. To observe the clinical outcomes of using a new imtnunentafion SOCON system in the treatment of degenerative spondylolisthesis. Methods. Retrospective clinical and roentgenograph review of 21 patients who suffered from degenerative spondylolisthesis with spinal stenosis treated by decompression, posterolateral intertransverse arthrodesis, and with transpedicle instrumentation of SOCON system. Results. Nineteen of 21 patients were completely recovery from their preoperative symptoms, 17 of 18 cases with grade one slippage reduced to normal spine alignment, 2 cases of grade two slippage fully reduced, and one case of grade two spondylolisthesis got 70% reduction. Post-operative satisfactory rate was 90.5%. Pain relief was 90.5%.Neither infection nor neurologic complication occurred in this series. Conclusion. Our short time follow-up and limited cases showed satisfactory preliminary result of surgical treatment of spondylolisthesis with SOCON instrumentation.  相似文献   

2.
To offset the disadvantage of inability to exhaust air automatically of the currently—used transfusion system. the authors have developed a safe and automatic air exhausting transfusion system in accordance with the density difference between air and water and the physical principle of suction, hence the effective prevention of the disastrous consequence of air embolism caused by the air that enters the veins. The new transfusion system substantially enhances the safety factors of the infused patients. Having been used on 3000 clinical patients, the new transfusion system proves to be stable in its functions, safe,trustworthy, economical and applicable. Besides, this new transfusion system is easy to handle and is worthy of being widely used.  相似文献   

3.
Objective To study the ossification of the posterior longitudinal ligament (OPLL) of thoracic spine which treated surgically, analysis the clinic characteristics and surgical strategy. Methods Fifty-five patients who had been treated surgically for thoracic OPLL were reviewed. There were 19 males and 36 females. The mean age was 51.9 years ( range, 35 - 73 years). All cases were with neurological deficits. The treatment procedures consisted of anterior decompression with instrumentation (15 patients), posterior removal of posterior wall of thoracic spinal canal (34 patients),  相似文献   

4.
Magnetic resonance imaging guided bone biopsies in the iPath-200 system   总被引:2,自引:0,他引:2  
Objective To study the clinical value of a new MRI compatible percutaneous bone biopsy systemMethods Twenty-six patients with bone lesions MRI-guided biopsies underwent using a 0.23-T open MR system combined with an iPath-200 optical leading system.Results Of the 26 biopsies, 23 samples were sufficient for histological examination and the histopathologic diagnoses were confirmed. In the high-risk areas like spine, the biopsies were successfully done in 11 patients. No procedural complications occurred.Conclusion Percutaneous biopsy of bone lesions performed under MRI-guidance in an iPath system was proved to be accurate and safe.  相似文献   

5.
Objective To explore whether bulbourethral sling procedure under urodynamie monitoring is effective in the treatment of male acquired urinary incontinence of postprostatectomy and posterior urethroplasty. Methods Between October 2000 and September 2004, 25 men aged 18 to 81 years (mean age,65 years) with acquired urinary incontinence underwent bulbourethral sling procedure. The causes of urinary incontinence were as follows: post-radical prostatectomy in 4 patients, TURP for BPH in 6, post posterior urethroplasty for urethral stricture in 6, and pro-static enucleation for BPH in 9. Preoperatively, 8 patients had completely urinary incontinence and 17 had stress urinary incontinence, with 1 - 5 urinary pads (mean, 3 pads) needed per day. All the patients experienced exercise of pelvic floor muscles without results. The mean duration of urinary incontinence was 4 years (range, 1 - 12 years).  相似文献   

6.
Objective: To assess the value of a parasympathomimetic drug(neostigmine) in the early resolution of acute colonic pseudo-obstruction(Ogilvie′s syndrome).Methods: To study 42 patients in Hawler Teaching Hospital with the diagnosis of acute colonic pseudo-obstruction between years 2004 and 2008.All had abdominal distention and radiographic evidence of colonic dilation,with a cecal diameter of more than 10 cm,and had had no response to at least 36 hours of conservative treatment.We randomly assigned 22 to receive 2.5 mg of neostigmine intravenously and 20 to receive intravenous saline.A physician who was unaware of the patients′ treatment assignments recorded clinical response(defined as prompt evacuation of flatus or stool and a reduction in abdominal distention),abdominal circumference,and measurements of the colon on radiographs.Patients who had no response to the initial injection were received another dose of neostigmine three hours later.Results: Twenty of the 22 patients who received neostigmine had prompt colonic decompression,as compared with none of the 20 patients who received placebo(P<0.001).The median time to response was 5 minutes(range,2 to 30).Fourteen patients in the placebo group and the two patients in the neostigmine group without an initial response received open-label neostigmine;all had colonic decompression.Four patients who had an initial response to neostigmine required colonoscopic decompression for recurrence of colonic distention;two eventually underwent subtotal colectomy.Side effects of neostigmine included abdominal pain,excess salivation,and vomiting.Symptomatic bradycardia developed in four patients and was treated with atropine.Conclusions: In patients with acute colonic pseudo-obstruction who have not had a response to conservative therapy,treatment with neostigmine rapidly decompresses the colon.  相似文献   

7.
Objective To explore the surgical approach of reducing the incontinence after radical retropubic prostatectomy with recent anatomic findings. Methods Sixteen patients with stage B prostate carcinoma received continence-preserving anatomic radical retropubic prostatectomy. Results All the patients were followed-up 3 months to 5 years, mean 13 months. Thirteen patients had normal voiding, two with mild stress incontinence. Only one was complicated with serious incontinence. Conclusion Identifing and preserving the external striated urethral sphincter and its innervation in performing anatomic retropubic prostatectomy will achieve postoperative urinary continence. 6 refs.  相似文献   

8.
Objective To investigate the correlation between subaxial cervical spine instability and cervical spondylotic sympathetic symptoms as well as the difference of cervical spondylotic subaxial instability between male and female patients. Methods We analyzed retrospectively 318 surgical cases of cervical spondylosis treated at Department of Orthopedic Surgery of Peking Union Medical College Hospital between July 2003 and December 2007. All cases were divided into group A without sympathetic symptoms (n=284) and group B with sympathetic symptoms (n=34). Angular and horizontal translation values between two adjacent vertebral bodies from C2 to C7 were measured separately on hyperflexion and hyperextension lateral cervical spine radiographs. Fisher's exact test was used to evaluate the correlation between subaxial cervical instability and sympathetic symptoms. Intragroup correlation between patient gender and subaxial cervical instability was also evaluated. Results Subaxial instability incidences in groups A and B were 21.8% (62/284) and 55.9% (19/34), respectively. Statistical analysis indicated a definite correlation between subaxial cervical instability and sympathetic symptoms (P=0.000). Among patients without sympathetic symptoms, subaxial instability incidences were 21.4% (37/173) in males and 22.5% (25/111) in females, respectively (P=0.883). While among patients with sympathetic symptoms, sub axial instability incidences were 27.3% (3/11) in males and 69.6% (16/23) in females, respectively, indicating significant difference (P=0.030). Subaxial instability was most commonly seen at C4-C5 intervertebral space in sympathetic cervical spondylosis patients. Conclusions High correlation exists between subaxial cervical spine instability and cervical spondylotic sympathetic symptoms, especially in female patients. Hyperextension and hyperflexion radiographs of cervical spine are important to assess sympathetic cervical spondylotic subaxial instability.  相似文献   

9.
Objective. To investigate the unique characteristics and treatment of thoracic spine fractures. Methods. Seventy-seven patients with thoracic spine fractures were retrospectively reviewed. Of these, there were 37 compression fractures, 34 fracture-dislocations, 3 burst fractures and 3 burst-dislocations. Twenty-six patients had a complete lesion of the spinal cord, 14 sustained a neurologically incomplete injury, and 37 were neurologically intact. Fifty-three patients were treated nonoperatively and 24 treated operatively. Resu/ts. All patients were followed up for 2 -15 years. None of the 26 patients with a complete lesion recovered any significant function. Of 37 neurologically intact patients, 13 had local pain although all of them remained normal function. Two of 14 patients with incomplete paraplegia returned to normal, 7 recovered some function and 5 did not recovered. Conclusions. Because of the unique anatomy and biomechanlcs of the thoracic spine, the classification commonly applied to thoracolumbar fractures is not suitable for thoracic fractures. Fusion and instrumentation are indicated when the fractures are unstable, while patients with incomplete lesion of the spinal cord may be the candidates for supplemented decompression.  相似文献   

10.
This is a study of 18 patients who had surgical treatment for spinal ttuberculosis All patients were admitted with the spinal tuberculosis and treated with a combination of anterior debridement and bone graft with posterior internal fixaton using the Luque or Dick technique.The patients were able to walk within a few days postoperation.Three to seven years follow-ups show no recurrence,kyphosis and/or solid fusinon.  相似文献   

11.
目的 探讨脊骶椎管病变患者发生上尿路损害的危险因素分析.方法 选取40例腰骶椎管病变患者,均经腰椎MRI检查确诊.40例行尿液分析及中段尿培养、血肌酐(SCr)测定;29例行泌尿系B超检查;30例行静脉泌尿系造影(IVU)检查;22例行膀胱返流造影检查;33例行尿动力学检查.以上尿路损害为应变量,以上尿路损害可能相关因素为自变量,行多元线性回归分析.结果 20例有上尿路损害,其中肾、输尿管扩张积水者12例,膀胱输尿管返流(VUR)17例27侧,SCr水平平均为(98.2±86.3)μmol/L,异常升高者6例.尿路感染者17例.35例行剩余尿量测定,31例有剩余尿量,平均(262±232)ml.尿动力学检查显示储尿期最大逼尿肌压(Pdetmax)平均为(41±21)cm H2O,顺应性平均为(22±19)ml/cm H2O;排尿期出现逼尿肌-外括约肌协同失调(DSD)16例(48.5%),逼尿肌无反射16例(48.5%),逼尿肌反射减弱13例(39.4%).16例行静态尿道压力描记,最大尿道闭合压(MUCP)平均为(76±33)cm H2O.与上尿路损害可能相关的因素有低逼尿肌顺应性、高储尿期逼尿肌压、剩余尿量增多、高最大尿道闭合压、逼尿肌收缩力受损、DSD、尿路感染(P<0.05).与上尿路损害可能无关的因素有年龄、性别、腰骶椎管病变类型、术式、尿流率、膀胱容量(P>0.05).结论 低逼尿肌顺应性、高储尿期逼尿肌压、剩余尿量增多、高最大尿道闭合压、逼尿肌收缩力受损、DSD、尿路感染是腰骶椎管病变患者发生上尿路损害的危险因素.  相似文献   

12.
目的探讨康复训练对脑卒中尿失禁患者早期膀胱功能训练的效果。方法随机选择60例脑卒中尿失禁的住院患者,分为治疗组32例和对照组28例。对照组给予常规药物治疗、单纯行导尿或自行排尿术。治疗组给予药物治疗同对照组,并在病情稳定后即行膀胱功能康复训练。结果与对照组比较,治疗组患者残余尿量明显减少,尿失禁发病率明显下降,总有效率87.5%优于对照组57.1%,差异具有统计学意义(P〈0.01)。结论早期实施膀胱功能训练可有效促进脑卒中尿失禁患者膀胱排尿功能的恢复,提高生活质量。  相似文献   

13.
目的:评估无张力尿道中段悬吊术治疗女性混合性尿失禁的中远期疗效。方法:随访分析2010年4月至2016年9月共26例无张力尿道中段悬吊术治疗女性混合性尿失禁患者的临床资料。26例随访到的患者中,4例采用经耻骨后无张力尿道中段悬吊术(retropubic tension free mid-urethral sling, TVT), 22例采用经闭孔无张力尿道中段悬吊术(transurethral middle obturator sling,TOT)。术后中远期电话随访尿失禁严重程度评分(urinary incontinence severity score,UISS)、逼尿肌不稳定评分(detrusor instability score,DIS)、尿失禁生活质量量表评价(incontinence quality of life scale evaluation,I-QOL)、泌尿生殖障碍量表简版(Urogenital Distress Inventory short form,UDI 6),与术前评分进行比较分析。结果:26例患者年龄42~80岁,平均62岁。体重指数(body mass index, BMI)21.48~31.14 kg/m2,平均26.82 kg/m2。随访时间8~69个月,平均26个月,14例患者手术前曾服用M受体阻滞剂,但未超过2周。术中无膀胱损伤、尿道损伤、闭孔血管及神经损伤等并发症,术后拔除尿管时,患者均无局部疼痛或排尿困难。压力性尿失禁治愈25例,达96.15%,急迫性尿失禁治愈20例,达76.92%。26例随访患者生活质量较手术前显著改善(P<0.05)。结论:无张力尿道中段悬吊术治疗女性混合性尿失禁总体有效率高,即使未长期服用M受体阻滞剂等药物,手术本身对急迫性尿失禁的治愈率达76.92%。手术的远期疗效稳定,患者生活质量能得到显著改善。  相似文献   

14.
目的:探讨经闭孔无张力尿道中段悬吊术(TVT-O)治疗女性压力性尿失禁的效果。方法:回顾性分析我院2008年1月~2010年12月行TVT-O手术治疗的21例单纯性压力性尿失禁患者的临床资料。术后随访3个月~3年。结果:手术平均时间18.5min(15~31min),术后平均出血量21ml(5~50m1)。20例压力性尿失禁患者术后得到有效控制,1例术后1个月再次出现压力性尿失禁。1例双大腿外侧疼痛,3个月后自行缓解。结论:TVT-O是治疗女性压力性尿失禁的一种有效方式,其创伤小,并发症低,恢复快。对于个别手术失败的原因需进一步研究。  相似文献   

15.
彭朝林  许仕海  林慧绒 《吉林医学》2012,33(14):3031-3032
目的:探讨重度颅脑损伤患者急诊早期留置尿管、胃管的重要作用。方法:将391例重度颅脑损伤的患者分为对照组和试验组,对照组在急诊诊疗过程中未留置尿管、胃管,试验组在接诊时即给予留置尿管、胃管接引流盒。结果:对照组201例中82例出现呕吐、误吸、尿储留或者尿失禁;试验组182中仅13例出现呕吐,无一例尿失禁、尿潴留。结论:对重型颅脑急诊早期留置尿管、胃管接引流盒,可有效预防患者呕吐、误吸、尿储留和尿失禁,对患者的治疗和预后起到积极有效的作用。  相似文献   

16.
前后路联合手术治疗腰骶段脊柱结核的效果分析   总被引:2,自引:0,他引:2  
目的探讨腰骶段脊柱结核手术治疗的方法及疗效。方法2000年1月-2006年1月间采用后路内固定联合前路病灶清除椎体间植骨融合术治疗腰骶段脊柱结核患者26例。男性18例,女性8例,年龄16-67岁,平均42岁。病变部位L4-S33例,L4-S116例,L5-S17例,伴有一侧或双侧腰大肌脓肿。术前抗痨治疗至少2周以上。后路内固定采用椎弓根钉系统。前路病灶清除后,采用自体髂骨植骨21例,钛网植骨融合5例。结果随访24例,平均随访时间16个月。伤口愈合良好无感染及窦道。骨性融合时间5个月。植骨块无滑脱,内固定无松动,无腰痛及功能受限,结核局部病灶无复发。所有患者切口均一期愈合。结论一期后路内固定加前路病灶清除椎体间植骨融合术治疗腰骶段脊柱结核的疗效确切,能达到彻底清除病灶和重建腰骶稳定的目的。  相似文献   

17.
H Sier  J Ouslander  S Orzeck 《JAMA》1987,257(13):1767-1771
The prevalence, time course, and factors associated with urinary incontinence were examined among 363 patients aged 65 years or older admitted to the acute medical and surgical services of a university hospital. Overall, 35% were incontinent of urine at some time during their hospital stay; incontinence was more common among women and among those older than 75 years. Indwelling catheters were used in 50% of the incontinent patients and 25% of the patients who were otherwise continent while in the hospital. Incontinence was associated with impaired cognitive and physical functioning and with treatment for urinary tract infections. In most of the patients who were incontinent while hospitalized, incontinence was a persistent phenomenon and had been present before hospitalization and was present afterward. Only 5% had "transient" or "nosocomial" incontinence. These data suggest that the acute-care hospital may provide a good opportunity for physicians to identify the often-ignored problem of incontinence, and to then initiate an appropriate diagnostic evaluation of this condition if it persists after hospital discharge.  相似文献   

18.
肛提肌训练对前列腺手术后尿失禁影响的研究   总被引:3,自引:0,他引:3  
目的评价术前术后肛提肌训练对于良性前列腺增生术后暂时性尿失禁的影响. 方法 对41例良性前列腺增生术后的患者分为常规护理组(对照组)和康复训练组(实验组),实验组给予严格的肛提肌训练,观察病程、年龄、手术方式、训练时间与术后尿失禁的关系. 结果 实验组和对照组拔管后尿失禁的发生率无统计学差异(P>0.05),在术后10、20、30、90 d时实验组的尿失禁的发生率低于对照组(P<0.05).在低于70岁的年龄段中实验组在术后20、30、90 d尿失禁的发生率低于对照组(P<0.05),在≥70岁的年龄段两组无明显差别(P>0.05).术后实验组的尿失禁持续时间为(20.0±7.6) d,低于对照组的(68.8±46.1) d (P<0.05).两种手术方式对术后尿失禁的影响无统计学差异(P>0.05). 结论 肛提肌的早期、长期训练对预防和治疗良性前列腺增生术后尿失禁的发生有积极作用,尤其对小于70岁的患者作用更明显.  相似文献   

19.
目的〓分析针灸治疗混合性尿失禁的用经、用穴及腧穴组方规律。方法 通过电子检索中国知网、维普医学资源数据、万方数据库、中国生物医学文献数据库、PubMed中关于针灸治疗混合性尿失禁的文献,建立数据库并用数据挖掘软件进行腧穴关联分析。结果 针灸治疗混合性尿失禁常选穴位有会阳、三阴交、足三里、中髎、次髎;常选经脉为膀胱经、脾经、胃经;常选部位为腰骶部;特定穴中以交会穴的运用最多;相关性较高的腧穴有足三里-三阴交,会阳-三阴交;刺激方法以电针为主。结论 针灸治疗混合性尿失禁取穴取经有规律,疗效肯定,为临床治疗用经选穴提供一定的参考依据。  相似文献   

20.
目的 探讨行动导向法在原位新膀胱患者康复中的应用效果.方法 选取36例新膀胱术后回归社区的患者,自出院当天起按"提出任务、计划制订、计划实施、自我反馈"4个完整的行动进行健康教育,6个月后评价患者尿失禁或尿潴留的发生率、新膀胱控尿效果、健康知识知晓率.结果 干预后患者尿失禁的发生率为2.78%、尿潴留为8.33%,新膀胱控尿效果和健康知识知晓率均为100%,与干预前比较差异均有统计学意义(P<0.05).结论 行动导向法对原位新膀胱患者进行健康教育,有利于提高患者学习积极性和依从性,促进理想自主排尿早日恢复.  相似文献   

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