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1.
目的:系统评价人工颈椎椎间盘置换术与颈前路椎间盘切除减压植骨融合术用于脊髓型颈椎病的临床效果。方法:选取我院骨科近1年来收治的脊髓型颈椎病的患者80例,年龄18~49岁,随机分成试验组与对照组,2组均为40例。试验组在治疗时接受人工颈椎椎间盘置换,对照组接受颈前路椎间盘切除减压植骨融合术。观察及对比2组临床疗效。结果:在80例患者中,人工颈椎椎间盘置换有效率91.03%,颈前路椎间盘切除减压植骨融合术的有效率为83.67%。经x2检验两两比较,人工颈椎椎间盘置换的有效率均高于单独用颈前路椎间盘切除减压植骨融合术,P值为0.042。人工颈椎椎间盘置换组无论是在手术时间,还是在患者下地活动时间和住院时间均明显低于颈前路椎间盘切除减压植骨融合术组,并且上述数值2组之间的差异有统计学意义(P值分别为0.025、0.031和0.043)。结论:人工颈椎椎间盘置换对于脊髓型颈椎病患者具有较好的临床疗效,较颈前路椎间盘切除减压植骨融合术对脊髓型颈椎病对神经的压迫具有较好的临床治疗效果。  相似文献   

2.
颈椎前路椎间盘切除加植骨术的护理史永茹,黄克云关键词:颈椎前路;减压植骨融合术;护理我科从1995年4月份起,开展颈椎前路减压植骨融合手术3例,有效率达100%。手术方法是从颈外侧入路,显露病变间盘,直视下切除间盘并刮除增生的骨质,充分减压后取自体髂...  相似文献   

3.
目的 探讨单节段和相邻两节段颈椎间盘突出症颈椎前路手术减压范围及颈椎前路Windows钢板内固定问题。方法 回顾分析2,4例颈椎间盘突出症患者采用颈椎前路椎间盘摘除植骨融合术治疗,其中13例单节段颈椎间盘突出症采取部分椎体切除加椎间盘摘除、椎间植骨融合术治疗,未做钢板内固定;5例颈椎间盘突出伴颈椎失稳患者行部分椎体切除加椎间盘摘除、椎间植骨融合,应用颈椎前路Windows钢板内固定治疗;6例相邻两节段颈椎间盘突出症采取椎间盘摘除加椎体次全切除、椎间植骨融合,应用前路Windows钢板内固定治疗。重点介绍了手术方式选择、手术技巧及注意事项等。结果平均随访1年,观察患者神经功能恢复情况及颈椎融合情况,优良率96%。结论 单节段颈椎间盘突出患者行颈椎前路减压、椎问植骨融合术可不需钢板内固定,单节段颈椎间盘突出伴颈椎失稳患者行颈椎减压椎间、植骨融合术以及相邻两节段间盘突出患者行椎体次全切除、植骨融合术需行颈椎前路Windows钢板固定,Windows钢板系统能够为减压节段提供足够的即刻稳定性。手术效果取决于减压彻底性及脊髓本身有无变性。  相似文献   

4.
目的:报告CIoward经颈前路术式治疗颈椎间盘突出疗效分析。方法:采用前路术式切除椎间盘、自体髂骨植骨、钛板固定。结果:10例中根型颈椎病2例,安全痊愈。脊髓型术后症状全部得到改善。结论:前路手术对颈椎间盘突出症效果好,减压彻底,术后并发症少。病程长,受累节段多的疗效差。因此,早期手术是保证术后效果的关键。  相似文献   

5.
目的:探讨闭合性颈髓损伤手术治疗的手术经路及效果。方法:对我科运用多功能动力系统的自停颅钻及高速微型磨钻施行的5例颈前路减压植骨融合术进行总结分析。结果:神经功能完全恢复正常2例,神经功能不同程度改善3例。结论:颈椎前中柱损伤,脊髓前方有压迫者,颈前路减压植骨融合术是最佳术式选择。  相似文献   

6.
目的:探讨两种不同术式治疗双节段脊髓型颈椎病的效果.方法:随机将该院2015年3月至2016年3月收治的56例双节段脊髓型颈椎病患者平均分为两组.观察组给予颈前路椎间盘切除减压融合术,对照组给予颈前路椎体次全切减压融合术.比较两组临床效果.结果:观察组手术时间、术中出血量等均明显优于对照组(P<0.05),但两组并发症情况、JOA评分以及植骨融合情况等指标差异无显著性意义(P>0.05).结论:两种术式疗效均理想,但颈前路椎间盘切除减压融合术创伤性更小,值得推广应用.  相似文献   

7.
目的 评价颈椎前路钛网植骨融合术治疗多节段颈椎间盘疾患的临床效果.方法 对68例颈椎前路钛网植骨融合术治疗颈椎间盘疾患的病例行影像学检查,观察骨密度、钛网修剪及放置情况、植骨融合、手术前后颈椎融合节段曲度高度变化情况等;JOA评分法评价手术前后神经功能改变情况.结果 所有病例手术过程顺利,无死亡病例及神经损伤等并发症.术后随访6~18个月,JOA评分术前平均9.1分,术后3个月平均14.4分,平均提高5.3分,术后改善率为83.8%,手术前后神经功能差异有统计学意义(P<0.05).患者术后轴性症状及其他不适症状均有不同程度改善,无症状加重、钛网脱出及钢板螺钉折断等.术后6个月,钛网植骨融合率达95.6%.结论 颈椎前路钛网植骨融合术治疗颈椎间盘疾患时,合理应用外科技术可避免取骨区并发症,改善神经功能,融合率高.  相似文献   

8.
目的:探讨经前路颈椎间盘切除椎间植骨手术的护理措施。方法:对31例前路颈椎间盘切除椎间植骨手术的患者进行术前颈部训练及术前心理疏导,术后需要密切观察病情、预防并发症、做好康复训练、生活、饮食及出院指导等综合性护理措施。结果:31例患者均顺利完成手术,患者围手术期无1例发生并发症。结论:严格手术病例准入标准、术前合理耐心的心理指导、全面有效的术前准备、术后密切观察,是前路颈椎间盘切除椎间植骨手术成功的关键。  相似文献   

9.
目的探讨颈椎前路减压植骨融合术治疗颈3/4椎间盘突出症的疗效及并发症。方法 52例颈3/4椎间盘突出症患者施行颈前路环钻减压+髂骨植骨融合手术,术后观察临床症状、神经功能改变、影像学改变及其并发症,疗效采用日本骨科学会(JOA)评分标准评定。结果 52例患者均顺利完成手术,发生手术相关并发症5例(9.6%)。患者均获得随访,随访时间平均13个月,术后影像学提示植骨融合好,融合时间36个月,颈椎生理曲度和椎间高度维持良好。末次随访时JOA评分为(13.3±0.4)分,明显高于术前的(7.0±0.3)分(P〈0.05)。结论颈前路环钻减压植骨融合术治疗颈3/4椎间盘突出疗效显著,并发症少。  相似文献   

10.
目的:评价颈前路锁定钢板(CSLP)在颈前路砬压术中的应用效果。方法:对23例颈脊髓病、颈椎创伤、肿瘤及结核患者在颈前路减压植骨融合术后行CSLP固定并分析其结果。结果:23例患者,切除椎体48个,完成减压71个间隙,平均3个间隙,术后植骨稳定,早期活动。随访6-16个月,平均8.7个月。颈脊髓病患者术前平均JOA评分8.1分。术后14.8分,恢复率为75.3%,优良率为87.5%,颈椎骨折脱位并脊髓损伤减压融合术后。SAIA分级平均提高1.5级,结论:颈前路锁定钢板能保证植骨稳定,减少并发症,简化手术程序。  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

20.
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

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