Colles骨折手法复位的治疗体会

Colles骨折是指桡骨下端2～3cm以内、骨折远端向背及桡侧移位的骨折.本院门诊于1994年1月至2005年4月共诊治Colles骨折240例,其中40例关节内骨折,经闭合复位后,关节面的移位仍大于2mm者,收住院手术治疗;门诊复位满意的200例患者中186例获得随访,总结如下.     

神经纤维瘤蛋白在先天性脊柱侧凸患者成骨细胞和软骨细胞中的表达

目的：检测神经纤维瘤蛋白在先天性脊柱侧凸患者成骨细胞和软骨细胞中的表达。方法：6例先天性脊柱侧凸患者，在后路手术时取髂骨及髂骨生长板，分离、培养成骨细胞和软骨细胞，分别行碱性磷酸酶染色和甲苯胺蓝染色。逆转录-多聚酶链反应（RT—PCR）检测神经纤维瘤蛋白mRNA．间接免疫荧光和Westemblot检测神经纤维瘤蛋白在成骨细胞和软骨细胞中的表达。结果：先天性脊柱侧凸患者成骨细胞和软骨细胞中存在Ⅱ型神经纤维瘤蛋白表达，该蛋白主要分布在细胞浆，所表达蛋白为三磷酸鸟苷酶活化蛋白（GAP）活性较弱的Ⅱ型异构体。结论：先天性脊柱侧凸患者成骨细胞和软骨细胞中存在神经纤维瘤蛋白表达，但该蛋白是否通过对成骨细胞和软骨细胞的影响导致骨骼系统异常还有待于进一步研究。     

胰岛素泵在围手术期应用

近年来，国内统计表明，外科手术病人中遇到糖尿病患者为3％，其手术期并发症及死亡率较非糖尿病患者高，易患胆道疾病。2003—2005年对30例糖尿病合并胆石症患者采用胰岛索泵治疗，获得满意疗效，报告如下：     

神经端侧缝合的应用与预后研究进展

1神经端侧缝合 端侧缝合应用于血管移植中主要适用于两条血管的外径相差太大，超过外径的1／2，剪成斜口仍不能端端缝合者、接受血管是受区唯一的一条供血动脉，切断后会引起肢体缺血或坏死者，如果将此方法应用于神经移植中也同样适用.     

糖尿病合并系统性硬化症一例

患者女 ,44岁 ,农民。 2 0 0 1年 2月 1 2日来院就诊。 2年前因口渴、多饮 ,饮量达 2 50 0ｍｌ/ｄ以上 ,伴多食、消瘦而诊断糖尿病。当时空腹血糖曾高达 2 0ｍｍｏｌ/Ｌ ,尿糖 (+++) ,服糖适平后好转。以后不规则服药 ,“三多”症状不重。近 1年余双手各指遇冷呈青紫色伴胀麻感 ,遇暖好转。同时双手及双足皮肤逐渐发紧 ,关节活动不灵活 ,进行性加重。无明显吞咽障碍及气短 ,听力正常。既往体健。母有糖尿病。体检 :一般状况好。身高 :1 65ｃｍ ,体重 :55ｋｇ。双手皮肤呈暗紫色 ,皮肤凉。各手指皮肤肿胀发紧 ,不能捏起。皮肤凉、肿、紧 ,范…     

前路器械内固定手术矫治脊椎侧凸

作者从１９７９年开始使用戴瓦氏手术，１９８３年开始使用斯伍基氏手术，至１９９４年共做５７例（男性２８例，女性２９例），年龄为９～２８岁。手术无死亡。术后并发症戴瓦氏手术：１例截瘫，２例椎体骨折伴螺丝钉拔出，２例螺丝钉折断，２例金属缆折断；斯伍基氏手术，１例杆折断，２例切口感染。     

Treatment of dislocation of distal radioulnar articulation by reconstruction of ulnar collateral ligament from pediculated partial ulnar flexor tendon of wrist

Background:Auricular pseudocyst,which is also calles serous perichondritis of thd auricle,is and aseptic local serous inflammatory mass in the perichondrium of the auricle.The cause is unknown,.It is difficult to the cured with a chronic course,and might transform into suppurative perichondritis because of incorrect treatment such as repeated puncture,and even necrosis occurs,resulting in deformation of the external ear.Objective:To study the therapeutic effect of magnetic application.Unit:Jianping County Hospital.Subjects:42 patients were included in this study,including 31 males,11 females aging 10 to 56 years,with unilateral attack in 38 cases,bilateral attack in 4 cases.No obvious cause was found in all of the cases.Local prominences occurred suddenly mostly at the navicular fossa,less at the triangular fossa,least in the cavity of concha.The site is felt hot and swelling with slight tenderness.The locus ranges from 0.5 cm to 1.5cm in diameter.The disease course ranges between 3 and 30 days.Interention:The intracapsular fluid was withdrawn out from the locus in all the pwatients.Two magnetic pieces of 100-170mT in intensity were chosen and fixed on both sides of the locus by wadhesive plaster with the S and N poles opposited.The magnetic pieces of the Npole were applied 24 hours a day.But the S pole should be taken off at night and 5-10 minutes every 1-2 hours in daytime.The application method must be clearly taught to the patients to avoid local ischemic change because of persistent pressure.The poles of the magnetic pieces should also be told to the pwatients lest the pwatients fixed the magnetic pieces in a contrary way.The treatment courese was 1 week but 2 weeks in patients wih larger loci.Result:All the patients were cured with no local induration,thickness,deformation,or dispigmenttation.No recurrence occurred after 3 months of telephone following up.Conclusion:The treatment of magnetic application is easily performed,safe,reliable,cheap and free of side effects with significant therapeutic effect.     

脊髓侧、后索亚急性混合变性20例临床分析

脊髓侧、后索亚急性混合变性 (ＳｕｂａｃｕｔｅＣｕｍｂｉｎｅｄＤｅｇｅｎ ｒａｔｉｏｎ ,ＳＣＤ)亦称ＶＢ12 神经病 ,临床少见 ,我院 1983— 2 0 0 1年共收治 2 0例 ,现结合文献 ,临床分析如下。1　临床资料1.1.　一般资料　男 12例 ,女 8例 ,发病年龄 2 2～ 6 5岁 ,平均(40     

为索前列醇用于晚期妊娠引产108例临床分析

目的:探讨米索前列醇用于晚期妊娠引产的效果和安全性。方法:回顾分析了108例米索前列醇引产和79例缩宫素引产的足月初产妇的临床资料。米索组:米索50μg置阴道后穹窿,给药 4h后如果没有发现规律宫缩则重复给药,24h总量不超过150μg。缩宫素组:缩宫素 2.5U加入5%葡萄糖 500ml静滴。8~10滴/分开始,最多不超过 50滴/分,用至5U,而无规律宫缩停止用药。结果:两组引产成功率分别为95%和85.4%,P <0.05,差异有显著性,产程时间分别为(7.6±3.3)h和(9.4±4.5)h,P<0.01,米索组产程明显缩短,宫缩过频及羊水污染率米索组偏高,但两组对比无显著意义(P>0.05)。分娩方式、胎儿窘迫及新生儿窒息率两组均无显著差异。结论:米索促宫颈成熟和诱发宫缩的双重作用使其引产成功率高,产程短,宫缩类似生理性,易于承受;局部用药,可以自由活动。用于晚期妊娠引产方便,有效,副反应少,用药后的监测重点是防止宫缩过频。