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991.
目的评价不同骨质疏松程度条件下,可注射性磷酸钙骨水泥对椎弓根螺钉稳定性强化作用,为其应用于合并有骨质疏松症的患者脊柱手术提供力学理论基础。方法采用新鲜尸体脊柱标本,根据骨密度检测结果,按临床诊断标准分成骨质正常、骨量减少、骨质疏松和重度骨质疏松四个水平;然后,每个骨密度水平,分直接置入椎弓根螺钉(对照组)和用可注射性磷酸钙骨水泥强化钉道后置入椎弓根螺钉(钉道强化组),各12枚,进行螺钉轴向拔出实验,测定最大拔出力、刚度和能量吸收值三项指标,进行组间的对比分析。结果骨密度水平从正常下降到重度疏松程度,最大拔出力、刚度、能量吸收值均随之下降,同种置钉方法组间存在显著性差异(P〈0.05)。骨质疏松条件下钉道强化组最大拔出力、刚度、能量吸收值与骨量减少条件下对照组的比较,两者无显著性差异(P〉0.05);但是,重度骨质疏松条件下钉道强化组的最大拔出力、刚度、能量吸收值均显著性低于骨量减少条件下对照组的(P〈0.05)。结论可注射性磷酸钙骨水泥强化钉道后可以提高椎弓根螺钉的稳定性,尤其是骨质疏松条件下经钉道强化后可以达到需要固定强度。 相似文献
992.
目的:观察得宝松与丹芎瘢痕涂膜联合应用治疗面、颈部增生性瘢痕的临床疗效。方法:治疗组采用得宝松瘢痕内注射(注射液配方:得宝松和2%利多卡因配比1:1)联合丹芎瘢痕涂膜外用治疗;对照组单纯采用得宝松瘢痕内注射治疗,分别进行对比分析两组痊愈率和有效率。结果:治疗组和对照组的痊愈率分别为63.1%、44.6%,经比较χ2=4.46,P<0.05,差异有统计学意义;有效率分别为95.4%、84.6%,两组相比较χ2=4.21,P<0.05,差异有统计学意义。结论:得宝松、丹芎瘢痕涂膜联合治疗面部增生性瘢痕疗效优于单纯得宝松瘢痕内注射。 相似文献
993.
【摘要】 目的 探讨关节镜下前交叉韧带(ACL)损伤后双束及单束单隧道重建的近期临床疗效差异。 方法 我科自2008年1月至2011年6月对38例ACL损伤患者进行关节镜下韧带重建,其中双束单隧道重建21例(A组),传统单束单隧道重建17例(B组)。所有患者术前及随访时均进行IKDC2000、Larson和Lysholm评分比较手术前后膝关节功能,并对结果进行统计学分析。 结果 38例患者(38个膝关节)获得随访,随访时间12~36个月,平均25个月。关节活动度均正常,A组手术前后的Lysholm评分,Larson评分及IKDC评分均有统计学差异,B组手术前后的3种评分同样有统计学差异;A、B两组比较,除了术后Larson评分双束组优于单束组(P<0.05)外,其余均无统计学意义。结论 关节镜下ACL胫骨端双束单隧道重建与传统单束重建,均能取得较为满意近期临床疗效,双束组可能优于单束组,但有待进一步证实。 相似文献
994.
目的 探讨肠系膜下动脉(IMA)根部结扎对直肠癌根治术的临床应用价值.方法 将2003年1月至2007年12月收治的173例直肠癌前切除术患者随机分成两组,其中根部结扎组85例,采用IMA根部结扎术及根部淋巴结廓清,非根部结扎组88例,采用IMA低位结扎及结扎部位淋巴结廓清.根部结扎组,比较两组患者的平均手术时间、淋巴结数及转移度、复发率、5年生存率、并发症发生率.结果 非根部结扎组的淋巴结数、淋巴结转移度、术后生存率明显低于根部结扎组,复发率则明显高于根部结扎组(P<0.05);两组手术时间、并发症比较,差异无统计学意义(P>0.05).结论 IMA根部结扎及根部淋巴结廓清对直肠癌的治疗效果优于IMA非根部结扎及结扎部位淋巴结廓清,值得推广应用. 相似文献
995.
【摘要】 目的 探讨微创多枚螺钉固定治疗股骨颈骨折的临床疗效。方法 对2008年8月~2010年8月于广州市第一人民医院创伤骨科及粤北人民医院关节外科采用闭合复位微创空心加压螺钉内固定治疗股骨颈骨折71例,对其随诊资料作回顾性的分析。患者包括男30例,女41例,年龄16~80岁,平均年龄62.4岁,全部为新鲜闭合性骨折。按股骨颈骨折Garden分型:Ⅰ型8例,Ⅱ型21例,Ⅲ型32例,Ⅳ型10例。随访时间14~60个月,平均31.5个月。结果 截至2012年8月,59例患者获骨性愈合,骨折平均愈合时间为5.1个月(3.6~11.3月),愈合率为83%;术后发生骨折不愈合,最终出现股骨头缺血性坏死12例(17%);髋关节功能按Harris评分:优良率84.7%;Garden Ⅰ、Ⅱ、Ⅲ、Ⅳ型的骨愈合率分别为100%、95.2%、78.1%、60%;Graden复位指数A、B、C组的愈合率分别为92.9%、77.3%、42.9%。结论 应用良好的牵引闭合复位和微创多枚空心加压螺钉内固定在治疗garden Ⅲ型以内的股骨颈骨折是一种疗效理想,操作简单、固定牢靠、创伤小的优良治疗方法。 相似文献
996.
P. Masquère L. LonjaretO. Fourcade V. Minville 《Annales fran?aises d'anesthèsie et de rèanimation》2013
We report a video laryngoscopic tracheal intubation under sedation in a patient with a hip fracture. Preoperative assessment revealed signs of difficult airway management linked to a cervical spine immobilization. Here we describe an alternative method to awake fiber optic flexible intubation. 相似文献
997.
M. Amor S. Nabil M. Bensghir A. Moussaoui S. Kabbaj N. Drissi Kamili W. Maazouzi 《Annales fran?aises d'anesthèsie et de rèanimation》2013
Introduction
Airtraq laryngoscope is a new and single use device for endotracheal intubation. Few studies showed the superiority of the Airtraq comparing to Macintosh laryngoscope in the setting of difficult intubation.Study design
To compare the performance of these two laryngoscopes by simulating a situation of reduced mobility of the cervical spine by applying the Manual in-line stablization (MILS) maneuver.Patients and methods
After obtaining the approval of the ethic committee, we realized a prospective single blind randomized study. During a 6-month period, 120 consenting patients scheduled for ORL or ophthalmologic surgery were included. They all had general anesthesia and orotracheal intubation. These patients were randomly and equally divided in two groups (n = 60), depending on the type of the laryngoscope used (Airtraq or Macintosh). Were excluded from the study the patients with history or criteria predicting difficult intubation. Each patient was intubated by one of the five experimented anesthetists selected for this work. The principle judgment criteria were: i) the time taken for the orotracheal intubation and ii) the intubation difficulty score (IDS). The secondary judgment criterion was the hemodynamic modifications after the endotracheal intubation.Results
Demographic and upper airway track variables were comparable between the two groups. There was no case of failure of intubation in this serie. Nonetheless, all the patients of the Airtaq group were intubated from the first attempt, whereas half of the patients of the Macintosh group were intubated after the third attempt. Comparing to the Macintosh, the Airtraq reduces the time taken for the orotracheal intubation (14 ± 1 s vs 19 ± 3 s, P = 0.01), the necessity of additional maneuver to facilitate the intubation, and the intubation difficulty score (0.7 ± 0.3 vs 3.8 ± 1, P < 0.001). Orotracheal intubation using the Airtraq laryngoscope caused less hemodynamic stimulation than using the Macintosh.Conclusion
Our study showed the usefulness of the Airtraq laryngoscope for endotracheal intubation for patients presenting conditions of difficult intubation such as reduced mobility of the cervical spine. 相似文献998.
Wenying Zhang Xiaodi Gong Qiongwei Wu Yu Liu Guoying Lao Jinyin Xiao 《Journal of investigative surgery》2013,26(6):560-565
AbstractPurpose/aim of the study: To investigate high-risk human papillomavirus (HPV) infection clearance following thin loop electrosurgical excision procedure (t-LEEP) among patients with cervical benign lesion. Materials and Methods: This retrospective study analyzed clinical data from patients with cervical benign lesion and HPV infection, who had undergone t-LEEP (T-Group), compared with patients with HPV infection undergone no treatment (NT-Group). Both groups attended regular follow-up between January 2008 and January 2012. Kaplan–Meier analysis was used to compare the HPV clearance time. Results: The average clearance time was 7.7?months (M) (95% confidence interval [CI]: 6.5–8.9 M) in T-Group, and 10.4?M (95%CI: 9.4–11.3 M) in NT-Group, with significant difference between groups (p?=?0.003). Among patients with low viral load, the HPV clearance times were 7.6?M (95%CI: 6.3–9.0 M) in T-Group and 9.7?M (95%CI: 8.6–10.8 M) in NT-Group (p?=?0.042). Among patients with high viral load, the HPV clearance times were 8.0?M (95%CI: 5.3–10.6 M) in T-Group and 11.4?M (95%CI: 9.7–13.1 M) in NT-Group (p?=?0.041). The average time of HPV clearance in T-Group was shorter than NT-Group in all age groups, with significant differences in ≤29Y-group (p?=?0.008) and 30–39Y-group (p?=?0.005). The accumulated clearance rate of HPV infection at sixth month and 12th month were 24.5% and 67.9% in T-Group, 7.8% and 43.1% in NT-Group, with significant differences (p?=?0.001 at 6th month, p?=?0.032 at 12th month). Conclusions: T-LEEP accelerates the clearance of high-risk HPV infection and make the HPV infection rates dropped rapidly in the first year. 相似文献
999.
Xi Yang Qi Chen Limin Liu Yueming Song Qingquan Kong Jiancheng Zeng Youdi Xue Chunpeng Ren 《International orthopaedics》2013,37(12):2421-2427
Purpose
The titanium mesh cage (TMC) is a typical metal cage device which has been widely used in cervical reconstruction for decades. Nano-hydroxyapatite/polyamide-66 (n-HA/PA66) cage is a novel biomimetic non-metal cage device growing in popularity in many medical centres in recent years. There has been no comparison of the efficacy between these two anterior reconstructing cages. The purpose of this study was to compare the radiographic and clinical outcomes of these two different devices.Methods
Sixty-seven eligible patients with single-level ACCF using TMC or n-HA/PA66 cage for cervical degenerative diseases, with four-year minimum follow-up, were included in this prospective non-randomised comparative study. Their radiographic (cage subsidence, fusion status, segmental sagittal alignment [SSA]) and clinical (VAS and JOA scales) data before surgery and at each follow-up was recorded completely.Results
The fusion rate of the n-HA/PA66 group was higher than TMC at one year after surgery (94 % vs. 84 %) though their finial fusion rates were similar (97 % vs. 94 %). Finial n-HA/PA66 cage subsidence was 1.5 mm with 6 % of severe subsidence over three millimetres, which was significantly lower than the respective 2.9 mm and 22 % of TMC (P < 0.0001). Lastly, SSA, VAS and JOA in TMC group were worse than in the n-HA/PA66 group (P = 0.235, 0.034 and 0.007, respectively).Conclusions
The n-HA/PA66 cage is associated with earlier radiographic fusion, less subsidence and better clinical results than TMC within four years after one-level ACCF. With the added benefit of radiolucency, the n-HA/PA66 cage may be superior to TMC in anterior cervical construction. 相似文献1000.
Jiaguang Tang Yishan Liu Yuan Hu Zheng Cao Xiang Lu Bin Lin 《International orthopaedics》2013,37(11):2205-2209