改进Zahradnicek手术治疗先天性髋脱位疗效观察

目的 :探讨先天性髋脱位治疗优化方法 ,减少并发症。方法 :自 1 986～ 1 998年应用改进Zahradnicek手术治疗先天性髋脱位 1 0 3例、1 36个关节 ,用特制的小儿髋臼钻有限切削臼软骨 ,重建髋臼孤形结构 ,恢复其头臼同心圆关系 ,同时矫正前倾角至 5°～ 1 0°,颈干角至1 2 0° ,用专用的 1 2 0°鹅颈钢板固定。结果 :术后疗效评定 :优 76髋 ,为 5 3% ,良 45髋 ,为 33% ,可 9髋 ,为 6 6 % ,差 6髋 ,为 4 4% ,优良率占 89%。结论 :此种手术在一次手术中使股骨头、髋臼、股骨颈及股骨干恢复或接近恢复正常解剖和功能的方法     

青年与老年急性心肌梗塞临床差异性探讨

目的 :探讨青年与老年急性心肌梗塞 (AMI)的临床特点。方法 :对 1 5例青年组 (年龄≤ 40岁 )与 1 4 3例老年组 (年龄≥ 6 5岁 ) AMI的临床资料进行了对比分析。结果 :青年组 AMI吸烟者占 73.3% ,明显高于老年组 (P<0 .0 1 )。老年组 AMI发病率 38.9% ,无心绞痛者占 37.8% ,合并心力衰竭、心源性休克及病死率分别为 2 9.4%、2 2 .4%及 2 7.3% ,均明显高于青年组 (P<0 .0 5 )。结论 :青年组 AMI吸烟者明显高于老年组 ,老年组 AMI发病率、无心绞痛者、合并心力衰竭、心源性休克及死亡率均明显高于青年组     

硬膜外麻醉对老年人气管插管时心血管反应抑制作用的临床观察

观察胸部硬膜外麻醉对老年人全麻气管内插管时心血管反应的抑制作用。方法：利用胸部硬膜外麻醉对４０例老年择期全麻手术病人进行分组对比研究,观察全麻气管内插管时血流动力学,心肌耗氧及应激性激素的变化。结果：实验组气管内插管时血流动力学和心肌耗氧指标及ＲＮ、ＡⅡ显著低于对照组并在围插管斯保持平稳。纣胸部硬膜外麻醉可抑制老年手术患者全麻气管内插管时血浆儿茶酚胺分泌,保持插管期间血流动力学的稳定。     

THE OPERATIVE TREATMENT OF SPINAL FRACTURE-DISLOCATION WITHOUT NEUROLOGIC DEFICITS

Objective. To evaluate the results of operative treatment of spinal fracture-dislocation without neumlogic deficits. Metods. Eighteen patients with spinal fracture-dislocation were neurologically intact at the time of injury, and all were treated operatively. The fracture sites were:8 cases in cervical spine, 3 cases in thoracic spine, and 7 cases in lumbar spine. Eight patients with cervical injuries had variant degrees of forward slide and kyphotic deformity. Of the 10 thoracic and lumbar fractures, one had lateral dislocation, 4 cases with kyphotic deformities, 5 cases withspinal canal compromise averaged 50% (ranging from 40% to 70% ).Results. The aveiage period of follow-up was 4.4 years with a range of 11 months to 13 years. All the patients returned to full-time work. No patient developed neurologic deterioration. Kyphotic deformity was corrected in the 4 cases, and no progressive kyphosis was noted. There was no operation-related complication. The averaged post-opera-five hospitalization time was 13 days. Conclusions. Despite the rare incidence of spinal fracture-dislocation without neurologic deficits, we suggested that kind of fracture be considered unstable fracture because of its potential risk of delayed neurologic deterioration and kyphotic deformity, and be treated operatively to restore the sagittal alignment and the stability of the spine.     

Lumbosacral fracture dislocation in a lumberjack

Summary Lumberjack fractures normally occur in the thoracic and upper lumbar spine as a result of hyperextension and shear. This case, however, involves a lumberjack who suffered a lumbosacral fracture dislocation without neurological deficits, which occurred as the result of shear and hyperflexion. Due to the high degree of instability of this lesion, the treatment consisted of dorsoventral fusion with instrumentation.     

全髋关节置换术后早期脱位发生原因探讨

目的：探讨全髋关节置换术后早期脱位发生原因,以指导预防和治疗。方法：统计１０１例患者的１１３侧全髋置换术临床资料,对其中发生早期脱位的７例患者进行治疗及随访观察。结果：脱位主要由术后搬动及康复锻炼不适当引起,保守治疗效果良好。结论：髋关节周围的组织完整是全髋关节术后稳定的主要因素之一     

外伤性晶状体脱位继发性青光眼的治疗分析

目的 探讨外伤性晶状本脱位继发性青光眼的治疗方法。方法 药物保守治疗１８例,单纯小梁切除７例,单纯晶状体摘出１４例,晶状体摘出联合小梁切除７例。结果 ４６例中２例在局部滴用噻吗心安后,眼压控制在２１ｍｍＨｇ以下。治疗后矫正视力和前相比差异有显著性。结论 外伤性晶状体脱位继发性青光眼的治疗关键是尽早地用药物或手术方法缓解瞳孔阻滞,房角损伤≥２个象限者加用滤过性手术。     

Cost of treatment of congenital dislocation of the hip

Early treatment for congenital dislocation of the hip is usually simple and inexpensive. However, if the disease is not detected by 6 months of age, treatment is often complicated and expensive. We evaluated the potential cost-saving of screening, by examining the costs in 36 late cases born in 1980 and found an average cost of pounds 6,674 per case for treatment to this date. This amount could justifiably be spent on each case detected in an effective screening programme.     

跟后石膏托加小夹板治疗踝部内翻骨折脱位

目的：探讨踝关节内翻型骨折脱位中国接骨法的新疗法。方法：用手法复位，跟后石膏托加小夹板外固定早期练功，并系统观察21例。结果：骨折愈合时间8周，随访17例功能优良者占88％，较手术疗法愈合时间短，功能恢复好。较袜套牵引法减少了卧床。     

The clinical physiology of aging

International Urology and Nephrology -