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71.
92例跟骨骨折后足部畸形功能障碍治疗探讨 总被引:6,自引:1,他引:5
本文对92例106足波及距下关节的跟骨骨折治疗后1~6年遗留足畸形、功能障碍的病例(PALey:舌型17足,中央压陷型53足,严重粉碎型36足)进行了分析和总结。作者强调解剖复位、牢靠固定、一期植骨、早期关节持续被动运动及不过早负重是预防跟骨骨折众多并发症的重要措施。 相似文献
72.
Background: Three acid-reducing operations have recently been described for the laparoscopic treatment of peptic ulcer disease. These
consist of a posterior truncal vagotomy combined with either (1) an anterior seromyotomy (SERO), (2) an anterior highly selective
vagotomy (AHSV), or (3) a linear stapled lesser curvature excision (STAP). The purpose of this study was to investigate the
physiologic effects of these procedures in terms of basal and maximal acid outputs.
Methods: Fifty New Zealand rabbits were prospectively randomized into five open laparotomy groups (n= 10): a control group without vagal manipulation (CON), a bilateral truncal vagotomy with pyloromyotomy group (VP), a SERO
group, an AHSV group, and a STAP group. All animals underwent placement of a gastrostomy tube for subsequent gastric secretory
analysis. On postoperative day 6, basal acid outputs (BAO) and maximal acid outputs (MAO) following IV pentagastrin stimulation
(30 μg/kg/h) were measured. Results were compared statistically using the ANOVA method.
Results: Pentagastrin stimulation was associated with a significant increase in MAO in the CON group (p < 0.05 vs BAO); however, this response was effectively blunted in all the experimental groups. There were no differences
in BAO or MAO between any of the vagotomized groups (SERO, HSV, STAP, VP).
Conclusions: We conclude that the three acid-reducing procedures modified for laparoscopy are equally efficacious in reducing gastric
acid secretion and that they compare favorably with VP. To our knowledge, this is the first report comparing basal and stimulated
gastric acid secretion between these new acid-reducing techniques.
Received: 27 March 1996/Accepted: 17 July 1996 相似文献
73.
74.
Open reduction and varus-detorsion osteotomy with femoral shortening in treatment of congenital dislocation of the hip 总被引:2,自引:0,他引:2
In this study, we clinically and radiographically evaluated open reduction with shortening of the femur in children more
than 1 year old with refractory congenital dislocation of the hip. In 19 children (aged 1–4 years), 22 joints were operated
on. The patients were followed-up for an average of 8.7 years (range, 2–13 years). Functional results were satisfactory in
all joints, and differences in limb length were not significant. Radiographically, good results (grades I and II) were obtained
in 16 of the 22 joints, according to Severin's criteria. This surgical procedure may be indispensable for treating refractory
congenital dislocation of the hip in children over 1 year old.
Received for publication on May 2, 1997; accepted June 3, 1998 相似文献
75.
This introduction traces the increasing awareness of the prevalence of child sexual abuse over the last 20 years, examines the nature and consequences of such abuse and summarizes current information on the use of group treatment and its evaluation with sexually abused children and adolescents and their parents. Four examples of group treatment with different populations of abused children are described in this issue. 相似文献
76.
Prof. Paul Bonnevialle Yves Bellumore Michel Mansat 《Operative Orthopadie und Traumatologie》1996,8(4):243-251
Summary
Goal of Surgery Stable internal fixation of extraarticular proximal humeral fractures.
Indications Extraarticular fractures angulated more than 30° which can be reduced closely or through a small incision.
Epiphysiolysis.
Fracture-dislocation of the humeral head.
Contraindications Pathological fractures.
Four part fractures.
Segmental fractures of the humerus.
Positioning and Anaesthesia Supine; the affected shoulder overhanging the edge of the table and supported by a radiolucent board.
General or regional anaesthesia.
Surgical Technique Closed pinning of two part and certain three part fractures of the proximal humerus being displaced, unstable, and mainly
at the metaphyseal level.
Introduction of Kirschner wires through a diaphyseal window and advancement into the proximal fragments after reduction which
is controlled by image intensification.
Postoperative Management Temporary immobilization in a sling.
Passive and active assisted movements after a few days.
Active movements after 2 weeks.
Removal of wires after 3 months.
Possible Complications Fracture of the humerus at the site of the cortical window. Injury to the radial nerve.
Results 32 patients, mean age 49 years, 30 two part fractures and 2 three part fractures. Number of Kirschner wires used: 3 to 6,
mean 4. Two out of 3 patients complained of pain at the site of wire insertion. All fractures consolidated. No avascular necrosis
nor infection.
Complications: Partial loss of internal fixation in 3 patients. One fracture of the humeral shaft. Sympathetic reflex dystrophy
in 3 patients. Half of the patients had a normal range of motion. Time of follow-up: 6 to 24 (mean 10) months.
Division of Orthopaedics and Traumatology, Purpan Hospital, Toulouse, France. 相似文献
77.
儿童陈旧性肱骨髁上骨折手术治疗 总被引:1,自引:0,他引:1
作者对24例儿童陈旧性肱骨髁上骨折畸形愈合、影响肘关节功能恢复的病人经手术治疗,发现影响关节功能活动的主要原因是鹰咀窝及冠状窝部位的骨痂增生及骨折近端前下方移位,妨对肘关节屈伸功能。认为:清除该二部位增生分痂以及使骨折得以满意复位是治疗成功的关键。 相似文献
78.
Pinborg A Lidegaard O la Cour Freiesleben N Andersen AN 《Human reproduction (Oxford, England)》2005,20(10):2821-2829
BACKGROUND: Spontaneous reductions are a possible cause of the increased morbidity in IVF singletons. The aim of this study was to assess incidence rates of spontaneous reductions in IVF/ICSI twin pregnancies and to compare short- and long-term morbidity in survivors of a vanishing co-twin with singletons and born twins. METHODS: We identified 642 survivors of a vanishing co-twin, 5237 singletons from single gestations and 3678 twins from twin gestations. All children originated from pregnancies detected by transvaginal sonography in gestational week 8. By cross-linkage with the national registries the main endpoints were prematurity, birth weight, neurological sequelae and mortality. RESULTS: Of all IVF singletons born, 10.4% originated from a twin gestation in early pregnancy. Multiple logistic regression analyses adjusted for maternal age, parity and ICSI treatment showed for birth weight <2500 g an odds ratio (OR) of 1.7 [95% confidence interval (CI) 1.2-2.2] and for birth weight <1500 g OR 2.1 (95% CI 1.3-3.6) in singleton survivors of a vanishing twin versus singletons from single gestations; corresponding figures were seen for preterm birth. This increased risk was almost entirely due to reductions that occurred at >8 weeks gestation. We found no excess risk of neurological sequelae in survivors of a vanishing co-twin versus the singleton cohort; however, OR of cerebral palsy was 1.9 (95% CI 0.7-5.2). Furthermore, we observed a correlation between onset of spontaneous reduction, i.e. the later in pregnancy the higher the risk of neurological sequelae (r = -0.09; P = 0.02). Adjusted OR of child death within the follow-up period was 3.6 (95% CI 1.7-7.6) in the survivor versus the singleton cohort. CONCLUSIONS: One in 10 IVF singletons originates from a twin gestation. Spontaneous reductions that occur at >8 weeks gestation are one of the causes for the higher risk of adverse obstetric outcome in IVF singletons. 相似文献
79.
Ulug U Jozwiak EA Mesut A Berksoy MM Bahceci M 《Human reproduction (Oxford, England)》2004,19(2):360-364
BACKGROUND: The purpose of this study was to determine the rate of spontaneous gestational sac loss during the first trimester in women achieving multiple pregnancies by ICSI. METHODS: A retrospective analysis was performed of 1448 consecutive multiple pregnancies conceived by ICSI. RESULTS: Of the cohort of 1448 pregnancies, twin gestations constituted 59.6% (864), triplets 30.2% (438) and quadruplets 10.0% (146). During the first trimester, 69 (4.7%) patients miscarried, while 179 (12.3%) continued their pregnancies and had fewer gestational sacs at the end of the first trimester than at the beginning. The overall loss rate of any gestational sac during the first trimester in these multiple pregnancies was 10.1%. There was a significant difference in the frequency of spontaneous reduction to twin or singleton pregnancies in the first trimester between women carrying triplets (11.7%) and those carrying quadruplets (3.5%) [P = 0.004; odds ratio (OR) 3.5; 95% confidence interval (CI) 1.3-9.1]. The frequency of gestational sac loss was significantly greater among women >35 years old (20.9%) than in women less than 35 years old (15.9%) (P = 0.03; OR 1.4; 95% CI 1.0-1.9). CONCLUSION: In multiple pregnancies there is a significant risk of spontaneous loss of any embryo during the first trimester. These findings should be considered prior to any decision about selective embryo reduction. 相似文献
80.
T. Takaki 《Medical & biological engineering & computing》1988,26(4):397-403
The paper considers the limiting factors in EEG enhancement in the presence of electrosurgery interference and presents a
design for a useful fibre-optic EEG monitoring instrument which is free from such problems as electrical shock (micro and
macroshock), patient burns and susceptibility to electrosurgery interference associated with conventional EEG monitors. 相似文献