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101.
102.
同种异体骨支撑架微创治疗股骨头坏死的临床研究 总被引:1,自引:0,他引:1
目的应用改良髓芯减压术结合同种异体骨支撑架加自体骨和脱钙骨基质(decalcified bone matrix,DBM)治疗早期股骨头坏死,探索早期股骨头坏死的微创治疗方法。方法2004年1月~2005年4月,23例24个髋关节采用经大转子下通过股骨颈钻隧道至股骨头骨坏死区,将装有自体松质骨和DBM的同种异体骨支撑架经隧道拧入骨坏死区直至软骨下骨约5mm处,隧道远端用自体髂骨填塞。观察手术前后Harris评分变化、x线影像学表现及是否需进一步治疗。结果本组所有患者均获得随访,平均随访19(12—27)个月,以最后一次随访资料作为最终评价依据。Harris评分,术前优良率为43.5%(10/23)。术后优良率为91.3%(21/23)。22侧髋关节影像学表现保持稳定,无明显并发症发生。结论同种异体骨支撑架植入结合自体松质骨和DBM治疗成人股骨头坏死,增加了股骨头负重区软骨下骨的机械支撑,成骨作用强,有利于股骨头坏死的修复与重建,同时,不破坏患者股骨头本身的血液供应,创伤小,操作简单,值得临床推广使用。 相似文献
103.
104.
目的分别应用三针锁针加压器外固定和空心拉力钉内固定疗法治疗股骨颈骨折,探讨股骨颈骨折最佳治疗方法.方法应用三针锁针加压器外固定治疗股骨颈骨折63例,其中男24例,女39例;年龄55~89岁,平均(64.5±3.2)岁;Garderl Ⅰ型2例,Ⅱ型15例,Ⅲ型38例,Ⅳ型8例.应用空心拉力钉内固定治疗63例,其中男29例,女34例;年龄45~76岁,平均(62.2±2.9)岁;Garden Ⅰ型4例,Ⅱ型24例,Ⅲ型28例,Ⅳ型7例.对其疗效进行分析.结果126例除2例死亡外均得到随访.115例愈合,其中10例股骨头坏死.外固定组愈合58例,股骨头坏死4例,死亡1例;内固定组愈合57例,股骨头坏死6例,死亡1例.根据Harris功能评定标准评价疗效,外固定组62例中优24例,良26例,可8例,差4例,优良率80.65%;内固定组62例中优23例,良27例,可6例,差6例,优良率80.65%.Harris评分外固定组平均(80.40±1.21)分,内固定组平均(79.14±1.47)分,两组Harris评分比较差异无统计学意义(P>0.05).结论采用内外固定治疗股骨颈骨折疗效无明显差异,但外固定创伤小、费用低、可早期离床;而采用拉力钉内固定器医疗成本高,卧病时间相对较长,且需二次手术取内固定钉. 相似文献
105.
106.
A Decision Rule for Predicting Bacterial Meningitis in Children with Cerebrospinal Fluid Pleocytosis When Gram Stain Is Negative or Unavailable 总被引:1,自引:0,他引:1
Bema K. Bonsu MBChB Henry W. Ortega MD Mario J. Marcon PhD Marvin B. Harper MD 《Academic emergency medicine》2008,15(5):437-444
Objectives: Among children with cerebrospinal fluid (CSF) pleocytosis, the task of separating aseptic from bacterial meningitis is hampered when the CSF Gram stain result is unavailable, delayed, or negative. In this study, the authors derive and validate a clinical decision rule for use in this setting.
Methods: This was a review of peripheral blood and CSF test results from 78 children (<19 years) presenting to Children's Hospital Columbus from 1998 to 2002. For those with a CSF leukocyte count of >7/μL, a rule was created for separating bacterial from viral meningitis that was based on routine laboratory tests, but excluded Gram stain. The rule was validated in 158 subjects seen at the same site (Columbus, 2002–2004) and in 871 subjects selected from a separate site (Boston, 1993–1999).
Results: One point each (maximum, 6 points) was assigned for leukocytes >597/μL, neutrophils >74%, glucose <38 mg/dL, and protein >97 mg/dL in CSF and for leukocytes >17,000/mL and bands to neutrophils >11% in peripheral blood. Areas under receiver-operator-characteristic curves (AROCs) for the resultant score were 0.98 for the derivation set and 0.90 and 0.97, respectively, for validation sets from Columbus and Boston. Sensitivity and specificity pairs for the Boston data set were 100 and 44%, respectively, at a score of 0 and 97 and 81% at a score of 1. Likelihood ratios (LRs) increased from 0 at a score of 0 to 40 at a score of ≥4.
Conclusions: Among children with CSF pleocytosis, a prediction score based on common tests of CSF and peripheral blood and intended for children with unavailable, negative, or delayed CSF Gram stain results has value for diagnosing bacterial meningitis. 相似文献
Methods: This was a review of peripheral blood and CSF test results from 78 children (<19 years) presenting to Children's Hospital Columbus from 1998 to 2002. For those with a CSF leukocyte count of >7/μL, a rule was created for separating bacterial from viral meningitis that was based on routine laboratory tests, but excluded Gram stain. The rule was validated in 158 subjects seen at the same site (Columbus, 2002–2004) and in 871 subjects selected from a separate site (Boston, 1993–1999).
Results: One point each (maximum, 6 points) was assigned for leukocytes >597/μL, neutrophils >74%, glucose <38 mg/dL, and protein >97 mg/dL in CSF and for leukocytes >17,000/mL and bands to neutrophils >11% in peripheral blood. Areas under receiver-operator-characteristic curves (AROCs) for the resultant score were 0.98 for the derivation set and 0.90 and 0.97, respectively, for validation sets from Columbus and Boston. Sensitivity and specificity pairs for the Boston data set were 100 and 44%, respectively, at a score of 0 and 97 and 81% at a score of 1. Likelihood ratios (LRs) increased from 0 at a score of 0 to 40 at a score of ≥4.
Conclusions: Among children with CSF pleocytosis, a prediction score based on common tests of CSF and peripheral blood and intended for children with unavailable, negative, or delayed CSF Gram stain results has value for diagnosing bacterial meningitis. 相似文献
107.
腹腔镜辅助子宫肌瘤剔除术30例手术体会 总被引:1,自引:0,他引:1
目的:观察腹腔镜辅助子宫肌瘤剔除术的疗效,探讨腹腔镜辅助子宫肌瘤剔除术的可行性。方法:回顾性分析我院2008年全年30例子宫肌瘤患者的手术方法及手术结果。结果:30例患者全部治愈,平均手术时间78min,术后患者指征数据佳。结论:腹腔镜辅助子宫肌瘤剔除术综合了经典开腹及微创手术的优点,可以提倡。 相似文献
108.
109.
M. Innocenti R. Civinini M. Villano C. Carulli E. Pratelli 《Journal of orthopaedics and traumatology》2007,8(2):106-109
Unicompartmental knee arthroplasty (UKA) is considered the treatment of choice in patients with single compartment arthritis
of the knee at early stages or with osteonecrosis limited to one compartment. However, results in the literature are still
controversial and it is a technically difficult procedure. The main goal of UKA is to restore the articular space of the afflicted
compartment, without influencing the limb alignment. Selection of patients and pre-operative planning are crucial. The necessity
to improve functional results and to reduce immobilization of the patients has led to the development of minimally invasive
surgery. Applied to UKA, this approach reduces blood loss and surgical time, causes fewer symptomatic postoperative complications,
and permits earlier recovery compared to the traditional incision. The shorter incision makes careful pre-operative planning
essential. We briefly review the indications for UKA, the pre-operative clinical and radiological assessment, and the surgical
procedure.
Proocedings of the Consensus Conference “TSS in hip and knee replacement” (Rapallo, Italy 22–24 June 2006) 相似文献
110.
闭合复位微创手术治疗Jones骨折12例临床报告 总被引:2,自引:0,他引:2
目的探讨闭合复位微创手术治疗Jones骨折的临床效果。方法2005年1月~2007年1月,采用闭合复位,经皮导针定位,两枚空心螺纹钉内固定治疗Jones骨折12例。结果均获随访,时间6~18月,12例患者均获得骨性愈合,平均时间5.5(4~8)周。踝关节功能评分良10例,可2例,良好率达83.3%。结论闭合复位微创手术治疗Jones骨折具有操作简便,固定牢靠,创伤小,出血少,伤口愈合快,有利于踝关节功能恢复等优点,是治疗Jones骨折的有效方法。 相似文献