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目的 总结分析手术在头颈部血管瘤和血管畸形治疗中的作用。方法 2009年2月—2013年2月,对保守治疗无效或影响外形及功能的38例血管瘤采用手术切除。对155例血管畸形(126例静脉畸形,17例动静脉畸形,12例微静脉畸形)采用平阳霉素病变内注射或电化学疗法联合高浓度平阳霉素或环扎法结合高浓度平阳霉素及栓塞法或手术切除治疗。结果 所有患者经0.5~4 a随访,血管瘤、静脉畸形、动静脉畸形、微静脉畸形的临床治愈率分别为94.7%、81.0%、70.6%和91.7%。面部外形及功能均有明显改善,未见明显并发症。结论 手术在血管瘤和血管畸形的治疗中具有治疗时间短、疗效确切的优点,具有不可取代的重要地位。 相似文献
63.
《Seminars in perinatology》2017,41(8):505-510
Preterm birth is the leading cause of neonatal mortality and morbidity worldwide. Spontaneous preterm birth is a complex, multifactorial condition in which cervical dysfunction plays an important role in some women. Current treatment options for cervical dysfunction include cerclage and supplemental progesterone. In addition, cervical pessary is being studied in research protocols. However, cerclage, supplemental progesterone and cervical pessary have well known limitations and there is a strong need for alternate treatment options. In this review, we discuss two novel interventions to treat cervical dysfunction: (1) injectable, silk protein-based biomaterials for cervical tissue augmentation (injectable cerclage) and (2) a patient-specific pessary. Three-dimensional computer simulation of the cervix is performed to provide a biomechanical rationale for the interventions. Further development of these novel interventions could lead to new treatment options for women with cervical dysfunction. 相似文献
64.
目的:使用杯状举宫器在孕早期行腹腔镜下宫颈环扎的极简手术方法,追踪妊娠结局。方法:回顾性研究2013年7月—2016年1月于首都医科大学附属复兴医院宫腔镜中心因宫颈机能不全伴有孕中期流产史,使用杯状举宫器在孕早期进行腹腔镜下宫颈环扎术的妇女20例,介绍手术方法,记录手术并发症,随访妊娠结局。结果:20例患者平均手术时间(59.2±21.7)min(24~110 min),出血量10(10,15)m L(5~100 m L)。1例因暴露困难中转开腹手术,术后病率为0。2例术后胎儿停止发育。18例于孕35~39周均剖宫产分娩,活产率90%(18/20),获活婴19例,平均分娩孕周(37.5±1.3)周,新生儿体质量平均(3 348.8±407.4)g。结论:对宫颈机能不全患者使用杯状举宫器进行腹腔镜下宫颈环扎术的方法微创、有效、易于掌握,妊娠结局良好。 相似文献
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66.
《Injury》2019,50(10):1627-1633
Cerclage techniques are simple, yet effective techniques to treat certain fractures and are known as one of the first operative techniques in orthopaedic surgery. The days when a twisted metal wire was the only available cerclage technique nonetheless have passed and today there are many different materials and techniques available.This review evaluates the differences between metallic and non-metallic cerclage techniques, thereby looking at biomechanical, technical and biological aspects. It also provides an overview of clinical applications for non-metallic cerclages.The use of metallic versus non-metallic cerclage might differ depending on indication, location and involved tissues. Currently metallic cerclage is mostly used to repair fractures because of its believed higher absolute strength. More recently though, non-metallic cerclage has been proven to withstand the same loads, while having a lower complication rate.This review suggests that mainly in the upper limb a non-metallic cerclage technique might become the golden standard, while in the lower limb both metallic and non-metallic cerclage techniques are complementary and dependent on indication. 相似文献
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68.
目的:探讨宫颈环扎术治疗妊娠期宫颈机能不全的疗效.方法:54例确诊妊娠合并宫颈机能不全者,32例施行宫颈环扎术治疗(环扎组),22例拒绝手术(非环扎组),观察其妊娠结局等各项指标.结果:环扎组与非环扎组除早产率外,足月妊娠率、流产率及新生儿成活率比较差异均有统计学意义(P均<0.05).结论:宫颈机能不全行宫颈环扎术可... 相似文献
69.
for the Vaginal Ultrasound Trial Consortium 《The journal of maternal-fetal & neonatal medicine》2013,26(12):2686-2689
Objective: To assess cerclage benefit in women with short cervix also receiving 17-α-hydroxyprogesterone caproate (17P) to prevent recurrent preterm birth (PTB). Methods: Secondary analysis of a multicenter trial of ultrasound-indicated cerclage for shortened cervical length (CL). Women with prior spontaneous PTB at 16–33 6/7 weeks, singleton gestation and CL < 25?mm between 16 and 22 6/7 weeks were counseled on use of 17P and randomized to cerclage or no cerclage. Outcomes of women who received 17P were analyzed by randomization group. Primary outcome was PTB < 35 weeks. Results: 99 women received 17P: 47 cerclage; 52 no cerclage. Rates of PTB < 35 weeks were similar, 30% for cerclage and 38% for no cerclage (aOR 0.64 (0.27–1.52)). In women with CL < 15?mm, PTB < 35 weeks was reduced for the cerclage group (17% vs. 75%, p = 0.02). However, this difference was nullified after controlling for total progesterone doses received (p = 0.40). Conclusions: Cerclage was shown not to offer additional benefit for the prevention of recurrent PTB in women with short CL < 25?mm receiving 17P, but the sample size is insufficient for a definite conclusion given the 36% nonsignificant decrease in the odds of PTB < 35 weeks. Cerclage may further offer substantial benefit to women with very short CL < 15?mm and further study is needed. 相似文献
70.