头皮针静脉采血在儿科临床的应用

静脉采血在儿科是一项常用的技术操作。以往用普通注射器于股静脉或颈外静脉采血,此法缺点是不利于固定,在患儿(?)闹时,针头易脱出或刺破血管,手持注射器找血管感觉不灵敏,易出误差,因此很难一针成功、增加了患儿的痛苦与家长的精神负担。 86年10月至今、我们用头皮针静脉采血     

髋臼骨折合并股骨头骨折的临床治疗

<正>髋臼骨折合并股骨头骨折是髋关节严重复合损伤,常由于强大暴力所致,多见于车祸。近年来随着交通事业的发展,高能量损伤的数量呈上升趋势,髋臼骨折合并股骨头骨折的发生逐渐增多,由于这种损伤相对较少,患者数量有限,最佳的手术治疗策略和方法仍存在争议。术前对患者损伤情况的全面评估,术中根据不同骨折类型对手术切口及内固定方法的选择,术后对创伤性关节炎及股骨头坏死等并发症的预防,是确保手术成功的关键。     

辽宁省碘缺乏病病区不同补碘时期出生儿童智力水平调查

objecfive To know and compare the intelligence level of children born in different time periods in regions with iodine deficiency disorders(IDD)in Liaoning province.Methods All 7-14 year-old children from ten schools were chosen as the subjects respectively from six villages in each of the six counties and in regions with iodine deficiency,who were respectively born at the initialization of iodinated salt supplying period(1978-1980);non-iodinated salt supplying period(1981-1990);recovery of supplied iodized salt period(1991-1995);universal iodized salt period(1996-2000),respectively.Intelligence quotient(IQ)was measured by Combined Ravens Test in China(CRT-C)and Combined Ravens Test-the Rural,in China,2nd edition(CRT-RC2).Results IQ of children during the non-iodized salt period(91.9±14.3)was significantly lower than the initial supply of iodized salt period(95.8±14.6,q=8.60,P<0.01),recovery of supplied iodized salt period(99.7±14.7)was significantly higher than the initial supply of iodized salt period, non-iodized salt sales period(q = 9.53, 18.13, all P < 0.01 ),universal salt iodization( 104.3 ± 14.9) was significantly higher than the initial supply of iodized salt period, non-iodized salt sales period, recovery of supplied salt iodization(q = 20.00,28.00,10.46, all P < 0.01). Children's rate of mental retardation (IQ≤69) was higher in non-iodinated salt supplying period (6.7%, 88/1314 ) than the initial supply of iodized salt (4.4%, 21/471, χ2 = 3.85, P < 0.05), recovery of supplied iodized salt period(3.3%,48/1470) was significantly lower than non-iodinzed salt supplying period (χ2 = 15.37, P < 0.01), universal salt iodization period(2.7%, 36/1344) was lower than the initial supply of iodized salt period(χ2 = 4.41, P < 0.05) and non-iodinzed salt supplying period(χ2 = 26.34, P < 0.01 ). The IQ and intelligent retarded rates in children born during the initial years of iodinated salt supplying period were not different. The IQ of the children during ten years of non-iodized salt supplying period fluctuated in a "∪" curve, while the intelligent retardation rates in a "∩" curve.The children born during the period of recovery supplied iodized salt increased their IQ and lowered the retardation rates year after year. The IQ of the children in universal iodized salt period kept on increasing while intelligent retarded rates reduced to the lowest level. Conclusions The intelligence level of children born in regions with IDD during non-iodized salt supplying period is remarkably lower than that of the beginning years of iodinated salt supplying period. The intelligence level of children born after universal iodized salt period is remarkably higher than that of the initial iodinated salt supplying period and recovery of supplied iodized salt period, respectively.     

辽宁省地方性氟中毒防治现状及建议

目的了解辽宁省防氟改水工作现状,总结防治经验,分析存在的问题,提出改进建议。方法应用现有防治调查资料进行分析。结果 2003年,辽宁省确认2705个地方性氟中毒(地氟病)病区,改水1 713 个村屯,改水率63．33%,有效地控制了病情,全省约70％病区达到控制标准。2003年地氟病病区水氟超标村屯占被调查村屯的55．92％,较1999年超标村屯的30．62％增加近25个百分点。全省86．80％的降氟工程为 1995年之前修建,十余年来由于相关部门和人员对其保护意识淡化或漠视,设备老化又疏于管理,人为或自然灾害的损坏,资金短缺无力维修,新建工程启动不畅并且速度缓慢,致使降氟改水工程停用,报废率达54．74％, 其他原因所致的不合格率为15．46％。造成56万病区人民重喝高氟水,部分病区病情回升。结论认清形势,改变现状,是辽宁省地氟病未来工作的重中之重。     

利伐沙班（Rivaroxaban）预防腰椎术后静脉血栓形成的疗效观察

目的观察利伐沙班在腰椎术后预防静脉血栓形成的临床疗效。方法自2011-10-2013-12期间在我院行腰椎手术的患者,根据骨科手术静脉血栓栓塞症危险分度选择具有高度或极高度风险的患者共156例,于术后6 h开始口服利伐沙班10 mg,以后每间隔24 h口服10 mg,直至术后2周。于前次口服利伐沙班18 h后即下次用药前6 h拔出引流管。抗凝治疗期间观察患者肺栓塞、下肢深静脉血栓发生率及出血性事件、不良反应发生情况。结果所有入选患者均完成2周利伐沙班抗凝治疗,期间无症状性静脉血栓形成事件发生。拔除引流管时间为术后（37.4±9.6）h,平均引流量为（220±160.4）ml。除3例患者出现切口淤斑,2例出现切口渗血外无大出血事件发生;7例患者出现轻度转肽酶、转氨酶升高,2例出现轻度皮肤瘙痒、红斑等局部过敏反应。结论利伐沙班可有效的预防具有高度或极高度静脉血栓形成风险的腰椎术后患者静脉血栓事件的发生,并且相关的不良反应发生率较低。     

BMP-4基因上两个多态性位点与颈椎后纵韧带骨化症的关联性研究

目的 通过测定颈椎后纵韧带骨化症患者与对照组骨形态发生蛋白-4上的2个单核苷酸多态性位点序列,探讨骨形态发生蛋白-4与颈椎后纵韧带骨化(OPLL)的遗传关联性.方法 OPLL病例组和正常对照组各200例,利用PCR和直接测序法分析骨形态发生蛋白-4(BMP4)上2个单核苷酸多态性位点6007C>T(rs17563),3...     

BMP-4基因上两个多态性位点与颈椎后纵韧带骨化症的关联性研究

目的通过测定颈椎后纵韧带骨化症患者与对照组骨形态发生蛋白-4上的2个单核苷酸多态性位点序列,探讨骨形态发生蛋白-4与颈椎后纵韧带骨化（OPLL）的遗传关联性。方法 OPLL病例组和正常对照组各200例,利用PCR和直接测序法分析骨形态发生蛋白-4（BMP4）上2个单核苷酸多态性位点6007C〉T（rs17563）,3564C〉T（rs2855532）基因型及等位基因型的分布。应用SPSS13.0软件进行统计学分析。检验水准α=0.05,如果P〈0.05认为有统计学意义。结果两组间位点rs17563,rs2855532基因型与等位基因型差异具有统计学意义（P=0.013,0.000）。OPLL组中rs17563带C等位基因型与不带C等位基因型骨化椎体数量差异具有统计学意义P〈0.001,前者骨化椎体数量明显少于后者;rs2855532T＋等位基因型（TT TC）与T-等位基因型（CC）骨化椎体数量差异也有统计学意义（P〈0.05）,前者骨化椎体数量多于后者。结论骨形态发生蛋白-4上的两个单核酸多态性位点rs17563,rs2855532等位基因型的突变与颈椎后纵韧带骨化症的发生和发展有关。     

同侧股骨干并股骨颈骨折漏诊1例并文献复习

<正>同侧股骨干并股骨颈骨折属于骨科少见的高能量创伤,占股骨干骨折的1%～9%^[1]。由于其独特的致伤机制和诸多合并损伤,虽临床上对其关注度逐渐提高,但漏诊率仍较高,20%～50%的病例会延迟或遗漏股骨颈骨折的诊断。及时识别股骨颈骨折有助于早期固定,降低骨不连和缺血性坏死的风险^[2-3]。相反,若在固定股骨干之前遗漏该骨折则可能会导致手术时股骨颈骨折移位加大,且由于初次股骨干骨折内固定物的限制易造成二期对股骨颈的固定难度加大等^[4-5]。本研究通过回顾性分析1例首诊于邯郸市中心医院骨一科,术前漏诊、术后延迟诊断并手术固定的该类型骨折患者,结合近期相关文献进一步总结阐述其临床特征,明确漏诊原因,及时总结相关经验,避免以后类似情况发生。