《中华骨科杂志》2002-2004年引文分析

目的研究《中华骨科杂志》文献引用规律及我国骨科学研究领域科研人员的文献利用与需求特征。方法利用引文计量分析法,统计《中华骨科杂志》2002-2004年间刊载的614篇论文所引用的参考文献。结果614篇论文中,有引文的论文共565篇,引文率为92.02%,篇均引文11.66条;引文中期刊6672条(93.22%),图书451条(6.30%);普赖斯指数45.44%,期刊自引361条,自引率5.04%。被引用频次居前20位的中、外文期刊的引文量占总引用期刊引文量的53.30%。结论《中华骨科杂志》涉猎文献范围广,引文类型以期刊为主,语种以英文文献为主,引文的外文语种结构较为单一,研究引用文献比较滞后,文献半衰期较长,专业人员利用近5年内新文献的能力有待于进一步提高。     

抗菌药物对骨科围术期预防感染的影响

目的探究抗菌药物对骨科围术期预防感染的影响。方法选择2016年1月-2019年1月瑞安市人民医院骨科收治的手术患者82例,随机数表法分为对照组和研究组,每组各41例,其中对照组围术期给予常规应用抗菌药物,研究组围术期给予干预性应用抗菌药物,观察两组抗菌药物使用情况、抗菌药物费用,并对抗菌药物使用的合理性进行评价。结果研究组住院时间、手术部位感染、治疗各项费用均低于对照组,差异有统计学意义(P<0.05);两组体温异常情况比较,无统计学差异;两组围术期抗菌药物使用均主要以单一用药为主,研究组单一用药多于对照组,二联用药低于对照组,差异有统计学意义(P<0.05);研究组在抗菌药物品种选择、预防用药时机、术后用药时间等围术期抗菌药物使用合理率均高于对照组,差异有统计学意义(P<0.05);两组治疗前肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-8、C-反应蛋白(CRP)各项血清炎性因子水平比较,无统计学差异;治疗后,两组血清炎性因子水平均下降,差异有统计学意义(P<0.05)。结论干预性应用抗菌药物对骨科围术期预防感染效果显著,在降低手术部位感染发生率的同时,提高抗菌药物使用合理性、缩短住院时间、降低住院费用。     

The influence of bariatric surgery on hip and knee joint pain: a systematic review

Obesity increases the risk of osteoarthritis and the chance of needing joint replacement arthroplasty to reduce lower limb joint pain. Although nonsurgical weight loss interventions can reduce hip and knee joint pain, bariatric surgery may be a more feasible treatment option for people with severe obesity. However, it is unclear whether weight loss through bariatric surgery can positively influence hip and knee joint pain. Our objective was to evaluate the influence of bariatric surgery on hip and knee joint pain in people with obesity by conducting a systematic review of the literature. The PubMed, EMBASE, and Cochrane bibliographic databases were searched for studies published between 1947 and September 2019. Risk of bias of the identified studies was independently assessed by 2 reviewers using JBI’s Critical Appraisal Checklist for Case Series and the Newcastle-Ottawa Scale. This review included 23 studies, all of which evaluated knee pain and 9 of which also evaluated hip pain. Reported results regarding hip pain intensity and the proportion of participants with hip pain were too limited to draw useful conclusions. Reported results regarding knee pain suggest that weight loss after bariatric surgery reduced knee pain intensity, as well as the proportion of participants with knee pain. The overall risk of bias of the majority of included studies (83%; n = 19) was judged to be unclear to high. Four small studies were judged as having a low risk of bias. Results of this systematic review suggest that bariatric surgery can positively influence hip and knee joint pain, but conclusive evidence is lacking because most of the included studies were judged as having plausible bias overall and in their key domains. Well-designed randomized controlled trials evaluating the influence of bariatric surgery on hip and knee joint pain using standardized joint pain measures are needed.     

我院骨科病区围手术期抗菌药物用药分析

目的:分析我院骨科试行"浙江省抗菌药物临床合理应用指导方案"前后围手术期抗菌药物的使用情况。方法:对骨科2004年7月60例,2003年7月66例手术病人围手术期抗菌药物使用品种、用药频度、联合用药、使用方法等进行统计分析。结果:2004年7月60例围手术期病例中,单一用药28例(46.7％),二联用药24例(40.0％),三联及以上用药无,未用抗菌药物8例(13.3％);围手术期合理使用抗菌药物23例(38.3％),基本合理32例(53.3％),人均药品费用为1 869.20元。2003年7月66例围手术期病例中,单一用药24例(36.4％),二联用药36例(54.5％),三联用药4例(6.1％),三联以上用药无,未用抗菌药物2例(3.0％);围手术期合理使用抗菌药物11例(16.7％),基本合理29例(43.9％),人均药品费用为2218.50元。结论:执行《抗菌药物临床合理应用指导方案》,可显著提高临床围手术期合理使用抗菌药物水平。     

一种骨科患者下肢多功能防护架的研制及应用

目的：研究一种骨科患者下肢多功能防护架的研制及应用。方法：该下肢多功能防护架，包括布朗氏架，在布朗氏架上安装有烧伤架。本试验选取2013年1-10月本院住院的下肢骨折329例和膝关节术后强直患者66例，前者分为试验组169例和对照组160例，后者分为试验组34例和对照组32例。试验组采用新型下肢多功能防护架治疗，对照组则单纯采取常规治疗措施。比较各组的治疗效果。结果：下肢骨折试验组24 h内消肿止痛评分达I、II级130例（77%），对照组仅有39例（24%），试验组显著优于对照组（P〈0.05）；膝关节强直术后试验组达Ⅰ、Ⅱ级28例（82%），对照组仅有12例（37%），试验组显著优于对照组（P〈0.05）。结论：新型下肢多功能防护架的应用效果较好，值得在临床上推广和应用。     

下肢多功能分体式皮布结合垫的制作及临床应用

根据血液动力学原理,通过多次实践、改进,2008年研制出抬高下肢的下肢多功能分体式皮布结合垫,该结合垫既能有效抬高制动患肢,又确保患肢放于功能位.在3年内临床应用于430例患者,患者足背动脉良好,患肢肿胀明显减轻,未出现下肢静脉血栓及足跟部压疮现象.下肢多功能分体式皮布结合垫设计合理、取材容易、制作简单、经济实用、使用操作方便,值得临床推广应用.     

Authorship decision-making in the field of orthopedic surgery and sports medicine

PurposeTo facilitate decision-making in authorship positions, the International Committee of Medical Journal Editor (ICMJE) developed a guideline that stipulates criteria authors should meet in order to merit authorship. Authors who did not meet these criteria and still enlisted as authors, are called ‘honorary’ authors. In this study, the prevalence and characteristics of honorary authorship (HA) is assessed in the field of Orthopedics and Sports Medicine.MethodsA survey was distributed among corresponding authors of articles published in 2019 in six Orthopedics-dedicated journals.Results479 of the 1392 approached authors responded, leading to a response rate of 34.4%. 91.6% of the respondents were aware of the ICMJE guidelines, whereas 67.8% were aware of the issue of HA. Overall, the prevalence of guideline-based HA was 41.9%, while the prevalence of self-perceived HA was 14.7%. Having a senior member automatically enlisted as author on the departments, was associated with a higher rate of guideline-based HA (OR 5.03) and self-perceived HA (OR 3.31).ConclusionsThe prevalence of HA in the field of Orthopedics and Sports Medicine is high, but comparable to other medical fields. Transparency in authorship decision-making is crucial to maintain liability in scientific articles.     

骨科患者的基础护理及健康教育

骨科病人大多由意外事故急诊入院,缺乏足够的心理准备及相关的疾病知识,而且病人年龄跨度大,多需卧床休息或有自理能力下降,住院期间需协助其生活护理及培养自理能力又由于骨科的病种多,手术方案不一,特别是近年来新技术、新器械的应用层出不穷,因此针对这些特点,我们采取了多种方法相结合,从病人入院至出院实施全程的健康教育,增加了疗效提高了病人的自我保健能力及康复锻炼技巧.基础护理工作对骨科病人尤为重要,通过加强护士职业道德教育,全体护士进一步提高了对骨科老年病人、危重病人基础护理工作重要性的认识,对骨科住院病人进行了全程监控,通过及时有效的基础护理质量管理、使基础护理合格率上升,达到了满意效果,并发症的发生率降到最低.骨科病人的基础护理不同于其它科病人,由于创伤、多发骨折、复合伤、截瘫病人,加之老年病人股骨颈、粗隆间骨折,因疼痛原因限制,给骨科基础护理工作带来一定难度,易发生并发症,因此我院从基础护理质量管理入手,进一步加强和提高了对基础护理工作的重视,加大督促检查力度取得了明显效果,病人基础护理合格率明显上升,最大限度的降低了骨科病人并发症的发生.