Treatment of Thoracolumbar Vertebrate Fracture by Transpedicular Morselized Bone Grafting in Vertebrae for Spinal Fusion and Pedicle Screw Fixation

To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A （n=20） were rein-forced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B （n=50） did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B （group A： 6.4 degree; group B： 5.4 degree）/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B （P=0.0001）. Postoperatively, greater anterior height was achieved in group A than in group B （P〈0.01）. During follow-up study, anterior vertebral height was maintained only in Group A （P〈0.001）. Both group A and group B showed good Denis pain scores （P1 and P2） but group A outdid group B in terms of control of severe and constant pain （P4 and P5）. By Frankel criteria, the changes in neurological functions in group A was better than those of group B （P〈0.001）. It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with th     

高喉头气管插管喉镜

气管插管术(下称插管)在现代临床麻醉和危重病急救医学中应用广泛。但是,由于某些因素常使插管困难乃至失败,而影响麻醉的进行和病人的安全。故是当前麻醉学科中的研究课题之一。     

自拟附子淫羊藿汤治疗病态窦房结综合征十二例报告

病态窦房结在临床中较少见,是严重及难治的心律失常。祖国医学属心悸、怔忡、胸痹、昏厥等范畴。由于病性危急,治疗常以西药为主,临床认为中药治疗本病有特殊疗效。现将十二例本证治疗报告如下: 临床资料一、诊断标准以心律失常及心率缓慢为主,结合临床表现及心电报告证实,进行全面分析再作出诊断。其诊断依据:持续或间歇出现的严重窦性心动过缓,(<50次/分)或同时伴有窦房传导阻滞,窦性停持,或有典型阿一斯综合征的发生,或有慢性心房颤动等。     

JT-ESWL-Ⅱ型机体外震波碎石病人的护理

我院自1988年10月至1989年10月使用上海交大研制的JT-ESWL-Ⅱ型机，行体外震波碎石治疗1000例泌尿系结石患，其护理小结如下：     

体外震波碎石X线定位探讨

我院自1988年10月开始采用上海交通大学研制的JT—ESWL—Ⅱ型肾结石粉碎机,迄今治疗尿路结石400余例,其中肾结石206例,输尿管结石148例(包括上段87例,中段5例,下段56例)膀胱结石4例,肾合并输尿管结石42例。现将本组400例X线定位的体会小结如下: 一、体位:大多数采用仰卧位,但略有区别,如输尿管上段结石采用患侧倾斜5°—15°;中段结石采用俯卧位,以避免碎石时骨骼对压力波的阻碍;下段结石及膀胱结石采用蛙形位,即双下肢屈曲外展的体位,有利于X线的穿透,减小X线的高毫安照射。     

强化麻醉在JT—ESWL一Ⅱ型机体外震波碎石术中的应用

我院自1988年10月引进JT—ESWL—Ⅱ型机行体外震波碎石治疗尿路结石1000例。原采用单次硬膜外麻醉计715例，麻醉平面在T6以下时部分病人仍有震波痛。为了减轻病人痛苦和震波冲击时对病人的病理或生理影响，现已由原来的高功率12—14KV在不影响碎石的情况下逐渐降低到8-11KV，     

严重手指外伤的治疗体会

由于机械压榨撕脱或爆炸伤导致的手指损伤,常引起手指多发复杂骨折并皮肤软组织、肌腱、血管、神经的损伤或缺损,我们称之为"严重的手指外伤".     

微创外固定架治疗Pilon骨折29例

目的:胫骨Pilon骨折微创外固定架治疗方法.方法:根据骨折严重程度,透视下采用小切口或不切开、关节面精确重建并微创外固定架 有限内固定.结果:随访1年～5年,全部骨折愈合,皮肤愈合时间超过2周2例,创伤性关节炎4例,优良率为92.0%.结论:微创外固定架 有限内固定治疗Pilon骨折,具有损伤小,不受皮肤条件限制,胫骨下关节面解剖复位,踝关节角度可调整,最大程度恢复功能.     

36例三踝骨折的手术治疗

踝关节是人体负重最大的关节,三踝骨折系踝关节严重损伤,一般合并有踝关节脱位.骨折后如关节面稍有不平或关节间隙稍有增宽,容易发生创伤性关节炎,影响患者的生活质量以及日常工作.另外由于踝关节周围软组织薄弱,术后切口感染、皮肤坏死也并非少见.因此对三踝骨折的复位要求高.我科自2000年1月～2007年8月共手术治疗三踝骨折36例,取得了比较好的疗效,现报告如下.