不同干预措施治疗腕舟骨骨折的网状Meta分析

目的采用网状Meta分析系统评价石膏固定、空心螺钉、Herbert螺钉、克氏针固定四种干预措施治疗腕舟骨骨折的疗效。方法检索建库至2019年12月31日的PubMed、EMbase、Cochrane Library、Glinical Trial、中国学术期刊网络出版总库(CNKI)、中国生物医学文献数据库(CBMdisc)、维普科技期刊数据库(VIP)、万方医学网等数据库所收录的腕舟骨骨折治疗随机对照试验,采用Stata 16.0对符合纳入标准的文献数据进行网状Meta分析及作图。结果纳入16篇文献,参与研究患者1193例。经网状Meta分析结果表明,治疗有效率方面,空心螺钉、Herbert螺钉、克氏针三种干预措施疗效均优于石膏固定,愈合时间均短于石膏固定。结论治疗腕舟骨骨折有效率、愈合时间SUCRA排序均为空心螺钉>Herbert螺钉>克氏针>石膏固定,因此空心螺钉成为最佳治疗措施的可能性最大。     

掌侧切口Herbert钉内固定治疗舟状骨骨折

<正>2007年1月~2014年1月,我科采用掌侧切口Herbert钉内固定治疗18例腕舟骨骨折患者,报道如下。1材料与方法1.1病例资料本组18例,男10例,女8例,年龄18~66岁。左手7例,右手11例。1.2治疗方法臂丛麻醉。取腕掌桡侧做S形切口,长约5 cm,牵开桡侧腕屈肌腱,切开关节囊,牵引复位脱位的腕骨,复位良好后用Herbert钉固定骨折端,螺钉尾端可埋入骨内,手术在C臂机透视监测下进行。术后石膏固定4~6周。2结果     

某海运集团船员幽门螺杆菌感染调查

目的 调查船员幽门螺杆菌(helicobacter pylori,HP)的感染情况及其影响因素.方法 采用随机整体抽样方法,对238名体检船员进行问卷调查和13C-尿素呼气试验检测.结果 船员HP感染率为61.8％,稍高于我国HP平均感染率59％,但明显高于广东省的平均感染率42％.船员HP感染呈现随船龄上升的趋势,与文化程度、航行时间、饮食、吸烟以及近期出现的上消化道症状等因素具有相关性(P＜0.05).结论 船员由于职业特性属于HP高感染群体,必须采取积极措施予以保护.提高个人素质,注意饮食卫生,改善居住环境,缩短航行时间、戒除吸烟嗜好,可降低船员HP的感染率.     

Evaluation of EMIT methods for the determination of the five major antiepileptic drugs on an automated kinetic analyser.

We have evaluated the performance of enzyme-multipled immunoassay methods for the five major antiepileptic drugs on an automated system, the Perkin-Elmer Model KA-150 Kinetic Analyzer. The precision in the normal duplicate mode was found to be in the range of 6% to 10% for all five tests over a typical working day. All EMIT methods were compared to gas-liquid chromatographic procedures and, in addition, the phenytoin and phenobarbital assays were compared to a liquid-chromatographic method. The phenytoin assay was also compared to RIA and to a manual spectroscopic method. In general, most of the comparison studies resulted in acceptable correlation, although one gas chromatographic method did not correlate very well with the phenytoin and phenobarbital immunoassays.     

Mason Ⅱ~Ⅳ型桡骨小头骨折手术治疗的疗效观察

目的探讨假体置换与 Herbert 钉内固定治疗 Mason Ⅱ～Ⅳ型桡骨小头骨折的临床疗效。方法回顾分析运用假体置换与 Herbert 钉治疗的21例 Mason Ⅱ～Ⅳ型桡骨小头骨折患者临床资料,采用 Broberg 和 Morrey 肘关节功能评分标准评定疗效。结果所有患者均获随访,随访时间1～3年。假体置换治疗患者：优3例,良2例,一般1例,优良率为83.33％;Herbert 钉治疗患者：优8例,良5例,一般2例,优良率为86.67％。结论假体置换治疗 MasonⅢ、Ⅳ型桡骨小头粉碎性骨折的近期效果满意,采用 Herbert 钉治疗 MasonⅡ型桡骨小头骨折具有较好的临床疗效。     

Improving patient safety using the sterile cockpit principle during medication administration: a collaborative,unit-based project

Aim To implement the sterile cockpit principle to decrease interruptions and distractions during high volume medication administration and reduce the number of medication errors. Background While some studies have described the importance of reducing interruptions as a tactic to reduce medication errors, work is needed to assess the impact on patient outcomes. Methods Data regarding the type and frequency of distractions were collected during the first 11 weeks of implementation. Medication error rates were tracked 1 year before and after 1 year implementation. Results Simple regression analysis showed a decrease in the mean number of distractions, (β = −0.193, P = 0.02) over time. The medication error rate decreased by 42.78% (P = 0.04) after implementation of the sterile cockpit principle. Conclusions The use of crew resource management techniques, including the sterile cockpit principle, applied to medication administration has a significant impact on patient safety. Implications for nursing management Applying the sterile cockpit principle to inpatient medical units is a feasible approach to reduce the number of distractions during the administration of medication, thus, reducing the likelihood of medication error. ‘Do Not Disturb’ signs and vests are inexpensive, simple interventions that can be used as reminders to decrease distractions.     

Herbert螺钉治疗肱骨小头骨折应用分析

目的 评价Herbert 螺钉治疗有移位的肱骨小头骨折的优越性.方法 自2005年3月以来应用Herbert螺钉治疗有移位的肱骨小头骨折11例,按Bryan-Morrey肱骨小头骨折分型:Ⅰ型7例,Ⅱ型1例,Ⅲ型3例.结果 经平均随访3年 8个月,术后功能按Mayo评分优7例,良4例,大多数患者完全恢复正常,无并发症.结论 Herbert 螺钉治疗肱骨小头骨折能提供牢固的内固定,大多数患者肘关节功能恢复良好,稳定无疼痛.在处理这类骨折中,本治疗方法 较常规方法 具有明显的优越性.     

Herbert螺钉联合带蒂桡骨骨瓣移植治疗腕舟状骨骨不连

目的探讨Herbert螺钉联合带血管筋膜蒂桡骨茎突骨瓣治疗腕舟状骨骨不连的临床疗效。方法采用Herbert螺钉固定联合带血管筋膜蒂桡骨茎突骨瓣治疗我院骨科自2010年9月~2016年1月收治的腕舟状骨骨不连患者25例。结果所有的患者平均随访5~24个月,骨折均愈合,骨折愈合时间是(12.7±2.1)周,使用改良Mayo腕关节评分评价腕关节功能,优秀16例,良好5例,一般3例,较差1例。结论对于腕舟状骨骨不连的患者,Herbert螺钉联合带血管筋膜蒂桡骨茎突骨瓣治疗腕舟状骨骨不连是一种有效且可行的方法。     

Herbert螺钉内固定治疗腕舟骨骨折

目的探讨用Herbert螺钉内固定治疗不稳定型腕舟骨骨折的疗效。方法 2003-01/2010-12,四川省科学城医院骨科用Herbert螺钉内固定治疗不稳定型腕舟骨骨折27例。结果全部病例随访1～2年,27例全部愈合,愈合时间为11～18周,功能恢复良好,优良率达100%。结论 Herbert螺钉内固定治疗不稳定腕舟骨骨折,愈合率高,疗效可靠,功能恢复好。