人工关节技术规范化操作十分重要

随着我国汽车时代的到来，由创伤导致的骨关节损伤不断增多，但治疗效果仍难以令人满意；而人工关节假体设计、手术操作等研究的进步，使手术的成功率大大提高，术后10年的优良率达90％以上，这极大地鼓舞了创伤骨科医师应用人工关节技术治疗骨关节损伤的患者。虽然人工关节技术使大部分伤者的僵硬关节功能得到满意恢复，但是近年来临床上由于不正规的人工关节置换操作导致的失败则越来越多，给患者带来了更大的痛苦和严重的伤害。因此，人工关节技术规范化操作在创伤骨科中十分重要。现就相关问题发表个人的观点，以供同道参考。     

重视人工关节技术在创伤骨科中的应用

随着我国现代化进程的加快,创伤骨科患者,尤其高能量损伤者有逐渐增多的趋势。创伤导致的关节损伤及其并发症治疗效果仍难以令人满意,而人工关节的假体设计、手术操作等研究的进步,使手术的成功率大大提高,术后10年的优良率达90%以上,从而极大地鼓舞了临床医师应用人工关节置换术治疗骨与关节损伤的患者,但也存在许多问题值得进一步研究与探讨[1]。为进一步提高人工关节技术在创伤骨科中的治疗水平,现就相关问题提出个人看法,供同道参考。1　手术适应证与禁忌证创伤性关节炎、创伤后股骨头缺血坏死并塌陷者(Ⅲ、Ⅳ期)、60岁左右或更高年龄的…     

运动医学小组赴法国参观、学习简介

<正> 此次赴法国主要任务是参观、学习圣太田(ST、ETTENNE)大学矫形及创伤科Bousquet教授的骨科及运动创伤的手术技术与理论观点。为期两个月。现将主要内容介绍如下。1.在矫形外科方面:Bousquet的主要成果是人工关节,他首创无骨水泥的人工关节。以髋关节及膝     

人工关节置换术在髋部骨折中的应用

20世纪 80年代以后 ,生物力学和材料学的研究进展 ,促进了人工关节的飞速发展。人工关节的假体设计、手术操作技术、围手术期处理和术后康复治疗等均日趋完善和成熟 ,手术的成功率大大提高 ,术后 1 0年的优良率达 95 %以上 ,极大地鼓舞了骨科医师应用人工关节置换术治疗髋关节疾病和损伤。更多的患者对人工关节置换的优良效果充满了信心 ,乐意接受人工关节置换术。本期《中华创伤杂志》组稿数篇探讨股骨颈骨折的关节置换效果和假体周围骨折及假体磨损的相关研究 ,集中介绍股骨颈骨折人工关节置换术的经验。从中可以学到不少新知识 ,但也有一…     

联合应用人工关节和游离组织瓣治疗严重肘关节损伤1例

报告严重肘关节损伤患者应用关节假体置换和游离组织瓣移植的临床应用结果。表明在掌握人工关节技术和显微外科技术条件下 ,联合应用人工关节和游离组织瓣治疗关节严重创伤可以获得良好的疗效     

创伤骨科中微创技术的应用

创伤骨科中微创技术的应用包括两方面的内容,一方面,在严重多发伤病人的骨折治疗中,微创外科技术可被作为损害控制骨科的有效手段,以降低早期确定性手术治疗的死亡率,创伤越严重,越应该受益于该技术;另一方面,微创技术广泛应用于关节周围骨折、骨盆和髋臼骨折、脊柱骨折等,以更小的创伤达到与传统骨折治疗相同或更佳的疗效,病人受益于更...     

关节外科国际学术研讨会及学习班通知

第三军医大学附属西南医院骨科和《中华外科杂志》编辑部、《中华骨科杂志》编辑部拟于2001年8月26～30日在重庆西南医院联合举办关节外科国际学术研讨会,同期开办人工关节及关节镜技术学习班。1.关节外科国际学术研讨会:(1)征文内容:①关节镜技术相关的基础理论及临床应用;②人工关节的生物力学及临床应用中的问题;③关节疾病的相关基础研究、诊疗新进展;④人工关节置换和翻修术;⑤疑难病例讨论。(2)征文要求:①所送论文必须是2000年12月31日以前未曾公开发表的。会议选用部分论文在大会上交流。优秀论文将向《中华外科杂志》和《中华骨科…     

人工关节置换术的现状及其进展

人工关节置换术是在关节成形术的基础和理念上发展起来的一门新技术。虽然最早人体应用人工关节是Ｇｌｕｃｋ于 1891年首先报告的 ,但是直到 2 0世纪 60年代Ｃｈａｒｎｌｅｙ通过大量临床实践和基础研究 ,确立了人工关节假体设计中的低摩擦原理 ,选择了金属 -高密度聚乙烯组合来替代金属 -金属组合和现代骨水泥技术 ,才使得人工关节置换术的临床效果出现较大的进步[1] 。 2 0世纪 70年代以来 ,人工关节在基础研究、设计生产和临床应用三方面的发展十分迅速 ,关节置换手术广泛开展。估计全世界每年约有 5 0余万人因创伤、骨关节炎、肿瘤等而…     

首届亚洲创伤骨科高峰论坛通知

为推动我国创伤骨科的发展，增进相互了解，扩大与亚洲地区各国的学术交流与技术合作，《中华创伤骨科杂志》社、亚洲创伤骨科学会（AADO）与中华骨科交流学会（台湾）于2005年11月11～14日在广州联合举办“首届亚洲创伤骨科高峰论坛”。会议将就创伤骨科领域国际最新技术与进展、主要以Video Symposium（多媒体动画）形式进行广泛的学术交流。     

骨折治疗的进展

骨折内固定理念的改变、微创手术的广泛使用以及复杂关节内骨折的手术与计算机技术在创伤骨科领域中的使用,使创伤骨科领域新理论、新技术、新方法近10年有了飞速的发展。笔者简要介绍目前创伤骨科领域新的发展趋势。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.