先天性马蹄内翻足的病因

先天性马蹄内翻足是小儿常见足部畸形，有关马蹄内翻足的病因未完全确定，主要有以下几个方面。     

先天性马蹄内翻足的治疗

先天性马蹄内翻足的治疗方法分为保守治疗和手术治疗。尽管各种治疗不可能使患足完全恢复正常，但总的治疗目标仍然是尽可能恢复足的外观和功能，使患足达到跖行、柔软和无痛。     

Ponseti法治疗先天性马蹄内翻足19例报告

2005年1月-2007年2月,我们采用Ponseti法治疗先天性马蹄内翻足19例（26足）,疗效满意。现报告如下。 临床资料：本组19例患儿中,男15例、女4例,年龄10d～8个月。患足为双侧7例、单侧12例。     

先天性马蹄内翻足的诊断与鉴别诊断

先天性马蹄内翻足表现为单侧或双侧的足部畸形，即足内侧软组织紧张，前半足不能外展，足跟紧不能背伸。诊断多不困难，但有时需与新生儿足内翻、麻痹性马蹄足、脑瘫后马蹄足、神经源性马蹄内翻足、多关节挛缩症等相鉴别。     

可吸收线替代钢丝固定胫前肌治疗小儿先天性马蹄内翻足

目的 改良胫前肌转移固定的方法 ,减轻患儿取钢丝的痛苦,提高先天性马蹄内翻足的治疗效果.方法 根据小儿马蹄内翻足的特点,改良胫前肌转移后的固定方法 ,采用ETHICON牌0号可吸收线代替钢丝固定胫前肌.结果 本组病例胫前肌固定牢固,未发生胫前肌松动现象.经3～7a随访,38例45足总优良率93.3％.结论 采用可吸收线固定胫前肌操作方便,利于将肌腱拉紧,附着性优于钢丝固定,且减少了拆除的环节,减少患儿痛苦和治疗费用,矫正效果满意.     

神经源性马蹄内翻足的治疗

神经源性马蹄内翻足是由于神经系统病变造成的足部畸形。根据原发病及畸形足的成因大致可归于三大类，即非痉挛性马蹄内翻足、痉挛性马蹄内翻足、麻痹性马蹄内翻足。其原发疾病以腰骶部脊膜膨出占首位，其次是脑性瘫痪，继发于神经系统外伤、炎症、肿瘤等病变的病例在临床上偶可遇到。导致神经源性马蹄内翻足的病因复杂，畸形表现亦多种多样，治疗措施需根据病因、畸形形态、患儿年龄等因素综合考虑。     

马蹄内翻足保守治疗中聚酯绷带的应用

2003年1月至2004年10月，我们在39例先天性马蹄内翻足患儿(4天至7个月)的保守治疗中，将传统的石膏固定改为聚酯绷带固定，优良率达91％。聚酯绷带中。二异氰酸脂占60％，多羟基化合物占30％，乙醇占10％，在水中浸泡5～10秒钟即可使用，固化时间仅为2～3分钟。聚酯绷带靴与传统的石膏靴相比。具有材质轻、塑型快、透气好、强度高等优点。     

Ponseti、Carroll疗法治疗小儿马蹄内翻足疗效对比观察

目的比较Ponseti、Carroll疗法治疗小儿马蹄内翻足的疗效。方法 135例（186足）小儿马蹄内翻足患者,0-6个月者80足,〉6个月者30足。其中78例（110足）采用Ponseti疗法治疗（A组）,57例（76足）采用Carroll疗法治疗（B组）。按Garcean标准评定疗效。结果 A、B组优良率分别为92.73%、93.42%,两组相比P〈0.05。A组年龄0-6个月者优良率为98.75%,年龄〉6个月者优良率随年龄的增长而不断降低。B组年龄6-12个月者优良率为100%,年龄〈6个月和年龄〉12个月者分别为92.3%、85.7%。结论 Ponseti、Carroll疗法均能有效的纠正小儿马蹄内翻足畸形。Ponseti疗法适用于年龄6个月以下的患儿,Carroll疗法适用于6-12个月的患儿。     

选择性下肢周围神经肌支切断术治疗痉挛性马蹄内翻足36例报告

2002年6月至今,我们对36例痉挛性马蹄内翻足的患儿施行了选择性胫神经肌支部分切断术,取得了良好的效果.现报告如下.     

脑性瘫痪致马蹄内翻足31例手术治疗分析

自1998年以来，我们对31例脑性瘫痪致足下垂并内翻足患者采用不同的手术方式治疗，效果良好。现报告如下。临床资料：本组31例，男22例，女9例。年龄4—16岁，平均9．5岁。病因：早产12例，难产9例，脑炎4例，其它6例。主要临床表现：行走时明显马蹄内翻足14例，轻度足下垂并内翻6例，慢跑时明显马蹄内翻足7例，不能行走和站立4例。肌张力按改良Ashworth分级标准：2级3例，3级22例，4级5例，5级1例。     

先天性甲状腺功能减退症患儿的诊治

先天性甲状腺功能减退症(congenital hypothyroidism,CH)简称先天性甲减,是指因甲状腺激素产生不足或其受体缺陷所导致的先天性疾病.原发性先天性甲减是临床上最常见的一类先天性甲减.临床经验表明,在出生后几周内给予甲状腺激素替代治疗,可以预防或明显减轻先天性甲减导致的神经精神发育异常.因此,必须建立...     

儿童先天性主动脉瓣狭窄的治疗进展

先天性主动脉瓣狭窄是一种常见的先天性心脏病。本文目的是总结双心室治疗儿童先天性主动脉瓣狭窄的进展。首次手术的方法包括经皮球囊瓣叶扩张术和外科瓣膜成形术。两种方法在不同年龄段的患儿中均取得了较满意的结果。然而,他们最终都要接受主动脉瓣置换术,其中Ross手术是目前最理想的选择。     

儿童先天性主动脉瓣狭窄的临床分类及转归分析

目的:探讨儿童先天性主动脉瓣狭窄的解剖特点、治疗方式及临床转归。方法:对2012年1月至2016年10月,于我科住院治疗的儿童先天性主动脉瓣狭窄(AS)患者82例(男女比1.16∶1,中位年龄48个月)按不同标准行临床分组研究:包括主动脉瓣解剖形态,合并的心内畸形及不同的干预手段等,通过随访超声心动图指标、临床症状及心功能,评估其转归及影响因素。结果:1本组病例单纯AS36例中,10例行经皮球囊主动脉瓣成形术(PBAV);11例选择外科手术9例行主动脉瓣成形术(AVP),2例行主动脉瓣置换(AVR),另15例随访观察;AS合并其他心血管畸形患儿46例中,14例选择外科手术同时矫治AS及其他合并畸形,合并动脉导管未闭或主动脉缩窄的部分病例因AS轻度未处理主动脉瓣,随访AS程度减轻。2瓣膜形态与疗效:40例三叶主动脉瓣(TAV)中,有13例行介入或外科手术治疗;41例二叶主动脉瓣(BAV)中,22例行介入或外科手术治疗。按BAV及TAV分组,本组提示同种干预方式时的即刻和中期压差变化差异无统计学意义(P0.05),且主动脉瓣反流均无明显加重。3干预方式与疗效:33例AS矫治成功的患者中,10例PBAV及23例AVP分组比较,发现在同种瓣膜形态时,即刻和中期压差下降,差异无统计学意义(P0.05),且随访主动脉瓣反流无明显加重。结论:PBAV或AVP治疗对BAV与TAV的AS患儿,早、中期疗效无明显差异。儿童AS需综合评估制定个体化随诊治疗方案。     

Transcanal endoscopic treatment for congenital middle ear cholesteatoma in children

To investigate the feasibility and efficacy of transcanal endoscopic treatment for congenital middle ear cholesteatoma in children.Eleven children diagnosed with congenital middle ear cholesteatoma, who underwent total ear endoscopic surgery under general anesthesia, were included from the Huazhong University of Science and Technology Union Shenzhen Hospital between January 2016 and December 2020. We retrospectively analyzed their operation process and surgical complications through the surgical video; moreover, we compared the pre- and postoperative hearing outcomes.One child underwent a planned second operation to reconstruct the ossicular chain. At 6 postoperative months, all 11 children underwent reexamination. There was no significant change and a significant decrease in the mean bone and air conduction hearing thresholds, respectively (P > .05 and P < .05); moreover, there was a significant reduction in the air–bone conduction difference (P < .05). Further, the air–bone conduction difference was reduced to >20 dB and >10 dB in 11 and 7 children, respectively. Follow-up of the children did not reveal sensorineural deafness, facial paralysis, and other serious complications; further, there were no cases of recurrence.Transcanal endoscopic treatment for congenital middle ear cholesteatoma in children is feasible, minimally invasive, and functional.     

Endoscopic coblation treatment for congenital pyriform sinus fistula in children

Congenital pyriform sinus fistula (CPSF) is a very rare branchial apparatus malformation. Traditional open surgery for fistulectomy might fail to excise the lesion completely, leading to continual recurrence. Herein, we report our experience of endoscopic coblation technique for treatment of CPSF in children.To observe the clinical efficacy of endoscopic coblation treatment of CPSF in children, especially for those in acute infection stage.Retrospective case series with 54 patients (including 20 cases in acute infection stage and 34 cases in non infection stage) who were diagnosed with CPSF between October 2017 to November 2019, all patients were treated with endoscopic coblation to close the piriform fossa fistula, neck abscess incision and drainage performed simultaneously for acute infection stage cases. Data collected including age of diagnosis, presenting symptoms, diagnostic methods, prior and subsequent treatments, length of hospitalization, and recurrence were analyzed.Of the 20 cases in acute infection stage, there were 3 children with transient vocal cord paresis all of which resolved with 1 month. Four children of the 34 cases in non infection stage appeared reddish swelling of the neck on the 4th, 5th, 6th, and 7th days after coblation and then underwent abscess incision and drainage. All cases experienced no recurrence, vocal cord paralysis, pharyngeal fistula and massive hemorrhage after their first endoscopic coblation of the sinus tract in the follow up of 3 to 28 months.Endoscopic coblation is an effective and safe approach for children with CPSF, neck abscess incision and drainage could be performed simultaneously in acute infection stage. We advocate using this minimally invasive technique as first line of treatment for CPSF.