肩胛骨骨折20例临床分析

<正> 2000年1月—2002年12月间我院共收治各类型肩胛骨骨折20例,根据外伤原因、骨折类型和部位,非手术治疗18例,手术切开复位内固定2例,现报告如下。1 临床资料1.1 一般资料 本组20例中,男16例,女4例,年龄18～55岁,平均年龄28.3岁。骨折类型:体部骨折4例,盂缘骨折8例,盂窝骨折2例,解剖颈骨折1例,外科颈骨折1例,肩峰骨折3例,喙突骨折1例。致伤原因:交通事故伤     

军训致股骨干骨折17例分析

1　临床资料　本组 17例 ,男性 ,年龄 17～ 2 0岁 ,均为当年入伍的新战士。其中股骨干完全骨折 15例 ,不完全骨折 2例 ;左侧 8例 ,右侧 9例 ;股骨上段 2例 ,中段 6例 ,下段 9例 ;15例完全骨折中斜形骨折 8例 ,横断骨折 3例 ,螺旋骨折 4例。Ｘ线检查均有骨膜增生反应 ,15例有骨折端重叠和移位 ,2例股骨仅部分皮质断裂。骨折均发生于非暴力情况 ,其中行走时 4例 ,跑步时 3例 ,下蹲时 3例 ,扭伤 2例 ,跌倒时 5例。骨折发生于新训期内 12例 ,发生于新训结束后参加连队体能强化训练期内 5例。骨折前均有不同程度的下肢疼痛、肿胀及活动不便等症状…     

手术治疗尺桡骨同时骨折64例

1986～1997年,我院手术治疗尺桡骨同时骨折64例,现分析报告如下。1　临床资料1.1　一般情况　本组男43例,女21例;年龄13～68岁,其中21～30岁37例,占58%。闭合骨折29例,开放骨折35例。伤后至入院时间:闭合骨折2h～17d,平均15h;开放骨折1～13h,平均4.6h。开放骨折合并软组织损伤的严重程度按蔡汝宾等[1]提出的方法分级:级11例,级16例,级8例。1.2　骨折类型　桡骨粉碎骨折34例,其中合并尺骨粉碎骨折21例,斜形或螺旋形骨折11例,横断形骨折2例;桡骨斜形或螺旋形骨折19例,其中合并尺骨粉碎骨折6例,斜形或螺旋形骨折12例,横断形骨折1例;桡骨横断形…     

CT在颌面部隐匿性骨折中的应用价值

目的 :探讨CT在颌面部隐匿性骨折中的应用价值。材料和方法 :本组 16例 ,男 10例 ,女 6例 ,年龄 10～ 67岁 ,平均 42岁。均有外伤史 ,骨折处疼痛 ,肿胀 ,部分伴有功能障碍。采用CT平扫或冠状位扫描。结果 :16例隐匿性骨折占同期颌骨骨折的 7 4%。其中面中部多发性粉碎性骨折 6例 ,LeFortⅠ型骨折 2例 ,颧弓根部骨折 1例 ,眼眶骨折 3例 ,髁状突骨折 2例 ,腭骨骨折 1例 ,蝶骨翼突骨折 1例。结论 :当临床怀疑有骨折而常规X线未能显示或显示不清楚 ,应进一步行CT检查 ,CT在颌面部隐匿性骨折的诊断中具有特殊的意义。     

髋臼骨折的手术治疗

目的：回顾性分析髋臼骨折的手术方法和治疗效果。方法：自2004-06~2009-03,共手术治疗髋臼骨折28例,其中新鲜骨折26例,陈旧性骨折2例。按Letournel-Judet骨折分型：后壁骨折10例,后柱骨折2例,后壁伴后柱骨折4例,前壁骨折2例,前壁伴前柱骨折3例,后壁伴横形骨折4例,＂T＂型骨折3例,手术采用Kocher-Langenbeck入路和髂腹股沟入路。结果：解剖复位22例,复位满意4例,复位不满意2例。全部病例获随访6~27月,平均10.2月,临床效果优良率为92.8%（26/28）。结论：手术是治疗髋臼骨折的有效方法,正确的手术入路选择、骨折解剖复位、稳定的内固定及早期功能锻炼是治疗的关键。     

颌面骨折钛合金微型钢板固定的护理体会

1996年8月～1998年11月,我们对52例颌面骨折行钛合金微型钢板固定术的患者进行护理,效果满意。现将护理体会报告如下。1　临床资料本组52例,男42例,女10例;15～25岁18例,25～45岁24例,45岁以上10例;开放性骨折30例,闭合性骨折22例;陈旧性骨折5例,多发性骨折16例,下颌体骨折21例,下颌升支骨折3例,下颌角骨折12例,颧弓骨折8例,上颌骨骨折6例,共计72例次。52例均有不同程度骨折移位、咬合关系紊乱、面部畸形,2例有明显感染。21　术前准备　一般准备:(1)入院后即用1∶5000呋喃西林液漱口,每日数次;(2)术前1ｄ备皮,如面中部骨折冠状切口或半冠状…     

颞骨关节结节骨折的CT表现分析

目的 探讨颞骨关节结节骨折在CT中的表现.方法 通过多层螺旋CT扫描,采用多平面重建(SPR)、最大密度投影(MIP)技术(其中部分病例普通CT横轴位扫描,冠状位重建)对18例20侧颞骨关节结节骨折根据骨折部位分为2类:颅段骨折和颅外段骨折.颅外段骨折又根据骨折线通过关节结节最外下后方突起的位置分为突起内侧骨折、突起骨折和突起外侧骨折3种亚型.结果 18例20侧骨折中,颅段骨折1例,颅外段骨折17例19侧.后者突起内侧骨折8例,突起骨折5例,突起外侧骨折6例,其中2例突起骨折伴对侧突起外侧骨折.结论 CT能对颞骨关节结节骨折的类型作出正确判断.     

眼窝爆裂骨折的CT诊断

作者报道70例眼窝爆裂骨折的CT所见。骨折发生于眶底者最多,计35例(50%),内侧壁22例(31%),眶底加内侧壁者13例(19%),内侧壁骨折较少。但Hammerschlag等对尸体眶骨给予钝性外伤性实验中,8例有7例出现内侧壁骨折。内壁骨折合并眶底骨折者35例(50%)。发生于眶底部骨折较小,内侧壁骨折多较大。眶底部骨折时,发生下直肌向骨折部陷入者13例,内侧壁骨折时,发生内直肌向骨折部陷入者1例。骨折大时,可见眶内脂肪向骨折部脱出,小时可发生陷入乃至嵌顿。全部病例均未见球内出血,仅7例出现眶内气肿,其中6例为内侧壁骨折。70例中残留有眼球运动障碍者多为小的眶底部骨折。脱出的脂肪组织陷入小的骨折部位容易发生绞窄,出现血循环障碍,     

眼眶爆裂骨折的CT诊断(附24例报告)

目的:探索CT对眼眶爆裂骨折的诊断价值。材料和方法:筛选24例眼眶爆裂骨折患者,男18例,女6例。采用GE 8800型CT扫描仪扫描。结果:单眶壁爆裂骨折15例,双眶壁爆裂骨折5例,复合爆裂骨折4例。结论:CT是诊断眼眶爆裂骨折最精确的方法。     

16层螺旋CT三维重建对头颅颌面骨骨折的临床应用分析

目的探讨16层螺旋CT三维（3D）及多平面重建（MPR）成像在头颅颌面骨骨折中的临床应用。方法对60例头颅颌面骨骨折患者行16层螺旋CT薄层扫描,然后采用多平面重建（MPR）及容积再现（VR）、最大密度投影重建（MIP）等三维重建技术成像。结果60例头颅颌面骨骨折中单发性骨折43例,多发骨折17例;23例为粉碎性骨折,37例发生骨折移位。骨折部位：下颌骨骨折15例,其中髁状突骨折8例;颧弓骨折15例,其中伴眼眶、鼻骨及副鼻窦骨折9例;上颌骨骨折17例,其中13例伴上颌窦前壁塌陷及眶下壁、鼻骨、碟骨、筛骨等多处骨折;单纯鼻骨骨折13例。采用16层螺旋CT三维及3D-SSD与MPR、MIP、VR相结合多平面重建成像技术,均获得了非常满意的图像。能够立体直观地显示骨折线的位置、走向、骨折范围、类型及骨折块的移位情况等。结论16层螺旋CT扫描的横断图像及重建图像能准确全面地显示颌面部骨折情况,对头颅颌面骨骨折的诊断治疗具有很高的临床应用价值。     

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.