联合术式治疗3～6岁儿童先天性髋关节脱位

目的：探讨3～6岁儿童先天性髋关节脱位手术治疗的方法及效果。方法：对72例（88髋）3～6岁先天性髋关节脱位患者采用切开复位、关节囊紧缩,Salter骨盆截骨,股骨转子下缩短旋转截骨三种联合术式进行治疗。结果：随访18～30个月,根据Mckay评定标准,优良率达89．8％。结论：对3～6岁儿童先天性髋关节脱位联合手术是一种有效的方法。     

HOX基因与先天性髋脱位

先天性髋脱位为多基因遗传病 ,受遗传因素和环境因素共同作用。通过控制环境因素可以减少先天性髋脱位的发生或抑制其发展 ,但仍有一些病例原因不明。本文主要以发育基因—— HOX基因作为先天性髋脱位的候选基因作一综述 ,旨在探索先天性髋脱位的遗传因素     

肌骨瓣髋臼造顶加粗隆间截骨术治疗先天性髋脱位的生物力学评价

目的 对带缝匠肌的髂骨瓣髋臼造顶加粗隆间截骨术治疗8岁以上大龄先天性髋脱位及髋发育不良患儿的疗效，进行生物力学评价；建立正常成人，正常儿童髋关节的各项生物力学指标的正常值范围。方法 采用legal的数学模型分别对正常成人，髋发育不良组，正常儿童组和缝匠肌造顶术后组的标准骨盆平片进行测量，并进行统计学处理。结果 15年临床随访和生物力学评价表明，该术式能够改善患者髋关节的生物力学状态，手术符合生物力学规律，并具有方法简单，效果可靠的优点。结论 应根据生物力学原则和患者的实际情况灵活选择术式。     

HOX基因与先天性髋脱位

先天性髋脱位为多基因遗传病，受遗传因素和环境因素共同作用，通过控制环境因素可以减少先天性髋脱位的发生或抑制其发展，但仍有一些病例原因不明，本主要以发育基因-HOX基因作为先天性髋脱位的候选基因作一综述。旨在探索先天性髋脱位的遗传因素。     

单侧先天性髋关节脱位病人的动态足底压力测定初步分析

为分析先天性髋关节脱位的动态足底压力分布，应用自行研制的足底压力分布视频图像测试系统，采用自身配对比较的方法，对7名单侧先天性髋脱位病人的双侧肢体进行步态周期中站立相的动态足底压力测定。结果表明：患肢在站立相时间、足底平均压力及压力时间积分等参数均与健肢有显著的差异（P＜0．05），这些差异与患肢髋脱位的病理生理有着密切的关系，是患肢因其髋关节脱位、肢体短缩、臀中肌功能不全对健肢的一种代偿形式，也是病理状念下，健患两侧肢体建立起来的一种平衡。通过足底压力的测试分析能加深了解先天性髋脱位的变化规律。比较术前、术后动态足底压力各个参数的变化，可作为从生物力学角度分析和评定手术效果的一项定量的参考指标。     

人工全髋置换联合髋臼造盖治疗先天性髋关节脱位

背景：以往采用单纯的人工关节置换、截骨重建等治疗成人CrownⅣ型先天性髋关节脱位的效果都不是很满意。 目的：探讨人工全髋置换联合髋臼造盖重建治疗成人CrownⅣ型先天性髋关节脱位的疗效。 方法：回顾性分析采用人工全髋置换联合髋臼造盖重建治疗23例成人CrownⅣ型先天性髋关节脱位的患者,其中男2例,女21例,年龄20-35岁,平均(24.26±3.56)岁。重建治疗后按Harrris髋关节功能标准评定术后疗效并进行统计学分析。 结果与结论：23例患者均获得随访,随访时间为12-60个月,平均(26.60±13.16)个月。采用SPSS19.0进行统计学比较后发现,手术前后髋关节功能Harrris评分差异有显著性意义(P < 0.01)。人工全髋置换联合髋臼造盖能重建髋关节正常结构,缓解疼痛,增加髋关节稳定性,是治疗成人CrownⅣ型先天性髋关节脱位的理想方法。     

小儿先天性普通型巨结肠手术方法改进治疗体会

小儿先天性巨结肠是临床较常见的一种消化道畸形,尤以婴幼儿多发,并且男性高于女性,有家族遗传倾向。先天性巨结肠的治疗方法有多种,但手术能达到根治。由于巨结肠的类型不同,故手术方式的选择也不相同。1984年以来,我们根据中国医科大学附属二院李     

Nuss手术治疗儿童先天性漏斗胸的护理

我院2007年5月～2008年5月对36例先天性漏斗胸的患儿实施了胸腔镜下Nuss手术,疗效满意。现将护理体会报告如下。1资料与方法1．1一般资料本组36例先天性漏斗胸患儿,男23例,女13例,年龄2岁6月～13岁,平均4岁,术前均行X线胸部正侧位片、胸部CT、     

手术治疗踝关节骨折脱位的临床分析

目的探讨手术治疗踝关节骨折脱位的临床疗效。方法 2009年3月至2010年9月期间我科诊治的踝关节骨折脱位患者72例随机分成两组,每组36例,其中对照组患者采用手法整复石膏外固定治疗,研究组患者采用切开复位内固定治疗,治疗后对两组患者的相关临床资料进行比较分析。结果两组患者在住院天数、骨折愈合时间及治疗费用方面均具有显著的统计学差异（P〈0.05）;两组患者在踝关节功能恢复总有效率方面具有显著的统计学差异（P〈0.05）;在治疗12 h后、第1、3天后,两组患者的VAS疼痛评分较治疗前具有显著的统计学差异（P〈0.05）。结论手术治疗虽然具有创伤大、住院天数及治疗费用多的缺陷,但踝关节功能恢复较好,明显减少患者的痛苦。     

Respiratory input and transfer impedances in children 9-13 years old

Reference values for respiratory impedances in children are scarce and limited to the situation where pressure is varied at the mouth. Total respiratory impedance was therefore measured from 4 to 30 Hz in 69 healthy children (9-13 yr) with both a pressure input at the mouth (input impedance, Zin) and a pressure input at the chest (transfer impedance, Ztr). Zin was characterized by the average resistance (R), the low-frequency limit of resistance (R0), the slope of the resistance-frequency curve (S), respiratory elastance (E) and respiratory inertance (I). Similar coefficients (R0', S', E', I'), some of which however have slightly different physiological meanings, were derived from Ztr. R, R0 and R0' were found to be significantly correlated to body height (p less than 0.001) and, independently, to age (p less than 0.05): R (kPa X l-1 X s) = 1.76-5.29 10(-3) height (cm) -4.13 10(-2) age (yr). Elastances were better correlated to height than to age: E (kPa X l-1) = 20.95-0.101 height (cm) and inertances better correlated to age than to height: I (Pa X l-1 X s2) = 4.39-0.128 age (yr). S and S' were not correlated to biometric variables. No difference was found between children living in polluted (n = 36) and nonpolluted (n = 33) areas, except for S which was significantly lower in the first group (p less than 0.01).     

小儿淋巴管瘤诊断与手术治疗体会

淋巴管瘤是一种错构瘤样新生物，尤以小儿为多发，由于生长部位不同，故也具有损害面容和影响器官功能的危害性，必须引起重视。我院自1985年至2001年间，共收治小儿各部位淋巴管瘤18例，均手术治疗，并由病理检查证实，现结合文献学习，将手术治疗体会进行报告。     

Changes over 13 years in skin reactivity to histamine in cohorts of children aged 9-13 years

BACKGROUND: Several studies report substantial differences in the prevalence of skin test reactivity to allergens in children from adjacent geographic areas; others report an increased prevalence over time. To find out whether these differences depend on variations in skin reactivity to histamine, we determined the time trend of histamine wheal sizes in successive cohorts of unselected children living in the same area (Viterbo, Italy). METHODS: We conducted three epidemiologic surveys, each including children aged 9 and 13 years. The 1983-7 study investigated 170 children (150 were tested twice); the 1992 study, 158 children; and the 1996 study, 208 children. RESULTS: In both age groups, the mean diameter of the wheal induced by histamine skin prick tests (10 mg/ml) increased significantly over time (9-year-olds: 3.25 mm in 1983, 4.68 in 1992, and 5.89 in 1996; 13-year-olds: 3.89 mm in 1987, 5.18 in 1992, and 6.50 in 1996) (P < 0.001 between subsequent studies). The distribution of the wheal diameters for both ages showed a trend to a right shift in the three successive studies (P < 0.001). The dose-response curves for three histamine concentrations (0.2, 1, and 10 mg/ml) had significantly steeper slopes in 1996 than in 1983-7 (P < 0.001). CONCLUSION: The marked time-related increase in the size of the histamine wheals could help to explain the trend toward an increased prevalence of positive allergen skin test reactions reported during the past years. The causes of increased skin reactivity to histamine remain conjectural.     

儿童先天性主动脉缩窄的解剖特点及外科治疗策略

目的 探讨儿童先天性主动脉缩窄(CoA)的解剖变异特点及相应外科治疗策略。方法 回顾性分析2012年5月—2014年6月南京医科大学附属儿童医院心胸外科手术治疗的30 例先天性CoA患儿的临床资料,其中男22例,女8例;年龄12 d～6岁。依据国际小儿心脏外科命名和数据库的分类标准:单纯型CoA 12例,合并室间隔缺损型8例,合并复杂先天性心脏病型 5例,合并主动脉弓发育不良型5例。30例患者中,体外循环下手术矫治20例,同期矫治心内畸形,其中8例在选择性脑灌注下行手术矫治;非体外循环手术10例,2例采用正中切口,其中1例采取镶嵌手术封堵肌部室间隔缺损,其余8例采用左后外侧切口。 结果 30例患者均顺利完成手术,手术时间95～675 min,平均165.68 min。术后死亡2例;1例术后出现气道压力增高,左上肺不张,不能脱离呼吸机,再次行手术悬吊松解,顺利脱离呼吸机并出院;余27例患儿均顺利康复并出院。28例患儿获随访,随访时间6个月～2年,其中1例于术后2年出现再次狭窄,上下肢血压压差在50 mmHg(1 mmHg=0.133 kPa)左右,目前仍在随访中;余患儿生长发育正常,术后上下肢血压压差＜10 mmHg。结论 对先天性CoA患儿,根据CoA不同的解剖分型选择相应的外科治疗及体外循环方案,可取得良好的治疗效果。     

湖南地区6～16岁焦虑障碍患儿生活质量及影响因素

目的:了解儿童青少年焦虑障碍患儿生活质量的水平及特点,并探讨其生活质量的影响因素.方法:本研究数据来自课题组2014年2-7月大型流行病学调查数据,研究对象来自湖南省长沙市和益阳市,采用C#程序1:2筛选出497例患有焦虑障碍的儿童作为病例组,性别、年龄与其匹配的994例健康儿童作为对照组,分别采用儿童期虐待问卷(CT...     

手术治疗重症胰腺炎体会

重症胰腺炎是指胰腺发生出血、坏死，同时伴有脏器功能衰竭和中毒性休克的炎症改变。该病临床较常见，其病程凶险，死亡较高，必须高度重视。我科自1990年12月至2003年12月收治各种胰腺炎92例，其中采用手术治疗重症胰腺炎72例，取得了满意效果。现报告如下。     

Safety and tolerability of fexofenadine for the treatment of allergic rhinitis in children 2 to 5 years old.

BACKGROUND: The safety of fexofenadine has been examined extensively in adults and school-age children. However, the safety of fexofenadine in children younger than 6 years has not been reported to date. OBJECTIVE: To compare the safety and tolerability of twice-daily fexofenadine hydrochloride, 30 mg, and placebo in preschool children aged 2 to 5 years with allergic rhinitis. METHODS: This was a multicenter, double-blind, randomized, placebo-controlled, parallel-group study, conducted between February 29, 2000, and June 14, 2001. Participants were randomized to either fexofenadine hydrochloride, 30 mg, or placebo twice daily for a 2-week period. To facilitate dosing, capsule content was mixed with applesauce (approximately 10 mL). Safety assessments depended on date of entry into the study because of an amendment to the protocol. Before the amendment, assessments included physical examination, vital signs reporting (oral temperature, heart rate, and respiratory rate), and adverse event (AE) reporting. After the amendment, safety assessments included laboratory testing (blood chemistry and hematology profiles), physical examination, 12-lead electrocardiography, and vital signs (oral temperature, blood pressure, heart rate, and respiratory rate) and AE reporting. RESULTS: Treatment-emergent AEs were observed in 116 of 231 participants receiving placebo and 111 of 222 receiving fexofenadine. These AEs were possibly related to study medication in 19 (8.2%) and 21 (9.5%) of the participants receiving placebo and fexofenadine, respectively, and most frequently involved the digestive system. No clinically relevant differences in laboratory measures, vital signs, and physical examinations were observed. CONCLUSIONS: The findings show that fexofenadine hydrochloride, 30 mg, is well tolerated and has a good safety profile in children aged 2 to 5 years with allergic rhinitis.