老年股骨颈骨折松质骨螺丝钉内固定的治疗

目的：通过采用松质骨螺丝钉内固定治疗38例老年股骨颈骨折的观察，探讨松质骨螺丝钉对老年股骨颈骨折治疗的疗效。方法：所有病例均于骨折的早期经大粗隆外侧切口行松质骨螺丝钉内固定术，术后穿木板鞋，3天后行患侧膝关节的持续被动练习和主动运动，3周后行髋关节功能锻炼。结果：所有病例骨折，愈合时间为8—12周，平均10周，4—6周开始负重。关节功能恢复良，关节优良率95％。结论：松质骨螺丝钉应用于老年股骨颈骨折治疗疗效可靠，费用低，是老年股骨颈骨折治疗的理想方案。     

中空加压螺丝钉治疗股骨颈及粗隆间骨折

中空加压螺丝钉治疗股骨颈及粗隆间骨折武警北京总队医院王伟，翟书亭，杨选平，刘冬发，赵志栋（北京１０００２７）中空加压螺丝钉治疗股骨颈骨折在国外已有报道［１］，与以往手术比较有骨折端加压可靠、内固定坚强、手术损伤小、操作准确简便等优点。我院于１９９２年...     

股骨颈骨折愈合及股骨头活力的超微结构变化

目的：对股骨颈骨折的愈合过程及股骨头活力做超微结构研究。方法：２８只实验犬造成股骨颈骨折模型，加压螺丝钉固定组和对照组采用电镜和相关指标观察骨折愈合与股骨头的活力。结果：（１）股骨颈骨折愈合过程主要由骨髓的成骨作用完成；加压螺丝钉可缩小骨折间隙，有利于骨髓循环通过骨折端建立新的哈佛氏系统，加速网状骨向板层骨转化，缩短愈合时间。（２）内固定组和对照组在股骨头缺血４周均可见骨细胞变性，胞浆成份溶解空化；但６周后固定组开始有较多的血管向头内生长，成骨细胞大量增生，提示股骨头开始复活。而对照组骨细胞萎陷、坏死继续加重。结论：股骨颈骨折及时准确复位和良好的内固定，可加速骨折愈合和尽早使股骨头恢复活力。     

AO股骨钉旁交锁髓内钉治疗同侧股骨颈、干骨折

目的通过观察AO股骨钉旁交锁髓内钉(UFN)治疗股骨干粉碎性骨折合并同侧股骨颈骨折的疗效，探讨同侧股骨颈、干骨折的损伤机制、特点及应用UFN治疗同侧股骨颈、干骨折的优越性、手术要点及注意事项。方法2001年1月-2003年12月使用UFN治疗11例同侧股骨颈、干骨折患者，手术使用骨科牵引床、C形臂X线机，采用闭合或小切口切开复位、锁定技术。结果所有患者随访8～36个月，平均15个月。1例股骨颈骨折为Grarden Ⅳ型合并同侧股骨干骨折术后8个月出现股骨头坏死，1例股骨干C，型骨折术后7个月发现骨折延迟愈合，经拔除远端锁钉改为动力固定5个月后骨折愈合，其余均Ⅰ期临床愈合，Ⅰ期愈合率为82％。股骨颈骨折临床愈合时间平均为5．1个月；股骨干骨折临床愈合时间平均为6，9个月。患肢关节功能优良。结论UFN治疗同侧股骨颈、干骨折具有手术创伤轻、切口小、固定可靠、骨折愈合率高的优点，符合生物力学要求，是治疗股骨干粉碎性骨折伴同侧股骨颈骨折的理想方法。     

三种内固定法治疗股骨颈骨折疗效分折

自１９８５年７月一１９９７年８月，笔者先后用三刃钉、加压螺丝钉及多枚可折螺钉闭合复位内固定治疗股骨颈骨折３０５例。临床资料男１６５例，女１４０例；年龄１５－８７岁，平均５８岁，５０岁以上２３０例，占７５％。新鲜骨折２５０例，陈旧性骨折５５例。骨折类型：头下型９９例，颈中型１０１例，基底型１０５例。按Ｇａｒｄｅｎ分型：Ⅱ型９８例，Ⅲ型１０８例，Ⅳ型９９例。随访时间ｌ－９年，平均５年６个月。治疗方祛：硬脑膜外麻醉下，仰卧于股骨颈骨折快速复位床上，复位成功后，沿转子下做ｓｃｍ纵切日，暴露转子下外端。（…     

Grosse-Kempf带锁髓内钉和AO钢板治疗胫骨骨折的疗效分析

目的：评价Grosse-Kempf带锁髓内钉和AO钢板对胫骨骨折的治疗效果。方法：回顾分析1994年以来应用AO钢板治疗胫骨骨折40例、带锁髓内钉治疗胫骨骨折55例患者的恢复情况。结果：经过10--26个月的随访，带锁髓内钉治疗组骨折愈合率为98．2％(54／55)，感染率为1．8％(1．／55)，骨折平均愈合时间为5．6个月；AO钢板治疗组则分别为90％(36／40)、12．5％(5／40)和7．5个月。结论：带锁髓内钉治疗胫骨骨折因其生物力学好，操作简单，固定坚强，对骨折局部血供破坏小，其治疗效果优于AO钢板，但其应用有一定局限性。     

儿童股骨颈骨折的治疗

目的　探讨如何提高儿童股骨颈骨折治疗效果及降低其并发症。方法　在 2 1例儿童股骨颈骨折病例中 ,对无移位者采用髋人字石膏固定 ,对移位者采用手法复位经皮多枚克氏针内固定 ,对手法复位失败者采用手术切开复位 ,空心螺丝钉内固定 ,对伤后 36小时入院者均行髋关节减压。结果　本组 17例经 1～ 13年的随访 ,其中 ,骨折无移位者无明显并发症 ;骨折有移位者中 ,股骨头缺血性坏死 2例 ,髋内翻 2例 ,股骨颈缩短大粗隆明显上移 2例。行关节穿刺减压后再行固定治疗的 5例无明显并发症。结论　儿童股骨颈骨折较少见 ,但并发症发生率高 ,采用早期关节穿刺减压 ,及时准确复位 ,坚强的内外固定 ,是减少并发症的重要措施     

中空加压螺丝钉治疗新鲜股骨颈骨折212例

对应用中空加压螺丝钉治疗的２１２例病人进行回顾性研究,以期了解中空加压螺丝钉治疗后骨折愈合、股骨头缺血坏死及晚期塌陷的情况。方法将病人年龄,性别、骨折类型,受伤至手术时间,骨折复位情况与肌骨头缺血坏死及晚期塌陷之间的相关关系进行统计学分析。结果中空加压螺丝钉内固定后股骨颈骨折愈合率达９５％。     

闭合复位内固定治疗儿童股骨颈骨折36例

儿童股骨颈骨折是一种较为特殊的骨折类型，处理不当可引起多种严重并发症，直接影响生活质量。1996年以来，我们采用闭合复位经皮克氏针内固定治疗儿童股骨颈骨折36例，疗效满意。现分析报告如下。     

螺纹斯氏针内固定治疗股骨颈及股骨粗隆间骨折

我院骨科自1981年9月以来,应用带螺纹斯氏针治疗股骨颈骨折及股骨粗隆间骨折36例(股骨颈骨折24例、股骨粗隆间骨折12例),取得较好的疗效,现介绍如下。一般资料 本组36例中,男性17例,女性19例,年龄最大80岁,最小16岁,平均64.4岁。受伤时间:     

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.