关节镜治疗创伤性髌前滑囊炎36例临床分析

目的 探讨关节镜下破坏囊壁治疗创伤性髌前滑囊炎的临床疗效.方法 回顾性分析2012年2月至2016年4月在本院行关节镜下治疗髌前滑囊炎的36例患者的临床资料.统计手术时间、出血量、住院时间等手术相关指标;比较术前术后VAS评分及膝关节屈伸活动度(ROM)评分情况.结果 患者手术时间30～60 min,平均(40±10)...     

C-反应蛋白在评价感染性心内膜炎预后中的价值

目的:评价血浆C-反应蛋白(CR P)系列测定对监测感染性心内膜炎(IE)预后的诊断性价值。方法和结果:自入院至第10周,测定129例IE患者(共发作134例次)的CR P、红细胞沉降率(ESR)和白细胞计数(W BC)。入院后第3个月评价心脏外科手术的需求和最终预后。对数据进行广泛的统计学分析。无并发症的康复患者血清CRP和W BC下降显著快于发生并发症或随后死亡的患者,但ESR无类似改变。第10周时CRP水平正常的80例患者中,无1例死于IE;第4周时CRP水平正常的22例患者中,无1例需行心脏外科手术;第6周时CRP水平正常的33例患者中,只有两例需行心…     

未足月特发性羊水过少的临床处理及妊娠结局

目的 探讨未足月特发性羊水过少的临床处理、妊娠结局以及二者之间的关系.方法 选择2009-2013年在温州医科大学附属第一医院产前检查的晚孕单胎妊娠孕妇(28～36+6周),按照羊水指数(AFI)进行分组:羊水过少组(27例)、羊水偏少组(47例)及羊水正常组(70例).对羊水过少组及偏少组给予补液治疗,对3组的妊娠结局以及补液治疗效果与妊娠结局的关系进行比较.结果 ①母体结局:补液治疗总有效率51.35％.补液治疗明显延长羊水偏少组的妊娠时间.早产为主要的并发症.羊水过少组的早产发生率为37.04％,主要为医源性早产.羊水过少组及羊水偏少组均以剖宫产为主要的终止妊娠方式,且2组的引产率均明显增加.②围产儿结局:羊水过少组围产儿不良结局发生率最高,为44.44％.羊水过少组新生儿体重最低.但如果期待治疗至37周后分娩,则3组围产儿不良结局发生率差异无统计学意义.③治疗效果与妊娠结局的关系:妊娠并发症发生率及剖宫产率与治疗效果无关,治疗有效孕妇早产及围产儿不良结局发生率明显降低、可维持的妊娠时间及新生儿体重明显增加.结论 有效的补液治疗对于改善未足月特发性羊水过少的妊娠结局可能是有益的.治疗有效及≥37周后分娩对未足月特发性羊水过少妊娠结局的改善可能有一定的预测作用.     

关节镜下等离子射频治疗尺骨鹰嘴滑囊炎

目的探讨关节镜下等离子射频治疗尺骨鹰嘴滑囊炎手术。方法选择难治性尺骨鹰嘴滑囊炎病例18例,应用关节镜辅助下经皮等离子消融气化,治疗滑囊炎。结果关节镜辅助下等离子射频气化治疗18例术后均无感染复发,无血管神经损伤等并发症。结论关节镜下等离子射频治疗尺骨鹰嘴滑囊炎,是一种操作安全、有效的治疗方法。     

12例坐骨结节滑囊炎的手术治疗

[背景]观察坐骨结节滑囊炎切除术的临床疗效.[病例报告]12例对保守治疗无效或反复发作的坐骨结节滑囊炎患者行滑囊切除术,无复发、感染及发生其他并发症病例.[讨论]坐骨结节滑囊炎应与坐骨神经痛相鉴别,一般经保守治疗多数可治愈,保守治疗无效或反复发作者应行滑囊切除术.     

鼻内镜咽囊手术疗效观察

目的:探讨鼻内镜咽囊手术的疗效,并观察术后创面的变化。方法:鼻内镜手术治疗咽囊炎12例、咽囊囊肿8例。术后第3天起用生理盐水冲洗鼻腔、鼻咽,每周鼻内镜下观察创面的变化。结果:治愈12例,有效6例,无效2例。术后创面白膜在2~3周内脱落。结论:鼻内镜手术治疗咽囊炎、咽囊囊肿疗效较好、创伤小。     

Management and outcome of brain abscess in renal transplant recipients

Although infection is the commonest central nervous system complication following renal transplantation, brain abscess is uncommon. Over the last 11 years, five renal transplant recipients who had brain abscesses were treated by computed tomography (CT)-guided stereotactic aspiration. Three patients had a fungal abscess, one a tuberculous abscess and the other had a methicillin-resistant Staphylococcus aureus abscess. One patient required a craniotomy for the excision of a fungal abscess which was persistent after two CT-guided stereotactic aspirations. The survivors in this group are the patient with a tuberculous abscess who is alive and well 5 years after diagnosis, and another with a dematiaceous fungal abscess (phaeohyphomycosis). CT-guided stereotactic surgery is minimally invasive, and can safely be performed in these patients. It often leads to an aetiological diagnosis in renal transplant recipients with brain abscesses. Specific antibiotic management directed towards the causative organism rather than empirical treatment can be instituted following the procedure. Although the ultimate prognosis in these patients is bleak even with specific antibiotic therapy, an occasional patient might have a good outcome with prompt and appropriate therapy.     

Osteomyelitis and infective endocarditis.

Osteomyelitis is thought to occur as a complication of infectious endocarditis in as many as 6% of cases of endocarditis. We describe this association in three patients. Osteomyelitis may be difficult to diagnose in patients with endocarditis because symptoms such as fever, bone pain and stiffness are common to both illnesses, therefore physicians need to have a high index of suspicion to avoid missing this important complication. We recommend that patients with endocarditis and persistent or localized musculoskeletal symptoms should be investigated to exclude osteomyelitis. Plain radiographs can be normal in 50% of cases of osteomyelitis in the early stages or show only minor abnormalities, but bone scans are highly sensitive. We suggest that a bone scan is performed if radiography is unhelpful, since a diagnosis of osteomyelitis can effectively be excluded if the bone scan is normal. We advocate close follow-up of these patients with prolonged antibiotic treatment consisting of at least 6 weeks of intravenous therapy, and 3 months or longer of oral therapy.     

感染性心内膜炎的诊断和外科治疗

目的：总结134例感染性心内膜炎的病理特点和外科治疗经验,以期更好地掌握手术时机和指征,提高对该病的诊治水平．方法：回顾性分析2002-07／2008-09我院感染性心内膜炎手术患者134（男91,女43）例,年龄9mo～68岁,病史16d～27mo．继发于先天性心脏病102例,风湿性瓣膜病29例,无基础心脏病3例．临床主要表现包括发热、气急、寒战、贫血、水肿、皮肤瘀斑和动脉栓塞．超声心动图检查提示128例患者有心内膜赘生物形成,血培养阳性29例（29／112）．全组均在体外循环下通过外科手术清除感染病灶及赘生物,并同期处理瓣膜病变和修复心内畸形．术后继续应用抗生素6～8wk．结果：手术死亡1例,早期死亡8例．125例痊愈出院．随访92例,随访时间2～96（68．6±19．1）mo,感染均未见复发．心功能恢复至Ⅰ级73例,Ⅱ级19例．结论：感染性心内膜炎应做到早期诊断,适时而妥善的外科手术和内科联合治疗可获良好效果．