不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

Closed reduction and intramedullary nailing versus open reduction and locking plate fixation in treatment of middle and upper humeral fractures北大核心CSCD

Objective To compare closed reduction and intramedullary nailing versus open reduction and locking plate fixation in the treatment of middle and upper humeral fractures. Methods A retrospective case-control study was conducted to analyze the clinical data of 62 patients with middle and upper humeral fracture who had been treated at Department of Orthopaedics, The First People's Hospital of Jinmen and at Department of Orthopedics, General Hospital of PLA Central Theater from October 2017 to February 2021. There were 35 males and 27 females, aged from 27 to 86 years. The left side was affected in 24 cases and the right side in 38 cases. All fractures were fresh. According to the AO classification, 16 cases were type A, 32 type B, and 14 type C. Of the patients, 29 were treated with closed reduction and intramedullary nailing (intramedullary nail group) and 33 with open reduction and locking plate fixation (locking plate group). The length of incision, operation time, intraoperative blood loss, hospital stay, fracture healing and complications were recorded and compared between the 2 groups. The pain degree was evaluated by visual analogue scale (VAS) at one week and one month after operation, and the functional recovery of the shoulder was evaluated by Constant-Murley score at one month and 12 months after operation. Results There was no significant difference in the preoperative general data between the 2 groups, showing comparability (P>0.05). The intramedullary nail group was followed up for 12 to 29 months and the locking plate group for 15 to 50 months. In the intramedullary nail group, the length of incision [(4.1±0.7) cm], operation time [(58.3±7.7) min], intraoperative blood loss [(52.7±6.5) mL], and hospital stay [(7.3±1.5) d] were significantly less than those in the locking plate group [(21.7±2.3) cm, (95.8±11.7) min, (237.4±14.9) ml, and (12.3±1.7) d] (P<0.05). The fracture healing time in the intramedullary nail group was (5.0±1.9) months, significantly longer than that in the locking plate group [(3.5±1.7) months] (P<0.05). The VAS scores at one week and one month after operation in the intramedullary nail group [(2.8±0.3) points and (1.2±0.5) points] were significantly lower than those in the locking plate group [(4.3±0.4) points and (1.6±0.5) points], and the Constant-Murley score at one month after operation in the intramedullary nail group [(63.5±7.4) points] was significantly higher than that in the locking plate group [(54.3±6.9) points] (P<0.05). However, at 12 months after operation, there was no significant difference in the Constant-Murley score between the 2 groups (P>0.05). In both groups, the VAS score at one month after operation was significantly lower than that at one week after operation while the Constant-Murley score at 12 months after operation was significantly higher than that at one week after operation (P<0.05). In the intramedullary nail group, intraoperative distal refracture happened in one case; in the locking plate group, incision infection occurred in one case and postoperative radial nerve injury in another. There was no significant difference in the incidence of complications between the 2 groups [3.4% (1/29) versus 6.1% (2/33)] (P>0.05). Conclusion In the treatment of middle and upper humeral fractures, compared with open reduction and locking plate fixation, closed reduction and intramedullary nailing shows advantages of a smaller surgical incision, shorter operation time, less intraoperative blood loss, shorter hospital stay and faster functional recovery. © The Author(s) 2022.     

膝关节后交叉韧带断裂治疗临床分析

目的 对35例膝关节后交叉韧带断裂治疗进行临床分析,重点探讨了有关交叉韧带断裂的治疗问题。方法 经明确诊断后,分析采用胫骨附着处撕脱骨折复位固定手术治疗26例、早期髌韧带中1／3移植重建3例、单纯长腿石膏固定6例。结果 本组病例全部进行随访,随访时间13个月－5年,胫骨附着处撕脱骨折复位固定及髋韧带中1／3移植重建29例为优良、单纯长腿石膏固定6例为差。结论 后交叉韧带断裂后应该及时给予手术修复;膝后外侧手术入路,操作简单,暴露充分;少于3个月的陈旧性病例仍适应手术治疗。     

不同方法重建指尖离断静脉回流的疗效分析

目的：探讨不同方法重建指尖离断静脉回流的疗效。方法：2008年3月-2013年2月收治指尖离断患者80例,38例吻合指侧方静脉重建回流,术中吻合动静脉比例1：1或1：2或2：2,平均1：2;22例吻合指腹静脉重建回流,术中吻合动静脉比例1：1;20例未吻合静脉,术中仅吻合1条动脉,行侧切口或甲床放血。观察各组治疗效果。结果：吻合指侧方静脉组手指全部成活,无一例发生回流障碍;吻合指腹静脉组19例发生静脉危象,其中4例手指坏死;未吻合静脉组20例均发生回流障碍,其中6例手指坏死。58例获随访,随访时间6~28个月。吻合指侧方静脉组32例,指尖外形佳、指腹饱满;吻合指腹静脉组14例,指体轻度萎缩,指甲生长不平整;未吻合静脉组12例,指体萎缩明显。吻合指侧方静脉组指甲生长近平整,长度长于其他两组[（14.4±3.2）mm比（12.5±2.3）mm和（12.2±2.2）mm],远侧指间关节活动度大于其他两组[（63±5）°比（48±3）°和（45±7）°],两点分辨觉小于其他两组[（4.6±0.4）mm比（7.1±1.2）mm和（7.3±0.6）mm],感觉级别高于其他两组[S（3.45±0.39）级比S（2.57±0.42）级和S（2.55±0.49）级],差异均具有显著性（P〈0.05）。吻合指腹静脉组和未吻合静脉组在指甲长度、运动和感觉方面差异无统计学意义（P〉0.05）。结论：吻合指侧方静脉能有效解决指尖再植静脉回流问题,可避免回流障碍,成活率高,促进指甲生长,可恢复 DIPJ 活动度及感觉。     

胫骨干骨折的手术治疗对策

目的：明确不同固定器械在胫骨干不同骨折类型固定中的特点，以指导临床应用。方法：68例胫骨干骨折，行加压钢板螺钉、交锁髓内钉、单侧外固定架固定后，作临床疗效分析。结果：加压钢板固定组42例，感染5例，骨不连1例，平均愈合时间3．8个月；交锁髓内钉固定组13例，无感染及骨不连，平均愈合时间5．4个月；单侧外固定架组13例，骨不连1例，踝关节背伸受限3例，平均愈合时间4．5个月。结论：胫骨骨折交锁髓内钉固定并发症少，功能恢复好，适用范围广，但要注意及时进行动力加压。加压钢板及外固定架固定应选择各自的最佳适应证，以达到理想的疗效。