手术治疗锁骨骨折79例临床分析

目的 探讨锁骨骨折切开复位内固定方式。方法2005年1月～2009年1月,锁骨骨折不同方式切开复位内固定79例。结果79例随访0．5～4年,钢板断裂1例,余均骨性愈合,肩关节功能良好。结论锁骨干接骨板治疗锁骨骨折有优点．术者手术操作及术后护理是关键。     

不同方法治疗锁骨骨折的疗效分析

目的探讨不同治疗方法对锁骨骨折的治疗效果。方法对168例锁骨骨折的病历资料进行回顾性分析。结果168例锁骨骨折,有146例效果良好,4例骨不连,18例畸形愈合。结论各种治疗方法各有优、缺点,其中以克氏针钢丝张力带固定,记忆合金环抱式接骨板内固定、锁骨钩钢板固定治疗锁骨骨折,具有固定可靠、关节功能恢复快等优点。     

锁骨骨折内固定术麻醉方法的探讨

锁骨骨折内固定手术的麻醉方法各家意见不一,2005年1—12月我院对40例锁骨骨折病人采取两种不同的麻醉方法,进行了观察比较,现报告如下。     

重建钢板在锁骨骨折中的应用(附27例报告)

探讨重建钢板内固定在治疗锁骨骨折中的临床作用。分析我院近2年采用重建钢板内固定治疗锁骨骨折27例的结果，评价其疗效和方法，认为对不稳定的锁骨骨折，只要没有手术禁忌证，均可选用切开复位，重建钢板内固定。     

生物内固定治疗锁骨斜形骨折17例

锁骨骨折以往多采用克氏针加钢丝捆绑内固定。2001-2003年，我们采用生物内固定治疗锁骨斜形骨折17例，手术方法简便，避免了二次手术折除内固定，效果满意。     

改良克氏针加PDS缝线治疗锁骨骨折

采用克氏针内固定加PDS缝线治疗锁骨骨折62例,本文探讨内固定治疗锁骨骨折的方法。     

锁骨骨折后3次内固定一例

锁骨骨折是临床常见病,占全身骨折的5％～10％[1].锁骨骨折内固定指征基本一致:保守治疗无效、骨折移位明显[2].临床实践中锁骨骨折内固定大多能够愈合,不愈合病例较少[3],但“内固定-不愈合-再内固定-再不愈合-第三次内固定+植骨-愈合”的病例罕见.笔者对1例锁骨骨折2次内固定后依然没有愈合患者进行治疗,随访3年骨折愈合、功能恢复满意.现报告如下.     

形状记忆合金环抱器在锁骨骨折不愈合中的临床应用

治疗锁骨骨折过去认为应以非手术治疗为主，近年临床观察发现，非手术治疗并发症多，效果不确切，锁骨骨折手术治疗越来越多，锁骨内固定术后骨折不愈合也引起人们注意。2000年1月-2006年1月我院收治23例锁骨骨折不愈合患者使用形状记忆合金环抱器内固定加植骨治疗，效果满意，现报告如下。     

肩胛骨骨折合并锁骨骨折治疗方法探讨

目的探讨肩胛骨骨折合并锁骨骨折的治疗方法. 方法 23例肩胛骨骨折合并锁骨骨折的患者,13例行保守治疗,2个月后进行肩关节功能锻炼;10例行锁骨骨折、肩胛骨骨折切开复位重建钢板内固定,术后4周进行肩关节功能锻炼. 结果 23例患者骨折全部愈合.18例获随访,其中手术治疗8例,保守治疗10例,随访时间8～16个月,平均12个月.手术患者7例肩关节功能恢复优良,1例可;保守治疗患者6例肩关节功能恢复优良,3例可,1例差. 结论肩胛骨骨折合并锁骨骨折切开复位内固定,恢复了肩关节的动力平衡及稳定性,可早期进行功能锻炼,是一种较好的治疗方法.     

高海拔地区手法复位外固定及克氏针内固定治疗锁骨中段骨折的疗效评价

锁骨骨折手术或非手术治疗的文献报道很多,但有关在高海拔环境下应用石膏绷带外固定和切开复位内固定治疗锁骨中段骨折的疗效评价未见有报道。我院地处海拔2800m地区,气候寒冷、干燥．氧分压低,自1996年1月-2001年11月间收治49例锁骨中段骨折患者,手法复位、石膏绷带外固定23例,切开复位克氏针内固定术26例,现将疗效评价如下。     

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.