Damage control of multiple injuries headed by cervica spinal cord injury

Objective ： To explore the strategy of damage control in clinical treatment of multiple injuries headed by cervical spinal cord injury. Methods： A retrospective analysis was performed in 32 patients. Cervical fractures associated with tetraplegia occurred in 18 patients, traumatic intervectebral disk hernia associated with tetraplegia in 2 patients, and cervical fractures and dislocation associated with tetraplegia in 12 patients. Seventeen cases were combined with craniocerebral injury, 7 combined with pulmonary contusion, multi-fractures of rib or hemopneumothorax, 2 combined with pelvic fracture and other 8 combined with fracture of limbs. The neural function was assessed by the American Spinal Injury Association （ASIA） scale. Results： Thirty-one patients were followed up for an average of 14 months. Of them, 10 got complete recovery, 13 obtained improvement of more than one ASIA grade, 8 did not improve, and 1 died. Conclusions ： For the emergency treatment of multiple injuries headed by cervical spinal cord injury, the damage control strategy is the principle to follow. The final operations are preferably performed within 5 to 10 days after injury so as to raise the successful rate of remedy.     

采用内外固定联合技术分阶段治疗陈旧性CⅠ、Ⅱ型骨盆骨折

目的总结联合应用骨盆外固定和内固定术分期分阶段治疗陈旧性CⅠ、Ⅱ型骨盆骨折的疗效。方法 2011年3月-2013年7月共收治6例陈旧性CⅠ、Ⅱ型骨盆骨折患者,男性4例,女性2例;年龄24-62岁,平均55岁。道路交通伤4例,高处坠落伤2例。受伤时间3周-2个月,均合并有不同程度其他组织脏器损伤。X线及CT检查示耻骨联合分离,其中2例分离间距＆gt;2.5cm,骶骨骨折未有骶髂关节分离脱位CⅠ型4例;骶骨骨折伴骶髂关节分离脱位CⅡ型2例。一期先采用外固定支架逐渐加压复位前环,纠正旋转不稳定,同时配合骨牵引纠正垂直不稳定,二期再行前后环内固定治疗。结果术后切口均Ⅰ期愈合,6例均获随访,随访时间5-26个月,平均15.5个月。术后患者主观感觉均较术前好转,骨折骨性愈合。术后对复位情况按Matta评分：优4例,良1例,中1例;对功能恢复情况按Majeed评分：优4例,良1例,中1例。结论联合应用骨盆外固定分阶段加压复位前环以及纠正垂直移位和切开复位重建钢板以及髂腰间椎弓根螺钉内固定治疗陈旧性CⅠ、Ⅱ型骨盆骨折,具有创伤小,出血少,术后恢复快等优点,取得了良好的治疗效果。     

Ollier病刮除后脱钙骨基质植入1例

患者叶某，男，27岁，司机。40天前因跌伤左腕部而摄X线片始发现左桡骨下1/3病理性骨折，无移位，同时发现左食指近节、左肱骨中上段骨质囊性病变，先后在黔、成都、重庆多家医院就诊，初步诊断均为“骨纤维结构不良”，未作特殊处理，于90年6月收住我科。查体：一般情况良好，左上肢较对侧短5cm，肱     

兔耳增生性瘢痕的形态学观察与羟脯氨酸含量变化

Inrecentyears，excessivedermalhyperplasiafollowingtotalskinlossofrabbit＇seariswidelyreportedbydomesticandforeignre－searchers．Histologicalstudiesshowexcessivedermalhyperplasiahascloserelationwithhypertrophicscarofhuman犤１－２犦．Characteristicsofcollagenmetabolismandmorphologicalchangeslawaboutexcessivedermalhyperplasiaremainunclear．Theinvolvedmechanismistheobjectiveofthisstudy．１Materialandmethod１．１Treatmentandcreationofwoundsinanimals８Japaneselarge－earrabbitsregardingnogenderwerei…     

成人肱骨近端骨折53例分析

我院1980年12月至1989年10月收治成人肱骨近端骨折53例,现将随访结果分析报告如下.临床资料一、一般资料本组53例中男30例,女23例.年龄17～86(平均44.2)岁,50岁以上28例(占52.8%).伤因:跌伤27例,车祸10例,坠落伤7例,自行车伤4例,机器绞压伤4例,斗殴扭伤1例.伤后入院时间:当天9     

Protective effect of adenovirus-mediated BDNF gene expression on spinal axon following in rats after spinal cord injury

The routine treatments of spinal cord injury are palliative in Practice at Present. Their goal is only to preventthe secondal injeq and the complications, and then thepatients to adapt new life style under palalysis condition.The sprouting and the Plasticity of the neims in foe centlal nervous system (CNS) Of malnlnals has been ProVedll]. It is wen known that the neurntrOPhins facilitatethe renovation and regenerahon of the ne~ns in CNS after injuries. HoweVer the c~ive effect Of the ne…     

紧急救治外科在美军军医培训中的作用

目的 借鉴紧急救治外科(Acute Care Surgery,ACS)在美军军医培训中的经验,对我军机动卫勤分队力量提出建设性意见.方法 通过访问美军三军医科大学和文献调研的方式了解ACS在美军军医培训中的作用,在调研我军机动卫勤分队的基础上对其军医培养方式提出合理化建议.结果 ACS是美国创伤学界建立的一种新的培训模式和创伤外科救治模式,有效地提高创伤外科医师的综合救治水平.ACS的成功模式被美国军方引入培训外科军医,有效地提高军医的综合战伤救治水平.我军机动卫勤分队队员专业过于细化,需要组建多支专业队伍以应对战伤的综合救治.ACS在美军军医培训的成功经验提示可针对现代战伤救治的需求,制定综合培训课程,培养有综合战伤救治能力的军医.结论 建议借鉴ACS的成功经验,培养具有综合战伤救治能力的军医,提高机动卫勤分队外科医师队伍的整体救治能力.