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The objective of the present study was to evaluate the clinical, radiological, and functional outcomes of a subscapularis transthoracic surgical approach and a posterolateral surgical approach with debridement, bone graft fusion, and internal fixation for the treatment of upper thoracic tuberculosis.There is currently debate over the best surgical approach for the treatment of upper thoracic tuberculosis. Traditionally, the subscapularis transthoracic approach has been preferred; however, the posterolateral approach has gained popularity in the past few years.A prospective, consecutive cohort of 43 upper thoracic tuberculosis patients with a mean age of 39 years (range: 20–52 years) was followed up for a minimum of 12 months (range: 12–60 months). Patients were randomly divided into 2 groups. Group A (n = 21) was treated by the subscapularis transthoracic approach and group B (n = 22) was treated by the posterolateral approach. All cases were evaluated for clinical, radiological, and functional outcomes. Intraoperative blood loss, operative duration, intraoperative and postoperative complications, hospital stay, the cure rate, fusion time, and the Frankel scale were used for clinical and functional evaluation, whereas the kyphosis angle was used for radiological evaluation.Grafted bones were fused by 10 months in all cases. There was no statistically significant difference between groups before surgery in terms of gender, age, segmental tuberculosis, erythrocyte sedimentation rate (ESR), Frankel scale, or Cobb''s angle (P > 0.05). The average operative duration for Group B was lower than that of Group A. There were no significant differences in intraoperative blood loss, intraoperative and postoperative complications, hospital stay, grafted bone fusion time, or cure rate between groups (P > 0.05). The Cobb''s angle correction rate for group B (68.5%) was significantly better than that of group A (30.9%). The neurological score showed significant postoperative improvement in both groups, with no significant difference between the groups.The subscapularis transthoracic approach and the posterolateral approach with debridement, bone graft fusion, and internal fixation are both sufficient and satisfactory for the surgical treatment of upper thoracic tuberculosis. However, the posterolateral approach is superior to the subscapularis transthoracic approach in terms of surgical trauma, operative time, and kyphosis correction. 相似文献
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目的 探讨员工援助计划服务对心内科护士职业认同感、职业价值观、职业压力的影响。 方法 选择2018年1-3月我院心内科护理人员58名,为其实施员工援助计划服务,评价实施前后心内科护士的职业认同感、职业价值观、职业压力感知、职业压力反应。 结果 实施后,心内科护士工作压力源各维度评分、压力感知与压力反应各维度得分均较实施前下降(P<0.05);职业价值观各维度及职业认同感各维度评分均较实施前显著提高(P<0.001)。 结论 员工援助计划可提高心内科护士职业认同感、职业价值观,缓解其职业压力感知以及职业压力反应。 相似文献
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Wen Wang Yanmei Liu Chuan Yu Jing Tan Weiyi Xiong Duo Dong 《Expert opinion on drug safety》2020,19(3):339-347
ABSTRACTObjectives: Limited evidence has suggested that cefoperazone-sulbactam causes coagulation disorders and bleeding.Methods: The authors conducted a retrospective study to compare patients receiving cefoperazone-sulbactam versus those treated with cefoperazone-tazobactam or ceftazidime. Propensity-score matching was used to explore whether treatment with cefoperazone-sulbactam increased the risk of prothrombin time (PT) prolongation, coagulation disorders, and bleeding, or decreased platelets (PLT).Results: The cohort included 23,242 patients. Among patients receiving cefoperazone-sulbactam, the risk of PT prolongation, coagulation disorders, decreased PLT, and bleeding was 5.3%, 9.2%, 15.7%, and 4.2%, respectively. Propensity-score matching analyses suggested that cefoperazone-sulbactam increased the risk of PT prolongation (aOR 2.26, 95% CI 1.61–3.18), coagulation disorders (aOR 1.81, 95% CI 1.43–2.30), and decreased PLT (aOR 1.46, 95% CI 1.25–1.72), but not increase bleeding (aOR 1.05, 95% CI 0.79–1.40) compared with ceftazidime. Patients receiving cefoperazone-sulbactam had higher risk of PT prolongation (aOR 1.53, 95% CI 1.11–2.10), coagulation disorders (aOR 1.53, 95% CI 1.21–1.95), but not decreased PLT (aOR 0.93, 95% CI 0.81–1.07) or bleeding (aOR 1.11, 95% CI 0.87–1.42), compared with those receiving cefoperazone-tazobactam.Conclusion: Cefoperazone-sulbactam may be associated with a higher risk of PT prolongation and coagulation disorders compared with cefoperazone-tazobactam and ceftazidime. 相似文献
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目的:综述运动系统软组织损伤引起慢性疼痛的各种治疗方法的研究进展。资料来源:应用计算机检索Medline1980—01/2006—04与运动系统软组织损伤引起慢性疼痛的治疗相关文章,检索词“Soft tissue injury,pain.chronic,comprehensive therapy”,并限定文章语言种类为“English”;同时计算机检索中国期刊全文数据库1994—01/2006-04期间的相关文章,检索词“软组织损伤、慢性疼痛、治疗方法”,并限定语言种类为中文。同时手工查阅相关书籍。资料选择:对资料进行初审,所选文献内容符合:①软组织损伤引起的慢性疼痛药物治疗的研究。②软组织损伤引起的慢性疼痛微创治疗的研究。③软组织损伤引起的慢性疼痛运动疗法的研究。④软组织损伤引起的慢性疼痛心理治疗的研究。⑤软组织损伤引起的慢性疼痛其他疗法的研究。排除重复性研究的文献。资料提炼:共收集到40篇关于软组织损伤引起的慢性疼痛治疗方法的文献,均为全文,23篇符合纳入标准,排除17篇重复性研究。同时录入书籍3本。资料综合:软组织损伤引起的慢性疼痛的产生是生理、心理及社会因素复杂结合的结果,个体表现差异较大,目前尚无特效治疗方法,常用的治疗方法有:药物治疗、微创治疗、运动疗法、心理治疗、物理疗法及其他疗法。结论:对于软组织损伤引起的慢性疼痛的治疗必须以整体的观点对其进行合理的评估和个体化治疗,才能收到良好的效果。 相似文献
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胰岛素使用方法的研究进展 总被引:11,自引:0,他引:11
胰岛素治疗是糖尿病治疗的重要内容,也是使糖尿病患者血糖达标的有效方法。严格的血糖控制对糖尿病慢性并发症的预防和延缓发生有重要意义,然而目前各国的糖尿病血糖控制达标率均不足50%。患者甚至包括医生对低血糖的恐惧是启动胰岛素治疗和达到最佳胰岛素治疗的主要障碍之一。 相似文献