闭合治疗Colles骨折伴下尺桡关节损伤

ｏｌｅｓ骨折伴下尺桡关节损伤并不少见，如不能及早发现及时治疗，往往会影响手的握力和前臂旋转功能的恢复。１９９４～１９９７年，我们采用手法整复，前臂旋后腕背伸位“Ｕ”型石膏外固定的方法治疗新鲜的Ｃｏｌｅｓ骨折合并下尺桡关节损伤，经随访观察，效果满意。现...     

老年股骨转子间骨折围修复期隐性失血量与内固定植入物及性别的关系

BACKGROUND: With the continuous renewal and development of clinical repair techniques, the intraoperatie  blood loss has been greatly reduced in the treatment of intertrochanteric fracture; however, no matter what kind of repair methods should be adopted, there are still a large amount of perioperative hidden blood loss, however, there are few clinical reports for the reasons and related factors. OBJECTIVE: To study the correlation of perioperative hidden blood loss with gender and internal fixation methods in the surgery of elderly femoral intertrochanteric fractures． METHODS: Totally 121 patients with elderly femoral intertrochanteric fractures who received the treatment at Department of Orthopedics, Nanyang City Center Hospital from March 2010 to June 2013 were divided into two groups according to the condition and treatment wishes of patients, and were respectively treated with dynamic hip screw and proximal femoral anti-rotation intramedullary nail internal fixation. The preoperative hidden blood loss, postoperative hidden blood loss, the total hidden blood loss, dominant blood loss and total blood loss of patients in these two groups were compared. The multiple linear regression analysis on the correlation of perioperative hidden blood loss with gender and internal fixation methods was conducted. RESULTS AND CONCLUSION: There was no significant difference in the preoperative hidden blood loss between these two groups (P > 0.05). The total blood loss, postoperative hidden blood loss and total hidden blood loss in the proximal femoral anti-rotation intramedullary nail group were significantly higher than those in the dynamic hip screw group (P < 0.05), and the dominant blood loss was significantly lower than that in the dynamic hip screw group (P < 0.05). There were significant differences in the preoperative, postoperative hidden blood loss and total hidden blood loss between males and females (P < 0.05), and above indexes in males were significantly lower than in females. The multiple linear regression analysis showed that gender and internal fixation methods were correlated with hidden blood loss (P < 0.05). These results suggest that the perioperative hidden blood loss in surgery for elderly femoral intertrochanteric fractures is closely related to gender and above indexes in internal fixation methods. The perioperative hidden blood loss of male patients is less than that of female patients, and the patients treated with proximal femoral anti-rotation intramedullary nail fixation have more hidden blood loss than dynamic hip screw fixation.      

椎旁封闭致全脊髓麻醉2例报告

椎旁封闭是临床用于治疗各种原因引起的神经痛的良好方法,但操作不当,常可引起严重的合并症。本院近期发生2例引起全脊髓麻醉者,报告如下。〔例1〕李某,女,45岁。因右上肢带状疱疹引起神经疼痛,第5次在我科门诊行颈椎旁封闭,取坐位,颈屈曲伏于椅背上。用8号注射针头在C_(5～6)椎间右侧旁开1.5cm处垂直进针,第1次针进入2/3时,有血液回流,考虑损伤椎动脉。拔出后向中心移0.5 cm再次进针,针进入2/3时,患者右上肢产生触     

大剂量地塞米松诱发癫痫二例

大剂量地塞米松引起癫痫大发作,目前尚未见报道。我们遇到二例,择其一例报道如下: 患者张×,男,10岁,因单纯性肾病综合征,给予强的松60mg/日分三次口服,以及青霉素,维生素、利尿剂等治疗。后改用地塞米松9mg/日分三次口服至第8周,又     

胃窦部腺鳞癌一例

患者,女,59岁。上腹胀痛不适,消瘦乏力6个月,经胃镜检查诊断胃癌入院行胃癌根治术,切除标本送病理检查,大体:次全胃,于窦部小弯侧见一巨大溃疡型肿块,9cm×8cm,边缘窿起,底部深2.5cm,外观灰褐色,切面灰白,质较粗糙,无光泽;肿瘤边缘至切除缘间粘膜完好,小弯及大弯侧淋巴结肿大。光镜:肿瘤由鳞癌和腺癌组成。鳞癌为主区,癌呈巢状分布,细胞异型明显,奇异核及瘤巨细胞多见,核分裂象不多,个别细胞角化,而无角珠形成;腺癌区,部分呈乳头状。     

高位腓动脉穿支供养的远端蒂腓肠神经营养血管皮瓣治疗足踝部软组织缺损的临床分析

目的探讨高位(外踝上8cm)腓动脉穿支供养的远端蒂腓肠神经营养血管皮瓣修复足踝部软组织缺损的临床效果.方法2004年2月~2011年12月对33例各种原因造成的小腿远端及足踝部软组织缺损采用该皮瓣进行修复.男25例,女8例.年龄7个月~76岁,平均32岁.缺损部位:外踝部10例,内踝部7例,足背部8例,足跟及足底部8例.结果8例术后3~7天皮瓣轻度肿胀,7天后肿胀逐渐消退,所有皮瓣全部成活.术后随访3~12月,平均随访5个月,皮瓣不臃肿,外形良好,供区功能无障碍.结论应用高位(外踝上8cm)腓动脉穿支供养的远端蒂腓肠神经营养血管皮瓣修复小腿远段及足踝部软组织缺损,效果较好,简单方便,实用.     

泊沙康唑主环的单晶制备及其结构表征

目的制备泊沙康唑主环的单晶,并对其进行结构表征和稳定性研究。方法通过溶剂挥法及气相扩散法制备出泊沙康唑主环的单晶,采用差示扫描量热仪(DSC)、粉末X射线衍射仪(PXRD)和单晶X射线衍射仪(SXRD)对其结晶形态进行表征。结果上述方法均可制备泊沙康唑主环单晶,其DSC和PXRD图谱一致,即晶型一致。SXRD结果表明泊沙康唑主环不对称单位化学计量式为C_(21)H_(21)F_2N_3O_4S,相对分子质量为449.47,晶体密度为1.408 g/cm~3,该晶胞属于单斜晶系,空间群为P2_1。均浆稳定性实验结果表明,不同极性溶剂中得到的晶体PXRD图谱未发生变化。结论实验确证了泊沙康唑主环的立体构型,且稳定性良好。     

高效液相色谱法测定阿昔洛韦眼用凝胶中阿昔洛韦含量

目的采用高效液相色谱法测定阿昔洛韦眼用凝胶中阿昔洛韦含量。方法以Hepersil C18不锈钢柱(250 mm×4 mm,5μm)为色谱柱,以水-甲醇-冰醋酸(92∶8∶0.1)流动相,检测波长为252 nm,流速为1.0 mL/min,柱温为室温(25℃),进样量20μL。结果阿昔洛韦质量浓度在12～32μg/mL范围内与峰面积线性关系良好(r=0.999 9),平均回收率为99.94%,RSD=0.48%(n=6)。结论该方法可有效控制阿昔洛韦眼用凝胶中阿昔洛韦的含量,方法简单、结果准确、灵敏度高。     

以McBride手术原理为主要方法矫治Ⅳ型复拇指术后后遗畸形

[目的]探讨小儿 Wassel Ⅳ型复拇术后畸形的矫正方法.[方法]自2002年2月～2008年12月,应用McBride手术原理结合综合矫治的方法,治疗Ⅳ型复拇术后遗畸形32例36指.[结果]32例36指,术后进行1～5年(平均28个月)随访,按TAM评定法优良率为100%,拇指外形及功能均取得满意效果.[结论]应用以McBride手术原理为主要方法矫治该型畸形,手术设计合理、操作简单,可取得较好疗效.     

复方氨息香酊的制备和含量测定

目的制备复方氨息香酊,建立其含量控制标准并进行疗效观察。方法以苯甲酸、樟脑、薄荷脑为主药制备成酊剂,采用高效液相色谱法测定复方氨息香酊中苯甲酸和樟脑的含量;采用气相色谱法测定薄荷脑的含量。结果高效液相色谱法中苯甲酸和樟脑分别在0．032-0．160、0．008-0．040mg·mL^-1线性关系良好。气相色谱法中薄荷脑在0．4～1．6mg·mL^-1线性关系良好。结论本组方合理、制备工艺可行,质控方法可靠,临床疗效确切。