双通道脊柱内镜在颈椎胸椎疾病手术中的应用

<正>随着脊柱微创手术的发展和病人对快速康复的需求,以脊柱内镜手术为主的精准微创技术的临床应用愈来愈普遍,双通道脊柱内镜(unilateral biportal endoscopy, UBE)逐渐成为治疗腰椎管狭窄症、腰椎滑脱症和腰椎间盘突出症等疾病的有效治疗方式。UBE技术组织损伤小、恢复快、效率高和围手术期并发症发生率低[1-3]。与单轴脊柱内镜系统不同,UBE手术具有观察通道和工作通道,器械内镜独立,手术视野较大,手术操作效率较高,     

蛆虫清创治疗机制的研究进展

近年来,由于抗生素的滥用,蛆虫清创治疗（maggot debridement therapy, MDT）重新回到人们的视野。MDT的清创效率和精确度优于任何外科医师,同时还具有良好的抗菌作用及促愈合作用,能有效对抗耐药菌群,促进难愈性创面的愈合。在过去几十年内,世界范围内就MDT各方面的作用机制,一直不够明确。本文就近年来MDT清创、抗菌、促愈合等机制的研究进展做一综述。     

冠脉正常者双层探测器能谱CT静息态心肌灌注成像的作用

目的 探讨双层探测器能谱CT在冠脉正常者静息态心肌灌注成像的作用。 方法 对156例疑似冠心病患者行双层探测器能谱CT冠状动脉血管造影及静息态心肌灌注成像检查,对28例冠脉正常者进行静息态心肌灌注成像的测量。根据美国心脏协会 17段心脏节段分析方法,分别在碘密度图、有效原子序数图像上测量心肌各节段(心尖除外)的碘密度值及有效原子序数值,同时记录主动脉根部的碘密度值及有效原子序数值,并对所得数据进行定量分析。 结果 左室中部层面各节段的碘密度值及有效原子序数差异有统计学意义(P均<0.001),基底部层面及心尖部层面心肌各节段的碘密度值及有效原子序数差异无统计学意义(P均>0.05)。结论 双层探测器能谱CT可以定量分析心肌各节段的碘浓度和有效原子序数,冠脉正常者左心室中部层面各节段的灌注不同。     

Prospective study of transsphenoidal pituitary surgery; is tumor volume a predictor for the residual tumor?

Background: The presence of residual tumor after surgery for pituitary adenoma may necessitate further treatment. The suprasellar and parasellar extension of the tumor have been widely considered as the predictors for residual tumor. However there is scarcity of studies regarding the preoperative tumor volume and residual tumor. This study was conducted to evaluate if tumor volume could predict the outcome of transsphenoidal pituitary surgery. Methods: A prospective study was designed and 48 patients who underwent transsphenoidal pituitary surgery within 1 year in the first affiliated hospital of Xi’an Jiaotong University were included in this study. The preoperative tumor volume and immediate postoperative tumor volume (within 4-7 days) were calculated in the contrast magnetic resonance imaging by using the formula of ellipsoid. All these volumes were divided into three subgroups, i.e. group 1, group 2 and group 3 with preoperative volume of less than 4 cm3, 4-8 cm3 and more than 8 cm3 respectively. The parasellar and suprasellar extension of the tumor were also classified by Knosp and modified Hardy’s classifications. Results: Baseline characteristics were comparable. The preoperative tumor volume of more than 8 cm3 (group 3, 12.1±1.1 cm3) had increased risk on postoperative tumor residue (P<0.01) than the other two groups (2.1±0.3 cm3 and 6.1±0.3 cm3 in groups 1 and 2). The mean postoperative volume in group 3 patients (2.2±0.1 cm3) was significantly higher than the other two groups (P<0.01). Conclusion: Preoperative volume of more than 8 cm3 can be considered as a predictor for postoperative residual volume.