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991.
992.
993.
目的总结瓣膜置换患者行胆道手术的术前用药方法。方法对38例瓣膜置换后在服用华法令过程中因胆道疾病需行择期手术治疗的患者随机分为2组,肝功能正常组(A组)23例、肝功能不正常组(B组)15例均于术前3d停服华法令,B组术前12h肌注VitK110mg。术前无应用华法令历史的患者115例做为对照组。结果38例患者停药2d后A组血浆凝血酶原时间与对照组差异无显著意义,B组于术前12h肌注VitK110mg后,血浆凝血酶原时间与对照组相比差异也无显著性意义。结论瓣膜置换患者在抗凝期间行胆道手术,只要准备充分,围手术期是安全的。 相似文献
994.
995.
Antegrade interlocking nailing of humeral shaft fractures 总被引:5,自引:0,他引:5
George Petsatodes Dimitrios Karataglis Pericles Papadopoulos John Christoforides John Gigis John Pournaras 《Journal of orthopaedic science》2004,9(3):247-252
The results of 39 humeral shaft fractures (37 patients) treated with antegrade locked nailing using a Russell–Taylor nail were reviewed. There were 30 acute fractures, 6 fractures malaligned in a hanging cast or brace, and 3 pathological fractures. Patient age ranged from 26 to 80 years (average, 59.7 years) and average follow-up was 25.7 months (range, 6–48 months). Fracture union was achieved in 92.3% of our cases, while shoulder function was excellent or good in 87.2% of cases. Antegrade locked nailing offers a dependable solution for the treatment of humeral shaft fractures, especially in polytrauma patients and cases of segmental or pathological fractures. Far less satisfactory results were obtained in comminuted fractures of the proximal third in the humerus, especially in osteoporotic patients, and we therefore advocate caution with the use of intramedullary nailing in this type of fracture. Certain technical aspects such as avoiding nailing the fracture in distraction, properly countersinking the tip of the nail, and achieving adequate fixation stability have been found to be of paramount importance to reduce the incidence of delayed union/non-union rate and to obtain better functional results from the shoulder joint. 相似文献
996.
Sadao Ii Hiroyuki Tsuchiya Koutaro Takazawa Hiroshi Minato Katsuro Tomita 《Journal of orthopaedic science》2004,9(2):152-156
Adamantinoma is a rare low-grade malignant bone tumor with an indolent course. The tibia is involved in 85%–90% of long-bone cases. We encountered a patient with primary adamantinoma of the proximal femur. A 60-year-old woman fell and fractured her proximal left femur in the area of a cystic lesion. She underwent an osteosynthesis procedure, and bone union was obtained. After 3 years she developed pain in the left thigh, and a radiographic abnormality was found at the fracture site. A metastatic bone tumor was suspected, and curettage and cementing were carried out. Histologically, we found an epithelial component but failed to detect any primary cancer. Local recurrence became evident after another 6 years. A marginal excision was performed and a bipolar femoral prosthesis was implanted. We finally diagnosed the patient with adamantinoma. In this report we describe the characteristics of this tumor and discuss the reasoning concerning the differential diagnosis and therapeutic plan. 相似文献
997.
目的 探讨腔内技术治疗尿流改道术后输尿管肠代膀胱吻合口狭窄的临床应用价值.方法 膀胱癌尿流改道术后输尿管肠代膀胱吻合口狭窄患者9例,狭窄段长度1~3 cm,均采用腔内技术治疗,顺行经皮肾处理8例,逆行输尿管镜处理1例;术中使用高压气囊配合筋膜扩张器扩张,术后留置双J管.结果 随访0.5~5.0年.1例吻合口闭锁患者术后3个月仍为重度积水,患者拒绝开放手术而长期留置肾造瘘管;8例患者肾积水减轻,再次逆行扩张狭窄段并留置双J管,其中5例经2~3次扩张换管,拔除双J管后复查肾积水稳定于轻度状态;3例拔除双J管后腰痛不适,需要长期留置双J管.结论 尿流改道术后输尿管肠代膀胱吻合口狭窄腔内技术治疗效果良好,可避免开放手术的风险. 相似文献
998.
Koichi Fujiu Ryuzo Kanno Yutaka Shio Jyun Ohsugi Yoshihiro Nozawa Mitsukazu Gotoh 《General thoracic and cardiovascular surgery》2004,52(7):345-348
A 36-year-old woman complained of cough and high fever. Computed tomographic scans demonstrated a mediastinal mass. A couple of months later, she developed dryness in her eyes and mouth. Biopsy of the lip confirmed the diagnosis of Sjögren’s syndrome. She underwent thymo-thymomectomy. Pathological findings of the mass revealed thymoma. At two months after surgery, she developed ptosis and dysphagia that were compatible with myasthenia gravis. The clinical symptoms were adequately controlled with prednisolone. At eleven months after surgery, she presented with severe anemia, which led to the diagnosis of pure red cell aplasia. The following treatment with cyclosporin caused hemoglobin concentration to rise. However, she continues to suffer from dryness of her eyes and mouth. The case is the first to be reported with Sjögren’s syndrome and the triad of thymoma, myasthenia gravis and pure red cell aplasia, and is compared with previously reported cases of the three conditions. 相似文献
999.
脑干、三叉神经及大脑动脉环的可视化研究 总被引:2,自引:0,他引:2
目的 建立人体脑干、三叉神经及大脑动脉环的可视化数字模型。方法 采用首例中国数字化可视人体数据集,在SGI工作站上对脑干及其周围毗邻结构进行计算机三维重建并立体显示。结果 获得人体脑干、三叉神经及大脑动脉环等器官组织的三维重建结构,可对其进行任意径线和角度的适时三维测量。结论 首例中国数字化可视人体数据集能够提供完整而精确的解剖断面数据,脑干及其毗邻的三叉神经、大脑动脉环的可视化模型准确反映出该区域复杂的解剖学结构特点及其相邻器官间的空间毗邻关系,可为该区域的疾病的影像诊断和外科治疗提供形态学依据。 相似文献
1000.
目的 探讨骨间后动脉血管变异时前臂背侧皮瓣的切取方法.方法 以骨间后动脉为蒂逆行岛状皮瓣转移修复手部皮肤软组织缺损时,遇到血管变异共9例,采取以骨间后动脉桡侧支为蒂切取逆行岛状前臂背侧皮瓣、以骨间后动脉近端为蒂切取游离骨间后动脉皮瓣、以骨间后动脉穿支为蒂切取游离前臂背侧穿支皮瓣等方法,进行皮瓣转移或移植修复手部创面.结果 9例皮瓣中有8例顺利存活;1例术后2 d皮瓣远端出现肿胀、青紫、小水泡,及时对症处理,5 d后部分皮缘形成干痂,皮瓣颜色恢复正常,脱痂后存活.9例随访3个月至2年,皮瓣质地柔软,弹性好,外形满意.结论 以桡骨间后动脉侧支为蒂的前臂背侧皮瓣逆行转移,以骨间后动脉近端或骨间后动脉穿支为蒂的前臂背侧皮瓣游离移植修复手部创面,是解决骨间后动脉血管变异较理想的方法. 相似文献