颈椎前路减压异体骨笼植入术

目的:评价颈椎前路环钻法减压、异体骨笼植入融合术的临床疗效.方法:采用椎间盘切除、异体骨笼植入治疗颈椎椎间盘病变患者60例,男25例,女35例;年龄37～72岁,平均47岁.并对其治疗结果进行分析.结果:60例患者平均随访23.2个月,不但临床症状得到改善,而且取得了骨愈合,并能维持颈椎解剖关系,无局部及全身异常反应.结论:颈椎前路环钻法减压、异体骨笼植入是具有应用前景的新方法.     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

胸椎骨质疏松椎体新鲜压缩骨折椎体成形术的临床研究

目的探讨胸椎骨质疏松新鲜压缩骨折椎体成形术的临床治疗效果和手术注意事项。方法在C型臂X线机监视引导下,对61例胸椎骨质疏松性新鲜椎体压缩骨折患者经皮穿刺椎体成形术（PVP）。共对93个椎体（61例）进行了PVP手术。术后第1天、1周、一月、三月、半年对疼痛缓解进行随访和评价。结果各椎体内骨水泥注射剂量2．5～4ml．术中未发生并发症,术后疼痛明显缓解或消失者54例。VAS术前评分8．42±1．96,术后2．76±1．64。术前与术后比较,统计学有显著性差异（P〈0．01）;术后各时间点VAS评分比较,统计学无显著性差异（P〉0．05）。结论经皮穿刺椎体成形术是一种治疗胸椎骨质疏松新鲜椎体压缩骨折缓解疼痛快速、安全、有效的方法,但也是一种相对高风险的手术。     

后路全脊柱截骨病灶清除、植骨内固定治疗胸椎结核

目的 探讨后路全脊柱截骨病灶清除、植骨内固定治疗胸椎结核的临床效果.方法 21例胸椎结核患者采用后路切除椎板、双侧椎弓根后椎体病灶完全清除,分两侧斜植骨、后路固定.结果 随访18～70月,平均38月,10例神经损伤病人不同程度恢复,X线检查见全部患者于术后3～9月(平均7.5月)植骨融合,均恢复正常生活与工作.结论 经后路全脊柱截骨病灶清除、植骨内固定治疗胸椎结核,具有病灶清除彻底,无需开胸手术,术后恢复快等优点,是治疗脊柱结核的有效术式.     

病毒性肝炎并发急性胰腺炎24例临床预后分析

目的 探讨病毒性肝炎并发急性胰腺炎的临床特点和预后.方法 回顾性分析近8年收治的24例病毒性肝炎并发急性胰腺炎患者的临床表现、实验室检查以及预后等方面的资料.结果 24例患者中,重型肝炎合并急性胰腺炎者14例,其中好转者4例,恶化者10例;非重型肝炎合并急性胰腺炎患者10例,全部好转出院.HBV相关者21例,好转13例,恶化者8例;HEV相关者7例,全部恶化,其中3例病情加重自动出院,4例死亡.结论 病毒性肝炎合并急性胰腺炎容易误诊.重型肝炎并发急性胰腺炎时预后明显差于非重型肝炎并发急性胰腺炎.HEV相关感染合并急性坏死性胰腺炎者的预后亦差于HBV相关感染合并急性坏死性胰腺炎者.     

三种疗法治疗尖锐湿疣150例临床分析

目的观察三种不同方法治疗外生殖器和肛周尖锐湿疣的疗效。方法150例尖锐湿疣患者分别采用单纯咪喹莫特、单纯电灼、电灼联合白细胞介素-Ⅱ治疗。结果疣体数目和面积差值在治疗后各组之间有明显差异,治疗后长期效果比较,单纯咪喹莫特治愈率为92%,与电灼加白细胞介素-Ⅱ治疗效果相类似,单纯电灼治疗后期复发率较高。结论咪喹莫特乳膏治疗尖锐湿疣疗效确切,使用方便,安全性好,局部炎症反应轻微,适合外生殖器及肛门周围表浅尖锐湿疣的治疗。     

不稳定Hangman骨折的手术治疗

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures.     

股骨近端抗旋髓内钉内固定治疗不稳定性股骨粗隆间骨折及粗隆下骨折

目的评价股骨近端抗旋髓内钉（PFNA）内固定治疗不稳定性股骨粗隆间骨折及粗隆下骨折的疗效及并发症。方法自2007年12月至2009年3月,采用PFNA内固定治疗不稳定性股骨粗隆间骨折及粗隆下骨折患者37例。结果平均手术时间48士11min,术中平均出血量70±15ml。所有病例获随访6～13个月,平均8个月。全部患者术后4．5个月内（平均3个月）达到临床骨折愈合标准,无骨折不愈合、内固定松动断裂及术后感染病例。按Harris髋关节功能评分,优24例,良10例,可3例,优良率为91．9％。结论PFNA内固定技术治疗不稳定性股骨粗隆间骨折及粗隆下骨折安全可靠,简便实用,疗效满意。