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目的探讨锁定钢板治疗Neer三部分及四部分肱骨近端骨折的疗效。方法回顾分析2008年7月-2011年5月,采用切开复位、锁定钢板内固定治疗并获12个月以上随访的77例Neer三部分及四部分肱骨近端骨折患者的临床资料。男39例,女38例;年龄18~81岁,平均54.2岁。致伤原因:跌伤47例,交通事故伤16例,高处坠落伤4例,运动伤5例,其他原因5例。受伤至手术时间2~16 d,平均4.5 d。骨折根据Neer分型标准:三部分骨折54例,四部分骨折23例。随访评估患者肩关节功能Constant评分、疼痛视觉模拟评分(VAS)及相关并发症。结果术后76例切口Ⅰ期愈合,1例Ⅱ期愈合。患者均获随访,随访时间12~36个月,平均18.5个月。末次随访时,Constant评分为(71.1±11.9)分;获优18例,良24例,中25例,差10例,优良率为54.5%。VAS评分为(2.8±2.2)分。2例患者发生骨不连;余患者骨折均愈合,愈合时间2~6个月,平均3.2个月。术后25例患者发生并发症,发生率为32.5%;15例行二次手术,二次手术率为19.5%。结论对于Neer三部分及四部分肱骨近端骨折应争取解剖复位、稳定固定、减少肱骨头血供破坏,以获得良好疗效。 相似文献
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Background Proper rotational alignment during total knee arthroplasty (TKA) is important for adequate postoperative patellofemoral and tibiofemoral kinematics, as well as for achieving balanced flexion space at 90º. The effects of computer navigation-assisted total knee replacement and conventional total knee arthroplasty on rotational alignment, mechanical axis, component position and clinical outcomes were compared.
Methods Two methods were used in 82 patients and the rotation of the femoral and tibial components in the transverse plane, the combined rotation of the two components, the mismatch between them, and the mechanical axis of the lower limb were analyzed. All of these parameters were measured from postoperative radiographs and computed tomography images. Functional outcomes were compared at 6 weeks and 6 months postoperatively.
Results Significant differences were found between the two techniques (P <0.05) in the following parameters: average rotation of the femoral component ((1.51±3.55)º vs. (−0.63±3.04)º); combined rotation of the femoral and tibial components (2.85±4.07)º vs. (0.28±3.43)º); and mismatch between the femoral and tibial components ((1.44±4.55)º vs. (−0.43±2.86)º). Differences in the rotation of the tibial component were not statistically significant. The prevalence of outliers (malalignment >±3° internal/external rotation) of the femoral component (31.7% vs. 12.5%) and the tibial component (36.6% vs. 15%) were significantly reduced when the navigation system was used (P <0.05). In addition, while patients in the navigation group had significantly better mechanical axis and functional outcomes at 6 weeks after surgery (P <0.05), there was no significant difference between the two groups (P >0.05) with respect to functional outcomes at 6 months.
Conclusion The navigation system exhibited higher accuracy than the conventional technique in the transverse and coronal plane, and provided better early functional outcomes.
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目的研究对重症肺炎合并呼吸衰竭患儿进行早期经鼻持续气道正压通气的临床效果。方法选取2012年2月至2014年2月期间由我院收治入院的小儿重症肺炎并发呼吸衰竭患儿69例,根据患儿是否进行经鼻持续气道正压通气治疗进行分组分对照组和治疗组。对照组则进行常规治疗及普通氧疗,治疗组则在基础常规治疗上早期应用经鼻持续气道正压通气的呼吸支持治疗,比较两组患儿的治疗前后心率、呼吸、血气等各项生理指标。结果数据显示,对照组在治疗前后心率、呼吸、血氧饱和度、血p H值无显著差异,而血中二氧化碳含量明显升高;治疗组心率、呼吸、血氧饱和度、血p H值都有很明显的改善。治疗组患儿的治愈率、住院时间明显高于对照组。结论对小儿重症肺炎合并呼吸衰竭的患儿进行早期的经鼻持续气道正压通气治疗非常有临床意义,值得在临床上推荐使用。 相似文献
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20世纪80年代后,中国已对出生缺陷进行积极研究。进入新世纪后,国家科技部全面启动出生缺陷预防的基础性研究和应用性研究,提出了要经济有效地降低出生缺陷发生的风险,要进行监测、调研,掌握基线资料, 相似文献
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目的回顾分析血清学产前筛查高风险孕妇产前诊断结果,以科学指导高风险孕妇采用合理的产前诊断措施。方法对2015年1月-2017年3月杭州市单胎妊娠孕妇进行中孕期二联法血清学产前筛查,计算21三体综合征(Down's Syndrome,DS)、18三体综合征风险率,并对产前筛查结果为高风险的孕妇进行羊膜腔或脐血穿刺,确定染色体核型并分析。结果在送检的2 440例血清筛查高风险孕妇中,包括DS高风险2 221例、18三体高风险157例、DS高风险伴高龄30例、DS高风险伴异常妊娠史25例和DS高风险伴超声异常8例,构成比分别为91.03%、6.39%、1.23%、1.02%和0.33%。羊水细胞培养染色体结果为染色体正常核型2 001例、多态性变异342例、非整倍55例和结构异常42例,构成比分别为82.01%、14.02%、2.25%和1.72%。在非整倍体中检出率排前三位的是DS高风险伴高龄组、18三体高风险和DS高风险伴异常妊娠史的孕妇,其检出率分别为13.33%、9.62%和4.00%。结论 DS高风险伴其他高风险的孕妇比单纯的DS高风险孕妇,其检出胎儿染色体异常的概率增大,因此产前筛查高风险孕妇应加强产前诊断意识。 相似文献
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静脉超声造影彩色多普勒检查淋巴结的初步体会 总被引:5,自引:1,他引:5
经静脉注射Levovisi(利声显)超声造影已广泛应用在腹部及心脏等器官,本研究将肝、脾超声造影余下的少量利声显尝试应用在肿大的淋巴结,现总结如下。 相似文献