体外反搏治疗脑外伤200例临床分析

体外反搏(ECP)问世以来,是治疗冠心病的特效医疗设备,我院1990年至1992年,用ECP治疗脑外伤200例,获得满意疗效,现报告如下。1临床资料全部病例随机分为两组,A组为ECP并外科治疗组,200例中,男147例,女53例,年龄7岁～78岁,以16岁～40岁者居多;病程2小时至8个月不等,多数在30天以内;有昏迷史的191例,短者30分钟,长者90天;致伤原因:车祸123例,撞击伤51例,挤压伤14例,坠落伤12例。按Glasgow昏迷评分(GCS)标准,轻型80例,中型70例,重型50例。B组,单纯外科治疗组200例,男155     

急诊复位三翼钉内固定治疗股骨颈骨折远期疗效观察(附58例报告)

本文介绍1976年以来,采用急诊复位传统的闭式三翼钉内固定方法治疗伤后72h以内股骨颈骨折58例.随访时间4～18年(平均11年),不愈合2例,占3.4%;股骨头缺血坏死3例,占5.2%;髋关节功能恢复满意率91.4%.结果表明,对股骨颈骨折的治疗在伤后48h以内效果较好.     

股骨干骨折合并同侧股骨颈骨折手术方法的选择及疗效分析

Objective To investigate clinical features,operative treatments and outcomes of ipsilateral fractures of femoral shaft and neck. Methods Forty-two cases of ipsilateral fractures of femoral neck and shaft were treated from November,2004 to November,2009 in our institution.They were 37 males and 5 females.Their ages ranged from 21 to 84 years,with an average of 59.2 years.The fracture involved 18upper shafts,17 middle shafts and 7 lower shafts.By Garden classification,there were 5 cases of type Ⅰ,10cases of type Ⅱ,21 cases of type Ⅲ,and 6 cases of type Ⅳ neck fractures.All cases were diagnosed in 3days after admission;there were no misdiagnosis or missed diagnosis.Twenty patients were treated by artificialjoint replacement(replacement group),while 22 patients by fixation with cannulated nails,intramedullary nails,or plate(fixation group).Outcomes were compared between the 2 groups. Results All cases were followed up for 1 to 3 years,with an average of 2 years.Femoral neck fractures united between 12 to 20weeks,with an average of 16 weeks;femoral shaft fractures united between 14 to 24 weeks,with an average of 18 weeks.There were significant differences between the 2 groups in average length of hospital stay,ambulation time,blood loss,postoperative activities and good to excellent rate of postoperative joint function(P<0.05).There were no significant differences between the 2 groups in the Merchan scores 1,2,and 3 years after operation for complication-free patients(P>0.05). Conclusion Surgical treatment of ipsilateral fractures of femoral neck and shaft depends on position of the shaft fracture,displacement of the neck fracture,physical constitution and age of the patient to be treated.