膝关节骨性关节炎的非手术疗法

膝关节骨性关节炎是常见的骨骼肌肉系统疾病之一 ,其发病原因为多方面。主要表现为关节功能减退、关节疼痛。尽管手术治疗方法和技巧较以前有了较大提高 ,但并不是每个患者都适合于手术。非手术疗法越来越受到重视 ,但实行连续、规律的治疗计划是困难的 ,本文只对与本病有关的主要非手术疗法作一简介。一、药物疗法　药物治疗在膝关节骨性关节炎治疗中占有重要地位 ,常用药物有以下几种 :1止痛剂 ;2非甾体类消炎药 ;3软骨营养类药物 ;4甾体类消炎药。给药途径有口服、外用和关节灌洗。最常用的止痛药物是扑热息痛 (对乙酰氨基酚 ) ,2 0 0 0…     

带血管蒂腓骨头骨骺截骨整形重建内踝的应用解剖与临床应用

Objective To provide an anatomical basis for repairing the medial malleolus with bone-severed vascularized fibular head epiphysis, and to explore the effect of clinical application with this method. Methods Figures of fibular head and medial malleolus were measured on 20 fresh lower limbs specimens of child age from 2 to 12 years old, then bone-severed formula was deduced. The bone-severed composite fibular head epiphysis to repair the defect of medial malleolus were carried for 6 child patients of emergency or post-poned cases on one stage. Obersved the clinical effect by following-up. Results The angle between fibular head and stem (M) was(170±8)°, angle of fibular head sadacc(N) was (145 ±6)°, length(1.5±0.2)cm and width (1.4±0.2)cm; angle between medial malleolus and stem(1) was(152±8)°, length of the articular surface of medial malholus was(1.25 ± 0.2)cm and width (1.25 ± 0.2)cm. Angle between defect surface and tibia was(Q). Formula: angle of bone-severing X = L-N-Q, and apex at the upper 1/6 of the reversed articular surface of fibular. 6 cases with this method was completed, all healed at stage one, following-up 1 to 3 years, medial malleolos developed well and no epiphysis ossification anticipation, and the ankle joint has no inversion with its loadind and walking function good. Conclusion The fibular head epiphysis and the medial malleolus differ in shape to some extent, but good donor can be got by bone-severing, can repair the epiphysis and soft tissue defect of the medial malleolus at one stage with additional flap, developing with the child at the same time, it is a perfect method to reconstruct the traumatic defect of child medial malleohs.     

硝普钠、艾司洛尔用于嗜铬细胞瘤手术病人的血液动力学观察

嗜铬细胞瘤患者因肿瘤分泌的内源性儿茶酚胺不同，其临床表现、术前准备、术中肿瘤摘除前后血液动力学变化及麻醉处理均有差异…。血管扩张药硝普钠(SNP)和β1肾上腺素能受体阻滞剂艾司洛尔(Esmolol)已成功用于该手术。本文拟观察两种药物对嗜铬细胞瘤术中血液动力学的影响及肿瘤摘除后血液动力学的变化特点。     

干扰素、转移因子防治反复呼吸道感染的疗效观察

我院 1998年 1月～ 2 0 0 1年 6月符合反复呼吸道感染(ＲＲＴＩ)诊断标准的门诊患儿 2 40例 ,对 12 0例采用干扰素、转移因子治疗 ,效果较好 ,现报告如下。对象与方法一、对象及分组　均符合 1987年 4月成都会议制定的ＲＲＴＩ诊断标准[1] 。随机分为两组 ,应用干扰素、转移因子治疗的 12 0例为观察组 ,常规方法治疗的 12 0例为对照组。ＲＲＴＩ每年 7～ 2 0次以上。两组年龄、性别、症状和体征、感染疾病、合并症及ＲＲＴＩ次数等临床资料相比 ,具有可比性。二、治疗方法　观察组给干扰素 (深圳科兴生物制品有限公司生产 ,批号 :19970 711)…     

旋髂浅动脉穿支嵌合骨皮瓣修复四肢骨与软组织缺损

目的 探讨旋髂浅动脉穿支嵌合骨皮瓣修复四肢骨与软组织缺损的应用特点.方法 2008年2月至2009年4月应用旋髂浅动脉穿支嵌合骨皮瓣修复四肢骨与软组织缺损5例,男4例,女1例;年龄22～44岁,平均31.2岁.车祸伤3例,机器挤压伤2例.掌骨2例,足2例,腓骨1例.皮肤缺损面积5 cm×2 cm～16 cm×5 cm.骨瓣切取范围2 cm×1 cm×0.8 cm～8 cm×2 cm×0.5 cm,皮瓣切取范围6cm×3 cm～18 cm×6 cm.血管吻合除1例动脉端侧吻合外,均采用端端吻合方式.骨瓣以钢板螺钉固定4例,克氏针固定1例.结果 1例术后第2天出现动脉危象,探查后发生皮瓣边缘浅表性坏死,经植皮愈合,其余皮瓣全部存活.供区伤口8～27 d愈合.全部患者随访8～19个月,皮瓣外观满意,无须特殊保护.骨愈合时间3～6个月.髋部外形轮廓未改变,无髋区疼痛,无瘢痕增生.修复手部缺损者患手恢复握持功能,基本恢复对掌功能;修复下肢缺损者患肢可负重,无疼痛.结论 旋髂浅动脉穿支嵌合骨皮瓣供区损伤小,是修复小面积骨缺损,尤其是合并较大范围软组织缺损的一种较好方法.     

手术后恶心呕吐的研究进展

手术后恶心和呕吐(postoperative nausea and vomiting,PONV)最为常见,其发生机制可能和脑干催吐中枢接受体内一些 催吐信号的刺激有关。影响PONV发生的因素众多,临床上单一用药在预防和治疗PONV可能难以达到预期效果,而联合用药可能 阻断引起PONV的多个病因,从而达到治疗目的。     

带血管蒂腓骨头骨骺截骨整形重建内踝的应用解剖与临床应用

Objective To provide an anatomical basis for repairing the medial malleolus with bone-severed vascularized fibular head epiphysis, and to explore the effect of clinical application with this method. Methods Figures of fibular head and medial malleolus were measured on 20 fresh lower limbs specimens of child age from 2 to 12 years old, then bone-severed formula was deduced. The bone-severed composite fibular head epiphysis to repair the defect of medial malleolus were carried for 6 child patients of emergency or post-poned cases on one stage. Obersved the clinical effect by following-up. Results The angle between fibular head and stem (M) was(170±8)°, angle of fibular head sadacc(N) was (145 ±6)°, length(1.5±0.2)cm and width (1.4±0.2)cm; angle between medial malleolus and stem(1) was(152±8)°, length of the articular surface of medial malholus was(1.25 ± 0.2)cm and width (1.25 ± 0.2)cm. Angle between defect surface and tibia was(Q). Formula: angle of bone-severing X = L-N-Q, and apex at the upper 1/6 of the reversed articular surface of fibular. 6 cases with this method was completed, all healed at stage one, following-up 1 to 3 years, medial malleolos developed well and no epiphysis ossification anticipation, and the ankle joint has no inversion with its loadind and walking function good. Conclusion The fibular head epiphysis and the medial malleolus differ in shape to some extent, but good donor can be got by bone-severing, can repair the epiphysis and soft tissue defect of the medial malleolus at one stage with additional flap, developing with the child at the same time, it is a perfect method to reconstruct the traumatic defect of child medial malleohs.     

拇趾腓侧皮瓣修饰再造手指的应用解剖学研究

目的剖析拇趾腓侧皮瓣修饰再造拇手指的应用解剖,改进切取拇趾腓侧皮瓣计算公式。方法对30例侧成人下肢标本和60例侧足趾移植病例的跖背、跖底血管进行解剖,对趾底动脉进行分型。对先期修饰性再造的14指的挛缩皮瓣进行研究,改进拇趾腓侧皮瓣计算公式。结果提出跖背动脉细浅支的存在,跖背动脉细浅支的出现率为17.8%,转归分为Ⅰ、Ⅱ、Ⅲ型。趾底固有动脉来源分为Ⅰ、Ⅱ、Ⅲ、Ⅳ型。拇趾腓侧皮瓣再植后挛缩度约15%,按改进后的计算公式切取的皮瓣克服了挛缩弊端。结论拇趾腓侧皮瓣的主要供血源为趾底动脉,跖背动脉细浅支不足以为拇趾腓侧皮瓣供血。改进后的皮瓣修饰再造的拇手指外形接近手指。     

中西医结合治疗毛细支气管炎28例

中西医结合治疗毛细支气管炎２８例原阳县人民医院儿科（４５３５００）路崇峰，刘学胜，贾平我科自１９９３年１月至１９９５年５月收治毛细支气管炎４６例．报告如下。临床资料一般资料所有婴儿年龄均≤６个月，平均３．６个月。男：女＝１．２：１。西医治疗组中，人工...     

带血管蒂腓骨头骨骺截骨整形重建内踝的应用解剖与临床应用

Objective To provide an anatomical basis for repairing the medial malleolus with bone-severed vascularized fibular head epiphysis, and to explore the effect of clinical application with this method. Methods Figures of fibular head and medial malleolus were measured on 20 fresh lower limbs specimens of child age from 2 to 12 years old, then bone-severed formula was deduced. The bone-severed composite fibular head epiphysis to repair the defect of medial malleolus were carried for 6 child patients of emergency or post-poned cases on one stage. Obersved the clinical effect by following-up. Results The angle between fibular head and stem (M) was(170±8)°, angle of fibular head sadacc(N) was (145 ±6)°, length(1.5±0.2)cm and width (1.4±0.2)cm; angle between medial malleolus and stem(1) was(152±8)°, length of the articular surface of medial malholus was(1.25 ± 0.2)cm and width (1.25 ± 0.2)cm. Angle between defect surface and tibia was(Q). Formula: angle of bone-severing X = L-N-Q, and apex at the upper 1/6 of the reversed articular surface of fibular. 6 cases with this method was completed, all healed at stage one, following-up 1 to 3 years, medial malleolos developed well and no epiphysis ossification anticipation, and the ankle joint has no inversion with its loadind and walking function good. Conclusion The fibular head epiphysis and the medial malleolus differ in shape to some extent, but good donor can be got by bone-severing, can repair the epiphysis and soft tissue defect of the medial malleolus at one stage with additional flap, developing with the child at the same time, it is a perfect method to reconstruct the traumatic defect of child medial malleohs.