鼻出血的治疗(附79例病例分析)

目的：总结鼻出血的治疗经验，分析治疗中可能存在的问题，探讨各种治疗措施在处理鼻出血中的意义。方法：对近6年来住院治疗的鼻出血病人79例进行回顾分析。结果：79例均治愈，治疗手段包括前后鼻孔填塞、内镜下激光烧灼、颈外动脉和/或筛前动脉结扎、经上颌窦颌内动脉结扎或数字减影血管造影颌内动脉栓塞等。结论：治疗鼻出血的关键是找淮出血部位及明确出血原因，并根据病人实际情况采取有效止血措施。     

经前路短节段固定矫形治疗青少年特发性脊柱侧弯的探讨

Objective To review our results of anterior approach of treating adolescent idiopathic lumbar and thoracic scoliosis with short-segment instrumentation. Methods Sixty-two cases of adolescent id-iopathic lumbar and thoracic scoliosis treated in our department from Jan 2002 to Dec 2007 were retrospec-tively analyzed. There were 39 cases of adolescent idiopathic lumbar scoliosis with Cobb angle from 45° to 75° (average 53.6°) and 23 cases of that with Cobb angle from 43° to 72° (average 51.7°). Detailed clinical and imaging assessment of each case were carried out. Lung function tests were performed to determine the vital capacity. Balloon blowing training was carried out for those with lung function less than 50% of normal The fixed segments and the scope of integration were prepared with preoperative imaging information. Results All patients were successfully operated on. The average correction rate for each group was 84.1% and 84.7% respectively. The complications included one spontaneous hemothorax,8 sympathetic trunk injury, one flatback deformity. Conclusions The anterior correction of scoliosis with short-segment instrumentation has minimal perioperative and long-term complications.     

急腹症术后短期内再手术的教训

腹部手术后早期再手术是临床常见情况,不论是急症还是择期性手术,都有可能发生。一旦发生,处理上非常棘手,对病人的预后关系甚大。我院1992年1月～1998年12月间施行腹部急症手术986例,其中术后短期内(4天内)再手术9例,占0.91%。本文分析其再手术原因,以吸取教训。1　临床资料1.     

康复训练及物理方法配合椎间盘镜治疗腰椎间盘突出症

目的 探讨椎间盘镜下髓核摘除术后配合物理方法治疗腰椎间盘突出症的效果及有关问题。方法 对120例患者经后路椎板在椎间盘镜下行髓核摘除术，术后采用一系列康复训练和物理措施。结果 手术操作时间30～120min．平均住院8d，门诊随访3～6个月。按有关标准评定其疗效，优108例，良9例，中3例，差0例，优良率达97．5％，治愈率90％。结论 椎间盘镜髓核摘除术．配合康复物理方法治疗腰椎间盘突出症，具有创伤小、出血少、脊柱力学结构完整、住院时间短、疗效高、恢复快、患者痛苦小、乐于接受等优点，应用前景广阔。     

损伤控制性手术理论在重症创伤患者中的应用

<正>损伤控制性手术(damage control surgery,DCS)较早应用于创伤患者,随着DCS理论在创伤患者的应用,重症创伤患者的治愈率逐渐提高,死亡率明显下降。现将本院2011年1月救治的2例重症腹部创伤病例资料报道如下。     

CT诊断脾结核一例

病例资料患者,女,36岁,左上腹胀痛1年余,近期加重,无咳嗽咳痰、发热盗汗、乏力等不适,否认结核家族病史,无其它部位不适。体查:左侧季肋部膨隆,脾肋下3cm扪及脾脏,有压痛;听诊心肺未见异常。实验室检查:WBC 6.5×109/l,RBC3.38×1012/l,HB 83g/l,PLT 130.5×109/l,ESR 3.0mm/h;     

三种高分子材料预防术后腹膜粘连效果比较

本实验旨在对Fe^3＋改性羧甲基纤维素（Fe^1＋ -CMC）、透明质酸钠、几丁聚糖3种高分子材料预防术后腹膜粘连的效果进行比较。 一、材料与方法1．动物与方法：健康Wister大鼠120只，体重（220＋30）g，雌雄不拘，随机均分为4组，各组均为10只，[第一段]     

Early total hip arthroplasty for severe displaced acetabular fractures

Objective ： To investigate the effect of early total hip arthroplasty for severe displaced acetabular fractures. Methods： Total hip arthroplasty was performed on 17 cases of severe fracture of the acetabulum from 1997 to 2003. The mean follow-up was 2.1 years（ 1-6 years） and the average period from fracture to operation was 8 days （5-21 day）. The average age of the patients was 53 years （ 26-69 years）. Restdts： At the final follow-up the Harris hip score averaged 82（69-100） points and 15 cases have got a good outcome. There was one case of heterotopic bone formation. There were no radiographic evidences of lateloosening of the prosthesis. One patient had severe central displacement of the cup. Conclusions： In patients with severe displaced acetabular fractures, particularly in elderly patients, early total hip arthroplasty is probably an alternative efficient way to achieve a painless and stable hip.     

微创小切口技术在全髋置换术中的应用

目的探讨微创小切口技术在全髋置换术中的方法和临床应用价值。方法22例27髋行微创小切口技术全髋置换术,记录切口长度、术中出血量、手术时间、术后引流量、住院天数、早期下地活动时间、并发症以及Harris评分等。结果手术切口长度平均8·5cm、术中出血量平均350ml、平均手术时间75min、术后24h引流量平均120ml、平均住院天数12d、无一例出现严重并发症、Harris评分平均96分。结论微创小切口技术行全髋关节置换术,具有确实可行、创伤小、出血少、瘢痕小、愈合快、关节功能恢复快等优点,是一种值得积极推广的手术方法。