MIPPO技术结合郑氏伤科药物治疗胫骨中下段骨折临床疗效观察

目的：探讨微创经皮钢板内固定(MIPPO)技术结合郑氏伤科药物创伤消肿片及玄胡伤痛片用于治疗胫骨中下段骨折患者对疼痛及其功能恢复的影响。方法：行便利抽样法纳入2020年10月～2022年10月经本院收治的120例胫骨中下段骨折患者，循数字表法随机划分为对照组及观察组，对照组采用MIPPO技术治疗，于对照组基础上，观察组另结合郑氏伤科药物创伤消肿片及玄胡伤痛片治疗，比较两组临床疗效、疼痛缓解情况、功能恢复情况、骨折愈合情况及并发症。结果：经治疗，两组肿胀、疼痛、瘀斑及舌脉评分均有下降，观察组低于对照组(P<0.05);观察组骨折愈合时间短于对照组，骨痂评分高于对照组(P<0.05);经治疗，两组VAS评分均有下降，观察组低于对照组(P<0.05);经Ridit分析，两组AOFAS评分比较，差异有统计学意义(P<0.05);观察组并发症发生率为1.67%,较对照组的11.67%更低，差异有统计学意义(P>0.05)。结论：胫骨中下段骨折患者应用MIPPO技术结合郑氏伤科药物创伤消肿片及玄胡伤痛片治疗可获确切疗效，疼痛获有明显缓解，且功能恢复加快，骨折愈合良好，...     

外固定支架与腓肠肌肌皮瓣联合应用治疗小腿严重创伤

辗轧、挤压、爆炸等高能量损伤致胫腓骨中下1/ 3开放性粉碎性骨折伴软组织缺损 ,临床上治疗十分棘手。作者于 1992年 9月～ 1999年 1月选用外固定支架与腓肠肌皮瓣联合治疗 16例 ,现报告如下。临床资料一、对象 :16例中 ,男 10例 ,女 6例 ;年龄 17～ 6 0岁 ,平均 35岁。急诊入院 1例 ,伤后 7天内入院 12例 ,伤后 3周内入院 3例。 16例均为开放性粉碎性胫腓骨中下 1/ 3骨折 ,并伴有软组织挫伤缺损 ;左侧 7例 ,右侧 9例。其中 3例外院手术后 3周小腿软组织坏死、感染 ,金属内固定物 (钢板、螺钉、钢丝 )及骨外露转入本院。二、方法 :急诊入院…     

肋骨分叉-基底细胞痣-颌骨囊肿综合征两家系基因序列变异分析

两家系肋骨分叉-基底细胞痣-颌骨囊肿综合征先证者均为男性，因X线摄片见颌骨多发低密度影就诊，临床及影像学检查见胸廓畸形、小脑幕及大脑镰钙化、眶距增宽等表现。两例先证者分别检出PTCH1基因位点的c.C2541C>A(p.Y847X)和c.C1501C>T(p.Q501X)杂合突变，对比先证者及其家系相关成员基因序列，结果两例先证者的母亲外周血中均检出PTCH1基因位点的杂合突变，明确该突变均来源于母亲。其中一例先证者临床表现为智力低下，还检出FANCD2基因位点的c.C2141T(p.P714L)和c.G3343A(p.V1115I)杂合突变；另一例先证者智力正常，未发现FANCD2基因突变。两例先证者均行颌骨囊肿开窗减压联合刮治术，随访原病灶处骨质生长状况良好，至今均未见复发。     

腹腔镜下治疗急性胆囊炎的临床观察

目的探讨腹腔镜下治疗急性胆囊炎的临床疗效。方法采用回顾性分析的方法,分析收治的120例急性胆囊炎患者临床资料,依据治疗方式不同分为开腹组和腹腔镜组。结果腹腔镜组患者手术切口长度、手术时间、术中出血量、术后排气时间、术后下床时间、住院时间明显低于开腹组,腹腔镜组切口感染、胆管损伤、胆瘘发生率均明显低于对照组,P<0.05,差异均有统计学意义。但两组临床疗效均为100%,无显著性差异。结论腹腔镜下手术治疗急性胆囊炎患者疗效良好,安全性高,值得临床推广应用。     

全反式维甲酸联合三氧化二砷治疗急性早幼粒细胞白血病临床观察

对16例初治急性早幼粒细胞白血病(APL)患者予全反式维甲酸(ATRA)25 m g/(m2.d),分2~3次口服,二氧化二砷(A s2O3)0.16 m g/(kg.d)静滴。根据外周血白细胞数量、不良反应等调整用量。结果15例完全缓解(CR),1例死亡,取得CR所需时间为(23.7±4.6)d。2例出现不良反应均经对症治疗好转,无1例停药。提示ATRA联合A s2O3治疗APL疗效好,不良反应少,达CR时间短。     

改良式腹壁横切口子宫全切除术108例临床分析

子宫全切除术是妇科常见手术,而钝性分离腹壁组织,改变传统切除子宫步骤,选择良好的医用缝合线,可以明显地缩短手术时间,减少出血,减少并发症,使患者更易接受。     

微创后侧入路肌关节囊瓣重建在人工髋关节置换中的疗效观察

Objective To compare the short-term effects of myocapsular flap repair through minimal posterior approach in Hip arthroplasty with traditional posterior approach in hip arthroplasty in elderly femoral neck fractures. Methods From August 2007 to may 2009, a total of 126 femoral neck fracture patients were randomly divided into two groups, with 63 patients treated with myocapsular flap repair through minimal posterior approach (the modified group), and 63 patients treated with traditional posterior approach (the traditional group). Fifty-eight patients underwent the first-ever total hip replacement and 68 patients underwent artificial double-acting femoral head replacement. Eighty-four cases were inserted with cemented implants and 42 cases with uncemented. Data of incision length, operation time, blood loss volume, drainage amount, blood transfusion volumes were recorded separately. Postoperative complications related to the surgery and hip joint function were also documented. Function of hip joint was scored with Harris scale. All data were statistically analyzed. Results Five patients died within 1 year of surgery, and 4 patients dropped out. All the remained 117 patients were followed up for 12 - 24 months. There were no significant difference in age, type of fracture and artificial the incision length in the modified group was significantly shorter than that in the traditional group([ 10. 5 ± 2. 4 ]cm vs [ 17. 2 ± 3.6 ] cm, t = 3. 012, P = 0. 004). The average operating time was significantly shorter in the modified group compared to the traditional group (t = 2. 455, P = 0. 038). Blood loss, drainage amount, blood transfusion volumes in the modified group were less than those in the traditional group( t = 3.211,2. 986 and 3. 352 ,Ps ＜ 0. 01, respectively). Conclusion Myocapsular flap repair through minimal posterior approach in Hip arthroplasty is a reasonable, mini invasive technique for hip replacement in older with a less blood loss and shorter operating time.fractures     

睾丸扭转14例诊治分析

睾丸扭转又称精索扭转，是泌尿外科常见急症之一，可发生在任何年龄的男性，但好发于青春期和青春前期。Ringdahl等报道25岁以下男性睾丸扭转的发生率约为1／4000，占阴囊急症的35％-40％。由于误诊率高，睾丸切除率高，已经成为青年男性丧失睾丸最主要的原因之一。     

酒精性肝病研究进展

酒精性肝病（alcoholic liver disease，ALD）是由于长期大量饮酒所致的慢性肝脏疾病，是造成人类肝脏损伤的重要原冈之一。在我国，随着人民生活水平的提高．酗酒者增多，ALD发病率迅速上升，在饮酒者中已达到6．1％[1]．成为仅次于病毒性肝病的第二大肝病[2]。对ALD的最新研究进展综述如下。