模拟全髋关节置换术后两种假体的应力对比分析

对比分析置入解剖型假体和置入传统型假体应力遮挡效应,为临床提供生物力学基础。随机取5个为模拟全髋关节置换术以（北京普鲁士钢研外植入物有限公司）传统型假体置入的股骨组,随机取5个以（德国LINK公司）保留股骨颈解剖型假体置入股骨组。首先在正常股骨标本的各测点上黏贴电阻应变片,进行应变电测量之后,待标本在室温不受力状态下放置24h后,对正常股骨标本分别置入传统型假体、保留股骨颈解剖型假体,分别测出置入传统型假体组和解剖型假体组股骨各测点的应变值,计算各测点的应力值,根据应力遮挡率计算公式,计算应力遮挡率值。置入传统型假体组股骨标本近端1～10号测点应力遮挡率值大于置入解剖型假体组股骨标本近端1～10号测点应力遮挡率值,差异显著（P＜0．05）。解剖型假体和传统型假体具有不同的防应力遮挡效果,保留股骨颈解剖型假体防应力遮挡效果显著。     

穴位注射治疗复发性口腔溃疡40例

目的:观察穴位注射治疗复发性口腔溃疡的疗效。方法:在常规选用华素片、复合维生素B1片、维生素C片的同时又选取双侧曲池、足三里穴位注射维生素B1注射液、维生素B6注射液。结果:总有效率92.5%。结论:针刺两穴能促进白细胞吞噬指数上升,增强其免疫能力,此方法具有清热解毒,调理胃肠,提高机体免疫力的作用。     

微创经皮肾镜碎石取石术治疗复杂性输尿管上段结石的疗效分析

目的探讨微创经皮肾镜碎石取石术在治疗复杂性输尿管上段结石中的疗效。方法回顾性分析180例复杂性输尿管上段结石经微创经皮肾镜治疗的临床资料。结果手术时间80~120分钟,平均（90±10）分钟,一次性手术成功率为100%,一次性结石取净率为99%,术中无附加手术干预,无严重手术并发症。结论微创经皮肾镜碎石取石术治疗复杂性输尿管上段结石具有创伤小、恢复快、结石取尽率高、安全有效等优点,可作为复杂性输尿管上段结石的首选治疗方法。     

极低出生体质量儿闪光视觉诱发电位检测的临床意义

Objective To study the clinical significance of flash visual evoked potential(FVEP)detection in very low birth weight infants.Methods FVEP was performed in group of 43 very low birth weight infants with Medelecsynergy evoked potential instrument(Oxford Company,UK) comparing with the group of 56 term infants.Results The mean latency periods of N1,P1 and N2 waves in very low birth weight infant group were(181.43±26.73) ms,(217.27±26.54) ms,(249.21±26.49) ms respectively,while in term infant group were(159.51±18.27) ms,(200.26±13.94) ms,(231.56±15.72) ms.There were significant differences between two groups(P＜0.05,P＜0,001).The abnormal rates of main wave P1 were 75.6% and 0 respectively in very low birth weight infant group and term infant group.Furthermore,the major effect model for related influencing factors in very low birth weight infants with abnormal main wave was 3.898-2.861 intracranial lesion.Intracranial lesion was the independent risk factor for abnormal FVEP (0R=0.057,95% CI 0.006～0.579,P=0.015).Conclusion The abnormal rate of FVEP is higher in the very low birth weight infants,which is closely related to the intraeranial lesion.It is recomraended that FVEP is detected at least twice in the first month after birth or achieving the corrected gestational age of 42 weeks for dynamic observation.     

极低出生体质量儿闪光视觉诱发电位检测的临床意义

Objective To study the clinical significance of flash visual evoked potential(FVEP)detection in very low birth weight infants.Methods FVEP was performed in group of 43 very low birth weight infants with Medelecsynergy evoked potential instrument(Oxford Company,UK) comparing with the group of 56 term infants.Results The mean latency periods of N1,P1 and N2 waves in very low birth weight infant group were(181.43±26.73) ms,(217.27±26.54) ms,(249.21±26.49) ms respectively,while in term infant group were(159.51±18.27) ms,(200.26±13.94) ms,(231.56±15.72) ms.There were significant differences between two groups(P＜0.05,P＜0,001).The abnormal rates of main wave P1 were 75.6% and 0 respectively in very low birth weight infant group and term infant group.Furthermore,the major effect model for related influencing factors in very low birth weight infants with abnormal main wave was 3.898-2.861 intracranial lesion.Intracranial lesion was the independent risk factor for abnormal FVEP (0R=0.057,95% CI 0.006～0.579,P=0.015).Conclusion The abnormal rate of FVEP is higher in the very low birth weight infants,which is closely related to the intraeranial lesion.It is recomraended that FVEP is detected at least twice in the first month after birth or achieving the corrected gestational age of 42 weeks for dynamic observation.     

封闭负压引流技术在40例GustiloⅢB、ⅢC型胫骨开放性骨折中的应用

目的探讨封闭负压引流技术(VSD)治疗GustiloⅢB、ⅢC型胫骨开放性骨折的临床疗效。方法选择2008年1月至2010年12月泸州医学院附属中医医院骨科收治的GustiloⅢB、ⅢC型胫骨开放性骨折伴皮肤软组织缺损患者77例,经患者知情同意并志愿选择分为实验组和对照组,其中实验组40例行VSD治疗,对照组37例采用常规更换敷料治疗,比较两组的疗效。结果实验组1、2、3个月患者创面细菌转阴及创面愈合情况[15(37.5%)、31(77.5%)、40(100.0%)和8(20.0%)、25(62.5%)、35(87.5%)]均优于对照组[8(21.6%)、17(45.9%)、30(81.1%)和3(8.1%)、10(27.0%)、21(56.8%)],差异有统计学意义(P<0.05)。结论采用VSD治疗GustiloⅢB、ⅢC型胫骨开放性骨折可促进严重皮肤软组织缺损术后的愈合。     

眼底血管荧光素钠造影引起荨麻疹1例报告

1 病历摘要 患者女,42岁,2008年11月28日以“视物模糊”为主诉就诊,门诊初步诊断为“眼底病”建议行“眼底血管荧光造影”进一步明确诊断。患者否认有药物过敏史及心、肝、肾疾病,血压110／80mmHg（1mmHg=0．133kPa）。美多丽散瞳后20min后,取20％荧光素钠0．1ml加生理盐水5ml,     

微创针刀镜佐治难治性膝关节痛风性关节炎42例临床分析

目的:总结微创针刀镜治疗难治性膝关节痛风性关节炎的临床效果。方法:临床纳入2015年3月至2018年3月南方医科大学中西医结合医院收治的难治性膝关节痛风性关节炎患者84例为研究对象,采用回顾性分析常规药物治疗(对照组,n=42)与在上述基础上联合微创针刀镜治疗(研究组,n=42),比较两组患者治疗效果、膝关节功能、疼痛情况及临床各指标水平。结果:与对照组相比,研究组治疗后总有效率明显提高,Lysholm、VAS评分明显增加,UA、CRP以及ESR明显降低,P均0.05。结论:在常规药物治疗基础上,辅以微创针刀镜对难治性膝关节痛风性关节炎治疗效果好,关节功能恢复佳,明显改临床症状和炎性指标,建议临床推广应用。     

超声引导下连续髂筋膜间隙阻滞联合单次坐骨神经阻滞用于老年全膝关节置换术后镇痛的效果

目的评价超声引导下连续髂筋膜间隙阻滞联合单次坐骨神经阻滞在老年全膝关节置换术后的镇痛效果和安全性。方法选择2015年8月至2017年7月在泸州市中医医院拟行全膝关节置换术的老年患者56例,按随机数字表法分为E组和C组,每组28例。E组采用连续髂筋膜间隙阻滞联合单次坐骨神经阻滞镇痛,C组采用静脉自控镇痛;比较两组患者术后2、6、12、24、48h的静息视觉模拟评分(RVAS)与活动时视觉模拟评分(PVAS),术后48h内下肢肌力Bromage评分,术后补救镇痛率及不良反应发生率。结果两组术后6、12、24、48h的RVAS评分和PVAS评分与同组术后2h时比较均明显升高(P0.05)。E组术后2、6、12、24、48h的RVAS评分和PVAS评分均显著低于C组(P0.05)。E组在术后2h和6h的下肢肌力Bromage评分显著高于C组(P0.05),两组术后6、12、24、48h的下肢肌力Bromage评分与同组术后2h比较明显降低(P0.05)。与C组比较,E组术后补救镇痛率及头晕、恶心呕吐发生率降低(P0.05)。结论超声引导下连续髂筋膜间隙阻滞联合单次坐骨神经阻滞能显著缓解膝关节置换患者术后疼痛,减少阿片类药物用量,不良反应少,有利于患者康复。