小儿前,后连合间径与身长和颅脑间相关性的探讨

取身长为50～150cm的小儿标本90例,分别测量了身长、头围、脑矢状径、脑垂半径和连合间径的长度,按身长不同分为三组统计均数和标准差,并作直线相关和回归分析。结果表明连合间径长度与身长、头围、脑矢状径和脑垂半径间存在明显的正相关关系,建立用身长、头围、脑矢状径和脑垂半径估计连合间径长度的一元和多元回归方程,初步找到连合间径随身长和颅脑生长发育的变化规律。填补了小儿连合间径方面的空白,为脑立体定位术中确定脑原点和脑矢状轴提供数据,并为研究小儿脑生长发育规律积累资料。     

颈前路带锁钛板在脊髓型颈椎病手术中的应用

目的评价脊髓型颈椎病前路减压后应用带锁钛板内固定的价值。方法对51例脊髓型颈椎病患者采用前路减压、取自体髂骨植骨和颈椎带锁钛板内固定治疗。结果随访43例,平均随访时间2a,术后3个月植骨块获得骨性融合,颈椎椎间高度和生理曲度维持满意,感觉、肌力明显恢复,钛板及螺钉无松动及断裂现象。结论脊髓型颈椎病前路减压术后应用带锁钛板内固定能促使植骨块融合,有效地维持椎间高度和颈椎生理曲度,有较高的应用价值。     

全肺切除术治疗肺癌的临床分析

目的 :探讨全肺切除术和经心包内处理血管的全肺切除术治疗肺癌的效果。方法 :对 74例Ⅱb～Ⅲb期肺癌患者行全肺切除术 ,其中 32例在肺癌的全肺切除术中进行了心包内处理血管 ,其余 4 2例行标准全肺切除术。结果 :心包内处理血管组与标准切除组术后各有 1例并发脓胸 ,其中心包内处理血管组的并发脓胸者死亡。术后两组分别随访 2 2例和 31例 ,5年生存率分别为 18.1%和 16 .1%。经心包内处理血管的全肺切除与标准全肺切除术患者 5年生存率和术后并发症发生率差异均无显著性 (P =1.0 0 0和P >0 .0 5 )。结论 :全肺切除术中力争达到根治 ,经心包内处理血管技术的应用 ,对于提高患者的生存率、改善晚期肺癌的生活质量是有价值的     

应用带骨间掌侧动脉背侧支血管蒂桡骨瓣治疗腕舟骨骨折不愈合

目的　探讨一种良好的治疗腕舟骨骨折不愈合的方法 ,丰富治疗腕舟骨骨折不愈合的手术方式。方法　切除腕舟骨骨折不愈合之硬化骨 ,以克氏针贯穿固定骨折端 ,用带骨间掌侧动脉背侧支血管蒂桡骨瓣翻转移植治疗腕舟骨骨折不愈合 15例。结果　术后随访 3～ 6个月 ,骨折完全愈合 ;9～ 18个月 ,腕关节活动正常无痛。结论　前臂间掌侧动脉背侧支解剖位置恒定 ,变异少 ,位置较表浅 ,血管蒂长、口径粗、游离安全容易 ,血供充分 ,能有效地促进舟骨骨折愈合。     

冠状动脉起源于肺动脉的影像学研究

目的 探讨冠状动脉(简称冠脉)起源于肺动脉(ACAPA)影像学诊断方法的价值。方法 回顾性分析11例ACAPA的影像学表现。11例均行X线胸片、超声心动图(Echo)和心血管造影检查，其中1例行电子束CT(EBCT)检查。结果 10例为左冠脉起源于肺动脉，1例为右冠脉起源于肺动脉。11例胸片均未确诊，Echo诊断3例，EBCT诊断1例。心血管造影全部诊断正确，其中左冠脉异常起源者左冠脉均发自主肺动脉后窦或后壁，通过扩张的右冠脉藉侧支逆行充盈；右冠脉异常起源者右冠脉从主肺动脉右窦发出。手术与造影所见相同。3例前乳头肌缺血性纤维化，二尖瓣环扩大，前叶脱垂致二尖瓣关闭不全。结论 X线胸片诊断受限，Echo简便、无创，但操作技术及认知水平有待提高。心血管造影仍是术前确诊的“金标准”。     

急性缺血性卒中大血管闭塞性质的判断与取栓方式和材料的选择

血管内机械取栓是治疗大血管闭塞性急性缺血性卒中的有效治疗方法。应结合病史、发
病形式及影像学检查等综合判断病变性质；依据病变性质并参考手术路径，个性化选择支架取栓、
抽吸取栓、球囊/支架血管成形术、动脉溶栓任一种或多种方法联合取栓；并依据手术方式选择手
术材料，以快速高效地完成手术。     

Saccular Aneurysm of the Azygos Anterior Cerebral Artery: Three Case Reports

The azygos anterior cerebral artery, a rare anomaly in the circle of Willis in which only a single vessel supplies the medial aspects of both anterior cerebral hemispheres, is closely associated with saccular aneurysms. We present three cases of azygos anterior cerebral artery aneurysms among the 781 cerebral aneurysms surgically treated at our institution in an 11-year period. These three cases all involved elderly women who presented with subarachnoid hemorrhage. Conventional cerebral angiography and CT angiography revealed small saccular aneurysms at the distal ends of the azygos anterior cerebral arteries. These aneurysms were clipped successfully using a bifrontal interhemispheric approach. Hence, the pathogenesis of these particular aneurysms relating to hemodynamic change, associated anomalies, and surgical pitfalls is discussed with review of literature.     

颈椎后纵韧带骨化症前路手术的多因素分析

[目的]探讨影响颈椎后纵韧带骨化症前路手术疗效的相关因素。[方法]48例颈椎后纵韧带骨化症患者，行前路手术治疗，随访1～4年，平均2．1年。根据术后神经功能JOA评分改善率，将患者分为预后良好、预后不佳2组。采用多元Logistic回归分析患者年龄、性别、神经功能、症状持续时间、合并糖尿病、Pavlov值、椎管狭窄率、骨化物分型、CT双影征、脊髓高信号、手术范围以及骨化物处理对患者手术疗效的影响。[结果]骨化物的处理方式是影响患者疗效的唯一因素（P=0．0067）。[结论]前路手术彻底切除骨化之后纵韧带，对脊髓充分减压是前路手术治疗颈椎后纵韧带骨化症的关键。     

The effect of central corneal thickness on estimates of the anterior chamber depth

Background: The slitlamp can be used to estimate the anterior chamber depth (ACD). The length of a slit object is increased until the corneal and iris/lens images appear to just touch. Multiplying the just‐touching‐slit‐length (JTSL) by a conversion factor gives an estimate of the ACD as measured by ultrasonography. The purpose of this study was to determine if central corneal thickness (CCT) affects the accuracy of this technique. Methods: The ACD of 50 subjects was measured by A‐scan ultrasonography and estimated by the slitlamp technique. CCT was measured by ultrasonic pachometry. The refractive error was determined subjectively. Results: The average ultrasonographic ACD for all subjects was 3.32 ± 0.65 mm. The average JTSL was 2.46 ± 0.38 mm. The conversion ratio between the ultrasonographic ACD and the average JTSL was 1.35. The predicted ACD using the regression equation of JTSL on the ultrasound anterior chamber depth (USACD) was 3.32 ± 0.54 mm. The corresponding value using the regression equation of JTSL and CCT on USACD was exactly the same, that is, 3.32 ± 0.54 mm. Conclusion: Incorporation of CCT into a regression equation does not improve the accuracy of the Smith technique.