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51.
Vertebral body replacement system Synex in unstable burst fractures of the thoracic and lumbar spine
U. Vieweg 《Journal of orthopaedics and traumatology》2007,8(2):64-70
A prospective longitudinal study was performed to evaluate the vertebral body replacement system Synex associated with posterior
fixation in unstable burst fractures of the lumbar and thoracic spine. Within 24 months, we treated 28 patients (average age,
41 years; range, 22–64 years; 14 women, 14 men) with acute unstable burst fractures without osteoporosis of the thoracolumbar
region (n=16) and the thoracic (n=3) as well as the lumbar (n=9) spine in two stages (primary dorsal transpedicular stabilization and secondary vertebral body replacement). The complications
were analyzed and the postoperative follow-up result was evaluated regarding stability, bone fusion, correction loss, pain
and neurological status. One patient showed a transient irritation of the lumbosacral plexus and one patient had a superficial
wound infection (complication rate, 7.1%). At the follow-up examination (mean follow-up, 13 months) only in two cases a minimal
loss of correction (<5°) was measured. Radiologically, 27 patients showed secure bone fusions and all patients had stability
of the osteosynthesis. Most of the patients stated no or just slight pain at follow-up. Only two patients with pain to a medium
degree had to take painkillers. The vertebral body replacement system Synex seems to be a good alternative for vertebral body
replacement in unstable burst fractures of the thoracic and lumbar spine since at present follow-up it shows a high rate of
bone fusion and minimal loss of correction. 相似文献
52.
F. Specchiulli R. Gabrieli D. Borsetti V. Di Carlo 《Journal of orthopaedics and traumatology》2007,8(3):123-127
We examined the clinical and radiographic results of 93 patients affected by knee arthritis or osteonecrosis subjected to
unilateral cementless mobile-bearing total knee arthroplasty with the LCS prothesis (Depuy/Johnson & Johnson). The mean follow-up
was 9.5 years (range, 7–12 years). Clinical evaluation was performed using the Knee Society rating system, while radiographic
evaluation was done according to the Knee Society roentgenographic system. At the latest follow-up, the mean knee score was
87 points: the functional score improved from 40 to 90. Radiolucent lines were small and not progressive. The implant survival
at 12 years was 88%. Six knees (7%) required revision for implant-related problems. We conclude that the mobile-bearing prosthesis
is a successful device even at long-term follow-up. 相似文献
53.
①目的 探讨现代玻璃体手术对开放性眼外伤玻璃体积血的治疗效果。②方法 对108例开放性眼外伤玻璃体积血的病人,于伤后2~4周施行玻璃体切割置换术(单纯玻璃体切割术24例,联合晶体切割84例,联合视网膜手术76例)。③结果 术后经随访2周~18个月,48例达功能治愈,36例达解剖治愈,总治愈率达77.7%。24例继发青光眼者眼压控制在1.37~2.24kPa。④结论 适时地施行玻璃体切割置换术,可很大程度地改善开放性眼外伤玻璃体积血病人的预后,对有效防治外伤性玻璃体视网膜病变以及牵引性视网膜脱离等具有重要作用。 相似文献
54.
瓣膜病合并肝功能不全患者的体外循环管理 总被引:5,自引:0,他引:5
目的 回顾52例瓣膜病变合并肝功能不全的行瓣膜置换术的患者,总结体外循环(CPB)经验。方法 CPB采取中度低温,保持较高的灌注压力。预充液加入白蛋白。心肌保护用高钾含血停搏液灌注。结果 结果CPB时间50~135min,主动脉阻断23~98min,心脏自动复跳率94%,无全心辅助和左心辅助,围术期死亡6人。结论 术中加强心肌保护的同时重视肝保护,可减轻术后心功能衰竭和肝功能衰竭,降低并发症和死亡率。 相似文献
55.
Paul Roderick Ruth Davies Chris Jones Terry Feest Steve Smith Ken Farrington 《Nephrology, dialysis, transplantation》2004,19(3):692-701
BACKGROUND: The demand for renal replacement therapy (RRT) in England has risen steadily, although from a lower base than many other developed countries. Predicting the future demand for RRT and the impact of factors such as the acceptance rate, transplant supply and patient survival, is required in order to inform the planning of such services. METHODS: A discrete event simulation model estimates the future demand for RRT in England in 2010 for a range of scenarios. The model uses current prevalence and current and projected future acceptance rates, survival rates and the transitions between modalities to predict future patient numbers. National population and mortality data, published literature and data from the UK Renal Registry and UK Transplant, are used to estimate unmet need for RRT, the impact of changing demography and incidence of Type 2 diabetes, patient haemodialysis (HD) survival and transplant supply. RESULTS: By 2010 the predicted prevalence will have increased from about 30,000 in 2000 to between 42 and 51,000 (900-1000 p.m.p.), an average annual growth of 4.5-6%. Changing transplant supply has a small effect on overall numbers but changes the proportion of patients with functioning graft by up to 8%. Even with an optimistic increase in transplant supply (11% p.a. for 5 years), numbers on HD will continue to rise substantially, especially in the elderly. The factors most influencing future patient numbers are the acceptance rate and dialysis survival. CONCLUSION: This model predicts a substantial growth in the RRT population to 2010 to a rate approaching 1000 p.m.p., particularly in the elderly and those on HD, with a steady state not being reached for at least 25 years. 相似文献
56.
髋臼内壁内移截骨全髋置换治疗成人髋臼发育不良的有限元分析及临床意义 总被引:5,自引:2,他引:3
目的 通过计算机辅助设计有限元分析,找寻髋臼内壁截骨的合适内移范围,为临床工作提供理论依据.方法 利用SolidWorks 2005软件,建立髋臼发育不良骨盆的三维模型,模拟髋臼内壁内移截骨术式,使髋臼内壁骨从未完全陷入盆腔内保持2 mm骨性接触处开始,逐渐内移至完全陷入盆腔内7 mm处,每隔1 mm为1个实验组,分成10个实验组.每组髋臼人为划成4个象限,分别对各组假体臼-骨界面间进行计算机模拟对比力学实验分析,测量出髋臼假体-骨界面间的Mises应力及剪切应力值,找寻出应力分布较为均匀的实验组.结果 Mises应力及剪切应力均有1个象限内的值较大,通过2次统计学分析计算,得出实验结果.结论 当髋臼内壁内移至未完全陷入盆腔内1 mm处到完全陷入盆腔内1 mm处的范围内,髋臼假体-骨界面间的应力分布均匀,最佳位置在完全陷入盆腔内1 mm处. 相似文献
57.
58.
Yoshimasa Sakamoto Kazuhiro Hashimoto Hiroshi Okuyama Shinichi Ishii Takahiro Inoue Katsushi Kinouchi Takayuki Abe 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(9):465-469
Objective The objective of the present study was to compare long-term results of single aortic valve replacement (AVR) with mechanical
(St. Jude Medical valves: standard) and biologic (the Carpentier-Edwards pericardial) prostheses. Method: Between 1995 and 2002, 95 patients who underwent single AVR with mechanical (n=46) or biologic (n=49) prostheses were enrolled
in this study. The mean age at the operation was 54.0±9.6 years (range: 20 to 69 years) with the mechanical and 68.8±7.1 years
(range: 44 to 85 years) with the biologic prosthesis. Results: The 9-year actuarial survival rate, which was calculated by taking perioperative mortality into account, was 90.3±4.6% for
patients with mechanical valves and 87.6 ±4.8% for patients with bioprostheses, with no difference between the two groups
(p=0.342). The 9-year freedom rate from thromboembolism, reoperation, endocarditis was 94.8+3.6%, 100% and 97.8 ±2.2% for
patients with mechanical valves and 98.0 ±2.0%, 97.5 ±3.4% and 95.0 ±3.4% for those with bioprostheses, respectively. After
9 years, freedom from cardiac death averaged 97.8% in the group with mechanical valves compared with 95.3% in those with bioprostheses
(p=0.541). Conclusion: We conclude that the mid-term durability of the Carpentier-Edwards pericardial valve in the aortic position for the elderly
is excellent. Nevertheless, the risk of tissue valve reoperation progressively increases with time, and a longer follow-up
may be necessary to provide its value compared with the mechanical valves in a country like Japan with a high life expectancy.
(Jpn J Thorac Cardiovasc Surg 2005; 53:465-469) 相似文献
59.
Teruyuki Usuba Yutaka Suzuki Akira Kuramochi Hisao Tajiri Katsuhiko Yanaga 《Digestive endoscopy》2007,19(1):18-21
Background: Buried bumper syndrome (BBS) is a rare complication of percutaneous endoscopic gastrostomy (PEG). Along with the widespread use of the button‐type kit, BBS is encountered frequently. Methods: In the present study, we examined causes and treatments for BBS among 1400 patients who had undergone PEG. Results: The causes of BBS after PEG were classified into two categories: early causes consisted of wound infection, inappropriate size of kit and severe lordosis, while late causes were inappropriate exchange of kit, rough management or weight gain. The treatments for BBS could be determined by the degree of wound infection, fistula and burial of the bumper. Conclusion: We prepared a flowchart for replacement, by which BBS can be managed safely and quickly without surgical or endoscopic intervention. 相似文献
60.
人工髋关节置换术后脂肪栓塞综合征的观察与护理 总被引:3,自引:0,他引:3
笔者报道人工髋关节置换术后脂肪栓塞综合征的护理措施认为重视氧饱和度及动脉血氧分压监测,注意观察中枢神经系统症状和呼吸系统症状,及时发现并纠止低氧血症,对不同的病人制定不同护理方案,严密观察病情,及时掌握病情变化:是护理的关键。 相似文献