重建钢板在多发性肋骨骨折手术治疗中的应用

目的:探讨多发性肋骨骨折应用重建钢板治疗的临床疗效。方法:回顾分析22例多发性肋骨骨折患者行切开复位重建钢板内固定手术治疗的效果,观察患者骨折愈合、胸部疼痛等临床症状的改善及恢复。结果:全部术口Ⅰ期愈合,术后胸部疼痛减轻,X-ray显示骨折断端对位良好,呈骨性愈合。术后无螺钉松动、肺部感染、肺不张等并发症。结论:多发性肋骨骨折应用重建钢板内固定治疗具有骨折复位好、固定牢靠、并发症少、促进骨折的愈合等优点,是一种有效的疗法。     

Thoracic wall lesions in children

Our objective was to review the clinical features and radiographic manifestations of chest wall lesions in a pediatric chest unit. Twenty-five patients (11 males and 14 females, aged 14 months to 15 years) were suspected of having a chest wall lesion on the basis of clinical examination and chest radiograph. A retrospective review of clinical characteristics and radiographic findings was performed in order to define the pathology and extent of lesions and outcomes of chest wall diseases in children. Thirty-six percent of pediatric patients studied for thoracic abnormalities had anatomical variations of the thoracic cage such as sternal titling, bifid ribs, and costal cartilage convexities. Tuberculous infections of the sternum and ribs were seen in 4 cases. Osteochondromas were seen in 4 patients, and were especially noted in patients with a history of familial exostosis. Other malignant thoracic wall tumors included in this study included chondrosarcoma (n=1), Ewing's sarcoma (n=1), and primitive neuroectodermal tumor (n=2). In conclusion, the protruding lesions arising from the chest wall demonstrate a wide range of normal, congenital variant, and pathologic lesions arising from the soft tissues and bony components. Those with life-threatening lesions (less likely located in the parasternal region) are more prone to have chest pains and dyspneic respirations; in most cases, plain chest radiographs tend to have a high rate of bony or pleural involvement as well as thoracic deformities. In an endemic area of tuberculosis, costal tuberculosis should be considered in undiagnosed bony lesions; a chest CT scan could be diagnostically useful.     

多发性肋骨骨折胸腔镜辅助小切口外科手术治疗31例体会

目的探讨多发性肋骨骨折外科手术治疗的经验和方法。方法采用华森医疗纯钛肋骨接骨板和胸腔镜辅助小切口外科手术治疗31例多发性肋骨骨折患者。回顾性分析、观察其临床疗效和并发症。结果共使用肋骨接骨板158个,平均（5．10±3．45）个;手术时间45～180min,平均（80．16±32．98）min;术后平均（3．0±0．89）d能坐起,使用呼吸训练器达到1200mL／s,吸气流速时的平均时间为（5．03±1．35）d,术后胸管留置时间（4．39±1．59）d。全组无气管切开,31例临床痊愈。所有病例无遗留胸廓畸形,随访3～32个月患者恢复良好。结论采用华森医疗纯钛肋骨接骨板和胸腔镜辅助小切口外科手术治疗多发性肋骨骨折术式较简单、创伤小、安全;术后活动早、恢复快、并发症少、内固定满意,值得进一步推广使用。     

乳腺癌根治术保留肋间臂神经的临床疗效分析

目的探讨乳腺癌根治术保留肋间臂神经的临床疗效。方法回顾性分析2009年1月～2010年1月收治的60例乳腺癌改良根治术患者的临床资料,其中32例在腋窝淋巴结清扫术中保留肋间臂神经,28例切除肋间臂神经,比较两组患者的临床疗效。结果 60例患者术后均获得随访,均未见复发、转移、死亡。保留组患者患肢的感觉障碍显著少于切除组,P〈0.05。结论对乳腺癌患者行保乳改良根治术时保留肋间臂神经是可行的,它能明显减少术后患肢感觉障碍及疼痛,提高患者的生活质量。     

肋骨内固定在多发性肋骨骨折治疗中的应用56例

目的：总结肋骨内固定在胸部创伤治疗多发性肋骨骨折中的应用经验。方法：56例胸部创伤多发性肋骨骨折,在气管插管全身麻醉下分离骨折断端,应用钛镍记忆合金环抱器,在冰水中将环抱器臂部张开并根据肋骨弧度塑形,迅速将其置于已经整复的骨折端上方,用热生理盐水（40℃~50℃）湿敷,使环抱器紧缩,紧紧环抱骨折端,固定肋骨。结果：本组无死亡病例,肋骨内固定后术前有呼吸困难的明显好转,出现急性呼吸窘迫综合症（ARDS）均顺利脱离呼吸机辅助呼吸,均痊愈出院。结论：应用钛镍记忆合金环抱器进行肋骨内固定对治疗胸部创伤,手术操作简单,时间短,效果确切,出现急性呼吸窘迫综合症的均能顺利脱离呼吸机,术后呼吸功能恢复快,缩短住院时间。     

X光胸片中肋骨框架自动检测方法的综述

实现对X光胸片中肋骨框架的自动精确定位在计算机辅助诊断分析中是具有意义的,然而它至今仍是一个没有完全解决难题.本文针对如今国外现有的一些算法进行了分析总结,并对现存的一些问题进行了相关讨论.     

单纯自体肋骨移植修复下颌骨半侧缺损(附21例报告)

目的　讨论自体肋骨移植修复半侧下颌骨缺损手术并发症的预防。方法　对 1989年 6月～ 1998年 6月在我科施行的手术进行总结研究分析。结果　 2 1例手术获得满意疗效。结论　术中、术后并发症的预防是手术成功的关键。     

Excess of congenital abnormalities in French-Canadian children with neuroblastoma: A case series study from Montreal

Neuroblastoma is one of the most common cancers of childhood. Some studies have shown an excess of congenital abnormalities in children who have been diagnosed with neuroblastoma. In this study we examined the medical records of all children with neuroblastoma seen at St. Justine Children's Hospital between the years 1977 and 1993. A total of 141 children (131 of French-Canadian ancestry) were included in this study. Twelve children (8.5%) had 21 defined congenital abnormalities (1,490 per 10,000 children). This compared with a rate of 444.3 children with abnormalities per 10,000 live births (4.44%) for all congenital abnormalities in the British Columbia Health Surveillance Registry, 1979–1988 (relative risk 1.91, P = 0.03). Six of the 12 children had cardiovascular malformations. These and previous results suggest that there may be a common developmental origin to neuroblastoma and to some congenital malformations. Genes that control development may be worthy of further study in these children. Med. Pediatr. Oncol. 29:272–279, 1997. © 1997 Wiley-Liss, Inc.     

胸椎骨折伴肋骨骨折的护理

目的：探讨胸椎骨折伴肋骨骨折的护理体会。方法：将90患者随机分为两组,治疗组系统护理干预,对照组一般护理,比较两组的临床疗效。结果：治疗后治疗组的JOA值明显高于对照组,经比较（p〈0.05）差异有统计学意义。结论：对胸椎骨折伴肋骨骨折患者进行系统的护理干预能提高该病的治疗疗效并能有效抑制并发症的发生,提高患者生活质量。     

小儿髋关节拍片时对其性腺的防护

本文报道了正常人(非钍尘作业)肋骨中钍核素含量.在27例单样肋骨中²³²Th、²³⁰Th、²²⁸Th的含量范围值(pCikg^-1鲜重)分别为O.25～2.29,O.00～2.15,1.06～15.01.文章中还利用27例样品钍含量的均值估算了骨剂量率和人体内钍含量.并对年龄与钍含量的关系,吸烟和非吸烟与钍含量的关系进行了讨论.