同种异体肾移植手术2种麻醉方法的效果比较

目的　比较同种异体肾移植手术椎管内阻滞和静吸复合全麻的优缺点。方法　回顾性分析 2 0 0 3年 1— 8月我院器官移植中心所做的同种异体肾移植手术的麻醉 ,对符合条件的 38例患者进行比较。结果　 2组间比较ASA分级 ,术中输液量 ,移植肾血流开放前收缩压、舒张压、心率、麻醉并发症 (仅包括硬膜外血肿或心功能衰竭 )和移植肾存活率无显著性差异 ,体质量和ICU停留时间有显著性差异 ,静吸复合全麻组比椎管内阻滞组体质量更重 ,ICU停留时间更长。结论　椎管内阻滞有时不能满足手术要求 ,能满足手术要求的椎管内阻滞 ,手术结束后循环功能较稳定 ,烦躁不安少见 ,手术后恢复较快 ;静吸复合全麻能更好地满足手术要求 ,尤其是体质量较大的患者 ,但在拔出气管导管前后可能引起血流动力学剧烈波动 ,甚至心功能衰竭 ,手术后恢复较慢     

椎管内脊膜瘤的临床特点及外科治疗

[目的]探讨椎管内脊膜瘤的临床特点、诊断及手术治疗原则。[方法]对1988年2月至2001年2月收治的28例椎管内脊膜瘤的临床资料进行总结。其中颈段5例，胸段19例，腰段4例。[结果]28例均行手术治疗，26例肿瘤全部切除，2例次全切除。术后23例经1—12年(平均5．5年)随访，评定为优18例，良3例，进步1例，差1例，优良率91，3％。[结论]椎管内脊膜瘤是椎管内较常见的肿瘤，多位于脊柱胸段。确诊以病理检查为主要依据，手术彻底切除肿瘤是行之有效的方法。     

Computer-aided 3-D reconstruction and measurement of the optic canal and intracanalicular structures

Ｔｒａｕｍａｔｉｃｏｐｔｉｃｎｅｕｒｏｐａｔｈｙｉｓａｖｉｓｉｏｎ ｔｈｒｅａｔｅｎｉｎｇｄｉｓｏｒｄｅｒ Ａｕｔｏｐｓｉｅｓａｆｔｅｒｈｅａｄｔｒａｕｍａｈａｖｅｓｈｏｗｎｔｈａｔｔｈｅｏｐｔｉｃｎｅｒｖｅｓａｒｅｏｆｔｅｎｄａｍａｇｅｄｍｏｓｔｓｅｖｅｒｅｌｙｗｉｔｈｉｎｔｈｅｏｐｔｉｃｃａｎａｌ 1 Ａｌｔｈｏｕｇｈｖａｒｉｏｕｓｋｉｎｄｓｏｆｍｉｃｒｏｓｕｒｇｉｃａｌｄｅｃｏｍｐｒｅｓｓｉｏｎｏｆｔｈｅｏｐｔｉｃｃａｎａｌｈａｖｅｂｅｅｎａｄｖｏｃａｔｅｄａｓｔｈｅｅｆｆｅｃｔｉｖｅｍｅｔｈ…     

27例外耳道癌临床分析

目的：探讨外耳道癌的诊断、治疗。方法：对本院27例外耳道癌行回顾性分析，本组病例以腺样囊腺癌多见．主要症状为耳痛、耳道肿物、耳溢液根据其病变范围不同行不同的根治性手术加术后放射治疗。结果：27例总的3年生存率为59．2％(16／27)，5年生存率为44．4％(12／27)，10年生存率为11．1％(3／27)；T1期3、5、10年生存率分别为86．6％(13／15)、80．0％(12／15)、20．0％(3／15)，结论：外耳道癌具有高度的复发倾向，因此强调早期诊断、选择合适的术式一次性根治性切除、术后放疗可获得良好的疗效～     

抗生素糊剂充填乳牙根管疗效观察

目的 探索一种疗程短、疗效好、患儿及家长易接受的根管治疗方法.方法 选择需行根管治疗的患儿162例,常规根管清理,试验组用抗生素糊剂充填乳牙根管,对照组用氢氧化钙糊剂,比较两组疗效.结果 经1年随访观察,抗生素组和氢氧化钙组乳牙根管充填成功率差异无显著意义.结论 用抗生素糊剂一次充填乳牙根管疗程短、疗效好,值得临床推广使用.     

Post-traumatic recto-spinal fistula

Acquired recto-spinal fistula has been described elsewhere as a rare complication of colorectal malignancy and Crohn's enterocolitis. We treated a young man who developed a recto-spinal fistula as a result of a high fall injury. The patient presented with meningeal signs, sepsis and perianal laceration. Computerized axial tomography revealed air in the supersellar cistern. Gastrografin enema showed that contrast material was leaking from the rectum into the spinal canal. Surgical management included a diverting sigmoid colostomy, sacral bone curettage and wide presacral drainage. To the best of our knowledge, rectospinal fistula of traumatic origin has not been previously reported in the English literature. Received: 7 December 1998; Revised: 10 May 1999; Accepted: 10 May 1999     

根充术和干髓术治疗乳牙牙髓炎的比较性研究

目的:比较不同充填方法在乳牙中牙髓炎治疗效果.方法:序贯对100颗乳牙牙髓炎随机分为2组,分别用根管充填和干髓治疗两种方法.结果:氧化锌丁香油根管充填术治疗组成功率为92%,而干髓术治疗乳牙牙髓炎成功率仅为48%.结论:根管充填术较干髓术疗效更肯定,减少患儿群体复诊数和人均复诊次数,有利于临床推广.     

Exostoses of the external auditory canal: a long‐term follow‐up study of surgical treatment

To determine the postoperative incidence, extent and recurrence rate of exostoses of the external auditory canal in a cohort of patients involved in different water sports. A cross‐sectional study of 31 patients (46 ears), with exostoses treated by surgery in the Royal Cornwall Hospital between 1980 and 1999. A questionnaire was used to obtain information about the type of water exposure pre‐ and postoperatively. The extent of recurrent stenosis was assessed. The mean postoperative time interval was 10 years (sd = 4.5 years). The degree of stenosis was assessed as: minimal (<30%) in 42.6%, moderate (30–60%) in 31% and severe (>60%) in 25% of ears. The Cox regression model was used to identify factors associated with a reduction in the recurrence rate of stenosis. The use of ear plugs was highly significant (P = 0.015), as was the age of the patient at the time of operation (P = 0.004), i.e. the older the patient, the faster recurrent disease developed. There was no evidence to show that either the type or seasonal pattern of water sport activity influenced recurrence of the disease postoperatively, although preoperatively, the stenosis was more marked in association with surfing and sailing. Exostoses developed faster preoperatively in those who were in the water all year round rather than just the summer months. Of five patients who stopped water sport activity completely after surgery, four of them developed significant recurrent exostoses (>50% stenosis).     

Vitapex糊剂用于乳牙根管充填的疗效观察

目的 :比较氧化锌丁香油糊剂和 Vitapex糊剂作为乳牙根管充填材料的临床疗效。方法 :用两种根管充填材料对乳磨牙进行根管充填 ,实验组用 Vitapex糊剂根管充填 ,对照组用氧化锌碘仿糊剂根管充填 ,观察 1年后的疗效。结果 :实验组平均有效率为 97.1% ,对照组有效率为 94 .2 % ,实验组和对照组无显著统计学差异 ( P>0 .0 5 )。结论 :Vitapex糊剂用于乳牙根管充填的疗效比较理想     

镍钛减速机用于根管预备的临床研究

目的　探讨镍钛减速机用于根管预备的临床效果。方法　在门诊患者中选择年龄为 2 0～ 5 0岁需做根管治疗的病人 2 0 0例 ,共计 2 0 0颗患牙 ,随机分成实验和对照两组 ,两组分别采用旋转镍钛根管扩大系统及用不锈钢 K型和 H型手动扩挫系统扩挫根管的方法进行根管预备 ,记录根管预备所需时间及术后疼痛反应的发生情况 ,并进行比较。结果　实验及对照两组中前牙根管预备所需的时间平均为 (4.92± 0 .73) min和 (5 .0 16±0 .0 2 5 ) m in,磨牙根管预备所需的时间平均为 (14 .4± 2 .8) min和 (17.8± 2 .2 ) m in;两组比较 ,有关前牙的根管预备所需时间比较差异无统计学意义 (t=1.33,P>0 .0 5 ) ;而磨牙的根管预备所需时间比较差异有统计学意义 (t=8.113,P<0 .0 5 ) ,实验组短于对照组。术后疼痛反应发生率两组比较 ,实验组 (12 % )明显低于对照组 (2 9% ) (χ2 =88,P<0 .0 1)。结论　镍钛减速机用于根管预备 ,大大提高了工作效率 ,减少了患者术后疼痛反应的发生 ,因此 ,镍钛机扩技术在临床上值得推广应用。