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51.
创伤性浮膝伴血管损伤的早期诊治 总被引:3,自引:0,他引:3
目的 探讨创伤性浮膝同时伴同侧血管损伤患者的早期诊断及救治.方法 总结1996年6月~2002年12月收治28例30个浮膝的手术固定方法、血管修复情况及术后治疗和恢复情况.结果 术后伤口一期愈合5例,17例伤口二期行植皮修复,4例胫前骨折部外露二期行皮瓣转移术,截肢2例,保肢成功率92.9%.术后26例经18个月~8年随访,骨折均愈合,下肢功能恢复优良率64.3%.结论 对浮膝损伤患者应高度重视伴有血管损伤可能,早期作出诊断,积极合理治疗,对患者预后至关重要. 相似文献
52.
目的探讨异位妊娠的诊断和治疗方法。方法对32例来本院就诊的异位妊娠患者进行回顾性分析。结果异位妊娠患者超声下表现多样,32例中保守治疗成功率96.9%。1例改行手术成功。结论异位妊娠的症状变化多样,病情凶险,应早期诊断,积极治疗。 相似文献
53.
Background The incidence rate of incisional hernias after open surgery has been reported to be higher than that of port site hernias
after laparoscopic surgery. No studies have compared the costs for the health care system in treating those two types of hernia.
Methods A systematic review was conducted to obtain the baseline data, and a decision analysis model was created to simulate the occurrence
and recurrence of incisional and port site hernias.
Results The overall risk of having incisional hernias was eight-times higher than that of having port site hernias (7.4% vs 0.9%).
A cost savings of £93 per patient can be generated for the health care system in the UK. Similar results were obtained for
Germany, Italy and France.
Conclusions The additional treatment costs for incisional hernia should be taken into account when the costs of a surgery performed by
open approach are compared with by laparoscopy. 相似文献
54.
55.
Donna K. McNeese-Smith Mary E. Wickman Marie Earvolino-Ramirez Mel Moncrieff Scott Robertson 《Journal of addictions nursing》2006,17(2):105-113
This article reports the results of semi-structured interviews with substance abuse treatment (SAT) program directors (PDs) regarding the ways SAT is being influenced by managed care (MC), plans for future SAT, and strategies for decreasing costs of care. It compares findings to an earlier survey of 50 SAT PDs.
Interviews were conducted in 20 SAT programs to gather information about treatment delivery since the advent of MC, including PD responsibilities, funding source, treatment intensity, location, duration, and methods of treatment. Open-ended responses were used to gather information about current and future plans in providing SAT, and awareness of new types of treatment being planned by organizations impacted by MC.
PDs reported changes in SAT secondary to MC such as decreased treatment length, limiting of inpatient and outpatient services, and delayed treatment secondary to benefit determination. Political and economic constraints were seen as barriers to providing adequate and effective services. SAT being subsumed by mental health was viewed as problematic along with an emerging split between alcohol abuse and drug treatment. A positive emerging treatment trend was the development of targeted programs for special need groups.
PDs revealed a variety of strategies that have promoted necessary adaptations to economic and political influences within the structure of managed behavioral care. Strategies such as varying treatment length, modality, and subspecialty care reflected necessary adaptations to diverse market needs.
Managed care continues to have a tremendous impact on the delivery of SAT services. While MC has helped to contain costs, negative outcomes are decreased availability of appropriate care and overtaxing of units that have survived MC cut backs. However, special need programs have allowed SAT programs to specialize, expand, and even flourish in today's competitive SAT market. Interviews with PDs reinforced the need for maintaining quality and diversified SAT services in today's MC environment. 相似文献
Interviews were conducted in 20 SAT programs to gather information about treatment delivery since the advent of MC, including PD responsibilities, funding source, treatment intensity, location, duration, and methods of treatment. Open-ended responses were used to gather information about current and future plans in providing SAT, and awareness of new types of treatment being planned by organizations impacted by MC.
PDs reported changes in SAT secondary to MC such as decreased treatment length, limiting of inpatient and outpatient services, and delayed treatment secondary to benefit determination. Political and economic constraints were seen as barriers to providing adequate and effective services. SAT being subsumed by mental health was viewed as problematic along with an emerging split between alcohol abuse and drug treatment. A positive emerging treatment trend was the development of targeted programs for special need groups.
PDs revealed a variety of strategies that have promoted necessary adaptations to economic and political influences within the structure of managed behavioral care. Strategies such as varying treatment length, modality, and subspecialty care reflected necessary adaptations to diverse market needs.
Managed care continues to have a tremendous impact on the delivery of SAT services. While MC has helped to contain costs, negative outcomes are decreased availability of appropriate care and overtaxing of units that have survived MC cut backs. However, special need programs have allowed SAT programs to specialize, expand, and even flourish in today's competitive SAT market. Interviews with PDs reinforced the need for maintaining quality and diversified SAT services in today's MC environment. 相似文献
56.
目的探讨巨大良性前列增生症(benignprostatichyperplasia,BPH)的治疗方法。方法回顾性分析41例巨大的BPH患者采用经尿道前列切除术(transurethralresectionoftheprostate,TURP)治疗的临床资料。结果TURP后,前列腺症状评分(internationalprostatesymptomscore,IPSS)由术前平均30±2郾5分,降至术后8郾1±2郾5分;最大尿流率由术前平均(5郾1±2郾4)ml/s升至术后平均(18郾6±5郾3)ml/s;剩余尿由术前50~1100ml降至术后0~40ml。手术并发症5例(12郾3%),其中前列腺电切综合征(transurethralresectionsyndrome,TURS)3例,继发出血2例。结论在熟练掌握TURP技术后,用TURP治疗巨大BPH是一种相对安全、并发症少、疗效好的方法。 相似文献
57.
58.
R. Bondì R. Padua L. Bondì A. Battaglia E. Romanini A. Campi 《Journal of orthopaedics and traumatology》2007,8(1):36-41
Abstract Calcaneal fracture is the most common of the tarsal fractures and represents 1%–2% of all fractures. The fractures may be
divided into extra-articular (not affecting the joint) and intra-articular (involving the talo-calcaneal and calcaneal cuboid
joints) types. The management of heel fractures includes nonoperative and operative treatments, but no clear consensus has
been reached. The choice of operative treatment is still controversial with many factors influencing the final clinical outcome.
Many studies have assessed the outcome of treatment of calcaneal fractures, but there is a general disagreement on their management.
The objective of this study was to collect and evaluate the scientific evidence reported in the literature supporting the
different treatments for calcaneal fractures. 相似文献
59.
心先安佐治小儿病毒性心肌炎临床疗效分析 总被引:1,自引:0,他引:1
目的:分析心先安佐治小儿病毒性心肌炎的临床疗效。方法:136例病毒性心肌炎患儿随机分为治疗组及对照组,在相同的 基础治疗条件下,治疗组应用心先安2~5mg kg,加液静滴,每天2次。结果:心先安组;痊愈51例(75%),好转12例(17.65%),无效5例(7. 35%),总有效92.65%。对照组痊愈41例(60.29%),好转14例(20.59%),无效13例(19.12%),总有效80.88%。两组相比、差异有显著性 (x2=4.09,P<0.005)。结论:心先安治疗小儿病毒性心肌炎疗效确切,且安全、可靠。 相似文献
60.
关节镜下可吸收性半月板箭治疗半月板损伤的初步报告 总被引:14,自引:1,他引:13
目的关节镜下应用可吸收性半月板箭治疗半月板损伤并评价其近期疗效。方法2002年2~10月,关节镜下采用半月板箭缝合固定12例12侧半月板损伤,男5例,女7例;年龄18~58岁,平均33.2岁。左膝4例,右膝8例。内侧半月板损伤4例,外侧半月板损伤8例;前角损伤2例,体部损伤3例,后角损伤7例。红区损伤10例,红-白区损伤2例。病程3d~5个月,平均2.3个月,其中急性损伤(病程<1个月)9例。关节镜下采用新型全内半月板箭技术固定,共使用25枚半月板箭(平均每例2.1枚)。5例同时施行其它类型手术。结果所有病例术后均无早期并发症发生。全部患者均获得随访,随访时间7~13个月,平均10.2个月。随访时所有患者膝关节稳定,无疼痛、绞锁等症状,6周后关节活动度全面恢复。Lysholm评分由术前的平均(45.6±13.4)分增加到术后平均(82.4±16.3)分,差异有显著性(P< 0.05)。2例分别于术后8个月和9个月出现关节积液,考虑为滑膜炎,经治疗后消失。结论对于半月板损伤,如撕裂类型和部位适当,可选择可吸收性半月板箭治疗。半月板箭技术是一种简便快捷、安全有效的半月板缝合方法。 相似文献