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131.
采用经皮弧式椎间盘切除器械治疗L_5~S_1椎间盘突出症22例,21例成功。术后优良率为86.4%。该器械能够避开髂嵴阻挡进入L_5~S_1椎间隙,并增加椎间盘切除量,提高经皮L_5~S_1椎间盘切除成功率。定位正确是成功的关键。 相似文献
132.
Summary The authors present their diagnostic and therapeutic protocol as well as the surgical outcome in a series of 119 patients with the lumbar facet syndrome.By use of different surgical techniques such as translaminar screw fixation (n=56), Louis plate fixation (n=36), Cotrel-Dubousset instrumentation (n=11) and soft system stabilization according to Graf (n=14) excellent, good, satisfactory, moderate and poor results were obtained in 78 (67%), 20 (17%), 14 (12%), 4 (3%), and 1 (1%) instances, respectively. 相似文献
133.
经内镜胆管引流术在肝门部恶性胆管梗阻中的应用及其评价 总被引:9,自引:2,他引:7
肝门部恶性肿瘤手术切除率极低,临床处理十分棘手。作者采用内镜胆管引流术治疗此类肿瘤288例次(肝门部胆管癌184例、胆囊癌23例、肝细胞癌侵犯肝门部胆管47例、其他转移性肿瘤34例),其中行内镜鼻胆管引流162例次、塑料内置管引流80例次、放置可膨式金属胆道支架46例、4例患者接受同期双内置管引流。引流总有效率为67.0%,其中效果满意者43.1%;40例患者术后1个月内发生胆管炎,发生率为13.8%,3例死亡;长期随访病例的平均存活期5.3个月。我们观察到治疗的效果与Bismuth分型有密切关系,如果全肝40%以上的胆系得到引流,黄疸有望消退;左、右两侧胆管同时引流可扩大引流范围,提高疗效;应合理选择三种内镜胆管引流方法并适时灵活转换才能获得满意的疗效。结论:对于肝门部肿瘤,内镜胆管引流术是一种安全有效的治疗手段,可作为首选的姑息性治疗。 相似文献
134.
腰穿放液治疗160例外伤性蛛网膜下腔出血的体会 总被引:1,自引:0,他引:1
目的:探讨腰穿放液对外伤性蛛网膜下腔出血的作用。方法:对160名外伤性蛛网膜下腔出血的病人行腰穿放液,少则2次,多则7次。结果:所有病人症状均好转,从脑脊液的力学上看脑脊液恢复正常性状的时间缩短,结论:腰穿放液治疗外伤性蛛网膜下腔出血是十分有效的方法,近期内临床症状明显改善,远期并发症减少。 相似文献
135.
Tommi Sukuvaara Erkki M. J. Koski Aki Mäkivirta Aarno Kari 《Journal of clinical monitoring and computing》1994,10(2):117-126
A knowledge-based alarm system for intensive care monitoring was designed, built, tested on-line, and evaluated. The system is a functional prototype of a highly specific patient monitor providing alarms on hypovolemia, hyperdynamic state, left ventricular failure and hypoventilation. These intelligent alarm functions aim to maintain the quality of patient monitoring even if nurses' attention is temporarily reduced or focused elsewhere. The alarm system has an electronic access to data available in a multichannel patient monitor and the patient data management system of the intensive care unit. Median filtering, trend estimation, and rule-based reasoning are applied when processing the measured variables and estimating the patient's state. 相似文献
136.
137.
Masao Tanaka Hiroyuki Konomi Hiroaki Matsunaga Kazunori Yokohata Naruhiro Utsunomiya Torahiko Takeda 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(1):16-19
Technical improvements, such as mechanical lithotripsy, stenting or nasobiliary drainage, and wire-guided cannulation, have reduced the risk of complications in endoscopic sphincterotomy. To determine the extent of this reduction in risk, we assessed the medical records of 1352 patients with common bile duct stones in whom the procedure was conducted. Complications examined were: acute cholangitis and pancreatitis. Stone clearance was achieved in 1256 patients (92.8%), with an overall morbidity rate of 7.7% and a mortality rate of 0.15%. One hundred and forty-two patients had stones with a diameter greater than 20mm; 97 of these patients did not undergo lithotripsy. Cholangitis occurred in 10 of these 97 patients (10.3%), whereas, in the 45 patients who underwent lithotripsy, there were no cases of cholangitis (P=0.02). Stone removal was not immediately accomplished or attempted in 396 patients. In 82 of these patients in whom a stent or a nasobiliary drain was placed in the common bile duct, the incidence of cholangitis was 1.2%, significantly less (P=0.045) than the incidence of 6.4% in the other 314 patients given no stenting or nasobiliary drain. To overcome difficult cannulation, precut sphincterotomy was conducted in 134 patients and wireguided sphincterotomy, a recently introduced procedure, was conducted in 55 patients. When the precutting technique was used, the incidence of acute pancreatitis was significantly higher (8/134; 6.0%) than that in the patients in whom the standard procedure was conducted, i.e., neither the precut technique nor wire-guided ES was used (23/1218; 1.9%) (P=0.008). There were no cases of pancreatitis in the 55 patients in whom wire-guided sphincterotomy was performed, although the difference was not statistically significant because of the small number of patients (P=0.06). Based on these findings, we conclude that improved technologies have led to a significant reduction of complications in endoscopic sphincterotomy. 相似文献
138.
M. Kneissel P. Roschger W. Steiner D. Schamall G. Kalchhauser A. Boyde M. Teschler-Nicola 《Calcified tissue international》1997,61(2):95-100
There is abundant data on cancellous bone in the aging human spine, but little relating to the growing vertebral cancellous
bone in childhood and adolescence. The purpose of this study was to map vertebral cancellous bone in a growth and age series
of historic skeletal samples and to make comparisons with data published on recent material. Lumbar vertebral bodies were
collected from 65 skeletons (0–60 years) from a medieval Nubian population. Ethnohistoric information was collected to interpret
conditions that might have influenced bone structure and metabolism. The cancellous bone was studied three dimensionally,
using stereophotography and scanning electron microscopy and morphometrically by performing a semiautomatic structural analysis
on digitized backscattered electron images of polymethacrylate-embedded material. The cancellous bone structure in the children
consisted mainly of a densely packed, uniform network of small rodlike trabeculae. The greatest bone volume fraction with
small, more platelike trabeculae was observed during adolescence. In young adults, larger platelike trabeculae were present
in the central zone and smaller trabeculae in the superior and inferior zones, as described for modern skeletal material.
Structural changes associated with aging were observed much sooner than in modern man. By the estimated age of approximately
50–60 years, the predominant architectural elements were slender rarified rods in both sexes. The ethnohistorical data suggest
that this was essentially a black African population of physically active peasants, not likely to suffer Vitamin D insufficiency
or deficient calcium intake. Thus an earlier onset of the biological age changes in cancellous bone found in modern populations
was probably prevalent.
Received: 1 March 1996 / Accepted: 31 December 1996 相似文献
139.
报告手术治疗腰椎间盘突出症合并退行性腰椎管狭窄症104例。术后随访90例,随诊时6个月~6年。优良率86.5%,无腰椎不稳和腰椎滑脱等并发症。为获得优良效果,作者强调在处理椎间盘突出的同时必须彻底解除侧隐窝及神经根管,黄韧带肥厚对神经根的压迫,才能彻底根除症状 相似文献
140.