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81.
We report the case of a thoracic epidural hematoma at the T7-T9 level which occurred after placement of spinal epidural catheter for continuous anaesthesia in acute pancreatitis. The male patient felt a sudden back pain after six days of successful analgesia and became paraplegic 24 hours afterwards. An emergency laminectomy and removal of the hematoma were performed; however, the patient recovered only incompletely.We discuss the clinical signs and symptoms of spinal epidural hematoma as well as its diagnostics and therapy. The controversial views from the literature concernings its etiology are critically reviewed. 相似文献
82.
R. P. Heaney T. M. Zizic I. Fogelman W. P. Olszynski P. Geusens C. Kasibhatla N. Alsayed G. Isaia M. W. Davie C. H. Chesnut III 《Osteoporosis international》2002,13(6):501-505
Risedronate treatment reduces the risk of vertebral fracture in women with existing vertebral fractures, but its efficacy
in prevention of the first vertebral fracture in women with osteoporosis but without vertebral fractures has not been determined.
We examined the risk of first vertebral fracture in postmenopausal women who were enrolled in four placebo-controlled clinical
trials of risedronate and who had low lumbar spine bone mineral density (BMD) (mean T-score =–3.3) and no vertebral fractures at baseline. Subjects received risedronate 5 mg (n= 328) or placebo (n= 312) daily for up to 3 years; all subjects were given calcium (1000 mg daily), as well as vitamin D supplementation (up
to 500 IU daily) if baseline serum 25-hydroxyvitamin D levels were low. The incidence of first vertebral fracture was 9.4%
in the women treated with placebo and 2.6% in those treated with risedronate 5 mg (risk reduction of 75%, 95% confidence interval
37% to 90%; P= 0.002). The number of patients who would need to be treated to prevent one new vertebral fracture is 15. When subjects were
stratified by age, similar significant reductions were observed in patients with a mean age of 64 years (risk reduction of
70%, 95% CI 8% to 90%; P= 0.030) and in those with a mean age of 76 years (risk reduction of 80%, 95% CI 7% to 96%; P= 0.024). Risedronate treatment therefore significantly reduces the risk of first vertebral fracture in postmenopausal women
with osteoporosis, with a similar magnitude of effect early and late after the menopause.
Received: 12 September 2001 / Accepted: 11 December 2001 相似文献
83.
用2‰游标卡尺对114具L1~L5段椎骨标本进行测量,包括椎孔上缘矢径及下缘矢径的距离和相互关系。结果:腰椎孔下缘矢径明显大于上缘矢径(P<0.01),腰椎孔下缘矢径明显大于腰椎孔中矢径。为腰椎管狭窄的临床诊断提供解剖学基础。 相似文献
84.
椎动脉型颈椎病的影像学诊断 总被引:2,自引:0,他引:2
本文描述了椎动脉型颈椎病的概念及发病机制 ,并对该病的各种影像学检查的主要表现及优缺点进行了综述。 相似文献
85.
目的 :研究老年人不同疾病时骨密度 (BMD)的分布情况。方法 :用DXADAS 6 0 0EX型骨密度仪对183例老年患者进行左侧远程桡骨加尺骨BMD检测。结果 :内分泌疾病组、消化道疾病组和其它疾病组的患病率分别为 72 7% ,2 0 6 %和 31 4 %。T值比较 :三组差异明显 (P <0 0 0 1)。累积骨丢失率 (ABLR)比较 :前一组明显高于后两组病人 (P <0 0 1)。BMD比较中 ,内分泌和其它疾病组明显低于消化道疾病组 (P <0 0 0 1)。相关分析显示 ,内分泌和消化道疾病组的年龄变化与BMD呈正相关 (r =0 5 19P <0 0 0 1和r =0 5 89P <0 0 0 1) ,内分泌疾病组和其它疾病组的体重变化与BMD呈正相关 (r=0 918P <0 0 0 1和r =0 338P <0 0 0 1)。结论 :老年人骨质疏松 (OP)患病率以内分泌疾病组最高 ,消化道疾病组较低 ;随年龄和体重增加 ,BMD降低加重。 相似文献
86.
目的探讨和分析应用锁骨钩钢板内固定配合康复治疗锁骨远端骨折的新方法。方法42例应用锁骨钩钢板配合术后早期康复治疗锁骨远端骨折的患者全部得到了随访,随访时间2~46个月(平均15.6个月),患者年龄36~57岁,平均45.6岁。术后2d患肩按照制定的康复训练方法进行功能训练,最终随访按Lazzcano评价标准〔1〕评价治疗结果。结果42例患者术后X线检查均达到满意复位与固定,局部Lazzcano功能评定关节功能恢复优良率97.6%。结论应用锁骨钩钢板治疗锁骨远端骨折手术操作简单,配合术后完善的康复治疗,可得到非常满意的结果。 相似文献
87.
目的:了解温州地区人群不同年龄组骨质疏松患病率及同年龄组男女骨质疏松患病的差异,强调早期预防治疗老年人及绝经期妇女骨质疏松的重要性,方法:应用单能量X线(SXA)骨密度仪测量246例正常人的右跟骨骨密度,结果:男性大于60岁组较小于60岁组骨密度(BMD)降低明显(P<0.05);女性50岁以上组与小于50岁组相比,BMD下降差异有极显性(P<0.01);各年龄组男女相比,男性BMD明显高于女性(P<0.05)。结论:女性骨质疏松症的发病大多以绝经后为主,雌激素在维持骨量方面具有重要的作用。SXA检测的跟骨含95%小梁骨,能较好地确定骨质疏松的风险水平,且其具有价廉、简便,快捷,较准确等特点,故不失为一种较好的临床筛查手段。 相似文献
88.
We followed all consecutive hip fracture patients admitted between 2004 and 2006, identified cases in which the intention was to treat non-operative and compared their functional outcome and mortality with a similar cohort treated surgically over the same period. We recorded length of hospital stay, place of discharge, pre and post-fracture mobility and residence, 30 days and 1 year mortality, re-admission due to same fracture and delayed surgery. The group treated surgically was recruited and matched for age, gender, pre and post-fracture mobility, mental confusion and independence. 25 patients were treated non-operative. 22 patients treated surgically over the same time period matched the patient characteristics of the non-operative arm. The mean hospital stay was 13 days in both groups. There were 4 extra-capsular fractures (3 displaced) and 21 intra-capsular fractures (5 displaced) in the non-operative arm and 11 extra-capsular fractures and 9 intra-capsular fractures in the surgically treated arm. 4 patients from the non-operative treatment group underwent late surgery because of persisting hip pain 20 days-2 months after the index event (2 cannulated screws, 1 hemiarthroplasty, 1 total hip arthroplasty). 11 patients in the surgical treatment arm underwent dynamic screw fixation, 1 had cannulated screw, 1 had total hip replacement and 7 had hemiarthroplasty. 14 of the non-operative treated patients were mobile independently or with aid before fracture but only 9 patients retained their pre-fracture mobility following treatment, compared to 16 patients pre-fracture and 11 patients post-fracture after surgery. 16 patients treated non-operative were living independently prior to injury but only 7 went back to their own residence. Of the operatively treated patients 14 patients were living independently and 10 patients went back to their previous residence. 1 month and 1 year mortality in the non-operative treated group was 4/21 and 7/21 respectively compared to 1/20 and 5/20 in the operative fixation group. There was no statistically significant difference in mobility, residence or mortality between the two groups (Fisher exact test, p > 0.05). Non-operative management after hip fracture is suitable for medically unfit patients and does not result in statistically significant difference in functional outcome or mortality compared to patients treated surgically. 相似文献
89.
90.