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51.
联合抗青光眼手术治疗不易控制眼压青光眼的研究 总被引:1,自引:0,他引:1
采用板层下巩膜床双咬切、睫状体剥离合并睛状体上腔植入硅橡胶条的抗青光眼联合手术治疗不易控制眼压的青光眼46例52眼,其中继发性青光眼27眼,原发闭角青光眼10眼,原发开角青光眼6眼,先天、青少年型青光眼7眼,虹膜角膜内皮综合征2眼。手术总有效率达94%。本术式具有小梁切除、睫状体剥离、睫状体扁平部引流的功能。作者认为用硅橡胶条作植入物,比异体或自体组织作植入物更为理想。 相似文献
52.
下腰痛患者后路手术并发症的防治 总被引:30,自引:0,他引:30
目的:分析下腰痛患者后路手术并发症出现的原因,探讨防治办法。方法:回顾分析我科自1988~1998年6月间采用后路手术治疗下腰痛,即腰椎间盘突出症和/或腰椎管狭窄症患者570例的临床资料。结果:33例发生术后并发症,发生率5.79%,早期(术后2周以内)并发症18例,晚期并发症15例,但无一例并发神经根损伤。结论:除了术中操作技能外,术前严格掌握手术适应证,术后及时观察、早期功能锻炼,都有利于并发症的防治。 相似文献
53.
Summary It has been widely observed that the outcome after repeat lumbar surgery is rarely comparable to that of primary surgery. In particular, the results of repeat surgery for lumbar spinal stenosis (LSS) have not been favourable. We used a matched-pair format in an attempt to decrease the confounding factors so as to determine as exactly as possible the effect of prior back surgery on the LSS patients surgical outcome. The matching criteria were sex, age, myelographic findings, major symptom, and duration of symptoms. From one group of 251 patients without prior back surgery (SO patients) and another of fifty-three patients with one preceding back operation (RS patients), forty-one similar matched patients pairs (one SO and one RS-patient) were formed.There were 8 female and 33 male pairs. The mean age of the SO patients was 51.6 and of the RS patient 51.4 years, and the mean follow-up time was 4.6 and 4.4 years. The assessment of outcome was based on a subjective disability questionnaire. The SO patients fared significantly better than the RS patients (32.1 versus 41.3, P = 0.026). A short time interval between operations in the RS patients had a worsening effect on outcome, but this trend was not significant.We concluded that one preceding back operation had a worsening effect on the outcome of patients operated on for LSS. As a whole, the results of RS patients were unfavourable. The proper time for achieving good surgical results in LSS patients is the initial operation. 相似文献
54.
William V. Giannobile Rafaél A Hernandez Richard D. Finkelman Susan Ryarr Christopher P. Kiritsy Mark D'Andrea Samuel E. Lynch 《Journal of periodontal research》1996,31(5):301-312
Platelet-derived growth factor (PDGF) and insulin-like growth factor I (IGF-I) in combination have previously been shown to enhance periodontal regeneration. The objective of this study was to further characterize the biological effects of this combination of growth factors in non-human primates and compare the effects to those of each growth factor individually. Ligature-induced periodontitis was initiated in 10 cynomolgus monkeys. After periodontal lesions were established, surgery was performed, and either a methylcellulose gel vehicle or vehicle containing 10 μg each of either PDGF-BB, IGF-I or both PDGF-BB and IGF-I was applied to exposed root surfaces. Biopsies were taken 4 and 12 wk after treatment and the extent of periodontal regeneration was assessed by histomorphometry. At both 4 and 12 wk vehicle-treated lesions generally revealed minimal osseous defect fill (ODF) (8.5±2.1% and 14.5±5.7%, respectively) and new attachment (NA) (34.1±5.2% and 26.6±10.5%, respectively). IGF-I treatment did not significantly alter healing compared to vehicle in any parameter at both 4 and 12 wk. PDGFBB-treated sites exhibited significant (p<0.05) regeneration of NA (69.6±12.0%) at 12 wk; trends for PDGF-BB treatment effect were also observed in other parameters at 4 and 12 wk. although these increases were not statistically significant. Treatment with PDGF-BB/IGF-I resulted in 21.6±5.1 % and 42.5±8.3% ODF at 4 and 12 wk, respectively, and 64.1±7.7% and 74.6±7.4% NA at 4 and 12 wk, respectively (all significantly greater than vehicle, p<0.05). The results from this study demonstrated that: 1) IGF-1 alone at the dose tested did not significantly alter periodontal wound healing; 2) PDGF-BB alone significantly stimulated NA, with trends of effect on other parameters; and 3) the PDGF-BB/IGF-I combination resulted in significant increases in NA and ODF above vehicle at both 4 and 12 wk. 相似文献
55.
Bojan Pajic Grigoris Pallas Gerding Heinrich Matthias Böhnke 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2006,244(1):22-27
Purpose It was the aim of this study to investigate the efficacy, longevity, and safety of a new ab interno intervention for the treatment
of primary open-angle glaucoma (POAG).
Methods The previously described method of radiofrequency-mediated “sclerothalamotomy ab interno” was applied in 53 eyes of consecutive
patients with POAG between April 2002 and July 2002. Average preoperative intraocular pressure (IOP) was 25.6±2.3 mmHg (range
18–48 mmHg). Sclerothalamotomies were carried out with a custom-made high-frequency dissection 19 G probe (tip 0.3×1 mm) applying
bipolar current with a frequency of 500 kHz (tip temperature 130°C).
Results After a follow-up period of 24 months, the average IOP was 15.0±1.6 mmHg (range 11–20 mmHg) (p<0.005). The average number of topical agents was 2.6±1.0 (range 1–5) preoperatively. Twenty-four months after surgery such
agents were used in only five (9.6%) eyes and the average was 0.21±0.53 (range 0–2). Transient IOP elevation was observed
in 12 of 53 eyes (22.6%) postoperatively. In all cases elevated IOP could efficiently be controlled with topical medication.
In general, IOP dropped continuously over the course of the 6 months following surgery and then remained constant.
Conclusions This study indicates that sclerothalamotomy ab interno is a safe and efficient surgical method for the treatment of POAG.
Long-term results clearly demonstrate the longevity of IOP reduction. 相似文献
56.
改良超滤对婴幼儿心脏手术输血的影响 总被引:4,自引:1,他引:3
目的 观察改良超滤技术在婴幼儿体外循环心血管手术中对输血及术后出血的影响。方法 6 0例接受体外循环下心血管手术的先天性心脏病患儿 ,均分为对照组 (不接受任何超滤 )、常规超滤组 (CUF组 )和改良超滤组 (MUF组 )。观察术中库血用量、血浆用量、血球压积的变化及术后2 4h出血量 ,并用SSPS/PC进行统计学处理。结果 MUF组库血用量、血浆用量、术后 2 4h出血量显著低于对照组和CUF组 (P <0 0 1) ,且滤出水量明显多于CUF组 (P <0 0 1)。结论 在婴幼儿心血管手术中 ,改良超滤可有效排出体内水分 ,提高血球压积 ,明显减少输血及术后出血 ,是节约用血的重要手段之一。 相似文献
57.
BACKGROUND: Recalcitrant gingival erythematous lichen planus/lichenoid lesions comprise a considerable therapeutic problem. The objective of this study was to evaluate the therapeutic effect of grafting keratinized oral palatal mucosa to the sites of gingival lichen. METHODS: In 12 patients 20 grafts were transplanted to buccal gingival lesions. Mean age of the patients was 59.8 +/- 7.1 years (range 46-71 years). The mean observation time was 32 +/- 32.7 months (range 5-97 months). RESULTS: On a 4-point clinical grade scale (0-3), 12 (60%) transplants showed complete healing grade 3, six (30%) grade 2 and two (10%) grade 1. CONCLUSIONS: Using oral mucosal grafts from the palatal mucosa for the treatment of recalcitrant erythematous gingival lichen planus/lichenoid lesions seems to be a promising treatment modality. 相似文献
58.
经尿道电切与气化切割和激光治疗前列腺增生症的疗效比较 总被引:11,自引:0,他引:11
目的 :比较经尿道电切前列腺术 (TURP) ,经尿道前列腺气化切除术 (TUVP)及经尿道接触式激光前列腺切除术 (TULP)的治疗效果。方法 :在 30 0 0例前列腺增生症患者中 ,按三种术式各随机抽取 2 0例术前条件具有可比性的患者 ,进行疗效比较。结果 :3种术式患者手术前后前列腺症状评分 (IPSS)、生活质量评分(QOL)、最大尿流率 (MFR)、剩余尿 (PVR)比较均得到显著改善 (P <0 .0 1) ,3组之间相比差异无显著性意义(P >0 .0 5 )。手术时间 :TUVP及TURP组明显短于TULP组 (P <0 .0 1) ,术中失血量及术后置管时间 :TUVP及TULP组明显少于TURP组 (P <0 .0 1)。TURP组术后继发感染、出血、暂时性尿失禁发生率少于TUVP及TULP组。结论 :3种术式治疗效果相同 ;TUVP操作简单、安全 ,对初学者来说尤其适宜 ;TURP仍为治疗BPH的金标准术式 相似文献
59.
Atul K Madan Constantine T Frantzides Christopher L Tebbit William C Park Nakka V Aruna Kumari Nina Shervin 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2004,8(2):191-193
BACKGROUND: Laparoscopic suturing and tying constitute advanced minimally invasive surgery skills. Developing proficiency in the standard methods with needle drivers is often an arduous process. Recent advances in laparoscopic instrumentations has allowed for easier methods of suturing and tying. This study investigated the hypothesis that the use of a specialized suturing device and a specialized tying device allows inexperienced medical students to suture and tie laparoscopically. METHODS: Preclinical medical students who had not received any training in open or laparoscopic surgery were included in this investigation. Each student was given a 5-minute demonstration of a specialized suturing device and a specialized tying device. The medical students were not allowed to deploy either device before actual use. After the demonstration, each student was given the device to use in a porcine model. Times were recorded and a subjective grade was given for each student. RESULTS: Twenty medical students were involved in this study. All medical students were able to complete the task of suturing and tying. The average time to suture was 104.6 seconds and the average time to tying was 31.2 seconds. The average subjective performance grade was 90 (out of 100). CONCLUSION: Specialized devices are easy to learn and use for laparoscopic suturing and tying with minimal instruction even for inexperienced medical students. Even surgeons who are not well versed in laparoscopic surgery should be able to suture and tie with certain laparoscopic instruments. 相似文献
60.
目的:探讨高分子材料和种植体同期植入缺损区进行同步骨缺损修复和牙列缺损修复的可行性。方法:以4只杂种狗为研究对象,制备下颌骨长约2.5cm的缺损的动物模型(保留下颌骨下缘),将骨水泥(聚甲基丙烯酸酯)植入骨缺损,同时将牙种植体植入骨水泥中并调整长轴方向,立即关闭术创。至术后3个月摄X线片,然后处死动物,局部巨检以了解骨水泥同骨组织的结合情况,并制备骨组织切片进行苏木精一伊红染色和甲苯胺蓝染色,以了解植入材料周边骨的生长情况及其对植入材料的反应。结果:术后3个月X线检查见骨缺损区充满骨水泥,骨水泥周边的骨小梁清晰,未见骨吸收或炎症表现,形成良好的骨-骨水泥界面,种植体则依赖其表面的螺纹结构与骨水泥间紧密的机械性嵌合而牢固的成为一体,植入的骨水泥块与周边天然骨结合紧密,无松动现象。植入材料周边局部脱钙骨的苏木精-伊红染色和甲苯胺蓝染色见骨结构正常,同时骨-骨水泥界有新骨形成。结论:骨水泥作为颌骨修复替代材料同期植入种植体是可行的。 相似文献