综合康复治疗对儿童肱骨髁上骨折术后疗效的影响

目的研究综合康复治疗对肱骨髁上骨折患儿术后疗效的影响。 方法共选取肱骨髁上骨折患儿46例，将其随机分为治疗组、热疗组及热疗+关节活动组。3组患儿均采用克氏针进行手术内固定处理，其中治疗组术后给予远红外线热疗及关节活动度训练（包括上肢持续被动活动训练）；热疗组术后给予远红外线热疗；热疗+关节活动组术后给予远红外线热疗及关节活动度练习（不包括上肢持续被动活动训练）。各组患儿于治疗前及治疗2周后采用Mayo肘关节功能评分进行疗效评定。 结果3组患儿经2周相应治疗后，其肘关节功能均较治疗前有不同程度改善，其中治疗组肘关节活动度改善最显著，热疗+关节活动组次之，热疗组最差，组间差异具有统计学意义（P<0.05）；治疗组患儿肘关节功能恢复总有效率及优良率均明显优于其他两组，差异具有统计学意义（P<0.05）。 结论远红外线热疗、关节活动度训练（包括上肢持续被动活动训练）联合治疗肱骨髁上骨折具有协同效应，对提高患儿术后疗效具有重要意义，可明显促进患儿肘关节功能恢复。     

降钙素对大白兔糖尿病骨质疏松模型假体骨密度及生物力学的影响

目的探讨降钙素对去势糖尿病模型假体周围骨密度及生物力学的影响。方法糖尿病模型造模成功后,将所有大白兔双侧卵巢切除,在兔子股骨中段截骨约0．5cm,置入3．0克氏针后用骨水泥固定假体,造模成功后将所有兔子随机分为2组,实验组和对照组,每组各7只。实验组采用降钙素6u肌注隔日一次,对照组肌注生理盐水1．5mL／次隔日一次,共24周,于24周处死兔子。骨密度检查分别于术前、术后8周、术后16周、术后24周在兴趣区（假体周围）骨密度检查。处死兔子后将手术侧股骨全长取出进行生物力学测试。结果实验组术前骨密度（0．1863±0．004）g／cm^2,术后24周骨密度（0．1753±0．005）g／cm^2,对照组术前骨密度（0．1865±0．002）g／cm^2,术后24周骨密度（0．1638±0．005）g／cm^2,2组术后24周差异有统计学意义（P〈0．05）。然后行手术侧假体拔出试验及假体扭转试验。生物力学结果：实验组假体拔出实验为（312．68±8．73）N／cm^2,对照组（205．43±12．45）N／cm^2,2组差异有统计学意义（P〈0．05）。实验组假体扭转实验为（80．47±2．51）N／cm^2,对照组（38．52±0．64）N／cm^2,2组差异有统计学意义（P〈0．05）。结论降钙素明显降低假体周围骨转换率,减少骨吸收,促进假体周围骨形成,提高骨密度,同时改善假体周围骨质量,提高生物力学效能,增加假体与骨质的把持力,对临床预防假体松动有积极意义。     

截瘫患者反射性膀胱功能的康复训练

截瘫患者由于脊髓损伤，排尿功能失去大脑控制，使排尿功能紊乱或丧失，加之长期卧床，易引起泌尿系感染，为了使截瘫患者提高生存质量，早期进行膀胱功能训练，是截瘫患者康复期的一个重要问题，亦是提高疗效的关键。１对象与方法患者２６例，男１６例，女１０例，年龄１７～５５岁，平均３２岁，CT或MRI证实脊髓损伤，均表现为完全性截瘫。颈髓损伤１２例，胸椎损伤１４例，手术治疗２３例，非手术治疗３例，留置尿管时间１０～３６６d。方法：（１）留置尿管期训练：用密闭式引流，严格无菌操作，夹闭尿管，定时开放，白天两三个小时开…     

人工全膝关节置换术后康复锻炼的评价

目的评价人工全膝关节置换术后康复锻炼在临床中的价值。方法术前让患者进行患肢髂关节的屈伸、旋转、活动,踝关节背伸、跖屈活动,股四头肌等长等张收缩锻炼,以提高患肢肌力,增强术后关节稳定性。结果20例患者平均关节活动度由80度提高到105度,平均KSS评分由46分提高到88分,术后功能恢复到接近正常人,无1例发生并发症。结论以预防并发症为中心的早期锻炼及指导患者出院后的持续功能锻炼,是患者康复的必由途径。     

老年人工股骨头置换术35例分析

目的观察老年人工股骨头置换术后疗效及预后。方法在连续硬膜外麻醉下手术植入人工股骨头。结果住院时间最长52天,最短23天,平均住院日39天。经髋关节置换术效果评定,优12例,占34．3％;良19例,占54．3％;可3例,差1例,优良率88．6％。术中有4例在股骨头置入及填充骨水泥后,患者有胸闷、气短、血压下降,心电图提示心肌缺血,经静脉滴注地塞米松及麻黄素或多巴胺后逐渐缓解。1例因发生感染而行Ⅱ期翻修术。结论对于股骨颈骨折的高龄患者实行人工股骨头转换术是切实可行的。     

降钙素对大白兔糖尿病骨质疏松模型假体骨密度及生物力学的影响

Objective To investigate the influence of calcitonin on bone mineral density and biomechanics around the artificial pros-thesis in ovariectomized diabetic rabbit model. Methods Fourteen femina New Zealand white rabbits at the age of 5 months old were select-ed, which weight 2.24 -2.65kg, averaging 2.26kg. First, the model of rabbit with diabetic osteoporosis was successfully established by the compound method of ovariectomy plus streptozotocin. Osteotomy in the middle part of femur was performed in both groups, fixation of artifi-cial prosthesis was done with 3.0 kirschner wire. After that, Rabbit models with diabetic osteoporosis were randomly divided into experimen-tal group and control group. Rabbits in the experimental group were treated with calcitonin 6U intramuscular injection once every other day. In control group, intramuscular injection of normal saline solution 1.5ml once every three days. Rabbit models of two groups were sacrificed in the 24th week. The BMD of the region of interest (ROI) around the prosthesis were detected before experiment and 8, 16 and 24 weeks after injection. After rabbits were killed, experimental femurs in both groups were complete removal and soft tissues were rejected. Determi-nation of the pull-out and torsion bone biomechanics experiments of prosthesis was done in both groups respectively. Results The BMD of ROI in the experimental group before operation was (0.1863±0.004)g/cm2 and (0.1753±0.005)g/cm2 in 24 weeks after operation, in control group before operation was (0.1865±0.002)g/cm2 and (0.1638±0.005)g/cm2 in 24 weeks after operation. There were significant difference between the two groups(P < 0.05). Biomechanical show that the pull-out strength in the experimental group was (312.68±8.73 )N/cm2 and (205.43±12.45 ) N/cm2 in control group. There were significant difference between the two groups(P < 0.05). The tor-sion strength in experimental group was (80.47±2.51) N/cm2 and (38.52±0.64) N/cm2 in control group. There were significant differ-ence between the two groups(P < 0.05). Conclusion Salmon calcitonin can reduce the bone turnover rate around prosthesis and decrease bone absorption in the rabbit of diabetic osteoporosis models, accelerate the bone formation around prosthesis, and increase the BMD. It can ameliorate the quality of bone around prosthesis, improve its biomechanics property, and increase the holding power between prosthesis and body mass. It is of clinical significance for the prevention and treatment of aseptic loosening artificial prosthesis.     

健康教育对于骨外科护理质量的效果分析

目的:探究健康教育给骨外科护理质量带来的效果。方法:选取我院2016年10月-2017年10月骨外科收治的患者60例作为研究对象,随机平均分为观察组与对照组,各30例,其中对照组应用常规护理措施,观察组在常规护理措施的基础上加用健康教育措施。结果:观察组的健康教育认知能力评分显著高于对照组(P0.05);观察组的患者护理质量满意度显著优于对照组(P0.05)。结论:骨外科护理中应用健康教育效果显著,有效提高了健康教育认知能力和患者护理质量满意度,值得推广。     

截瘫病人反射性膀胱功能的康复训练

截瘫病人由于脊髓损伤 ,排尿功能失去大脑控制 ,使排尿功能紊乱或丧失 ,加之长期卧床 ,易引起泌尿系感染。为了使截瘫病人提高生活质量 ,早期进行膀胱功能训练 ,是截瘫病人康复的一个重要问题 ,是提高疗效的关键。1　临床资料本组 2 6例 ,男 16例 ,女 10例 ,年龄 17岁～ 5 5岁