慢性咽炎患者中全面护理干预的实施效果

目的 探究全面护理干预应用在慢性咽炎护理工作中的价值体现。方法 本次研究于2020年8月至2021年8月开展,随机选择90例慢性咽炎患者为研究对象,所有患者均行雾化吸入治疗,依据不同护理方法将其中45例归为一组,采取常规护理干预,以参比组命名;将余下45例纳入一组,实施全面护理干预,以分析组命名。对比不同护理干预方法的实施效果。结果 在总治疗有效率方面,分析组高于参比组,P<0.05;在生活质量方面,干预后分析组生活质量较参比组明显更优P<0.05。结论 在慢性咽炎患者护理工作中采取全面护理干预的效果较常规护理干预更为明显,可辅助提高治疗总有效率,患者生活质量得到显著改善。     

前十字韧带重建中的移植物位置偏移

目的 计算可吸收界面螺钉导致的移植物偏离隧道位移,探讨其对前十字韧带重建产生的影响.方法 19个新鲜尸体膝关节标本,随机选取5个,采用7 mm、8 mm、9 mm界面螺钉固定自体肌腱,测定偏移距离.另外14个膝关节分为等长组和解剖组,等长组膝关节测量界面螺钉固定后及校正位置的移植物拉长距离;解剖组膝关节于膝关节生物力学测试仪上分别测定ACL完整组、ACL缺失组、偏移组和校正组在134 N前向负荷下膝关节屈曲0°、15°、30°、60°和90°位的胫骨前向位移.结果 (1)肌腱偏移:直径7mm、8 mm、9mm的界面螺钉分别使移植物偏移(2.36±0.11)mm、(2.72±0.06)mm、(3.00±0.06)mm.(2)等长性:初始拉长小于3 mm,偏移拉长大于3 mm,校正拉长小于3 mm.(3)生物力学:屈膝0°、15°位,ACL完整组与偏移组、校正组差异无统计学意义.屈膝30°、60°、90°位ACL完整组与其他各组比较差异均有统计学意义,屈膝30°、60°位偏移组与校正组比较差异有统计学意义.结论 无论等长重建还是解剖重建,界面螺钉均影响移植物的股骨隧道口位置.前十字韧带重建预先校正股骨隧道口位置,移植物基本会处于预先的理想位置.

Abstract：

Objective To investigate the impact of graft position shift on anterior cruciate ligament reconstruction induced by femoral fixation of interference screw. Methods Nineteen fresh cadaveric knees were used and assigned to three groups. 1) Study of graft position shift: 5 knees were randomly selected, interference screws of 7 mm, 8 mm and 9 mm were used in autologous tendon fixation, then the graft position shift were measured. 2) Study of isometry: 7 knees were randomly divided into the isometric reconstruction group (D group). In the D group, Retrobutton, interference screw and interference screw in location-corrected bone tunnel were used respectively as fixation. The isometry of grafts was evaluated. 3) Study of tibia anterior translation: 7 knees were randomly divided into the anatomic reconstruction group (J group). In the J group,the tibia anterior translation was measured in four different conditions in the same joint: intact knee joint,knee joint without ACL, ACL anatomic reconstruction by interference screw fixation, and ACL anatomic reconstruction by interference screw fixation with corrected bone tunnel location. Results 1) With 7 mm, 8mm and 9 mm interference screw fixation, graft position shift were (2.36±0.11) mm, (2.72±0.06) mm and (3.00±0.06) mm respectively. 2) Graft length change: graft length change in Retrobutton group and corrected bone tunnel group were less than 3 mm, while graft length change in those fixed with interference screw were stretched in more than 3 mm. 3) Study of tibia anterior translation: there was no difference among the intact group, the anatomic group and the corrected group at 0° and 15°. However, the difference was found between the intact group and other groups at 30°、60° and 90° of flexion, as well as between these two reconstructed methods at 20° joint flexion (P＜0.05). Conclusion In both isometric and anatomic ACL reconstruction with interference screw, the graft is pushed tightly toward the femoral tunnel wall, which shifts the graft away from the desired position. In our study we find out that the corrected location of the femoral bone tunnel significantly improves the isometry of ACL reconstruction and anatomic reconstruction.